World Health Organization (WHO)

1 Leadership and risk governance for health: 

WHO continues to promote, advocate health priorities for the disaster risk reduction. From prevention preparedness to response and recovery WHO engages with its Member States and partners to ensure the implementation of DRR towards resilience.

In 2024, a resolution on strengthening health emergency preparedness for disasters from natural hazards was adopted during WHA 77. Amongst others, it emphasizes age, gender responsiveness and other inclusive actions and prioritizes the integration of health into multi-sectorial, whole-of-society coordination mechanisms before, during and after an emergency or disaster resulting from natural hazards. Link: https://apps.who.int/gb/ebwha/pdf_files/WHA77/A77_ACONF4-en.pdf

WHO has been actively engaged in DRR working group under G20 led by Brazil. Out of five priorities, financing disaster risk reduction was committed by the world leaders to fast track the implementation of Sendai Framework for Disaster Risk Reduction. WHO commits to support the initiative and working closely with the countries to transforms the commitment into actions in health.

WHO supported the colloquium of European Countries hosted by European Parliament in Brussels, Belgium to strengthen the disaster preparedness of the region based on WHO Health Emergency Preparedness and Response Framework. The colloquium was organized by ASPHER, WADEM and ECDM inviting the key public health institutions and Accademia of the European countries. WHO provided one of the lead roles at this colloquium. The European Parliament, Brussels colloquium created and served as a first pivotal platform to address the complex challenges posed by current crises and future threats and offer the opportunity for individual and organizational learning needs analyses. Drawing from the broad constituencies of the three sponsoring organizations this inaugural convening established an augmentative framework in support of collective and individual institution's public health curricula development. This colloquium complements and builds on the WHO and ASPHER 2020 curriculum competency frameworks and supports the development and release of the updated 2024 framework. This alliance building initiative is constructed organically out of necessity within and across our many sectors. By synthesizing knowledge and expertise, the outcomes from this colloquium at the European Parliament will pave the way for transformative public health training and education platforms. In this way the public health professionals of the future will be better prepared to navigate the intricate landscape and unique challenges of the 21st Century, ultimately contributing to resilient societies in Europe and beyond.

WHO and World Meteorological Organization (WMO) with funding from Wellcome Trust, collaborated to support Member States address the health impacts of ENSO, strengthen seasonal forecasting and enhance collaboration and coordination between health and meteorological sectors. Through the initiative, WHO became part of the Inter Agency Standing Committee ENSO Analysis Cell and contributed to several reports of the UN Climate Crisis Coordinator for the El Niño / La Niña Response published. Based on the WMO ENSO and climate outlook and the results of the scoping review, WHO contributed to a first analysis update for the April to June period, and another update for the period July to October with estimated risks on health outcomes for East Africa, Southern Africa, South Asia and Latin America and the Caribbean. In collaboration with WHO regional offices, 3 regional webinars (South America, South-East Asia and Africa), were held August-September to describe the impact of ENSO on health and articulate potential anticipatory actions for risk mitigation. The webinars aimed to foster peer learning and support countries in their planning and capacity-building efforts.

WHO SEARO is set to engage CDRI in the World Health Summit 2025, where a dedicated session on urban health emergency preparedness will delve into infrastructure resilience as a core theme. This platform will foster strategic discussions among sister UN agencies such as UNESCAP, regional bodies like National Disaster Management Agencies (NDMAs), development partners including the Asian Development Bank (ADB), and elected representatives such as mayors, to explore synergies for integrating disaster-resilient health infrastructure within urban planning. This initiative underscores WHO SEARO's commitment to advancing risk-informed health systems, reinforcing hospital and urban resilience, and fostering multi-sectoral collaboration in disaster risk reduction, in line with the Sendai Framework's priority areas.

WHO WPRO scaled up its implementation of the Asia Pacific Health Security Action Framework (APHSAF). Endorsed by Member States in 2023, APHSAF is designed to engage multisectoral actors in health security and to reflect the complex nature of public health emergencies. The Framework presents six interconnected, multisectoral domains of work that form a comprehensive, multi-hazard health security system with emphasis on the One Health approach.

WHO, in collaboration with Member States, continues to scale-up the implementation of APHSAF. As with previous strategies, this Framework provides an important collaborative platform for Member States, WHO, partners and others to work together in an efficient, pragmatic, flexible and forward-looking way that supports collective action for health security and health system strengthening.

To support implementation of the Framework, WHO has established a community of practice that brings together Member States to discuss key health security topics and foster learning.

WHO WPRO scaled up its implementation of the Asia Pacific Health Security Action Framework (APHSAF). Endorsed by Member States in 2023, APHSAF is designed to engage multisectoral actors in health security and to reflect the complex nature of public health emergencies. The Framework presents six interconnected, multisectoral domains of work that form a comprehensive, multi-hazard health security system with emphasis on the One Health approach.

In 2024 WHO consolidated its action to lead and contribute to the Hazards Information Profile, WHO joined the HIP Task Force along with International Science Council, UNDRR and UK Health Security Agency.

WHO, in collaboration with Member States, continues to scale-up the implementation of APHSAF. As with previous strategies, this Framework provides an important collaborative platform for Member States, WHO, partners and others to work together in an efficient, pragmatic, flexible and forward-looking way that supports collective action for health security and health system strengthening.

WHO attended the UN Senior Leadership Group meeting that took place on 12 July. Dr Ryan reiterated WHO's commitment to Sendai Framework for Disaster Risk Reduction implementation in health and as well highlighted WHO's stronger engagement in disaster response and climate crisis while continuing the policy level work on DRR.

2 Building resilient health facilities and hospitals:

Throughout the year the need for preparing the hospitals remain as a priority in all six regions of WHO. WHO continued to provide support to the regions for making health facilities safer and resilient using evidence base approach. Throughout 2024 WHO continued to promote, provide technical support and build and strengthened partnership to support its Member States for making the health facilities and hospitals safer and resilient and better prepared to ensure continuity of service in any emergency and disasters. This includes advocacy, developing technical guidance, training workforce and as well generating resources for the maintenance of supply chain through a whole of society and whole of governance approach.

In Europe and EMRO regions trainings were conducted on safe and resilient health facilities initiative to enhance regional capacity to better support the countries based on WHO Health Emergency and Disaster Risk Management Framework.

WHO SEARO, in partnership with the Coalition for Disaster Resilient Infrastructure (CDRI), mobilized technical resources in 2024 to support Nepal in conducting safety assessments for key hospitals, strengthening their resilience to health emergencies and disasters.

Rollout of the updated Virtual Course and implementation Hospital Safety Index in 12 countries, evaluating over 120 hospitals for structural, functional, and organizational safety, with new components on climate risk and inclusive practices

To support implementation of the Framework, WHO has established a community of practice that brings together Member States to discuss key health security topics and foster learning.

3 Understanding risks for health system resilience:

Creating all-hazards health risk profiles and integrating them into emergency preparedness and response plans is crucial for enhancing health emergency readiness through a risk-based approach. The WHO Health Emergency and Disaster Risk Management (HEDRM) Framework serves as a guiding strategy, enabling the identification and management of risks from diverse hazards. This framework emphasizes the importance of multisectoral collaboration and coordination, ensuring a comprehensive and adaptable approach to emergency management at the country level.

In 2024, 21 countries conducted all-hazards strategic risk assessment using WHO's Strategic Toolkit for Assessing Risks (STAR). This brings the number of STAR workshop completed to date to 172 workshops in 102 countries. As a flexible methodology, STAR has been adapted for strategic risk assessment in multiple country contexts, including districts/community, hospital and distinct hazard-focused (climate change, infectious hazards) risk assessments. In 2024, Uganda conducted both district-level strategic risk assessment exercises and a city level (Kampala) exercise in the context of urban preparedness for emergencies and disasters. WHO provided both remote and in-person support to facilitate the multi-sectorial STAR workshops, resulting in the development of all-hazards country risk profiles. Countries are increasingly using the all-hazards country risk profile to trigger early warning and anticipatory actions for emergency management, such as prepositioning supplies in hazard-prone areas, developing/updating Emergency Medical Teams (EMT) deployment protocols, linking the seasonal calendar to risk alert models etc. The country risk profile is also informing the development of NAPHS, multi-hazard response plans and contingency plans for specific risk in some countries.

During 2024, risk profiling was initiated in Jordan (both National and Subnational levels for Aqaba area), Libya, Qatar and virtually for Whole of Syria. A virtual training on using the Strategic Tool for Assessing Risks (STAR) was conducted for Somalia. Based on the priority risks, Whole of Syria developed all Hazards preparedness and response plan based on the updated risk profile while the process was initiated in Yemen and Qatar.

The Western Pacific Region continued to scale-up the developing of country emergency risk profiling exercises using the Strategic Toolkit for Assessing Risks through multi-sectoral approach to inform prevention, preparedness and response actions. In 2024, six countries have developed emergency risk profiles at the national, provincial and city levels to inform contingency planning, risk communication strategies, simulation exercises, operational actions across the sectors, and development of National Action Plans for Health Security (NAPHS).

The Government of the Kingdom of Tonga, for example, convened 12 sectors to assess risks and potential impact in the country with joint facilitation by the Ministry of Health, the National Disaster Risk Management Office and WHO. This aligns with the Sendai Framework's focus on improving disaster risk management at all levels.

WHO in Europe continued to enhance health security and bolster emergency prevention, preparedness, and response capacities for all hazards through technical cooperation with member states to develop and implement National Strategic Risk Assessments (SRA), contributing directly to the Sendai Framework's priority of understanding disaster risk and strengthening disaster risk governance. For example, in Georgia, WHO supported the implementation of a National SRA to identify, describe, and rank risks, and develop a country risk profile, whereby supporting the Sendai Framework's goal of enhancing disaster preparedness for effective response and to "Build Back Better" in recovery, rehabilitation, and reconstruction. The results of the SRA in Georgia will ensure that the National Action Plan for Health Security (NAPHS) and National Health Emergency Response Operations Plans (NHEROP), are based on comprehensive risk assessments. focus on improving disaster risk management at all levels.

4 Evaluation and monitoring of health system resilience:

A Joint External Evaluation (JEE) is a voluntary, collaborative, multisectoral process to assess country capacities to prevent, detect and rapidly respond to public health risks whether occurring naturally or due to deliberate or accidental events. The JEE helps countries identify the most critical gaps within their human and animal health systems to prioritize opportunities for enhanced preparedness and response. The e-JEE | Electronic Joint External Evaluation Platform is a digital tool developed by the World Health Organization (WHO) to facilitate the implementation of the Joint External Evaluation process. JEE evaluates the risk informed capacities in countries for health emergencies with a multisectoral approach. In 2024, 19 countries conducted the assessment.

Implement the international health regulations' activities and initiatives addressing DRR in a wholistic and comprehensive approach by integrating systematic evaluations, multi-sectoral engagement and sustainable financing mechanisms in the EMR countries. The JEE conducted in Iraq, Pakistan, Qatar, Syria, and Yemen, the After-Action Review for the floods in Pakistan and the FIFA events in Qatar, and Intra-Action Review for the response to the war in Gaza have provided valuable insights, enabling targeted interventions to address critical gaps. The IHR capacity-building mission in Afghanistan strengthened national M&E mechanisms, setting a precedent for improved health security assessments across the region. Eight simulation exercises on IHR, Cholera, MERS-CoV, and radio nuclear emergencies were successfully conducted for eight countries in the region. UHPR expanded the scope to strengthen DRR, fostering multi-sectoral engagement in health security in Iraq. The Pandemic Fund has been instrumental in mobilizing resources for strengthening preparedness and response capacities, with successful seven single country proposals alongside regional proposal approved for mpox including countries. Meanwhile, the 7-1-7 early action review mechanism has been leveraged to accelerate outbreak detection and response, ensuring timely containment measures that minimize public health impacts, two countries signed the alliance.

5 Research, innovation and learning - a community of practice for health in DRR:

WHO Thematic Platform for Health EDRM Research Network (Health EDRM RN) is a global expert network aiming to share up-to-date Health EDRM knowledge and evidence, and facilitate international research collaboration, since 2018. The global Health EDRM research priorities have been updated at the Core Group Meeting of the Health EDRM RN, followed by the research funding by WHO Kobe Centre (WKC). In 2021, involving 164 experts from 30 countries of the network, the first WHO Guidance on Health EDRM Research Methods was developed in 2021 by WKC. Since then global research capacity building initiatives have been implemented in collaboration with the HQ and all Regional Office DRR focal points.

In 2024, a joint workshop on Health EDRM research capacity building was organized by WKC and WHO EURO convening 10 Member States of Europe Region. These Health EDRM research initiatives are highlighted at a special session at the WHO Emergency Medical Team Global Meeting 2024 held in Abu Dhabi bringing disaster risk reduction actions closer to humanitarian response towards peace building and resilience.

Following the publication of the second edition of the WHO Guidance on Research Methods for Health EDRM an interactive training course to learn Health EDRM research methods will be developed with WHO Academy to support the operational research on disasters in the countries to enhance evidence-based action for risk reduction. In collaboration with WHO Kobe center and EURO WHE, the first regional research capacity development workshop was held in Oxford, UK to set up research priorities for all hazards emergency and disaster risk management including pandemic by providing knowledge on recent developments in Health EDRM research and evidence, including case studies that inform implementation and operation of disaster risk reduction (DRR)/Health EDRM policies and programmes.

Innovation was a priority throughout the regions. In Americas implementation of the INGRID-H Methodology (Inclusion in Risk Management in Hospitals) across 339 hospitals in 11 countries, with 295 interventions and 1,784 professionals trained on gender, age, and disability-sensitive planning.

Policies and Programmes in DRR

The World Health Assembly (WHA), the supreme governing body of WHO decided at its 69th Session to welcome the progress made in the development of the new Health Emergencies Programme, the elaboration of an implementation plan and timeline for the new Programme, and the establishment of the Emergencies Oversight and Advisory Committee (WHA69.9).

The WHA adopted WHA Resolution (WHA64.10) on "Strengthening national and community health emergency and disaster management capacity and resilience of health systems" in May 2011. Resolutions have been passed by every WHO Regional Committee over the past 20 years to reinforce the mandate given to WHO and to strengthen capacities of Member States.

The commitment of Member States and WHO for health emergency and disaster risk management is expressed in various international agreements, frameworks and resolutions for specific hazards and areas of public health, such as the International Health Regulations (2005), mental health, disability, food safety, non-communicable diseases, environmental health, climate change and health, radiation safety and chemical safety.

Strategic Objective 12 for the Organization-wide Programme area Country Health Emergency Preparedness & International Health Regulations in WHO's 2016-2017 biennial global work plan has two outputs that focus on WHO activities to support countries in the areas of health sector risk reduction, including emergency preparedness, and to build institutional capacity in WHO for emergency preparedness and response, as follows: 12.2.1: Monitor, evaluate and objectively assess country core capacities; and 12.2.2: Assist countries to develop national plans and critical core capacities for all-hazard health emergency preparedness, readiness and disaster risk management for health.

In 2016, the 68th Session of the Regional Committee of WHO for the Americas - 55th Directing Council of the Pan American Health Organization - approved the Plan of Action for Disaster Risk Reduction 2016-2021 (CD55/17, Rev. 1), that recognized the 2030 Agenda for Sustainable Development, the Paris Agreement on climate change, the Sendai Framework for Disaster Risk Reduction 2015-2030 and the Agenda for Humanity, as well as the reform of the response capacity of the World Health Organization (WHO) in outbreaks and emergencies.

In 2014, the Regional Committee for the Western Pacific adopted the Western Pacific Regional Framework for Disaster Risk Management for Health (RC65/9).

In 2012, the Regional Committee for Africa adopted a resolution (AFR/RC62/R1) to establish a Disaster Risk Management: A Health Sector Strategy for the African Region in order to institutionalize disaster risk management in the health sector, focusing on preparedness for, and response to emergencies and post-emergency recovery. AFRO has developed and applied several tools for Disaster Risk Management for Health (DRM-H) including guidelines for conducting Capacity Assessments, Vulnerability and Risk Assessment Mapping (VRAM) and a training curriculum framework.

Membership in Key Networks

• UNDRR Senior Leadership Group for Disaster Risk Reduction for Resilience and UNDRR Inter-Agency Group
• UNDRR Global and Regional Platforms and equivalent bodies (Arab States, Africa, Americas, Asia, Europe, Pacific)
• UNDRR Science and Technical Advisory Group
• Capacity for Disaster Reduction Initiative (CADRI)
• Thematic platform on health emergency and disaster risk management
• Interagency Standing Committee and subsidiary bodies
• Global Health Cluster
• International Programme on Chemical Safety
• Emergency Medical Teams Initiative
• Global Outbreak Alert and Response Network (GOARN)
• Global Health Security Agenda (observer)
• WHO's Radiation Emergency Medical Preparedness and Assistance Network (REMPAN)
• Global Framework for Climate Services

National Counterpart

Ministry of health

Disaster Reduction Focal Point(s)

• Disaster Risk Management Focal Point, Country Health Emergency Preparedness and International Health Regulations Department, WHO, Geneva (WHE/CPI)
• Country Health Emergency Preparedness and International Health Regulations, WHO Regional Office for Africa (AFRO), Brazzaville, Congo
• Country Health Emergency Preparedness and International Health Regulations, WHO Regional Office for Europe (EURO), Copenhagen, Denmark
• Country Health Emergency Preparedness and International Health Regulations, WHO Regional Office for the Eastern Mediterranean (EMRO), Cairo, Egypt
• Country Health Emergency Preparedness and International Health Regulations, WHO Regional Office for South-east Asia (SEARO), New Delhi, India
• Country Health Emergency Preparedness and International Health Regulations, WHO Regional Office for the Western Pacific (WPRO), Manila, The Philippines

Websites

• http://www.who.int/hac/techguidance/preparedness/en/
• http://www.afro.who.int/
• http://www.emro.who.int/entity/eha/index.html
• http://www.euro.who.int/en/health-topics/emergencies/disaster-preparedness-and-response
• http://www.paho.org/disasters
• http://www.searo.who.int/topics/emergencies/en/
• http://www.wpro.who.int/emergencies_disasters/en/

Other activities

Understanding risk (Sendai Framework Priority 1)

WHO provides guidance and assistance to countries on assessing risks to health and health systems using analyses of hazards, vulnerabilities and capacities and provides global reports on country capacities for health emergency and disaster risk management. WHO coordinates the implementation of four components of the International Health Regulations (2005) Monitoring and Evaluation Framework (IHR MEF), i.e., Annual Reporting, Simulation Exercises, After Action Reviews and Joint External Evaluations. WHO plays an active role in global surveillance and monitoring of potential threats to health, particularly from biological, natural and technological (such as chemical and radiological hazards) sources to enable early detection and warning to prompt early action by the public, health workers and other sectors. WHO has assisted countries with the application of tools for monitoring and assessing capacities, which serve as the basis for capacity development plans.

Strengthening disaster risk governance to manage disaster risk (Priority 2)

WHO provides technical guidance and support to Ministries of Health for strengthening all-hazards health and multi-sectoral disaster risk management policies, strategies and legislation. At global level, WHO is facilitating the development of an all-hazards framework on emergency and disaster risk management for health , which describes key principles and the capacities which countries should have in place for managing the public health risks of emergencies. It also assists Ministries of Health in fulfilling their role in promoting whole-of-society action asserting that no one is left behind (e.g., children, older people, people with disabilities, etc.) and describes the roles and responsibilities of actors in health and other sectors which contribute to positive health outcomes.

Investing in disaster risk reduction for resilience (Priority 3)

At the core of investing in disaster risk reduction for health resilience are measures to reduce poverty and inequities by addressing the social determinants of health and strengthening health systems aimed at improving the underlying health status of people and managing the risks associated with natural hazards, inclusive of outbreaks and the health effects of climate change as well as human-made hazards. WHO is working with health systems colleagues, Ministries of Health and technical departments to integrate health emergency risk management in all aspects of health systems, including national health plans, UN Development Assistance Frameworks and technical areas. Technical assistance is also designed to strengthen the capacity of health systems to deliver safe and quality health services before, during and after emergencies, for example, in trauma care, mental health, environmental health, disease surveillance and response, non-communicable diseases and nutrition. WHO provides support to countries in making hospitals safer and better prepared for emergencies and disasters through the Safe Hospitals Initiative. Guidance, training and tools are available, to assess the safety and preparedness of existing health facilities (using the Hospital Safety Index), and for developing new hospitals with a sufficient level of protection to remain being functional at maximum capacity and deliver uninterrupted health services in emergency situations. WHO also provides guidance on the protection of other vital infrastructure, and facilities that have the potential to generate risks to public health, such as water and sanitation systems and chemical facilities, and that should apply risk management measures.

WHO works with Member States, academia and other learning institutions in all Regions on the development and delivery of regional and national learning programmes and technical guidance to strengthen the knowledge, skills and attitudes of professionals in health and other sectors for managing the health risks and consequences of disasters. Risk communication for health workers, households and communities at risk also promotes healthy behaviours (e.g., keeping survival kits, simulating drills and evacuation plans) to reduce risks and prepare for emergencies and disasters.

Enhancing disaster preparedness for effective response and to "Build Back Better" in recovery, rehabilitation and reconstruction (Priority 4)

WHO provides support for emergency and disaster preparedness including the operational readiness of Member States and WHO. This support includes all-hazards response planning, contingency planning, training, pre-positioning of health supplies, development of surge capacity (including the Emergency Medical Teams and the Global Outbreak Alert and Response Network), and exercises for health care professionals and other emergency service personnel. WHO supports Member States and partners in the development and implementation of plans for health systems recovery including measures to reduce risks of future disasters through application of best practices and lessons learnt documented from previous disasters.