2.1.2 Capacities for emergency preparedness strengthened in all countries

Scorecard

The strong global scores for WHO’s effective delivery of technical support and leadership as well good value-for-money for output 2.1.2 demonstrate that the world has made great strides in terms of health emergency preparedness over time; it was clearly, however, not fully prepared for an emergency on the scale of the COVID-19 pandemic, and this explains the potential for higher scores across all five dimensions. WHO’s technical support in this area encompasses the provision of strategic, credible and evidence-based advice through the publication of guidance, checklists and training materials for Member States and partners which reflect the evolving expertise, latest knowledge and best practices for health emergency preparedness. In its leadership capacity, WHO continues to build strategic partnerships and networks, keeping preparedness on the radar and driving the agenda, advocating for emergency preparedness principles and actions that focus on strengthening health systems for health security, whole-of-society approaches, multisectoral collaboration and sustainable financing. WHO’s delivery of global public health goods under output 2.1.2 was also strong with, for example, the development and roll out of operational tools to build capacities at the IHR human-animal-environment interface and publication of the Multisectoral Preparedness Coordination (MPC) Framework in May 2020. COVID-19 has brought many challenges, but it has also brought about a unique opportunity for the world to change how it finances and prepares for health emergencies. The costs of effective preparedness are dwarfed by the costs of a failure to prepare. There is also an opportunity for WHO to integrate gender, equity and human rights more firmly into its core work; this is the overarching mission of the Secretariat’s new Gender Working Group.

Achievements and challenges

The COVID-19 pandemic has revealed the strengths and weaknesses of all-hazards health emergency preparedness capacities in every country, including risk communications, laboratory diagnostics, points of entry, and other core capacities of the International Health Regulations (2005). It has highlighted the importance of health systems that can surge to meet the demands and needs of health emergencies, the significant vulnerability of hospital settings and the critical interdependence of strong health systems and robust health security at all levels. And it has underscored the preparedness gaps that exist across multiple sectors. 

In many cases, COVID-19 has acted as a catalyst for the rapid development and implementation of capacities that were previously lacking or underdeveloped. At the national level this reactive capacity building largely displaced normative preparedness capacity building including the implementation of National Action Plans for Health Security (NAPHS) throughout 2020. A major priority for WHO during this period was to support countries in order to ensure that preparedness capacities developed in response to COVID-19 followed a coordinated and sustainable strategy, adopting a whole-of-society, whole-of-government approach that can be leveraged for long-term preparedness. WHO also published interim guidance to support local authorities in cities and urban settings to strengthen preparedness in densely populated environments. 

During the initial COVID-19 response phase, preparedness capacity coordination was enhanced by the COVID-19 Partners Platform, a tool launched in March 2020 to enable all countries, implementing partners, donors and contributors to collaborate in the global COVID-19 response. The Platform features real-time tracking to support the planning, implementation and resourcing of country preparedness and response activities against an evidence-based checklist of key activities. The Platform enabled WHO to play a dual leadership and partnership role within a broader whole-of-UN approach to preparedness and response. In addition, WHO updated the Strategic Partnership for IHR and Health Security Portal in 2020 to better support donor and country alignment for IHR (2005) implementation and long-term health security. 

In order to guide and rationalize national efforts to rapidly boost health emergency preparedness capacities, WHO also published interim guidance for Member States on investing in and developing longer-term health emergency preparedness during the COVID-19 pandemic. These guidance documents provide maps of COVID-19 preparedness and response actions to sustain IHR (2005) core capacities and advocate for effective allocation of COVID-19 funds to address longer-term preparedness needs, with implementation supported by all three levels of the Organization. 

COVID-19 is not the first and will not be the last health emergency. Indeed, many countries were required to manage concomitant crises during 2020. The COVID-19 pandemic is a stark reminder, however, that the costs of effective preparedness are dwarfed by the costs of a failure to prepare. The world now has an opportunity to build on progress made in 2020 and move towards a sustainable future of emergency preparedness and readiness built on a foundation of strong and resilient health systems. Seizing that opportunity will require political will and financial commitment, and WHO played a central role during 2020 to foster both. 

On 1 October 2020, the governments of France, Finland and Indonesia co-hosted a virtual United Nations General Assembly side event with WHO titled “Sustainable preparedness for health security and resilience: Adopting a whole-of-society approach and breaking the ‘panic-then-forget’ cycle”. The meeting, which was attended by over 220 high-level participants, brought together Ministers and leaders of Member States, regional and international organizations, funders and partners to highlight and advocate for long-term sustainable preparedness in the context of COVID-19. 

Later in October WHO hosted a side event on the margins of the Global Health Security Agenda ministerial meeting titled “Building better for the next Pandemic: Advancing Multisectoral and Whole-of-society Approaches to Health Security Preparedness”. The event highlighted strategic perspectives, lessons learnt and best practices in strengthening multisectoral engagement for preparedness during COVID-19, and effective mechanisms for leveraging current progress and investments toward sustainable health security. In line with this event, WHO is rolling out the Global Strategic Preparedness Network to allow technical human resources to be matched with country needs where they can support capacity building. 

Throughout all WHO engagements in 2020, several themes stand out. Firstly, the widely recognized need for sustainable multisectoral collaboration and whole-of-society approaches to facilitate preparedness and disaster risk reduction. Secondly, the broad recognition of the value of capacity-building measures, including regular preparedness assessments, to enhance long-term health security. Thirdly, and perhaps most importantly, an acceptance that the world needs to change how it finances preparedness for health emergencies, and how it integrates gender equality within preparedness measures. 

Sustainable and predictable financing is required on a scale an order of magnitude greater than that currently available in order for the world to be protected from the next pandemic and other health emergency threats. In the words of the statement from the co-Chairs of the Global Preparedness Monitoring Board to the Joint Meeting of G20 Ministers of Finance and Health in September 2020: “we must change the way we pay for preparedness”. Global health security cannot rely on inadequate contributions from official development assistance that are fundamentally mismatched to the scale of need and sustained level of outlay required in the medium and long term. 

Breaking the cycle of panic and neglect means addressing subnational deficits in preparedness capacity on the global scale. The Global Preparedness Monitoring Board has called on the G20 Ministers to work with WHO to develop a mechanism that ensures sustainable and predictable financing based on the principles of commonality and multilateralism.