WHO/HSE/GCR/2015.15
Technical consultation on monitoring and evaluation of functional core capacity to implement the International Health Regulations (2005) Lyon, France 20–22 October 2015
Executive summary Recent Ebola outbreaks in West Africa, and Middle‐East respiratory syndrome coronavirus (MERS‐ CoV) in the Republic of Korea, have shown that the world remains vulnerable to emerging infectious diseases. The foundation to address these and other public health emergencies lies with the health system, supported by the relevant core capacities needed to implement the International Health Regulations (2005). To sustain the capacities – and strengthen them where needed – relies on an accurate assessment of the status in each country. However, major recent events have illustrated that self‐assessment alone cannot adequately evaluate a country’s functional core capacity. In 2015 the World Health Assembly endorsed the recommendation of the second International Health Regulations (IHR) Review Committee to strengthen the IHR monitoring and evaluation processes, with a view to improving confidence and trust in the assessment of IHR (2005) core capacitiesi. As a result, a concept note entitled “IHR Monitoring and Evaluation Framework post‐ 2016" was welcomed by the five WHO regional committees that had met by the date of this consultation. The framework includes a self‐reporting tool, after‐action review, simulation exercises and an external evaluation. Feedback from the regional committees has been positive. At a WHO technical consultation held on 20–22 October 2015 in Lyon, France, participants from Member States, key international organizations, partners, and WHO regional and headquarters staff met to develop further the assessment approach called for by the 2014 IHR Review Committee. With the goal of developing a tool that can be used as part of joint external evaluations, participants agreed on a practical approach to integrating existing work and experience, such as the Global Health Security Agenda country assessments and WHO tools developed under the IHR (2005), such as those for health systems strengthening. Others include the performance of veterinary services tool of the World Organization for Animal Health, and those of other international agencies. Key points and issues raised during the meeting WHO needs to have an objective joint external evaluation process with existing partners. The process should use an assessment tool that builds on the experience and tools of WHO and its partners to accelerate the full implementation of the IHR (2005). This task is urgent for three major reasons: all countries are facing constant risks; the strengthening of national capacities is critical; and as regional committees follow the example of the Eastern Mediterranean to begin implementing © World Health Organization 2015. All rights reserved
WHO/HSE/GCR/2015.15
joint external evaluations, convergence is essential. The recent external evaluations of the Global Health Security Agenda on its action packages, which will continue throughout 2016, reinforce the need to seek convergence as a priority. The Lyon consultation greatly facilitated this convergence process. A critical purpose of these evaluations is to identify information that will help closing the gaps in country needs related to activities and, more specifically, partners and resources to close those gaps. There is a need for a simpler self‐administered tool for annual reporting. One option would be to combine the IHR monitoring tool with that used for joint external evaluations. Other components of the new IHR monitoring and evaluation framework post‐2016 – such as after‐ action reviews and simulation exercises – need more work to develop and ensure they are appropriate for all countries. Confidence in the assessment of IHR (2005) core capacities is essential in order to support and enhance transparency; trust would be improved by making external evaluation reports publicly available. Adequate funding for the proposed new joint external evaluations is important and must be addressed for their successful implementation. The consultation produced three main outcomes 1. The essential features of a joint external evaluation identified are: voluntary country participation; multisectoral teams composed of national health authorities and local specialists, WHO staff and external technical experts; support from a WHO‐coordinated professional group; transparency and openness of data and information sharing; and the public release of reports. 2. A joint external evaluation tool, structured around IHR (2005) core capacities and drawing upon existing questions used by WHO and other initiatives was drafted. A training programme for future evaluators and other key stakeholders, including national focal points, will need to be developed. 3. A timeline for implementing the IHR monitoring and evaluation process is currently being developed with regional offices. Immediate next steps The WHO Secretariat will continue working on the IHR monitoring and evaluation process and tools developed through this consultation, and will pilot it in volunteer countries. i http://apps.who.int/gb/ebwha/pdf_files/EB136/B136_22Add1‐en.pdf Implementation of the International Health Regulations (2005): Report of the Review Committee on Second Extensions for establishing national Public Health Capacities and on IHR implementation
© World Health Organization 2015. All rights reserved