At a time when health emergencies are happening faster than ever, 31 countries and areas from across the World Health Organization (WHO) Western Pacific Region participated in an annual simulation exercise to test their readiness for the next pandemic. The latest iteration of IHR Exercise Crystal enabled them to assess their preparedness and practise procedures for cross-border and inter-agency responses to emerging health threats.
Representatives from the participating countries and areas tested their communication capacities − as outlined in the International Health Regulations (IHR) − by responding in real time to incoming information about a fictitious novel respiratory illness. The simulation exercise offered an opportunity for focal points to practise verifying and sharing information with WHO, as well as assessing public health risks and coordinating with a range of sectors.
Embedding a culture of readiness and risk reduction
“The Western Pacific is demonstrating, through actions, what regional solidarity looks like,” said Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific. He commended Member States for their commitment to strengthening national IHR capacities, which will in turn enhance regional preparedness. “IHR Exercise Crystal, along with other efforts to enhance national IHR capacities, is reflective of the investment our countries and areas are making to ensure that our Region is prepared, better connected and better coordinated for health emergencies,” he said.
Simulation exercises like IHR Exercise Crystal are a critical tool for building a culture of preparedness and reducing risk. They allow emergency responders to stress-test contingency plans, procedures and systems in a safe environment. This offers a much-needed opportunity to evaluate, refine and iron out coordination challenges and practise teamwork before a real crisis hits.
A platform for multisectoral coordination
Supported by the Pandemic Influenza Preparedness (PIP) Framework Partnership Contribution, this year’s exercise ensures that countries are ready to respond to novel influenza threats and can test the existing IHR communication and coordination mechanisms situated in their pandemic preparedness plans.
Given how emergencies impact diverse sectors and areas beyond health, participants were given opportunities to practise response actions that were multisectoral in nature. Centering the simulation exercise around a novel influenza outbreak and public health measures at points of entry − borders, airports, ports − gave national responders an opportunity to communicate and coordinate with counterparts across sectors and ministries.
Reiterating the value of this multisectoral approach, Ms Qiu Yi Khut, Programme Area Manager, IHR and Health Security Policy, WHO Regional Office for the Western Pacific, noted: “By focusing on implementing public health safety measures at points of entry, we were able to get representatives from across sectors in the same room − thus enabling coordination beyond traditional silos. Giving responders a chance to ‘row together’ in the same direction is critical to an effective emergency response.”
Dr Gerna M. Manatad, Director, Epidemiology Bureau, Department of Health, Philippines, concurred: “IHR Exercise Crystal brought together colleagues from across sectors and expertise to work side by side. It offered a critical space to test our communication channels across different bureaus and agencies. This kind of simulation is foundational to improving interoperability, decision-making and trust between sectors so that when emergencies strike, we respond faster, clearer and together.”
Strengthening national IHR capacities; safeguarding regional health
The WHO Regional Office for the Western Pacific has run IHR Exercise Crystal 17 times since 2008, leveraging varied scenarios including a novel influenza outbreak, a radiological event and an emerging arbovirus outbreak, among others.
Since 2010, the Asia−Europe Foundation (ASEF) and Japan’s Ministry of Foreign Affairs have partnered with WHO to help Member States prepare for and respond to emergencies through investments in simulation exercises, emergency logistics, risk communication and community engagement, and health emergency operations centres to coordinate response actions. “Based on our experience with multiple health emergencies, we know that multisectoral coordination at points of entry is critical to contain pandemics effectively, and at an early stage. In this regard, the scenario presented in this year’s IHR Crystal Exercise is apt,” noted Dr Shimoaraiso Makato, Public Health Advisor at ASEF. “While this year’s exercise focused on a novel influenza outbreak, the outcomes can be applied to other priority hazards as well. We hope that the experience gained will be leveraged in regional capacity-building efforts,” he added.
Based on recent data available − including scores from IHR States Parties Self-Assessment Annual Reports (SPARs) − countries in the Western Pacific are now scoring better when it comes to National IHR Focal Point capacities, including the timely sharing of information on acute public health events.
In the Pacific, Kiribati has consistently shown improvements in National IHR Focal Point functions, as reflected in the country’s annual SPAR scores since 2021. Chief Health Inspector, Nikarawa Karoua, from the Ministry of Health and Medical Services, shared the value of simulation exercises in enhancing Kiribati’s communication capacities: “The exercises not only strengthen inter-agency coordination but also enhance the capacity and confidence of local health workers and stakeholders to respond to real public health emergencies. Lessons learnt from these simulations have informed updates to national preparedness plans and improved protocols for information-sharing. For an island nation like ours, with populations scattered across a vast area, this is all the more crucial, giving us the confidence that we can face formidable challenges in the future.”
IHR Exercise Crystal and other simulation exercises reinforce the culture of learning and improvement. Recommendations from this year’s exercise can help countries and areas to further improve their National IHR Focal Point capacities. These efforts to strengthen and maintain IHR communication functions are also supported through the Asia Pacific Health Security Action Framework (APHSAF). Priority actions under APHSAF enable countries in the Asia Pacific region to better prepare for the next health event, prevent outbreaks from escalating into epidemics, and ultimately save lives.
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About WHO in the Western Pacific
The World Health Organization Regional Office for the Western Pacific works with 38 countries and areas to build strong, resilient health systems. WHO supports evidence-based policy, training and advocacy to promote health, prevent violence and protect vulnerable populations.