Region
Western Pacific Region
Country
Palau
Status
Assessment Date
P.3.1 National IHR Focal Point functions
2
P.6.1 Surveillance of foodborne diseases and contamination
2
P.5.2 Response to zoonotic diseases
3
P.5.1 Surveillance of zoonotic diseases
4
P.4.2 Surveillance of AMR
2
P.4.1 Multisectoral coordination on AMR
2
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
3
P.7.1 Whole-of-government biosafety and biosecurity system is in place for human, animal and agriculture facilities
5
P.1.3 A financing mechanism and funds are available for timely response to public health emergencies
4
P.1.2 Gender equity and equality in health emergencies
2
P.1.1 Legal instruments
3
D.4.4 FETP or other applied epidemiology training programme in place
2
D.4.3 In-service trainings are available
2
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
2
P.7.2 Biosafety and biosecurity training and practices in all relevant sectors (including human, animal and agriculture)
5
D.2.2 Event verification and investigation
3
Recommendation P6
Implement biosafety officer oversight and training in all laboratory sectors including at the BNH, in community health centres and private human health facilities, and throughout the animal and environment sectors.
Establish entry controls and security and inventory systems for areas handling or storing infectious and hazardous materials.
Implement, then review and revise the national biosafety and biosecurity regulations.
Recommendation Re1
Draft a practical emergency response plan for radiation and nuclear emergencies, and test it using a tabletop exercise.
Formalize the existing arrangements with the Philippine Nuclear Research Institute and other partners for laboratory services, training and assessment of contamination in case of radiation incidents.
Implement the Ionization Act which is currently in preparation.
Recommendation R5
The NEC should consider establishing a multisectoral communication hub or joint information centre to further strengthen the risk communication system during emergencies.
The NEC and the MOH should include risk communicators during risk assessments, recognising the importance of risk perception in maintaining trust, steering individual and community decisions about the acceptability of risks, and influencing behaviours before, during and after an emergency.
The MOH should look at options for strengthening community engagement, dynamic listening and the management of miscommunication during routine operations and emergency responses, including through developing targeted risk communications for vulnerable, marginalized and hard to reach groups.
All sectors should identify a diverse group of community leaders, peer leaders, volunteers and/ or champions to leverage their personal and collective leadership and social influence for trusted communication engagement and social mobilization.
Recommendation R4
Assess resources for medical countermeasures from a One Health perspective, with assistance from subject matter experts to determine their capacity to address all needs related to public health response.
Complete the national plan for receiving and sending health personnel to include full implementation of the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP). The plan should also assess and address emergency medical team capacity.
Develop a system to recognize, treat and manage chemical and/or radiological incidents that includes training of local staff and utilization of regional and international subject matter expertise.
Recommendation R2
Update the Public Health Emergency Operations Plan to reflect lessons from exercises and real events.
Include the IHR’s whole-of-government approach within National Emergency Committee (NEC) training to strengthen response capacities in public health emergencies.
Recommendation R1
National multi-hazard emergency response plans must include appropriate coordination at and between national and state levels.
Plans must be regularly exercised through tabletop, field and full-scale simulation exercises.
The Public Health Emergency Operations Plan should be updated and aligned with or incorporated into the National Disaster Risk Management Framework.
Include risk mapping of animal-related emergencies in future plan and framework updates.
Develop a business continuity plan in the BNH and throughout all relevant sectors to enhance resilience.
Recommendation POE1
Provide facilities at points of entry that are equipped to assess suspected ill passengers or crew on aircraft and/or other vessels. Ensure these facilities have adequate space, staff and equipment.
Enhance existing control programmes for vectors and reservoirs at and around points of entry.
Legislate to establish capacities at points of entry to inspect conveyances and issue Ship Sanitation Certification.
Recommendation P7
The Palau Ministry of Health (MOH) CORE immunization team should develop and execute a plan for more routine community outreach to identify and locate under-immunized children and bring their vaccinations up to date.
The MOH should work to identify additional sources of funding for vaccines and immunization staff through the national government (e.g. from the national insurance programme or from taxes on tobacco, alcohol or unhealthy food) and through development partners.
Efforts should be made to strengthen the vaccine cold chain, including through increased temperature monitoring at satellite sites and during vaccine transport, and regular testing of the system.
Recommendation P5
Strengthen inspection services and laboratory capacity to detect additional foodborne pathogens and selected residues in foods.
Enhance messaging for prevention of foodborne diseases for food operators and the general public, and for risk communication during outbreaks.
Develop case studies and simulation exercises to test and enhance capacities for outbreak investigation and response.
R.1.1 Emergency risk assessment and readiness
4
Recommendation p4
Identify priority zoonotic diseases and create awareness among all relevant stakeholders in the human health, agriculture, wildlife, fisheries and environment sectors, and others, as necessary.
Explore means of including the marine and wildlife sectors in the relevant activities of the Healthcare Coalition (HCC).
Set up mechanisms and capacities for enhanced coordination, communication and collaboration between the Bureau of Public Health, the Bureau of Agriculture and the marine and wildlife sectors on surveillance and early response to zoonotic diseases. Finalize the existing draft Memorandum of Understanding (MOU) for overarching collaboration in prevention and control of zoonotic disease.
Develop a zoonotic disease prevention and control plan (including to ensure availability of rabies post-exposure prophylaxis and personal protective equipment (PPE)).
Recommendation P3
Expedite the finalization and endorsement of the Antimicrobial Resistance National Action Plan and the Pharmacy Act in support of AMR mitigation and antimicrobial stewardship.
Implement the legal framework, policies and procedures needed to regulate the use and reporting of antimicrobial agents, and ensure that all health care providers adhere to national IPC guidelines, including through regular inspection.
Move quickly to implement the recommendations of the 2019 review of IPC practices at the Belau National Hospital (BNH).
Monitor and regulate the use of antimicrobial agents in terrestrial and aquatic animals and in animal feed.
Identify long-term solutions to provide veterinary expertise for Palau.
Recommendation P2
Strengthen IHR advocacy to all relevant sectors and stakeholders, and continue to strengthen communication and coordination between the national IHR focal point and other relevant government agencies (e.g. agencies responsible for One Health matters and stakeholders for chemical and radiation matters), ensuring timely and systematic exchange of information.
Formalize guidelines and/or SOPs for coordination between the national IHR focal point (IHR NFP) and other stakeholders.
Test and update the functions of the IHR NFP to achieve efficient management of event communications and coordination, using reviews of real events or joint simulation exercises.
Recommendation P1
Complete the IHR implementation review of existing mechanisms with all the relevant ministries and develop One Health policies that address health threats at the animal-human-environment interface.
Establish a budget line for core capacity development and implementation of the IHR (2005).
Expand and diversify the base for timely funding in case of a health emergency.
R.3.1 Case management
2
R.2.3 Emergency Operations Program
5
R.2.2 Emergency Operations Center Operating Procedures and Plans
5
R.2.1 Public health and security authorities (e.g. law enforcement, border control, customs) are linked during a suspect or
5
R.1.2 Public health emergency operations centre (PHEOC)
3
D.2.3 Analysis and information sharing
2
D.2.1 Early warning surveillance function
2
D.1.4 Effective national diagnostic network
2
R4: Average Capacities Score(%)
53
R5: Average Capacities Score(%)
72
PoE: Average Capacities Score(%)
50
CE: Average Capacities Score(%)
60
RE: Average Capacities Score(%)
40
Recommendation Ce1
Develop a comprehensive framework for monitoring and managing chemical events, with an updated national chemical risk map and updated guidelines and plans for chemical management in line with the requirements of the IHR (2005).
Develop a task force, proportional to the need in Palau, with expertise covering all of the essential technical areas in monitoring and managing chemical events.
Develop laboratory capacity to monitor high-risk chemicals in food, water, consumer products and the environment.
Recommendation D1
Implement linkages between the human and animal health sectors, e.g. by establishing systems for information exchange and cooperation.
Accelerate approval and implementation of the national laboratory quality system.
Establish a laboratory accreditation system for national, community health centre and private laboratories.
Assessment End Date
Recommendation D3
Develop protocol/training to assess and report potential public health emergencies of international concern, including through the use of the IHR Annex 2 Decision Instrument.
Ensure the national IHR focal point is available 24/7.
Empower backup officers to comply in a timely manner with IHR requirements for assessing and reporting potential public health emergencies of international concern.
Strengthen communication and collaboration for joint reporting by the animal and human health sectors, through the IHR NFP, the OIE focal point and emergency Food Safety Authorities Network (INFOSAN) focal point.
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Recommendation D4
Implement the draft public health workforce development plan, and ensure it is reviewed, tracked, updated and reported regularly (at least annually).
Develop training plans and conduct regular training, including on the One Health approach to meet the requirements of the IHR (2005) at all levels.
Encourage and facilitate relevant staff to access field epidemiology training to build capacity and lessen the load on current staff. Ensure that Palau has sufficient epidemiological capacity
CE.1 Mechanisms are established and functioning for detecting and responding to chemical events or emergencies
3
R.4.1 IPC programmes
3
Recommendation R3
Assess the capacity of existing multisectoral mechanisms for information sharing and response through an exercise with a deliberate event scenario that may cause a potential public health emergency, in order to identify gaps between the public health and security sectors.
Develop a robust interface between the public health and security sectors by formalizing joint risk/threat assessment and investigation protocols, and carrying out joint training on potential deliberate biological, chemical and radiological events.
D.3.1 Multisectoral workforce strategy
3
R.4.2 HCAI surveillance
2
D.3.2 Human resources for implementation of IHR
2
R.4.3 Safe environment in health facilities
3
Recommendation D2
Legislate for the notification of infectious diseases in both humans and animals.
Strengthen the event-based surveillance system to make it fully functional, including by implementing event-based surveillance in public and private facilities and in communities.
Review and streamline the existing surveillance system: revise SOPs and tools to ensure they reflect current best practice; improve reporting functions; and consider the planned transition to a system of electronic medical records.
Formalize a One Health working group to facilitate information sharing between the human, animal and environmental sectors.
Produce periodic epidemiological bulletins and disseminate them widely among relevant stakeholders.
R.5.1 RCCE systems for emergencies
4
R.5.2 Risk communication
4
R.5.3 Community engagement
4
R.5.4 Communication Engagement with Affected Communities
4
R.5.5 Dynamic Listening and Rumour Management
2
D.1.1 Specimen referral and transport system
3
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
2
RE.1 Mechanisms are established and functioning for detecting and responding to radiological and nuclear emergencies.
2
PoE.1 Core capacity requirements at all times for PoEs (airports, ports and ground crossings)
3
PoE.2 Public health response at PoEs
2
P1: Average Capacities Score(%)
60
P2: Average Capacities Score(%)
60
P3: Average Capacities Score(%)
35
P4: Average Capacities Score(%)
26
P5: Average Capacities Score(%)
70
P6: Average Capacities Score(%)
40
P7: Average Capacities Score(%)
100
D1: Average Capacities Score(%)
55
D2: Average Capacities Score(%)
46
D3: Average Capacities Score(%)
50
D4: Average Capacities Score(%)
40
R1: Average Capacities Score(%)
70
R2: Average Capacities Score(%)
100
R3: Average Capacities Score(%)
40