Contribution to WHO COVID-19 SPRP for Iran, the occupied Palestinian territory, Africa Region, and Eastern Mediterranean Region
The overall goal of country COVID-19 preparedness and response plans is to support health systems to accelerate capacity to prevent, detect and respond to any potential COVID-19 outbreak. Country preparedness and response plans outline key public health measures to be implemented in collaboration with key stakeholders and partners and also help to coordinate and streamline work with partners and mobilize the needed resources for implementing the plans.
Some key expected results of the overall programme include:
• Strengthened regional and country level coordination;
• Enhanced risk communication and community engagement (RCCE);
• Enhanced event, indicator and ILI/SARI surveillance;
• Strengthened capacities at major points of entry (PoE) for identification of symptomatic individuals,
• Reinforced capacity for Rapid response teams (RRTs) at regional, sub regional, national and subnational level,
• Strengthened capacity of national laboratory systems to detect SARS-CoV-2 (NLS),
• Improved infection prevention and control (IPC) in health care settings and in communities,
• Established capacity for case management of COVID-19 cases and ensure continuity of essential health services (CM),
• Strengthened logistics, procurement and supply chain management systems
• Regular monitoring and evaluation of countries’ preparedness and readiness capacity using Key Performance Indicators-KPIs,
• Accelerated priority research and innovation
Specifically for the ADA contribution expected results are:
• 48,000 lab tests to diagnose COVID-19 conducted
• Isolation units of 5 hospitals strengthened
• Train 400 health workers on case definition, management, IPC
• Ensure one hospital can treat COVID-19 cases, focussing on intensive care unit capacity for the most severe cases
• Ensure that at least 200,000 Palestinians are reached with public health advice to prevent spread of COVID-19
The Austrian contribution of €1,000,000 will contribute to the expansion of the response to Covid-19 in the WHO African Region: namely in the following areas: risk communication/social mobilization in the context of Africa, strengthening of countries' surveillance and strategic Health Information for action (i.e., scaling up electronic tools for data collection.)
Risk Communication and community Engagement
• Enhancement of community engagement activities through Community Engagement Taskforces, community-level Health Clubs, and community-led implementation of on prevention and control efforts, namely in Sao Tome and Principe, Comoros, CAR, Mali, Burkina Faso, and Burundi.
• Training of Community Health response teams including traditional healers, women and youths in trust building and communication skills so they are sensitive to, and can adapt to, community contexts when responding in in Sao Tome and Principe, Comoros, CAR, Mali, Burkina Faso, and Burundi.
• Increase standard and administrative precautions awareness at health facility level
• Strengthen triage activities at healthcare facility level
Surveillance and strategic Health Information for action:
• Support the deployment and use of electronic tools through training, purchase of mobile phones, funding of mobile data and remote technical assistant of the regional office.
• Recruit experienced health information officers to support surveillance and information management activities.
Case finding, contract tracing and management
• Trained rapid response teams in six priority countries on case finding, contact tracing and management.
• Developed contact-tracing guideline and translate it to Arabic.
• Support at least two countries to implement the WHO early investigation protocols.
• At least six countries shared the COVID data through influenza surveillance platforms.
• Developed case management protocol and translate it to Arabic.
• At least two countries in the region supported to join the WHO SOLIDARITY clinical trial
Infection Prevention and Control
• Implemented COVID-19 IPC precautions and measures as per WHO guidelines
The programme targets the entire country (82 million people) with an emphasis on high-risk provinces (cities).The local population in all affected and at risk provinces will benefit, directly if subject to contamination, indirectly if belonging to communities where COVID cases are identified, from this action. About 8.7 million people will benefit from the Austrian contribution.
occupied Palestinian territories (oPt):
200,000 to receive information and services financed by the Austrian contribution.
Africa Region (AFRO):
WHO targets populations in all countries in the AFRO region. Austria’s contribution is expected to be used for activities specifically in Sao Tome and Principe, Comoros, CAR, Mali, Burkina Faso, and Burundi. In total there will be about 20 million people benefiting from ADA funds.
Eastern Mediterranean Region (EMRO):
WHO targets populations in all countries in the EMRO region.
COORDINATION, PLANNING, AND MONITORING: Support regional / national preparedness and response through multi-sectoral, multi-partner coordination mechanisms and surge capacity and deployments to provide technical support to coordinate and implement operational plans
RISK COMMUNICATION & PUBLIC ENGAGEMENT: Public information campaigns on preventive measures against the coronavirus need to be stepped up. There is a need to intensify the risk communication efforts for the public on measures to prevent and protect against the spread of the disease particularly through simple behavioural change. WHO intends to strengthen country-level capacity to develop and implement strategies to engage with at-risk or affected population, including through their influencers (e.g., community leaders, religious leaders, health workers, traditional healers, etc.) and other existing social networks.
SURVEILLANCE: Implement COVID-19 surveillance using existing disease and syndromic surveillance systems and hospital-based surveillance. The main objectives will focus on rapid detection of cases, comprehensive and rapid contact tracing, and case identification.
POINTS OF ENTRY: Support implementation, evaluation and improvement of points of entry public health emergency response plan
LABORATORY TESTING CAPACITY: Accurate detection and diagnosis is as important as clinical rescue to control the COVID-19 epidemic - a crucial tool for clinical diagnosis of infections, from assessing initial symptoms to release from isolation, recovery, and discharge. WHO, as part of strengthening the laboratory surge capacity also intends to enhance the national laboratory capacity to detect the virus through the following activities:
• establish and sustain laboratory confirmatory capacity for COVID-19;
• adapt and disseminate standard operating procedures for bio hazardous specimen collection, management and transportation for COVID-19 diagnostic testing;
• provide support to strengthen ensure availability of testing kits and other essential supplies at all national reference laboratories;
• establish access to a designated international COVID-19 reference laboratories; coordinate with and build capacity for the collection, storage and transportation of samples;
• operationalize a web based platform to integrate lab result information with epidemiologic and clinical data
CLINICAL CASE MANAGEMENT:Treat patients and ready hospitals for surge; develop triage procedures. Promote self-initiated isolation of people with mild respiratory symptoms to reduce the burden on health system. WHO, through this project, will assist in the strengthening of triage and isolation capacity in referral hospital(s) in high-risk areas by enhancing the capacity of isolation units in priority referral hospitals. In addition, WHO will share up-to-date WHO IPC guidance and support to ensure health care service continuity (medicines, supplies and medical devices) and enable implementation of surge plans, including establishment of an internal referral system. Moreover, through this project, WHO will provide case management technical expertise and guidance that would be further cascaded towards to the health facilities and public health staff at district level. The activity will also support training for health clinical management and care of the COVID-19 cases.
EXPANSION OF THE HEALTH CARE FACILITIES NETWORK: WHO will support the expansion of the health care facilities network to ensure continuity of adequate, equal and essential health services, including addressing crucial measures regarding clinical management (medicines, supplies and medical devices)
EARLY CASE DETECTION AND CONTACT TRACING:Enhance active case finding, contact tracing and monitoring; quarantine of contacts and isolation of cases;
INFECTION PREVENTION AND CONTROL (IPC): WHO aims to procure and distribute personal protective equipment (PPE) such as gloves, gowns, respiratory protection, and eye protection for all health care providers who enter the room of a patient with known or suspected COVID-19.WHO will also provide the necessary technical support on correct use, proper putting on and taking off, and disposal of used PPE. Moreover, WHO intends to procure and distribute PPE supplies to manage suspected, probable and confirmed cases from admission to discharge. The PPEs and the disinfectants will be distributed and delivered to referral hospitals. Train staff in IPC and clinical management specifically for COVID-19. Prepare for surge in health care facility needs, including respiratory support and PP.
OPERATIONAL SUPPORT AND LOGISTICS: support COVID-19 supply chain management and provision of essential supplies to control and response to outbreak
PRIORITY RESEARCH AND INOVATION: support priority research and innovation
In the Islamic Republic of Iran, as at 31 March 2020, the Iran Ministry of Health and Medical Education (MOHME) has recorded a total of 44,606laboratory-confirmed cases of Covid-19, with 3,000 deaths. Overall, all provinces have been affected by the Covid- 19 outbreak. Epidemiological evidence shows that COVID-19 can be transmitted from one individual to another. The rapid increase in the number of confirmed cases highlights the importance of disease-control and response activities in the country.
occupied Palestinian territory (oPt)
Since the first cases were reported globally, WHO office in the occupied Palestinian territory (oPt) and its partners have been working with the Palestinian Authority’s Ministry of Health (MoH) to prepare for and respond to COVID-19.
The WHO supported the MoH with technical guidance on COVID-19, with capacity building of Palestinian hospital health services staff as well as doctors and health workers, by delivering essential laboratory supplies including COVID-19 testing kits to the public health laboratories in the West Bank and Gaza to ensure that they are able to test for COVID-19, and by delivering personal protective equipment (PPE) kit items.
On 05 March 2020, the Ministry of Health confirmed its first 7 cases of COVID-19 to WHO. They are thought to be related to contact with a group of Greek tourists who visited the area in late February and tested positive for Coronavirus upon their return to Greece. As at 31 March, the MoH has reported an additional 110 confirmed cases of COVID-19, bringing total to 117 cases and 1 confirmed death.
Africa Region (AFRO)
The WHO African region is experiencing a COVID-19 epidemic since 26 February 2020. As at 31 March 2020, a total of 3,833 confirmed COVID-19 cases have been reported across 41 countries/terriroties in the WHO African Region. Following the emergence of cases in the region, WHO AFRO has shifted its focus from readiness to response. Although WHO AFRO is supporting countries to strengthen their readiness, some gaps remain around coordination, information management, risk communication, case management and infection prevention and control. WHO is working closely with national authorities and partners to close these gaps.
The need for risk communication in outbreaks has been identified as critical.
The African Region adopted a Risk Communication and Community Engagement (RCCE) package which includes five modules: Community engagement; Risk Communication systems; Public Communication; internal and external partner communication; and management of risky behaviors and rumors. These modules have been pretested in Rwanda, Nigeria, Senegal, Burundi and Cote D’Ivoire. In addition, there is also a need to highlight evidence that RCCE works through use of available tools such as Community Tool Box, Africa Health Action Toolkit and Community Engagement Framework.
Development of IEC materials electronic and print for intensification of public awareness remain imperative and needs to be scaled up. This will be accompanied by continuing education carried out by key influential figures at community level to minimize fear, panic and build trust and encourage individual, families and wider communities to take precautionary measures on prevention and control of COVID 19.
Eastern Mediterranean Region (EMRO)
Many countries in the WHO Eastern Mediterranean Region are directly or indirectly experiencing complex emergencies; compounded by fragile health systems, weak disease surveillance, poor response capacities and a suboptimal level of public health preparedness. These factors are likely to increase the emergence and rapid transmission of high-threat pathogen diseases. Furthermore, major religious mass gathering events take place in the Region, which pose unique risks to public health security. In 2019, outbreaks of chikungunya, dengue, diphtheria, cholera, Crimean-Congo haemorrhagic fever, MERS-CoV, Rift Valley fever and extensively drug-resistant typhoid occurred in many countries of the Region.
Detecting and responding to emerging infectious diseases have become important public health priorities for the Eastern Mediterranean Region. Although the majority of the countries in the Region have influenza and other respiratory disease surveillance systems through an extended network of sentinel sites, overall capacity is inadequate to rapidly detect and respond to the potential importation or local transmission of COVID-2019 virus. To date, 20 out of the 22 countries in the Region have functioning reference laboratories with the ability to detect and confirm seasonal influenza virus, MERS-CoV and other high threat pathogens. However, these national reference laboratories still require additional support to improve diagnostic capacity, biosecurity and biosafety, and specimens transportation. Most of the national influenza laboratories are active members of the Global Influenza Surveillance and Response System (GISRS), whereby information, testing kits and other relevant components are shared. In the past, some countries in the Region have used the existing influenza surveillance system to detect and monitor emerging infectious diseases. For example, the system was sensitive enough to detect the emerging avian influenza virus in 2006 and MERS-CoV in 2012. Nonetheless, countries with complex emergencies and weak health systems are in need of additional support to enhance epidemiological and virological surveillance for emerging infectious diseases.
As at 31 March, total 53,734 cases and 3,099 deaths reported to date from 21 countries, states and territories in the EMRO region. Only Yemen has not yet reported a case.