W O R L D H E A L T H ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU RÉGIONAL DU PACIFIQUE OCCIDENTAL REGIONAL COMMITTEE WPR/RC70/3 Seventieth session 20 August 2019 Manila, Philippines 7–11 October 2019 ORIGINAL: ENGLISH Provisional agenda item 8 PROGRAMME BUDGET 2018–2019: BUDGET PERFORMANCE (INTERIM REPORT) This document summarizes the status of the Programme Budget 2018–2019 as at 30 June 2019, with a focus on the Western Pacific Region. The details include a summary by funding source, utilization by programme category, budget centre and status comparison with the previous biennium at the same period (18 months). The Region’s overall utilization from all sources of funds as at 30 June 2019 was US$ 205.8 million or 74.9% of the total available resources (US$ 274.6 million) between 1 January 2018 and 30 June 2019. Tables showing utilization by programme category, budget centre and category of expenditure are included herein. Information is provided on progress made by the Western Pacific Region towards achievement of outputs for which the Secretariat is accountable (as defined in the Programme Budget 2018–2019). This information is based on a midterm assessment from 1 January to 31 December 2018, with a further review of outputs at risk or in trouble as at 30 June 2019. The Regional Committee for the Western Pacific is requested to review and note the interim report on budget performance. WPR/RC70/3 page 2 1. FINANCIAL UTILIZATION OF PROGRAMME BUDGET 2018–2019 This document presents the interim report on utilization of the programme budget by the Western Pacific Region for the 2018–2019 biennium by source of funding, category, budget centre and category of expenditure as at 30 June 2019. 1.1 Level of programme budget The Programme Budget 2018–2019 was approved at the Seventieth World Health Assembly in May 2017. It is the last of the three biennial budgets formulated under the Twelfth General Programme of Work 2014–2019. The approved programme budget for 2018–2019 for the Western Pacific Region was US$ 285.9 million. During the biennium, there was a net increase in the Region’s budget ceiling of US$ 33.7 million (11.8%). The changes represent: increases of US$ 3.6 million for noncommunicable diseases (Category 2), US$ 32.6 million for the polio eradication programme (Category 10) and US$ 3.0 million for outbreak crisis response and scalable operations (Category 13); and reductions of US$ 1.1 million for promoting health through the life-course (Category 3), US$ 2.5 million for health systems (Category 4) and US$ 1.9 million for the WHO Health Emergencies Programme (Category 12). Thus, the current working allocation for the Region as at 30 June 2019 was US$ 319.6 million (Table 1). Table 1. Programme Budget (PB) allocation: 2018–2019 (US$ million) Approved budget Current working allocation Change Approved budget Current working allocation Change 285.9 319.6 11.8% 285.6 291.8 2.2% PB 2018-2019 as at 30 June 2019 PB 2016–2017 as at 30 June 2017 WPR/RC70/3 page 3 Table 2 summarizes the gaps in financing between the programme budget allocation and available funds for the 2018–2019 biennium. Table 2. Gaps in financing for 2018–2019 by category – all funds (US$ million) The total funds available from all sources as at 30 June 2019 amounted to US$ 274.6 million, consisting of US$ 75.2 million (US$ 77.5 million in June 2017) from assessed contributions and US$ 199.4 million (US$ 153.7 million in June 2017) from voluntary contributions. This represents 85.9% of the current working allocation of US$ 319.6 million. There was a net increase in voluntary contributions for the Region of US$ 45.7 million, including an increase of US$ 18.8 million for polio eradication, compared with the same period of the previous biennium. 1.2 Funds utilization The total utilization of funds as at 30 June 2019 amounted to US$ 205.8 million or 74.9% of the available resources and 64.4% of the current working allocation. AC VC Total Communicable diseases 74.6 12.7 55.9 68.6 (6.0 ) 92.0 (8.0 ) (19.3 ) Noncommunicable diseases 42.9 11.4 22.3 33.7 (9.2 ) 78.6 (21.4 ) (13.6 ) Promoting health through the life-course 26.9 7.6 12.3 19.9 (7.0 ) 74.0 (26.0 ) (7.6 ) Health systems 50.2 18.0 29.7 47.7 (2.5 ) 95.0 (5.0 ) (10.7 ) Corporate services/enabling functions 48.6 16.8 30.0 46.8 (1.8 ) 96.3 (3.7 ) (1.8 ) Preparedness, surveillance and response/WHO Health Emergencies Programme 36.2 8.7 17.4 26.1 (10.1 ) 72.1 (27.9 ) (5.2 ) Total Base Programme 279.4 75.2 167.6 242.8 (36.6 ) 86.9 (13.1 ) (58.2 ) Emergencies Polio eradication 37.2 - 30.3 30.3 (6.9 ) 81.5 (18.5 ) (1.3 ) Outbreak and crisis response 3.0 - 1.5 1.5 (1.5 ) 50.0 (50.0 ) (1.1 ) Total Emergencies 40.2 - 31.8 31.8 (8.4 ) 79.1 (20.9 ) (2.4 ) Grand Total 319.6 75.2 199.4 274.6 (45.0 ) 85.9 (14.1 ) (60.6 ) AC = assessed contributions, VC = voluntary contributions Category PB 2018-2019 as at 30 June 2019 PB 2016-2017 Gap as at 30 June 2017 Current working allocation Available resources Gap % Available resources against Current working allocation % Gap against Current working allocation WPR/RC70/3 page 4 The total utilization of assessed contributions amounted to US$ 55.3 million or 73.5% of the available resources. The activities utilizing voluntary contributions amounted to US$ 150.5 million or 75.5% of the available resources. The utilization by source and by level of funding as at 30 June 2019 is shown in Tables 3a and 3b, including comparison status in the previous biennium. Table 3a. Utilization of all funds (US$ million) Table 3b. Funds utilization by country office and regional office (US$ million) Fund Current working allocation Available resources Expenditures Encumbrances Funds utilization % Utilization against Current working allocation % Utilization against Available resources Current working allocation Available resources Funds utilization % Utilization against Current working allocation % Utilization against available resources Assessed contributions 75.2 50.9 4.4 55.3 17.3 73.5 77.5 56.6 19.4 73.0 Voluntary contributions 199.4 137.1 13.4 150.5 47.1 75.5 153.7 116.5 39.9 75.8 Total 319.6 274.6 188.0 17.8 205.8 64.4 74.9 291.8 231.2 173.1 59.3 74.9 319.6 291.8 PB 2018-2019 as at 30 June 2019 PB 2016-2017 as at 30 June 2017 Level Assessed contributions Voluntary contributions Total % Assessed contributions Voluntary contributions Total % Country 33.3 113.1 146.4 71.1 33.6 77.5 111.1 64.2 Regional 22.0 37.4 59.4 28.9 23.0 39.0 62.0 35.8 Total 55.3 150.5 205.8 100.0 56.6 116.5 173.1 100.0 PB 2018-2019 as at 30 June 2019 PB 2016–2017 as at 30 June 2017 WPR/RC70/3 page 5 Tables 4a and 4b detail the Region’s utilization of funds (all sources), by category and by budget centre, respectively. Table 4a. Funds utilization by category (US$ million) Communicable diseases 74.6 68.6 50.7 68.0 73.9 41.6 55.7 75.1 Noncommunicable diseases 42.9 33.7 24.7 57.6 73.3 19.7 48.3 72.4 Promoting health through the life-course 26.9 19.9 14.2 52.8 71.4 14.0 53.2 74.9 Health systems 50.2 47.7 34.5 68.7 72.3 32.2 59.7 74.5 Corporate services/enabling functions 48.6 46.8 35.1 72.2 75.0 34.9 70.9 73.6 Preparedness, surveillance and response/WHO Health Emergencies Programme 36.2 26.1 20.7 57.2 79.3 16.4 56.2 68.3 Total Base Programme 279.4 242.8 179.9 64.4 74.1 158.8 57.9 73.6 Emergencies Polio eradication 37.2 30.3 24.5 65.9 80.9 10.6 82.8 92.2 Outbreak and crisis response 3.0 1.5 1.4 46.7 93.3 3.7 75.5 97.4 Total Emergencies 40.2 31.8 25.9 64.4 81.4 14.3 80.8 93.5 Grand Total 319.6 274.6 205.8 64.4 74.9 173.1 59.3 74.9 Funds utilization % Utilization against Current working allocation Current working allocation Available resources Funds utilization % Utilization against Current working allocation % Utilization against Available resources % Utilization against Available resources Category PB 2018-2019 as at 30 June 2019 PB 2016–2017 as at 30 June 2017 WPR/RC70/3 page 6 Table 4b. Funds utilization by budget centre (US$ million) AC VC Total AC VC Total AC VC Total American Samoa 0.1 - 0.1 0.1 - 0.1 100.0 - 100.0 0.1 100.0 Cambodia 3.4 14.0 17.4 2.4 10.7 13.1 70.6 76.4 75.3 11.5 74.7 China 7.2 10.2 17.4 5.4 8.1 13.5 75.0 79.4 77.6 13.2 80.0 Cook Islands 0.4 - 0.4 0.3 - 0.3 75.0 - 75.0 0.4 80.0 Federated States of Micronesia 0.8 1.3 2.1 0.7 1.0 1.7 87.5 76.9 81.0 1.0 76.9 Fiji 2.4 1.9 4.3 1.5 1.5 3.0 62.5 78.9 69.8 3.0 76.9 Kiribati 0.6 0.5 1.1 0.5 0.3 0.8 83.3 60.0 72.7 0.9 75.0 Lao People's Democratic Republic 2.9 15.0 17.9 2.0 11.8 13.8 69.0 78.7 77.1 16.4 81.6 Malaysia 1.0 1.0 2.0 0.9 0.7 1.6 90.0 70.0 80.0 1.3 76.5 Marshall Islands 0.3 0.1 0.4 0.3 - 0.3 100.0 - 75.0 0.2 66.7 Mongolia 2.5 3.0 5.5 1.9 2.6 4.5 76.0 86.7 81.8 4.4 81.5 Nauru 0.1 - 0.1 0.1 - 0.1 100.0 - 100.0 - - Niue 0.1 - 0.1 - - - - - - 0.1 100.0 Pacific Island Countries 4.2 13.6 17.8 2.6 10.5 13.1 61.9 77.2 73.6 9.3 74.4 Palau 0.1 - 0.1 0.1 - 0.1 100.0 - 100.0 0.1 50.0 Papua New Guinea 4.2 49.6 53.8 3.1 38.7 41.8 73.8 78.0 77.7 12.6 73.7 Philippines 2.6 12.2 14.8 1.7 8.2 9.9 65.4 67.2 66.9 10.3 79.2 Samoa 2.0 1.7 3.7 1.2 1.1 2.3 60.0 64.7 62.2 2.4 77.4 Solomon Islands 2.4 8.4 10.8 1.3 5.3 6.6 54.2 63.1 61.1 5.1 68.0 Tokelau 0.1 - 0.1 0.1 - 0.1 100.0 - 100.0 0.1 100.0 Tonga 0.8 0.4 1.2 0.6 0.3 0.9 75.0 75.0 75.0 1.4 87.5 Tuvalu 0.1 - 0.1 0.1 - 0.1 100.0 - 100.0 0.1 100.0 Vanuatu 1.6 2.9 4.5 1.5 2.1 3.6 93.8 72.4 80.0 3.3 76.7 Viet Nam 5.9 12.7 18.6 4.8 10.2 15.0 81.4 80.3 80.6 13.8 74.6 Others* 0.2 - 0.2 0.1 - 0.1 50.0 - 50.0 0.1 50.0 Total Countries 46.0 148.5 194.5 33.3 113.1 146.4 72.4 76.2 75.3 111.1 76.7 Office of the Regional Director 3.1 3.0 6.1 2.7 1.7 4.4 87.1 56.7 72.1 4.4 69.8 Division, Administration and Finance 0.8 7.9 8.7 0.2 5.8 6.0 25.0 73.4 69.0 6.0 67.4 Division, Communicable Diseases 5.0 13.8 18.8 3.5 10.6 14.1 70.0 76.8 75.0 16.0 79.2 Division, Health Security and Emergencies/WHO Health Emergencies Programme 3.9 6.2 10.1 3.3 5.0 8.3 84.6 80.6 82.2 8.1 72.3 Division, Health Systems 7.5 8.9 16.4 5.0 6.5 11.5 66.7 73.0 70.1 12.1 76.6 Division, NCD and Health through the Life-Course 6.1 5.9 12.0 4.8 4.7 9.5 78.7 79.7 79.2 10.3 73.6 Division, Programme Management 2.8 4.4 7.2 2.5 3.0 5.5 89.3 68.2 76.4 5.1 72.9 Division, Asia-Pacific Centre for Environment and Health in WPR - 0.8 0.8 - 0.1 0.1 - 12.5 12.5 - - Total Regional Office 29.2 50.9 80.1 22.0 37.4 59.4 75.3 73.5 74.2 62.0 71.8 Grand Total 75.2 199.4 274.6 55.3 150.5 205.8 73.5 75.5 74.9 173.1 74.9 *Others include cumulative total for budget centres with available resources less than US$ 50 000, namely Brunei Darussalam, Commonwealth of the Northern Mariana Islands, French Polynesia, Guam and Singapore AC = assessed contributions, VC = voluntary contributions Budget Centre PB 2018-2019 as at 30 June 2019 PB 2016-2017 as at 30 June 2017 Available resources Funds utilization % Utilization against Available resources Funds utilization % Utilization against Available resources WPR/RC70/3 page 7 Table 5 shows the utilization of total available resources by expenditure category. Table 5. Funds utilization by category of expenditure (US$ million) In line with past biennia, the largest percentage of expenditure was attributed to staff costs (39.1%). This is followed by transfers and grants to counterparts (25.4%), contractual services (21.4%) and travel (7.9%). Compared with the previous biennium, staff costs decreased by US$ 0.9 million, and contractual service expenses increased by US$ 8.1 million. Transfers and grants to counterparts (US$ 52.2 million) include Direct Financial Cooperation (DFC) agreements with government counterparts (US$ 46.4 million), equipment for third parties (US$ 3.7 million), fellowships (US$ 1.6 million) and grant letters of agreement with United Nations agencies, humanitarian, charity or non-profit organizations (US$ 0.5 million). There was an increase in transfers and grants to counterparts of US$ 26.3 million, US$ 8.1 million in contractual services and US$ 2.6 million in travel, compared with the previous biennium. These increases are mostly attributed to ongoing immunization/outbreak response activities in Papua New Guinea, as well as increased activities in the Pacific island countries. There is close collaboration between staff in these country offices and the Regional Office to mitigate risks inherent in increased activity levels. Category PB 2018-2019 Funds utilization as at 30 June 2019 % PB 2016–2017 Funds utilization as at 30 June 2017 % Staff costs 80.5 39.1 81.4 47.0 Transfers and grants to counterparts 52.2 25.4 25.9 15.0 Contractual services 44.0 21.4 35.9 20.7 Travel 16.3 7.9 13.7 7.9 General operating costs 8.2 4.0 8.8 5.1 Medical supplies and literature 3.3 1.6 4.8 2.8 Equipment, vehicle and furniture 1.3 0.6 2.6 1.5 Total 205.8 100.0 173.1 100.0 WPR/RC70/3 page 8 Table 5a summarizes the utilization of available resources by category of expenditure for country offices with available resources exceeding US$ 10 million. Table 5a. Funds utilization by category of expenditure for country offices with available resources exceeding US$ 10 million (US$ million) For the eight country offices with available resources greater than US$ 10.0 million per office in PB 2018–2019, total available resources were US$ 126.8 million compared with US$ 92.2 million during the same period of the previous biennium. The most significant increase in funds utilized is in the WHO Office in Papua New Guinea, especially in the areas of contractual services, transfers to government and travel. This relates to implementation of polio outbreak response and immunization activities. 1.3 Audit activities As of this date, all external audit recommendations have been implemented and the audit reports officially closed. Internal auditors performed an audit of the WHO Office in Mongolia and an administrative review of the Regional Office. Both received a rating to signify that the controls in place to mitigate the key risks were satisfactory. The internal audit recommendations for Mongolia were implemented in a timely manner and the audit officially closed. The implementation of the audit recommendations for the Regional Office is on track. The Secretariat continues to welcome auditors to the Region to assess the overall control environment and identify areas for improvement. An internal audit of the Division of Pacific Technical Support/WHO Representative Office in Fiji is scheduled before the end of 2019. On average, the Secretariat closed audit recommendations in less than five months, reflecting a strong commitment to implement the audit findings and rapidly carry out the recommendations across the Region. Category Lao People's Democratic Republic Viet Nam China Papua New Guinea Cambodia Philippines Pacific Island Countries Solomon Islands 2018-2019 Total 2016–2017 Total Staff costs 5.4 5.1 5.9 7.2 5.9 3.6 4.5 2.1 39.7 38.6 Contractual services 2.5 2.2 1.8 7.1 2.5 4.9 4.0 2.3 27.3 19.3 Transfers and grants to counterparts 3.6 6.0 4.7 24.1 3.6 0.4 1.8 0.9 45.1 21.2 Travel 0.5 0.6 0.3 1.8 0.5 0.5 1.9 0.8 6.9 4.1 General operating costs 0.7 0.6 0.7 1.2 0.5 0.2 0.6 0.3 4.8 4.2 Medical supplies and literature 1.0 0.4 - 0.2 - 0.2 0.2 0.2 2.2 3.3 Equipment, vehicle and furniture 0.1 0.1 0.1 0.2 0.1 0.1 0.1 - 0.8 1.5 Grand Total 13.8 15.0 13.5 41.8 13.1 9.9 13.1 6.6 126.8 92.2 WPR/RC70/3 page 9 1.4 Compliance and controls In addition, the Secretariat continues to improve controls through strengthened management, training, communications and monitoring of high-risk transaction areas in the Region, specifically DFC contracts, goods and service procurement activities, and assets and inventory management. The introduction of donor proposal and reporting templates, revision of the Programme Management User Handbook, introduction of automated reminder notifications for overdue and upcoming donor reports, and overall monitoring through the Programme Committee, Regional Administration Network and the Programme Management Officers’ network have improved accountability to Member States and donors. The introduction of online validations during transaction processing and enhanced workflow approvals in the Global Management System, supported by periodic reports, have led to better monitoring and control. As part of the overall compliance management, the Region has been prioritizing DFC agreements with government, which has led to enhanced collaboration with counterparts and improved reporting for results. Since September 2015, the Region has continued to maintain zero overdue DFCs. DFC assurance activities are performed quarterly, covering a minimum of three DFCs per WHO country office in the Region, in coordination with health ministry counterparts. Further, the status of all cash and bank account reconciliations has been reported with an “A” rating to signify that no reconciliation items are pending longer than 90 days. Gender balance and geographical distribution of staff continue to be high priorities. Significant progress in gender parity has been made through recruitment policy adjustments and increased awareness-raising among staff. The share of female international staff in the Region has risen to 48.6% as of the end of June 2019. The geographical distribution of staff remains wide in the Region, with the 177 international professional staff being represented by 45 countries as of June 2019, with nearly half of the international professional staff coming from outside the Region and across the globe. The Regional Office continues to work closely with Member States on outreach activities, focusing on unrepresented and underrepresented countries in the Region to attract more candidates and further enhance the geographical balance of staff. In order to strengthen compliance and risk management, the Compliance and Risk Management Officer reports directly to the Regional Director and helps to coordinate risk and compliance work across the Region. The Region’s Accountability Advisory Group was established to identify action areas and monitor progress. Potential risks are identified, evaluated, monitored and mitigated during the programme budget planning and implementation process. The annual Internal Control Framework self- assessment checklist was completed on time by all budget centre managers. The overall regional WPR/RC70/3 page 10 summary score for the self-assessment by budget centres reported for the end of 2018 was 94.5% (3.76 out of 4.0), showing strong operational awareness of functional controls in the Region. 1.5 Outputs and results The midterm assessment examines progress towards achievement of the outputs for which the Secretariat is accountable, as defined in the programme budget. Annex 1 contains the detailed midterm assessment of implementation of the Programme Budget 2018–2019 conducted as of 31 December 2018, with a second step of review at 30 June 2019 to assess any major changes. In the 2018–2019 midterm review, the Region assessed 106 of 107 programme outputs as “on track” and one as “at risk”. Programme output 2.3.4 (Improved pre-hospital and facility-based emergency care systems to address injury) was assessed as “at risk”. This was due mainly to the lack of financial resources in the first part of the biennium. However, this programme was recently transitioned into broader systems strengthening and improving service coverage and access under the Regional Action Framework on Improving Hospital Planning and Management in the Western Pacific. Under this broader framework, the Secretariat has reprogrammed funding to support the development of emergency care management systems currently under way in two countries. 2. ACTIONS PROPOSED The Regional Committee for the Western Pacific is requested to review and note the interim report on budget performance.
WPR/RC70/3 page 11 ANNEX DRAFT Programme Budget 2018–2019 Summary of Progress in Categories and Programme Areas 1 January 2018 to 31 December 2018 WPR/RC70/3 page 12 Annex WPR/RC70/3 page 13 Annex Contents Introduction 15 Category 1. Communicable Diseases 15 Category 2. Noncommunicable Diseases 19 Category 3. Promoting Health through the Life-Course 23 Category 4. Health Systems 26 Category 6. Corporate Services/Enabling Functions 28 Category 12. WHO Health Emergencies Programme 31 Category 9. Special Global Projects 34 Category 10. Polio Eradication 34 Category 13. Outbreak, Crisis Response and Scalable Operations 35 WPR/RC70/3 page 14 Annex WPR/RC70/3 page 15 Annex Introduction This document contains a detailed midterm assessment of the implementation of the Programme Budget 2018–2019, conducted as of 31 December 2018. The midterm assessment examines progress towards achievement of the programme outputs for which the Secretariat is accountable, as defined in the Programme Budget. In the 2018–2019 midterm review, from a total of 107 programme outputs, the Western Pacific Region assessed 106 as “on track” and one as “at risk”. Programme output 2.3.4 (Improved pre-hospital and facility-based emergency care systems to address injury) was assessed as “at risk”. This was due mainly to the lack of financial resources in the first part of the biennium. However, this programme was recently transitioned into broader systems strengthening and improving service coverage and access under the Regional Action Framework on Improving Hospital Planning and Management in the Western Pacific. Under this broader Framework, the Secretariat has reprogrammed funding to support the development of emergency care management systems currently underway in two countries. BASE PROGRAMMES Category 1. Communicable Diseases Communicable diseases – including HIV/AIDS, hepatitis, tuberculosis, malaria, neglected tropical diseases and vaccine-preventable diseases – and antimicrobial resistance HIV and hepatitis Output Status 1.1.1. Increased capacity of countries to deliver key HIV interventions through active engagement in policy dialogue, development of normative guidance and tools, dissemination of strategic information, and provision of technical support On track 1.1.2. Increased capacity of countries to deliver key hepatitis interventions through active engagement in policy dialogue, development of normative guidance and tools, dissemination of strategic information and provision of technical support On track WHO continued working with Member States to implement the global health sector strategies as well as the regional action plan and framework, aiming to position the responses to HIV, hepatitis and sexually transmitted infections under the umbrella of universal health coverage. The WHO Western Pacific Region provided technical support to countries in their efforts in HIV prevention and treatment. At the end of 2017 in the Region, 81% of people living with HIV had received a diagnosis; 62% received treatment; and 55% of those treated achieved viral suppression. All Member States had adopted the WHO “Treat all” policy. WHO helped countries implement action plans for viral hepatitis. Twelve countries completed disease burden estimates, and 17 countries have developed national strategic plans. WHO supported Member States to integrate essential health services for HIV and viral hepatitis into health systems, which included: development of the Regional Framework for the Triple Elimination of Mother-to-Child WPR/RC70/3 page 16 Annex Transmission of HIV, Hepatitis and Syphilis in Asia and the Pacific, 2018–2030; inclusion of testing and treatment services under national health insurance systems; and the merger or linking of health information systems. Tuberculosis (TB) Output Status 1.2.1. Worldwide adaptation and implementation of the End TB Strategy and targets for tuberculosis prevention, care and control after 2015, as adopted in resolution WHA67.1 On track 1.2.2. Updated policy guidelines and technical tools to support the implementation of The End TB Strategy and efforts to meet targets for tuberculosis prevention, care and control after 2015, covering the three pillars: (1) integrated, patient-centred care and prevention; (2) bold policies and supportive systems; and (3) intensified research and innovation On track The Western Pacific Region has made substantial progress in tuberculosis (TB) care and prevention and has succeeded in reducing TB deaths by 7% and incidence by 3%, compared to 2015 levels. The Region has made progress in the implementation of the Regional Framework for Action on Implementation of the End TB Strategy in the Western Pacific, 2016–2020, endorsed by the Regional Committee in 2015. An estimated 14 000 additional new and relapse TB cases and 7000 drug-resistant TB cases were notified in 2017 (compared to 2014 figures) largely due to the expanded use of the rapid molecular diagnostic tool and systematic screening. Programmatic management of drug-resistant TB has been strengthened in all five high-priority countries, including the introduction of a shorter treatment regimen and newer drugs. The Region took urgent steps for the rapid adoption of the WHO updated treatment guidelines on drug-resistant TB and TB preventive therapy, which resulted in transition plans for all seven priority countries. Eight countries determined baselines for catastrophic costs due to TB, while an increasing number of countries are reviewing social protection and other schemes for compensating the financial burden associated with TB. They are also working with ministries other than health, such as welfare and labour, to better design and implement a scheme that benefits people with TB. Despite these achievements, TB continues to be a major public health challenge. In 2017 in the Region, an estimated 1.8 million people developed TB, and approximately 100 000 people died from the disease. The slow reduction of incidence (2% per year) is a major concern in reaching the End TB target. Moreover, TB concentrates in vulnerable populations which makes the response more challenging. More than 25% of the estimated incident TB cases and about 80% of the estimated drug- resistant TB cases are missed by national programmes. Momentum generated by the first-ever United Nations General Assembly High-level Meeting on Tuberculosis in September 2018 energized Member State commitment, including: high-level missions to Mongolia, the Philippines and Viet Nam; a meeting of national TB programme managers; and a regional consultation for effective engagement of civil society and affected communities. WPR/RC70/3 page 17 Annex Malaria Output Status 1.3.1. Countries enabled to implement evidence-based malaria strategic plans, with focus on effective coverage of vector control interventions and diagnostic testing and treatment, therapeutic efficacy and insecticide resistance monitoring and surveillance, through strengthening of capacity for enhanced malaria reduction On track 1.3.2. Updated policy recommendations, strategic and technical guidelines on vector control, diagnostic testing, antimalarial treatment, including for hard-to-reach populations, integrated management of febrile illness, surveillance and disaggregation of data, epidemic detection and response for accelerated malaria reduction and elimination On track Countries continue to report remarkable progress in malaria control and elimination efforts. Therapeutic efficacy surveillance activities supported by WHO helped guide the updating and implementation of national treatment guidelines for malaria, with a focus on resistance of Plasmodium falciparum parasites to artemisinin and its partner drugs in the Greater Mekong Subregion. Surveillance-strengthening activities continued with the standardizing of indicators and establishment of a regional database. WHO also supported strengthening of malaria diagnostic capacity in countries through the development and adoption of standard operating procedures. Neglected tropical diseases Output Status 1.4.1. Implementation and monitoring of the WHO roadmap for neglected tropical diseases facilitated On track 1.4.2. Implementation and monitoring of neglected tropical disease control interventions facilitated by evidence-based technical guidelines and technical support On track 1.4.3. New knowledge, solutions and implementation strategies that respond to the health needs of disease-endemic countries developed through strengthened research and training On track The WHO Western Pacific Region continued to make significant progress in the control and elimination of neglected tropical diseases towards the targets in Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases: A Roadmap for Implementation. Three countries were newly validated for parasitic disease control with the Food and Agriculture Organization of the United Nations and the World Organisation for Animal Health. Encouraged by the regional success and acknowledging emerging challenges and opportunities in the Region, WHO developed the Regional Action Framework for Control and Elimination of Neglected Tropical Diseases in the Western Pacific, which was endorsed by the Regional Committee in October 2018. WPR/RC70/3 page 18 Annex Vaccine-preventable diseases Output Status 1.5.1. Implementation and monitoring of the global vaccine action plan with an emphasis on strengthening service delivery and immunization monitoring in order to achieve the goals of the Decade of Vaccines On track 1.5.2. Intensified implementation and monitoring of strategies for measles and rubella elimination, hepatitis B control, and maternal and neonatal tetanus elimination facilitated On track 1.5.3. Research priorities and comprehensive reviews of vaccination policies for new vaccines and other immunization-related technologies defined and agreed, in order to develop and introduce vaccines of public health importance and overcome barriers to immunization On track In 2014, the WHO Regional Committee for the Western Pacific endorsed the Regional Framework for Implementation of the Global Vaccine Action Plan in the Western Pacific. Member States have since worked tirelessly with WHO and other partners to make tremendous progress. Success stories abound: 22 countries and areas in the Region have reached the Global Vaccine Action Plan coverage target for diphtheria–tetanus–pertussis vaccine of over 90%; 24 countries and areas achieved the 2017 goal of less than 1% prevalence among 5-year-old children for the surface antigen of the hepatitis B virus; and all countries of the Region except one achieved elimination of maternal and neonatal tetanus. In 2017, the Regional Committee endorsed the Regional Strategy and Plan of Action for Measles and Rubella Elimination in the Western Pacific. This has helped Member States to expand immunization services to more hard-to-reach populations and marginalized groups, such as cross-border migrants and urban poor. In 2018, a worldwide resurgence of measles occurred affecting all six WHO regions. At the time in the Western Pacific Region, nine countries and areas were verified to have achieved and sustained measles elimination. Many others are now close, despite increased importation of the measles virus from endemic countries. China, Malaysia and Viet Nam have sustained a relatively stable incidence of endemic measles. Antimicrobial resistance Output Status 1.6.1. All countries have essential capacity to implement national action plans to monitor, prevent and reduce infections caused by antimicrobial resistance On track 1.6.2. Appropriate use and availability of antimicrobial medicines in human health and food production settings as a contribution to improving access to and maintaining effectiveness of treatment On track 1.6.3. High-level political commitment sustained and effective coordination at the global level to combat antimicrobial resistance in support of the Sustainable Development Goals On track With support from WHO in the Western Pacific Region, 15 countries have developed national action plans on antimicrobial resistance. WHO is working with all countries in the Region to help them strengthen surveillance, monitor antimicrobial use, and improve infection prevention and control. In the area of pharmaceuticals, the Secretariat has developed training and monitoring materials to help ensure rational use of and access to safe and effective antimicrobials. WPR/RC70/3 page 19 Annex Country snapshots In October 2018, Malaysia was certified as the first country in the Region to have achieved elimination of mother-to-child transmission of HIV and syphilis. Mongolia launched an initiative to eliminate hepatitis by 2020 and was selected to host the global event for World Hepatitis Day 2018. Analyses of subnational trends in Papua New Guinea and the Philippines helped national TB programmes to prioritize interventions where they are most needed. The WHO Regional Office coordinated stockpiling of medicines for drug-resistant TB in eight Pacific island countries. China has reported no indigenous malaria cases since mid-2016. In 2018, Malaysia reported no human malaria cases for the first time. In 2018, Cambodia reported no malaria deaths for the first time. In 2018, Palau, Viet Nam, and Wallis and Futuna achieved elimination of lymphatic filariasis as a public health problem. Tokelau eliminated blinding trachoma in 2018. Category 2. Noncommunicable Diseases Noncommunicable diseases – cardiovascular diseases, cancer, chronic respiratory diseases and diabetes – and their risk factors (tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol), as well as mental disorders, disability, violence, injuries, substance abuse, food safety and zoonoses. Noncommunicable diseases and tobacco control Output Status 2.1.1. Development and implementation of national multisectoral policies and plans to prevent and control noncommunicable diseases accelerated On track 2.1.2. Countries enabled to implement strategies to reduce modifiable risk factors for noncommunicable diseases (tobacco use, diet, physical inactivity and harmful use of alcohol), including the underlying social determinants On track 2.1.3. Countries enabled to improve health care coverage for the management of cardiovascular diseases, cancer, diabetes and chronic respiratory diseases and their risk factors, including in crises and emergencies On track 2.1.4. Monitoring framework implemented to report on the progress made on the commitments contained in the Political Declaration of the High-level Meeting of the United Nations General Assembly on the Prevention and Control of Non-communicable Diseases and in the WHO global action plan for the prevention and control of noncommunicable diseases 2013–2020 On track 2.1.5. Enhanced coordination of activities, multi-stakeholder engagement and action across sectors in collaborative work with relevant United Nations System organizations, other intergovernmental organizations and non-State actors, to support governments to meet their commitments on the prevention and control of noncommunicable diseases On track The WHO Western Pacific Region supported countries and areas in the Region in their efforts to develop and implement national multisectoral plans on strengthening capacity on the prevention and control of noncommunicable diseases and their risk factors. Progress has been made in the Region in WPR/RC70/3 page 20 Annex implementing cost-effective measures to reduce unhealthy diets, as well as tobacco taxation increases in line with WHO-recommended levels. The WHO Regional Office regularly provided Member States with technical support on tobacco control, including legal empowerment and training, often with the aim of countering tobacco industry interference. Significant progress has been made at subnational and city levels in extending protection from second-hand smoke in public places in countries where national smoking bans are not in effect or enforced. Mental health and substance abuse Output Status 2.2.1. Countries’ capacity strengthened to develop and implement national policies, plans and information systems in line with the comprehensive mental health action plan 2013–2020 and other governing body resolutions and action plans On track 2.2.2. Countries with technical capacity to develop integrated mental health services across the continuum of promotion, prevention, treatment and recovery On track 2.2.3. Countries have technical capacity and policy development strengthened for expanding country strategies, policies and systems to increase coverage and quality of prevention and treatment interventions for disorders caused by alcohol, psychoactive drugs and addictive behaviours On track In 2018, in line with the Regional Agenda for Implementing the Mental Health Action Plan 2013–2020 in the Western Pacific, 18 countries and areas in the Region were implementing the Mental Health Gap Action Programme. This Programme includes the scaling up of care for priority mental, neurological and substance use conditions in nonspecialized care settings with the aim of moving towards universal health coverage. WHO supported Member States in their efforts to implement the Global Strategy to Reduce the Harmful Use of Alcohol, focusing on interventions to protect young people in the Lao People’s Democratic Republic, Mongolia and Viet Nam. Mental health and psychosocial support were integrated into emergency responses in the Lao People’s Democratic Republic and Papua New Guinea. Community-based health services for dementia, in line with the Global Action Plan on the Public Health Response to Dementia 2017–2025, were implemented in China and the Philippines in 2018. Violence and injuries Output Status 2.3.1. Development and implementation of multisectoral plans and programmes to prevent injuries, with a focus on achieving the targets set under the Decade of Action for Road Safety (2011‒2020) On track 2.3.2. Countries and partners enabled to develop and implement programmes and plans to prevent unintentional deaths and injuries from burns, drowning and falls On track 2.3.3. Development and implementation of policies and programmes to address violence against women, young people and children facilitated On track 2.3.4. Improved pre-hospital and facility-based emergency care systems to address injury At risk WPR/RC70/3 page 21 Annex In December 2018, a total of 21 countries participated in the launch of the Global Status Report on Road Safety 2018, and three countries began development of national action plans. The WHO Regional Office signed an agreement with the Royal National Lifeboat Institution of the United Kingdom of Great Britain and Northern Ireland to develop status reports on drowning prevention. The Regional Office also conducted a conference on seven strategies for ending violence against children, with participation by 17 countries. Technical support was further provided to five countries to support introduction of the seven strategies to national stakeholders. Programme output 2.3.4 was assessed as “at risk”. This was due mainly to the lack of financial resources in the first part of the biennium. However, this programme was recently transitioned into broader systems strengthening and improving service coverage and access under the Regional Action Framework on Improving Hospital Planning and Management in the Western Pacific. Under this broader Framework, the Secretariat has reprogrammed funding to support the development of emergency care management systems currently underway in two countries. Disabilities and rehabilitation Output Status 2.4.1. Implementation of the WHO global disability action plan 2014–2021: better health for all people with disability, in accordance with national priorities On track 2.4.2. Countries enabled to strengthen comprehensive eye care services in the framework of health systems On track 2.4.3. Countries enabled to strengthen prevention and management of ear diseases and hearing loss in the framework of health systems On track Progress in improving the understanding and importance of rehabilitation was demonstrated by the October 2018 Regional Committee endorsement of the Western Pacific Regional Framework on Rehabilitation. The first of its kind in any region or at the global level, the Framework provides specific guidance to countries such as Solomon Islands, Mongolia and Viet Nam on opportunities to strengthen health systems to deliver rehabilitation. The Framework also contributes to addressing the health and well-being of many people living with reduced daily functioning due to noncommunicable diseases or age-related impairments. The WHO Regional Office provided direct support on rehabilitation to eight countries in 2018, including to Solomon Islands, which undertook its first national rehabilitation situation assessment to inform the development of its first national rehabilitation strategic plan. In addition to direct country support, WHO coordinated two Pacific-wide activities in 2018. One activity resulted in the production of updated training materials developed with Fiji National University and Solomon Islands National University to support community-based inclusive development in the Pacific, with the material online at the Pacific Open Health Learning Network. The second activity was the coordination of a feasibility study to address the procurement and provision of assistive products (such as hearing aids and wheelchairs) for people in the Pacific. A meeting of WHO, the International Agency for the Prevention of Blindness and the Brien Holden Vision Institute was held in Singapore, identifying priority action areas and strategies for integration in the Region. WPR/RC70/3 page 22 Annex Nutrition Output Status 2.5.1. Countries enabled to develop and monitor implementation of action plans to tackle malnutrition in all its forms and achieve the global nutrition targets 2025 and the nutrition components of the Sustainable Development Goals On track 2.5.2. Norms, standards and policy options for promoting population dietary goals and the global nutrition targets 2025 and nutrition-related Sustainable Development Goals developed, adopted and integrated into current national health and development plans On track The WHO Regional Office convened a group of experts to collaborate on drafting a Regional Action Framework on Protecting Children from the Harmful Impact of Food Marketing. The draft Framework was structured with four pillars of action: (1) policy framework; (2) multisectoral and multistakeholder collaboration; (3) advocacy and communications; and (4) monitoring and evaluation. An expert consultation on the draft Framework was held in December 2018. Eight countries received technical support and guidance for prevention of obesity in one or more of the following areas: fiscal policy on sugar-sweetened beverages; nutrition labelling; regulating food marketing in schools; and the regulatory actions on healthy diet elimination of unsaturated fatty acids or trans fats. In addition, technical support and guidance were provided to five countries on national efforts to reduce the double burden of malnutrition, including: review and development of a national nutrition and food security strategy in Cambodia; revision of national guidelines on the Baby-friendly Hospital Initiative in Cambodia and Mongolia; development of training modules on nutrition for health workers in Mongolia; school nutrition in Cambodia and Vanuatu; and food fortification in the Philippines and Viet Nam. Food safety Output Status 2.6.1. Countries enabled to control the risk and reduce the burden of foodborne diseases On track 2.6.2. International standards set and a global information exchange platform as well as multisectoral collaboration in place for effectively managing foodborne risks On track 2.6.3 Scientific advice in food safety to support the work of the Codex Alimentarius Commission and Member States to develop food safety standards, guidelines and recommendations On track Implementation of the Regional Framework for Action on Food Safety in the Western Pacific is ongoing. The WHO Regional Office conducted an emergency communications exercise to verify procedures between national focal points for the International Health Regulations (2005) and emergency contact points for the International Food Safety Authorities Network. The team worked with the Pacific island countries to develop practical guidance for accessing food analysis capacity and enhancing capacity for food safety incident and emergency response. In the Lao People’s Democratic Republic and Papua New Guinea, the capacity to manage food safety risks during mass gatherings has improved through provision of training, practical guidance and simulation exercises. Food inspection in Viet Nam is progressing to employ a risk-based approach through the provision of recommendations and the development of a curriculum on risk-based food inspection. In Cambodia, the capacity to prevent and respond to food safety emergencies has improved through practical guidance and development of an action plan to prevent future methanol poisoning events. In Mongolia, steps have WPR/RC70/3 page 23 Annex been taken to strengthen the legal framework for food safety through analysis and assessment of the legal and policy environment. Country snapshots In China, 15 cities met WHO standards for smoke-free public places, with the result that 10% of the Chinese population was being protected against second-hand smoke. In the Lao People’s Democratic Republic in the aftermath of tropical storm Son Tinh, a local mental health team assisted by WHO staff provided psychological first aid to affected communities. Solomon Islands developed new legislation on the blood alcohol content threshold in line with WHO recommendations. The Pacific island chiefs of police have added road safety to their list of mandated programmes. The WHO Regional Office and Mongolian country office helped develop a training module on nutrition for use by health workers in the country. In Cambodia, a draft food safety policy was developed to strengthen the national food safety system as a comprehensive and unified entity across sectors. Category 3. Promoting Health through the Life-Course Promoting health through the life-course – including equity, social, economic and environmental determinants, gender equality and human rights Reproductive, maternal, newborn, child and adolescent health Output Status 3.1.1. Countries enabled to improve maternal health through further expansion of access to, and improvement in the quality of, effective interventions for ending preventable maternal deaths from pre-pregnancy to postpartum and perinatal deaths (stillbirths and early neonatal deaths), with a particular focus on the 24-hour period around childbirth On track 3.1.2. Countries enabled to implement and monitor effective interventions to cover unmet needs in sexual and reproductive health On track 3.1.3. Countries enabled to implement and monitor integrated strategic plans for newborn and child health, with a focus on expanding access to high-quality interventions to improve early childhood development and end preventable newborn and child deaths from pneumonia, diarrhoea and other conditions On track 3.1.4. Countries enabled to implement and monitor integrated policies and strategies for promoting adolescent health and development and reducing adolescent risk behaviours On track 3.1.5. Research undertaken and evidence generated and synthesized for newborn, child and adolescent health and related programmatic research for designing key interventions On track 3.1.6. Research undertaken and research capacity strengthened for sexual and reproductive and maternal health through the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) On track WPR/RC70/3 page 24 Annex Countries in the Region were supported to provide high-quality, people-centred health services. To improve care for preterm and low-birthweight babies, assessments of Kangaroo Mother Care were done in 10 hospitals in six countries using Early Essential Newborn Care (EENC) Module 4 – Introducing and Sustaining EENC in Hospitals: Kangaroo Mother Care for preterm and low- birthweight infants. Module 4 was published in August 2018. The Second Biennial Progress Report (2016–2017) for the Action Plan for Healthy Newborn Infants in the Western Pacific Region (2014–2020) was published in June 2018. Assessments of hospital information systems for maternal and newborn data were conducted in the Philippines and Viet Nam. Assessments of family planning services were conducted in six provinces in the Lao People’s Democratic Republic and in 18 family health clinics in Mongolia. The assessments used the Primary Health Care Quality Improvement Guide Module 1: Preventing Unplanned Pregnancies. Assessments of child health services were undertaken in 18 family health clinics and 54 health facilities in the Philippines using the Primary Health Care Quality Improvement Guide Module 1: Care for Infants and Young Children. The quality of emergency obstetric care was assessed in five hospitals in Cambodia. The national Maternal Death Surveillance and Response (MDSR) Committee was supported to review maternal deaths and develop recommendations to prevent future deaths. Ageing and health Output Status 3.2.1. Countries enabled to develop policies, strategies and capacity to foster healthy ageing across the life-course On track 3.2.2. Countries enabled to deliver older person-centred and integrated care that responds to the needs of women and men and to tackle health inequities in low-, middle- and high-income settings On track 3.2.3. Evidence base and monitoring and evaluation strengthened, informing policies and actions to address key issues relevant to the health of older people On track 3.2.4. Age-friendly environments developed and maintained in countries in line with the WHO strategy and plan of action on ageing and health On track WHO provided policy-focused guidance and technical assistance to strengthen awareness and capacity for the development of policies and strategies that foster healthy and active ageing in Cambodia and Mongolia. In Viet Nam, WHO’s public health framework on healthy ageing was introduced and widely accepted. In China, the Government established a new department of ageing and health. WPR/RC70/3 page 25 Annex Health and the environment Output Status 3.5.1. Country capacity enhanced to assess health risks and to develop and implement policies, strategies or regulations for the prevention, mitigation and management of the health impacts of environmental and occupational risks On track 3.5.2. Norms and standards established and guidelines developed for environmental and occupational health risks and benefits associated with, for example, air and noise pollution, chemicals, waste, water and sanitation, radiation, and climate change and technical support provided at the regional and country levels for their implementation On track 3.5.3. Public health objectives addressed in implementation of multilateral agreements and conventions and initiatives on the environment, the Paris Agreement (as adopted by United Nations Framework Convention on Climate Change), international labour conventions related to occupational health and safety, and in relation to the Sustainable Development Goals On track The WHO Regional Office developed a draft report on air quality and health in the Region, which is slated for publication in 2019. Mongolia was provided with technical and strategic support to address health impacts of winter air pollution. Small island developing states in the Pacific were supported in the development of the Pacific Islands Action Plan on Climate Change and Health. Country profiles on climate change and health were produced in nine countries in the Region. The six least developed countries in the Region were supported to build climate-resilient health systems. Twelve countries received WHO technical support to assess and improve water and sanitation in communities and health-care facilities through the UN-Water Global Analysis and Assessment of Sanitation and Drinking-Water. In addition, WHO supported Member States to improve policies on chemical safety and occupational health. Technical support was provided in Mekong countries for elimination of exposure to asbestos, mercury and lead through a multisectoral approach. Technical assistance was provided to build the institutional capacity on basic occupational health services in China, the Philippines and Viet Nam. The collaboration between health and environment sectors was promoted through WHO support for the Asia-Pacific Regional Forum on Health and Environment, which is chaired by the Philippines. WHO also made substantial progress towards the establishment of the WHO Asia-Pacific Centre for Environment and Health in the Republic of Korea. Equity, social determinants, gender equality and human rights Output Status 3.6.1. Equity, gender equality, human rights and social determinants addressed across WHO programme areas, and Member States enabled to promote, design, and implement related health strategies, policies, plans, programmes and resolutions or laws On track 3.6.2. Improved country policies, capacities and intersectoral actions for addressing social determinants, in order to improve health equity through Health in All Policies, and whole-of-government approaches On track 3.6.3. WHO Secretariat and Member States have enhanced capacities for measuring and monitoring equity, gender equality, human rights and social determinants On track The gender team organized sessions in the Pacific islands to raise awareness on the importance of gender and equity. The WHO Regional Office supported assessments on equity in Cambodia, WPR/RC70/3 page 26 Annex Mongolia and Viet Nam and adoption of a Health in All Policies approach to China’s healthy city movement. In Kiribati, social determinants of health including gender were integrated into health promotion programming. Country snapshots In Cambodia, the quality of emergency obstetric care was assessed in five hospitals. China, the Philippines and Viet Nam received support for development of occupational health systems. In Papua New Guinea, support was provided for the development of a national training curriculum on gender mainstreaming and gender-based violence. Category 4. Health Systems Health systems based on primary health care, supporting universal health coverage National health policies, strategies and plans Output Status 4.1.1. Improved country governance capacity to formulate, implement and review comprehensive national health policies, strategies and plans (including multisectoral action, a “Health in All Policies” approach and equity policies) On track 4.1.2. Improved national health financing strategies aimed at moving towards universal health coverage On track 2018 marked a milestone in that the World Health Day theme was “Universal health coverage: everyone, everywhere”. The campaign aimed to inspire, motivate and guide all stakeholders to make commitments towards universal health coverage. WHO provided support to the Lao People’s Democratic Republic for monitoring and evaluation; to Viet Nam for development and financing of primary health care; and to Mongolia for development of health-technology assessments. In the Philippines, WHO supported the development and passage of a landmark bill on universal health coverage. In addition to providing technical assistance in drafting the bill, WHO facilitated policy dialogues between the Department of Health and Congress to strengthen political support for the bill, including through the hosting of the Asia-Pacific Parliamentarian Forum on Global Health in August 2018 in Manila. WHO also supports a bill to increase tobacco taxes as a means of sustainable financing to ensure implementation of the universal health coverage law. The Asia-Pacific Parliamentarian Forum on Global Health was co-chaired by the health committees of the Senate and House of Representatives of the Philippines, in collaboration with the Department of Health. In all, 55 parliamentarians from 21 countries attended. The meeting highlighted the role of parliamentarians in advancing universal health coverage through strengthening of legal frameworks and securing sustainable financing. The Forum is an important part of WHO’s strategy to assist Member States in advancing universal health coverage through a whole-of-government approach. Engagement with parliamentarians represents a new way of working for WHO in championing health beyond the health sector to achieve the Sustainable Development Goal health targets. WPR/RC70/3 page 27 Annex Integrated people-centred health services Output Status 4.2.1. Equitable integrated, people-centred service delivery systems in place in countries and public health approaches strengthened On track 4.2.2. Health workforce strategies oriented towards universal health coverage implemented in countries On track 4.2.3. Countries enabled to improve patient safety and quality of services, and patient empowerment within the context of universal health coverage On track A regional progress report on primary health care was developed in preparation for the global conference on primary health care in Astana, Kazakhstan. Country case studies in China, Samoa and Viet Nam were shared at the conference. Two regional networks were established: one for regulators of the health workforce and a second for quality. Hospital quality and patient safety management training took place in Cambodia, the Lao People’s Democratic Republic, Mongolia, the Philippines and Viet Nam. Access to medicines and other health technologies and strengthening regulatory capacity Output Status 4.3.1. Access to and use of essential medicines and other health technologies improved through global guidance and the development and implementation of national policies, strategies and tools On track 4.3.2. Implementation of the global strategy and plan of action on public health, innovation and intellectual property On track 4.3.3. Improved quality and safety of medicines and other health technologies through norms, standards and guidelines, strengthening of regulatory systems, and prequalification On track The WHO Regional Office supported development of national medicines policies and essential medicines lists in Cambodia and Mongolia and the development and review of pharmaceutical laws and regulations and good governance for medicines in the Federated States of Micronesia, Papua New Guinea and Cook Islands. The team also helped strengthen procurement systems, pharmaceutical management and the use of information technology for drug management in Cambodia, Papua New Guinea, the Philippines and Solomon Islands. In the area of regulation, several countries received assistance with the assessment of the capacity of national regulatory authorities. The WHO Regional Office worked across departments and country offices to ensure access to medicines and vaccines for health emergencies. WPR/RC70/3 page 28 Annex Health systems, information and evidence Output Status 4.4.1. Comprehensive monitoring of the global, regional and country health situation, trends, inequalities and determinants using global standards, including data collection and analysis to address data gaps and system performance assessment On track 4.4.2. Countries enabled to plan, develop and implement an eHealth strategy On track 4.4.3. Knowledge management policies, tools, networks and resources developed and used by WHO and countries to strengthen their capacity to generate, share and apply knowledge On track 4.4.4. Policy options, tools and technical support provided to promote and increase research capacity on health and address ethical issues in public health and research On track Universal health coverage profiles were developed for all countries in the Region in 2018. The WHO Regional Office provided technical support for health information system development in 11 countries. A Regional Action Agenda on Harnessing e-Health for Improved Health Service Delivery was developed and approved at the sixty-ninth session of the WHO Regional Committee for the Western Pacific. Technical support on health research ethics was provided to Fiji, Papua New Guinea, Samoa, Tonga and Vanuatu. Country snapshots In the Philippines, with support from WHO, there was swift bicameral approval by the Senate and the House of Representatives of a bill on universal health coverage. In the Lao People’s Democratic Republic, an initiative to strengthen the capacity of teaching hospitals included actions to improve student assessment methods. The WHO Regional Office helped advance the establishment of a platform to support regulation of medical products throughout the Pacific island countries. Category 6. Corporate Services/Enabling Functions Leadership and governance Output Status 6.1.1. Effective WHO leadership and management and improved capacities of the WHO Secretariat and Member States to promote, align, coordinate and operationalize efforts to achieve the Sustainable Development Goals On track 6.1.2. Effective engagement with other United Nations agencies and non-State actors in building a common health agenda that responds to Member States’ priorities On track 6.1.3. WHO governance strengthened with effective oversight of governing body sessions and efficient, aligned agendas On track The Organization fostered support for the Sustainable Development Goals across the Region. Specific achievements included finalizing the Republic of Korea–WHO Country Cooperation Strategy 2019– 2023, which details strategic priorities for collaboration over the next five years; and the Third Regional Forum of WHO Collaboration Centres in the Western Pacific, which was convened in November 2018 and attended by more than 200 delegates from more than 150 institutions. WPR/RC70/3 page 29 Annex Transparency, accountability and risk management Output Status 6.2.1. Accountability ensured and corporate risk management strengthened at all levels of the Organization On track 6.2.2. Organizational learning through implementation of evaluation policy and plans On track The WHO Regional Office developed a mechanism to anchor organizational learning, taking into consideration the consolidated findings and recommendations from WHO exercises. These included stocktaking of WHO reforms since 2009 and global transformation and culture surveys. Through 2018, the goal was for continual improvement in the service of Member States. A clear risk management process was incorporated in Programme Budget planning activities in 2018. This process was an important part of the planning cycle, including monitoring and evaluation. This systematic risk management process informs decision-making and embeds risk management into all corporate processes and culture throughout the Region. The WHO Western Pacific Region enjoys high rates of compliance, and the level of accountability is high. Strategic planning, resource coordination and reporting Output Status 6.3.1. Needs-driven priority-setting in place and resource allocation aligned to delivery of results On track 6.3.2. Predictable, adequate and aligned financing in place that allows for full implementation of WHO’s programme budget across all programme areas and major offices On track For budgeting and planning, the Regional Office and country offices worked hand in hand through daily communication and monthly teleconferences or videoconferences to ensure that progress in specific areas was being maintained. Collaboration with programme management officers and regional administrative networks contributed to achievement of targets, effective use of resources, compliance with administrative processes, and strengthening of key financial controls and compliance. The WHO Regional Office actively participated in the development of a WHO resource mobilization strategy. The Regional Office continues to maintain the highest rate of on-time donor reports across all regions. Management and administration Output Status 6.4.1. Sound financial practices managed through an adequate control framework On track 6.4.2. Effective and efficient human resources management and coordination in place On track 6.4.3. Efficient and effective computing infrastructure, corporate and health-related systems and applications On track 6.4.4. Provision of operational and logistics support, procurement, infrastructure maintenance and asset management, and of a secure environment for WHO staff and property On track WPR/RC70/3 page 30 Annex The finances of the WHO Western Pacific Region were on track, and transactions complied with key financial rules and policies. In the area of human resources, major priority was given to improving the staff gender balance. The percentage of female staff in the WHO Western Pacific Region increased from 36% in 2015 to 48% in 2018, with 42% of positions at grade P4 or above held by women. The information technology team upgraded the data storage and backup architecture and revamped the Staff Information System. The procurement and logistics team conducted market research, which identified 20 potential new regional suppliers of laboratory goods and medical devices for inclusion in the procurement catalogues. This allows faster purchasing and greater quality assurance for the global procurement network. Strategic communications Output Status 6.5.1. Accurate and timely health information accessible through a platform for effective communication and related practices On track 6.5.2. Organizational capacity enhanced for timely and accurate provision of internal and external communications in accordance with WHO’s programmatic priorities, including during disease outbreaks, public health emergencies and humanitarian crises On track The role of communications as an enabling function was strengthened in 2018. Key activities included strengthening media relations, deploying surge capacity for emergency/risk communications and delivering in-person capacity-building workshops in four countries. The complete migration of the Regional Office and country office websites over six months is one of 2018’s major accomplishments. This was made possible through support from senior leadership and close collaboration with communications focal points in the Regional Office and country offices working with technical colleagues. More than 1200 stakeholders were surveyed about the new sites, which netted highly positive feedback. Country snapshots WHO collaborated with Viet Nam’s Ministry of Health on communication and advocacy to advance universal health coverage, which increased the public’s understanding of where and why they should seek primary care services. The WHO Regional Office deployed a risk communications officer and team of epidemiologists to support the Ministry of Health in its response to the outbreak of hepatitis A in Tuvalu, which helped reduce transmission risk. The Philippines country office established a strong system of internal control and risk management and received positive feedback from the Independent Expert Oversight Advisory Committee. WPR/RC70/3 page 31 Annex Category 12. WHO Health Emergencies Programme Infectious hazard management Output Status 12.1.1. Control strategies, plans and capacities developed for diseases such as cholera, viral haemorrhagic fever, meningitis and influenza and those due to vector-borne, emerging and re-emerging pathogens On track 12.1.2. Global expert networks and innovative mechanisms developed to manage new and evolving high-threat infectious hazards (such as for clinical management, laboratories, social science, and data modelling) On track WHO continued supporting influenza surveillance, laboratory work and preparedness, particularly in Cambodia, the Lao People’s Democratic Republic, Mongolia, selected Pacific island countries and Viet Nam. The 12th Biregional Meeting of National Influenza Centres and Influenza Surveillance in the Western Pacific and South-East Asia was organized in Nepal in July 2018 to review progress and challenges. At this meeting, training on pandemic influenza severity assessment was provided. The Regional Office provided technical assistance to advance pandemic preparedness through various regional meetings and country support. A simulation exercise called PanStop was supported in Mongolia to practise rapid containment of pandemic influenza, engaging multisectoral stakeholders. The WHO Regional Office made regular reports on avian influenza and seasonal influenza and summarized the status of the seasonal influenza vaccination programme in the Region. Country health emergency preparedness and the International Health Regulations (IHR) Output Status 12.2.1. Country core capacities for health emergency preparedness and the International Health Regulations (2005) independently assessed and national action plans developed On track 12.2.2. Critical core capacities for health emergency preparedness, disaster risk management and the International Health Regulations (2005) strengthened in all countries On track 12.2.3. Operational readiness plans (WHO and partners) in place and tested for specific threats in highly vulnerable countries On track 12.2.4. Secretariat support provided for implementation of the International Health Regulations (2005) On track WHO continued supporting countries to advance implementation of the International Health Regulations (2005), known as IHR (2005), for health security. WHO worked with countries to further strengthen core capacities in preparedness, surveillance, risk assessment, response, laboratory, prevention and risk communications, as guided by the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies. Cambodia, the Lao People’s Democratic Republic, Malaysia and Mongolia updated and implemented their national action plans for health security. The WHO Regional Office also supported countries to conduct monitoring and evaluation of their IHR (2005) implementation. Joint external evaluations were conducted in five countries in 2018. The incident management support team at the Regional Office was developed and actively used during all emergencies. WPR/RC70/3 page 32 Annex In Mongolia, multisource rapid risk assessments were conducted routinely for verified events, and a national strategic risk assessment was conducted. Linkages of risk communications with surveillance, risk assessment and response were established. A field epidemiology training mentorship programme was launched. The WHO Philippines Office and the Regional Office conducted risk assessment training for the Department of Health. International Air Transport Association shippers were trained to reduce the risk of disease spread. In Viet Nam, support was provided for operational research to assess risk for emerging diseases, notably Zika virus disease. Health emergency information and risk assessment Output Status 12.3.1. New events detected and public health risks assessed On track 12.3.2. Reliable and up-to-date information available to inform public health interventions and monitor response operations On track 12.3.3. Accurate information about emergency events reported in a timely manner On track From January to December 2018, the regional event-based surveillance at the WHO Regional Office detected approximately 2000 signals of potential emergency health threats, of which 71 were identified as new public health events and entered into the WHO’s Event Management System. The team responded to more than 60% of these events through providing on- and off-site technical support. Formal WHO three-level rapid risk assessments were completed for three events (circulating vaccine-derived poliovirus type 1 in Papua New Guinea, measles in the Philippines and invasive meningococcal disease in the South Pacific) to inform decision-making. Information sharing was also enhanced through the timely development of information products, including 17 statements on the event information site for IHR (2005) national focal points and five disease outbreak news postings completed for major public health events during the period. The team contributed to regional skilled workforce development through support for the training of 11 fellows of the Field Epidemiology Fellowship Programme at the WHO Regional Office. Emergency operations Output Status 12.4.1. Health operations effectively managed in support of national and local response On track 12.4.2. Collective response by operational partners effectively coordinated On track 12.4.3. Effective logistics and operational support rapidly established and maintained On track 12.4.4. Priority gaps in humanitarian policy and guidance addressed, with specific emphasis on health On track The Regional Office Incident Management Support Team structure was strengthened with identification of clear roles and responsibilities. The team developed an operational readiness toolkit with templates and tools to improve efficiency of response. The Contingency Fund for Emergencies was used effectively for emergencies in the Lao People’s Democratic Republic, Papua New Guinea, the Philippines, and among Pacific island countries and areas. The Division of Pacific Technical Support’s Health Cluster Coordinator provided emergency preparedness and response support to a number of Pacific island countries, including strengthening emergency medical teams, and in response to events in the Lao People’s Democratic Republic and Papua New Guinea. WPR/RC70/3 page 33 Annex Emergency core services Output Status 12.5.1. WHO Health Emergencies Programme effectively managed and sustainably staffed and financed On track 12.5.2. Effective communication and resource mobilization On track 12.5.3. Effective leadership, planning and performance management On track The WHO Regional Office for the Western Pacific and country offices provided leadership, effective and timely guidance, and capacity-building for countries during public health events, including a ferry disaster in Kiribati, tropical cyclone Gita in the Pacific, an earthquake in Papua New Guinea, a flood in the Lao People’s Democratic Republic, volcanic activity in Vanuatu and Typhoon Mangkhut in the Philippines. Activities included the provision of technical support, information sharing through IHR (2005), deployment of staff to the field and provision of emergency supplies. There were efficient and timely responses to outbreaks of vaccine-preventable diseases in the Region including circulating vaccine-derived poliovirus type 1 in Papua New Guinea, meningococcal disease in Fiji and New Zealand, and a measles outbreak in the Philippines. Country snapshots Simulation exercise PanStop was conducted to practise rapid containment of pandemic influenza in Mongolia, engaging multisectoral stakeholders. The WHO Regional Office supported infectious substance shipment training for Pacific island countries and Papua New Guinea. In Fiji, the early warning system was expanded to 61 sentinel reporting sites, and the Ministry of Health and Medical Services worked closely with WHO in the Western Pacific Region to produce real-time public health event information. The WHO Regional Office and the Papua New Guinea country office responded rapidly to the February 2018 earthquake, assisting the National Department of Health with the disaster response in the country. WPR/RC70/3 page 34 Annex NON-BASE PROGRAMMES Category 9. Special Global Projects Pandemic Influenza Preparedness Framework Output Status 9.2.1. National influenza laboratory and surveillance systems contribute to GISRS for timely risk assessment response measures On track 9.2.2. Influenza disease burden estimates are used for public health decisions On track 9.2.3. Timely access to assured-quality pandemic influenza products is supported On track 9.2.4. Tools and guidance are available for countries to enhance influenza risk communication and community engagement On track 9.2.5. Plans for effective efficient deployment of pandemic supplies are optimized On track 9.2.6. National pandemic influenza preparedness plans are updated in the context of all- hazards preparedness and global health security On track Priority countries in the Region were supported for the following: o Maintaining and strengthening influenza laboratory and surveillance, including virus and data sharing. This included strengthening severe viral pneumonia surveillance in Viet Nam. o Advancing pandemic influenza preparedness planning, including through a meeting for three Greater Mekong Subregion countries (Cambodia, the Lao People’s Democratic Republic and Viet Nam), and country support. o Determining the burden of influenza through hospital admission surveys, with results presented at international fora and submitted for publication. Category 10. Polio Eradication Polio eradication Output Status 10.1.1. Technical assistance to enhance surveillance and ensure high population immunity to the threshold needed to maintain polio-free status, especially in at-risk areas On track 10.1.2. Number of countries with an agreed timeline for cessation of use of bivalent oral poliovirus vaccine in all routine immunization programmes globally On track 10.1.3. Processes established for long-term poliovirus risk management, including containment of all residual polioviruses, and the certification of polio eradication globally On track 10.1.4. Transition plan for post-polio eradication era finalized and under implementation globally On track Key activities in surveillance and increasing population immunity included the following: o The WHO Western Pacific Region conducted supplementary polio immunization activities in high-risk areas of China and the Lao People’s Democratic Republic. WPR/RC70/3 page 35 Annex o In response to the outbreak of circulating vaccine-derived poliovirus type 1, Papua New Guinea implemented five rounds of national and subnational supplementary immunization activities. o In-country acute flaccid paralysis surveillance reviews were conducted in the Lao People’s Democratic Republic, Mongolia and Papua New Guinea. o Viet Nam introduced inactivated polio vaccine into its routine vaccination schedule. o The Philippines and Papua New Guinea expanded environmental surveillance to include six new sites and five new sites, respectively. In the area of poliovirus destruction and containment, the WHO Regional Office has initiated a process to establish long-term poliovirus risk management within polio laboratory networks in accordance with the regional endgame strategy. Category 13. Outbreak, Crisis Response and Scalable Operations Increase access to essential health and nutrition services Output Status 13.1.1. Health service delivery On track Support to countries was provided during the following events: o Flood response in the Lao People’s Democratic Republic: psychological first aid was provided in affected communities, and mental health training was provided to clinicians. o The Marawi conflict in the Philippines: the response focused on basic health-care delivery, repair of damaged health facilities and disaster risk-reduction planning at the municipal level. The team minimized the spread of diseases in remote disaster- and conflict-affected areas through supplementary vaccination campaigns. o Typhoon Mangkhut in the Philippines: the team provided supplementary vaccination in difficult-to-access areas with low coverage. o Cyclone in Tonga: Rapid deployment of Regional Office staff, who provided support to the Tonga Ministry of Health to coordinate continuity of health service delivery. Prevent and control outbreaks Output Status 13.2.1. Outbreak prevention and control On track The team provided technical support for surveillance and response during the following events: o A flood in the Lao People’s Democratic Republic: the National Centre for Laboratory and Epidemiology established intensive surveillance among temporary shelters and affected villages with support from the WHO Western Pacific Region. Disease clusters were rapidly detected and responded to. o An earthquake in Papua New Guinea: two rapid response teams were established in Hela and the Southern Highlands provinces. The teams investigated reports of pertussis, diarrhoea, measles and influenza-like illness. Outbreaks of the latter three were confirmed and rapidly controlled. WPR/RC70/3 page 36 Annex Strengthen surveillance, early warning and health information management Output Status 13.3.1. Surveillance and health information management On track The team assessed 96 000 media articles and detected 2000 signals of potential public health events. Following signal verification and assessment, 71 new public health events were reported and monitored, including: o Measles outbreaks were declared on the three island groups of the Philippines between January and April 2018. The WHO Regional Office provided support needed to update the risk assessment. o During an outbreak of meningococcal disease in Fiji, the WHO Regional Office helped the Ministry of Health and Medical Services formulate strategies for vaccination and preventive treatment. o The WHO Regional Office deployed staff to Papua New Guinea to support information management and surveillance, operations support, and logistics and risk communications during an outbreak of circulating vaccine-derived poliovirus type 1 in June 2018. o In November 2018, Malaysia notified WHO under IHR (2005) about a rabies outbreak. The WHO country office in Malaysia provided technical assistance and supported procurement of human vaccine to the Ministry of Health. Establish effective coordination and operations support Output Status 13.4.1. Leadership, coordination and operations support On track The WHO Regional Office and WHO country offices provided support and coordination for all emergencies in the Region in 2018. The support and coordination included: assessments and response planning; incident management systems and emergency operations centres; enhanced surveillance, outbreak prevention and control; and the provision of medical and mental health care and supplies and logistics. There was also effective coordination with partners including emergency medical teams, the Global Outbreak Alert and Response Network and the WHO Global Health Cluster. Fast track research for infectious hazards Output Status 13.5.1. Emergency Research and Development On track Emergency research and development were not activated during 2018, as there were no Grade 2 or 3 emergencies in the Region.