Region
Eastern Mediterranean Region
Country
Iraq
Status
Assessment Date
P.3.1 National IHR Focal Point functions
3
P.6.1 Surveillance of foodborne diseases and contamination
2
P.5.2 Response to zoonotic diseases
2
P.5.1 Surveillance of zoonotic diseases
2
P.4.2 Surveillance of AMR
1
P.4.1 Multisectoral coordination on AMR
3
P.3.4 Antimicrobial stewardship activities
1
P.3.3 Strategic planning for IHR, preparedness or health security
2
P.3.2 Multisectoral coordination mechanisms
2
P.2.1 Financial resources for IHR implementation
2
P.7.1 Whole-of-government biosafety and biosecurity system is in place for human, animal and agriculture facilities
3
P.1.3 A financing mechanism and funds are available for timely response to public health emergencies
1
P.1.2 Gender equity and equality in health emergencies
1
P.1.1 Legal instruments
2
D.4.4 FETP or other applied epidemiology training programme in place
4
D.4.3 In-service trainings are available
3
D.4.2 Human resources are available to effectively implement IHR
2
D.4.1 An up-to-date multi-sectoral workforce strategy is in place
2
P.6.2 Response and management of food safety emergencies
3
P.7.2 Biosafety and biosecurity training and practices in all relevant sectors (including human, animal and agriculture)
2
D.2.2 Event verification and investigation
2
Recommendation P6
Endorse and implement the national regulatory framework for biosafety and biosecurity.
Provide (refresher) trainings in biosafety and biosecurity for laboratory staff in all sectors, including field staff.
Areas of training to include attention to risk assessment and managing highthreat pathogens.
Continue to maintain an updated inventory of dangerous pathogens and toxins.
Recommendation Re1
Update the national plan of action for responding to radiation hazards by streamlining and clarifying the role of the health sector in clinical management, surveillance and risk communication In close coordination with CBRN teams, designating specific hospital(s) for clinical management of victims of radiation and radio-nuclear emergencies.
This will require training and supply of needed equipment, antidotes and other medicines.
Improving the coordination between health, environment, industry, science and technology, CBRN and other related sectors responsible for management of radiation and radio-nuclear events in line with the multi-hazard national public health emergency preparedness and response plan to meet IHR core capacity requirements.
Improving the technical capacity of existing surveillance, laboratory and response teams, and networking with neighbouring countries for radiation and radio-nuclear event detection, reporting and response Updating the radioactive waste management mechanisms and standard operating procedures.
Recommendation R5
Develop a multisectoral and multi-hazard risk communication strategy and action plan that is integrated with national plans for public health emergencies.
Establish a multisectoral and multi-disciplinary technical advisory board to guide evidencebased development and implementation of risk communication.
Review and upgrade the structure and functions of the risk communication unit at MoH to better fulfil its mandate across all IHR-bound sectors.
Formalize the existing risk communication coordination mechanism among relevant ministry's entities and stakeholders.
Establish a network and build the risk communication capacity of existing communication staff at national and provincial level.
Develop and formalize a system for rumour and misinformation tracking and response.
Recommendation R4
Ensure fast-track approval procedures are in place for sending and receiving medical countermeasures with allocated emergency funding.
Develop protocol/guidance/procedures for active participation in Global Outbreak Alert and Response Network (GOARN) and development of Emergency Medical Teams (EMTs).
Develop and disseminate policies and protocols for sending and receiving personnel to other organizations/agencies in country and internationally to respond to public health events.
Develop and provide training on case management guidelines for cases contaminated with chemical and radiation contamination.
Recommendation R2
Establish a national poison registry.
In view of the ongoing evaluation commissioned by H.E.
Minister of Health and Environment, consider establishing a unique national emergency call number.
Review and update standard terms of reference and operating principles while upgrading the EOC and consider joining the Public Health Emergency Operations Centre Network (EOC-NET).
Establish routine after-outbreak or after-action reviews related to all public health events and document lessons learnt with outcomes reflected in updated response plans
Recommendation R1
Accelerate ongoing work for Sendai Framework for Disaster Risk Reduction by conducting national multi-hazard strategic risk assessment to prioritize public health threats, from all sources, and identify resource requirements for response activities.
Map the resulting resource requirements for public health and identify critical information requirements (correlated to nationally notifiable diseases) for the national Public Health Emergency Operations Centre (PHEOC) within the National Medical Operations Centre (NMOC) to monitor on a daily basis.
Conduct a needs assessment for training needs (including material, equipment and infrastructure).
Continue to engage the interministerial, intersectoral operations-level working group, including development partners, in reviewing the national public health response plan that reflects a whole-of government approach to responding to priority public health threats.
Recommendation POE1
Using the risk assessment approach, review and update the list of designated PoEs.
Develop a plan for IHR implementation for designated PoE(s).
Conduct cost-effectiveness analysis for goods storage sites (i.e.private versus governmental) to recommend reactivation of public storage sites.
Ensure MoH is part of the ‘single window’ system for trade facilitation.
Establish/integrate vector surveillance and control at designated PoE(s).
Develop a training plan on IHR-related requirements for staff at PoE(s).
Over the long term, develop a plan to renovate infrastructure.
Recommendation P7
Conduct an extensive mapping of potential new vaccine delivery opportunities to support the ongoing programme immunization network wherever needed to improve physical access.
In order to prevent further vaccine stock-outs at both central and peripheral levels, use the opportunity of the support being provided by United Nations Children’s Fund (UNICEF)/ Eastern Mediterranean Public Health Network (EMPHNET) to undertake a comprehensive assessment of the vaccine procurement system (within the forthcoming effective vaccine management (EVM) assessment), to identify major hurdles and undertake necessary correction measures.
Urgently address the data quality and accuracy problem through conducting a national coverage survey to get a better indication of the country achievement; and a data quality self-assessment (DQS) to identify weaknesses and improve the programme data management system.
Expand the ongoing microplanning improvement process (capacity-building and ‘micro-plans’ development) to remaining districts and governorates, while improving mapping of low immunity population groups and areas and microplans updating accordingly.
Update the national strategy and plans.
Recommendation P5
Finalize the plan of action based on the recommendations of WHO food safety mission.
Establish clear procedures to improve the coordination between food safety actors.
Integrate with the Arab League strategy on health and the environment.
Disseminate International Food Safety Authorities Network (INFOSAN) focal point contact details among actors.
Enhance in-country laboratory capacity for the identification of all foodborne and waterborne contaminants.
R.1.1 Emergency risk assessment and readiness
1
Recommendation p4
Review and update the sector and level representation in the national zoonotic committee to ensure functionality.
Ensure that the development of a ‘One Health’ strategy is among its responsibilities.
Establish a joint surveillance plan with all relevant sectors under the One Health strategy.
Based on assessment of training needs, offer training opportunities to veterinarians such as access to the field epidemiology training programme (FETP).
Expand active surveillance to cover all priority zoonotic diseases.
Identify opportunities to fully apply compensation for diseased livestock.
Upgrade laboratory capacity for the detection of zoonotic diseases.
Review the existing plans for zoonotic disease preparedness and response to cover all priority zoonotic diseases.
Recommendation P3
Approve, fund and implement the national antimicrobial resistance plan.
Develop national AMR surveillance plans in both the human and animal sector.
Update the national infection prevention and control (IPC) guidelines and train health care workers on its implementation.
Add antimicrobials to the national Essential Medicines List (EML), in line with the WHO guidelines.
Monitor appropriate use of antimicrobials in human and animal health and agricultural sectors.
Recommendation P2
Establish an electronic platform for information sharing between IHR-bound sectors re.risk assessment and early interventions.
Review terms of reference (ToR) of existing coordination mechanisms to ensure integration and clarity of roles and responsibilities.
Conduct advocacy and training activities on IHR for IHR-bound sectors, with wide dissemination of related documents.
Advocate for the representation of IHR NFP in high-level coordination structures with clear line of information sharing among the members of the IHR multisectoral committee.
Organize regular drills/simulation exercises to test coordination and communication mechanisms including at points of entry (PoEs).
Recommendation P1
Review Iraq laws to update laws and provide clarity about available powers, designations of responsibility and scope of powers across sectors.
Use available constitutional powers to draft subordinate legislation or regulations, or instructions to provide more detail on: management of communicable disease (including meeting basic data collection requirements); quarantine; and arrangements to align with the National Strategy and Plan for Disaster Risk Reduction.
Utilize executive power to make a regulation or instruction nominating the IHR National Focal Point (NFP) and setting our his or her powers and responsibilities and those of all focal points of affected agencies in support of this function.
In the short to medium term, conduct a review to consider a new Public Health Law to be made by the Parliament to replace the 40-year-old existing law.
R.3.1 Case management
3
R.2.3 Emergency Operations Program
3
R.2.2 Emergency Operations Center Operating Procedures and Plans
3
R.2.1 Public health and security authorities (e.g. law enforcement, border control, customs) are linked during a suspect or
4
R.1.2 Public health emergency operations centre (PHEOC)
2
D.2.3 Analysis and information sharing
3
D.2.1 Early warning surveillance function
2
D.1.4 Effective national diagnostic network
2
R4: Average Capacities Score(%)
40
R5: Average Capacities Score(%)
36
PoE: Average Capacities Score(%)
60
CE: Average Capacities Score(%)
40
RE: Average Capacities Score(%)
60
Recommendation Ce1
Identification of the most hazardous chemicals in Iraq through evidence-based multisectoral health risk assessments.
These chemicals shall be the back bone of the national poisoning surveillance and clinical management systems.
In close coordination with chemical/biological/ radiological
uclear (CBRN) teams, designating specific hospital(s) for clinical management of victims of chemical events.
This will require training and supply of needed equipment, antidotes and other medicines.
Strengthen the capacity of the poison consultation centre for providing information and advisory services 24/7 to all parts of Iraq.
This requires networking with other poison centres at national and regional levels; in order to improve the technical capacity of existing surveillance, laboratories and linkages with response teams.
Improving the coordination between the different sectors responsible for management of chemical events in line with the multi-hazard national public health emergency preparedness and response plan to meet IHR core capacity requirements.
Strengthening the capacities for chemical event detection, reporting and response.
Updating the chemical waste management mechanisms and SOPs.
Recommendation D1
Develop, endorse and implement a national laboratory policy to guide future activities in a coordinated and sustainable manner, and by making optimal use of resources.
Subsequently, to develop, endorse and implement a national laboratory strategic plan to translate the national laboratory policy into strategic objectives.
Develop, endorse and implement national laboratory quality standards that can be adapted and applied to laboratories throughout the country.
Conduct a situational analysis summarizing locations and capacities of key laboratories across the country serving different sectors, including public health, clinical, animal health, food safety, chemical and radiation, to support tier-specific testing strategies and national referral testing.
Test the functionality of the national specimen referral system through conducting a simulation exercise, specifically a ‘skills drill’.
Assessment End Date
Recommendation D3
Develop a policy and standard operating procedures (SOPs) for notification of a potential Public Health Emergency of International Concern (PHEIC) for all reporting entities, and from IHR NFP to WHO.
Improve understanding of WHO, World Organisation for Animal Heath (OIE) and Food and Agriculture Organization of the United Nations (FAO) notification/reporting requirements through multisectoral discussions.
Disseminate information on roles and responsibilities of INFOSAN, World Animal Health Information System (WAHIS), International Atomic Energy Agency (IAEA) and IHR focal point to relevant stakeholders.
Conduct training to enhance knowledge and use of the IHR decision instrument for the notification of potential all-hazard PHEIC.
Review previous event compliance of IHR notification to identify gaps and recommend improvements.
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Recommendation D4
Identify/develop an intersectoral mechanism to coordinate the exercise of developing, implementing, monitoring and sustaining an adequate intersectoral work force to implement IHR at all country administrative levels, through: • -Establishing a sustainable incentive mechanism to attract and sustain a critical number of good quality experts in the various IHR capacities at the various country administrative levels. • -Developing adequate budgeted action plans in all IHR relevant sectors for in-service training to sustain HR capacities, building on available opportunities. • -Accelerating, diversifying and expanding the country EMPHNET-supported FETP programme to laboratory, animal health (vets and animal health technicians) and environmental health in order to better respond to the priorities of various administrative levels more rapidly.
CE.1 Mechanisms are established and functioning for detecting and responding to chemical events or emergencies
2
R.4.1 IPC programmes
3
Recommendation R3
Plan and conduct joint training programmes between public health and security sectors, especially at the governorate levels.
Document the collaboration between public health and security sectors in responding to public health threats.
D.3.1 Multisectoral workforce strategy
2
R.4.2 HCAI surveillance
1
D.3.2 Human resources for implementation of IHR
2
R.4.3 Safe environment in health facilities
2
Recommendation D2
Establish a database to capture all public health events.
Formalize the current event-based surveillance system.
Integrate laboratory information into existing indicators and event-based surveillance.
Enhance in-country laboratory capacity to allow for the prompt identification of national priority pathogens.
R.5.1 RCCE systems for emergencies
2
R.5.2 Risk communication
2
R.5.3 Community engagement
1
R.5.4 Communication Engagement with Affected Communities
2
R.5.5 Dynamic Listening and Rumour Management
2
D.1.1 Specimen referral and transport system
4
D.1.2 Laboratory quality system
4
D.1.3 Laboratory testing capacity modalities
2
RE.2 Enabling environment in place for management of radiological and nuclear emergencies
3
RE.1 Mechanisms are established and functioning for detecting and responding to radiological and nuclear emergencies.
3
PoE.1 Core capacity requirements at all times for PoEs (airports, ports and ground crossings)
3
PoE.2 Public health response at PoEs
3
P1: Average Capacities Score(%)
26
P2: Average Capacities Score(%)
40
P3: Average Capacities Score(%)
40
P4: Average Capacities Score(%)
26
P5: Average Capacities Score(%)
40
P6: Average Capacities Score(%)
50
P7: Average Capacities Score(%)
50
D1: Average Capacities Score(%)
60
D2: Average Capacities Score(%)
46
D3: Average Capacities Score(%)
40
D4: Average Capacities Score(%)
55
R1: Average Capacities Score(%)
30
R2: Average Capacities Score(%)
66
R3: Average Capacities Score(%)
60