Lessons Learned From a Large Cross-Border Field Simulation Exercise to Strengthen Emergency Preparedness in East Africa, 2019.

Field simulation exercises (FSXs) require substantial time, resources, and organizational experience to plan and implement and are less commonly undertaken than drills or tabletop exercises. Despite this, FSXs provide an opportunity to test the full scope of operational capacities, including coordination across sectors. From June 11 to 14, 2019, the East African Community Secretariat conducted a cross-border FSX at the Namanga One Stop Border Post between the Republic of Kenya and the United Republic of Tanzania. The World Health Organization Department of Health Security Preparedness was the technical lead responsible for developing and coordinating the exercise. The purpose of the FSX was to assess and further enhance multisectoral outbreak preparedness and response in the East Africa Region, using a One Health approach. Participants included staff from the transport, police and customs, public health, animal health, and food inspection sectors. This was the first FSX of this scale, magnitude, and complexity to be conducted in East Africa for the purpose of strengthening emergency preparedness capacities. The FSX provided an opportunity for individual learning and national capacity strengthening in emergency management and response coordination. In this article, we describe lessons learned and propose recommendations relevant to FSX design, management, and organization to inform future field exercises.

Estimating Joint External Evaluation Scores Using Country Data from 77 Countries, 2016-2018.

Since 2016, Joint External Evaluations (JEEs) help countries assess their health security preparedness and capacity to respond to public health risks. JEEs are 1 of 4 components of the International Health Regulations 2005 (IHR) Monitoring and Evaluation Framework. Compared with the mandatory State Party Self-Assessment Annual Reporting tool, JEEs use a transparent, rigorous, and collaborative process with international and in-country experts to evaluate IHR implementation. Because it is voluntary and not all States Parties have completed JEEs, we conducted a multiple linear regression model using publicly available JEE data to estimate global IHR implementation. We extracted JEE scores from the published JEE reports for 78 States Parties to the IHR and 12 sociodemographic, economic, and health indicator variables from 3 official reports and 3 official databases for all 194 World Health Organization Member States. Our final model consisted of 4 variables that significantly account for the variance of JEE score: total score from IHR annual reporting, lost disability-adjusted life years due to communicable diseases, gross domestic product, and health professional density (adjusted R2 = 0.833; P < .0001). We estimated only 1 in 10 countries (n = 19, 9.7%) worldwide had achieved average scores indicating demonstrated capacity or sustainable capacity across the 19 technical areas in the JEE tool. All 19 of these countries were in the high-income group, according to the World Bank classification, and were ranked very high on the Human Development Index, according to the United Nations Development Programme. These findings highlight the importance of ongoing efforts toward advancing global health security, especially in middle- to lower-income countries with limited resources.

Building the hospital event-based surveillance system in Viet Nam: a qualitative study to identify potential facilitators and barriers for event reporting.

INTRODUCTION: Hospitals are a key source of information for the early identification of emerging disease outbreaks and acute public health events for risk assessment, decision-making and public health response. The objective of this study was to identify potential facilitators and barriers for event reporting from the curative sector to the preventive medicine sector in Viet Nam. METHODS: In 2016, we conducted 18 semi-structured, in-depth interviews, as well as nine focus group discussions, with representatives from the curative and preventive medicine sectors in four provinces. We transcribed the interviews and focus group discussions and used thematic analysis to identify the factors that appeared to affect public health event reporting. RESULTS: We identified five major themes. First, the lack of a legal framework to guide reporting meant hospital staff relied on internal procedures that varied from hospital to hospital, which sometimes delayed reporting. Second, participants stated the importance of an enabling environment, such as leadership support and having focal points for reporting, to facilitate reporting. Third, participants described the potential benefits of reporting, such as support provided during outbreaks and information received about local outbreaks. Fourth, some challenges prohibited timely reporting such as not perceiving reporting to be the task of the curative sector and hesitancy to report without laboratory confirmation. Finally, limited resources and specialist capacities in remote areas hindered timely detection and reporting of unusual events. DISCUSSION: This study identified potential opportunities to promote the detection and reporting of unusual events from health-care workers to the public health sector, and thus to improve the overall health security system in Viet Nam.The influenza virus is a respiratory pathogen that is transmitted through respiratory droplets. 1 During seasonal influenza epidemics, high attack rates cause a significant public health burden. 2 The infection is usually self-limited in young adults but can lead to severe infections in people in high-risk groups, including elderly people (> 65 years old), pregnant women, children aged 6-59 months and adults with chronic illnesses. 3.