Joint external evaluation of the International Health Regulations (2005) core capacities of the United States of America: mission report, 18–25 September 2024
Overview
The Joint External Evaluation (JEE) team would like to express its appreciation to the United States of America for volunteering to undertake a second JEE using the third edition of the JEE tool. This revised edition of the tool incorporates relevant lessons of the COVID-19 pandemic and other public health emergencies.
The JEE team sincerely appreciates the United States’ efforts to meet the requirements of the JEE process, and the warm hospitality that was offered to the JEE team. All countries that make the effort to undergo the JEE process should be commended for the transparency they have shown in service of strengthening global health security.
Findings from the Joint External Evaluation
During the JEE mission, which took place in Washington, DC and Atlanta, Georgia from 18 to 25 September 2024, the United States’ capacities in 19 technical areas were evaluated through a peer-to-peer, consultative process. This process brought together a multisectoral group of national subject matter experts and the multinational, multidisciplinary expert JEE team for a week of discussion, interaction and selected site visits.
After a week of collaborative talks this process led to consensus on scores, as well as JEE recommendations for priority actions across the 19 technical areas.
The evaluation also generated eight wider, overarching recommendations that, if implemented, will consolidate the United States’ progress and remove bottlenecks that might impede implementation of the agreed priority actions. These recommendations, outlined below, address cross-cutting challenges affecting the capacities of the United States across many of the different technical areas that were explored in greater depth in the JEE process.
Overarching recommendations of the JEE
- Structures: continue to improve alignment and harmonization of political, legal, and technical frameworks across all regions and territories.
- Extend preparedness to the level of state, local, tribal and territorial (SLTT) jurisdictions, ensuring that any capacity gaps in SLTTs are addressed so that preparedness, prevention, detection and response are rooted at local level.
- Workforce: ensure close monitoring of the US$ 7 billion American Rescue Plan workforce investments and other initiatives to strengthen the future public health workforce, addressing declining trends in workforce numbers and the high proportion of staff considering leaving the public sector.
- Funding: maintain investment in preparedness through existing agencies and programmes and consider reviewing the cost effectiveness of how funds are currently used, with particular focus on addressing fragmentation and duplication.
- Trust: strengthen community engagement to improve the impact of emergency responses, with focus on building trust – ensuring the inclusion of communities that are harder to reach, or which have diverse needs.
- Strengthen trust in data, services, and systems.
- Equity: continue measures to ensure health security for all the population of the United States, addressing existing inequities and working to expand coverage of essential health care through federal initiatives, more and better partnerships, and improved health literacy and research.
- Solidarity: continue the United States’ admirable contributions to global health security and solidarity, maintaining the willingness to share the benefits of its high capacity through deployment of staff to other parts of the world, training, capacity building, and sharing of knowledge and best practices.
