Region
African Region
Country
United Republic Of Tanzania
Status
Assessment Date
P.3.1 National IHR Focal Point functions
1
P.6.1 Surveillance of foodborne diseases and contamination
2
P.5.1 Surveillance of zoonotic diseases
1
P.4.3 Prevention of Prevention of multidrug resistant organism (MDRO)
2
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
1
P.3.2 Multisectoral coordination mechanisms
1
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.1.2 Gender equity and equality in health emergencies
2
P.1.1 Legal instruments
2
D.4.3 In-service trainings are available
2
D.4.2 Human resources are available to effectively implement IHR
4
D.4.1 An up-to-date multi-sectoral workforce strategy is in place
2
D.2.4 Syndromic surveillance systems
2
P.6.2 Response and management of food safety emergencies
1
P.7.2 Biosafety and biosecurity training and practices in all relevant sectors (including human, animal and agriculture)
3
D.2.2 Event verification and investigation
1
Recommendation P6
Develop and implement biosafety and a biosecurity legislation/regulatory framework that encompasses the One Health approach and is in line with existing documents from the mainland of the United Republic of Tanzania.
Conduct risk assessment and facility mapping for biosafety and biosecurity.
Develop and implement formal training plans in biosafety and biosecurity for laboratory personnel.
Establish linkages to address biosafety/biosecurity among human, animal and environmental health sectors in line with the One Health approach
Recommendation Re1
Review and amend the Atomic Energy Act, No. 7 of 2003 of the United Republic of Tanzania to include linkages between the TAEC and food safety agencies on mainland United Republic of Tanzania and Zanzibar to manage and regulate radioactivity in food, cosmetics and drugs.
Review the national radiation plan for the United Republic of Tanzania to reflect linkages within the mainland and Zanzibar.
Establish a coordination mechanism that includes stakeholders at all relevant sectors, such as PoE, MoH, Ministry of Agriculture, Livestock and Fisheries and Natural Resources, etc.
Provide adequate human resources, equipment and other resources for detection of radiation emergencies.
Designate two health facilities (one in Pemba and the other in Unguja) to handle radiation emergencies and scale up their capacity in terms of human resources, facilities and equipment to make them fit for purpose to manage radiation emergencies.
Recommendation R5
Develop a fully equipped physical structure for the Emergency Communication Center.
Train staff on the emergency communication system used in the ECC.
Establish a specific public health risk communication system that transmits two-way information bet- ween local, regional and national levels.
Recommendation R4
Develop a legal and regulatory framework and plans for receiving and sending health personnel and medical countermeasures during public health emergencies, including: o guidelines on licensure and supervision of international personnel received during public health emergencies, liability concerns for using health personnel during international deployment, a pre- deployment training package and criteria and standards for health personnel who will be received or sent during public health emergencies among others.
Develop a list of priority essential emergency medical countermeasures needed on short notice for response to common public health emergencies in Zanzibar, based on a national risk profile.
Establish a small stockpile for priority essential emergency supplies and medicines for public health emergency response and make prior contractual arrangements with suppliers/manufacturers that will enable Zanzibar to quickly get more essential supplies during public health emergencies.
Conduct table-top simulation exercises to test Zanzibar’s system of receiving and sending health personnel and medical countermeasures.
Recommendation R2
Establish a fully equipped and functional disaster management EOC and public health EOC with a clear and robust linkage between the two.
Develop SOPs for operating the EOCs.
Provide training and mentorship to staff on the incident management system and EOC management.
Provide specific training for staff on public health emergency response and the role of the public health EOC within that response.
Recommendation R1
Review and update the Zanzibar Emergency Preparedness and Response Plan (ZEPRP) to address public health risks and emergencies using an all-hazard approach to meet IHR core capacities; ensure that the update of ZEPRP also takes into account preparedness and response at regional and district levels.
Conduct vulnerability/risk assessment and mapping of public health events and national resources.
Raise awareness among the general public on the need to prepare for public health risks and emergencies.
Recommendation POE1
Establish a public health contingency plan for points of entry.
Strengthen the patient referral system.
Institute routine capacity building by improving the infrastructure and upgrading equipment.
Conduct broad training sessions on disease surveillance, management and response.
Conduct table-top simulation exercises to test the plans put in place.
Recommendation P7
Conduct in-depth investigation of the causes of the declining trend of measles vaccination and address any identified causes to increase demand for immunization.
Implement the plan to sustain the cold-chain system, and include within it provisions for regular cold chain maintenance, replacement of materials and addition of new technology as appropriate.
Improve immunization data management, analysis and monitoring and use data to identify and intervene in areas where immunization coverage is declining.
Include zoonoses and epidemic-prone diseases in the vaccination plan (in the long term).
Recommendation P5
Identify focal points in all sectors relevant to food safety in Zanzibar.
Formalize a mechanism for inter-sectoral collaboration, with clearly defined roles and responsibilities for each sector.
Develop or review existing SOPs for response to food-related events.
Strengthen surveillance and laboratory response to food-borne events of importance, including routine inspections.
Strengthen reporting mechanisms between the ZFDB and the national IHR Focal Point for public health events.
R.1.1 Emergency risk assessment and readiness
1
Recommendation p4
Establish a National One-Health Coordination Unit.
Perform a systematic prioritization of zoonotic diseases and develop an updated national plan for coordinated One-Health surveillance of those priority zoonotic diseases in both animal and human populations.
Supply laboratories with adequate knowledge/support, laboratory equipment and reagents/kits for surveillance of priority zoonotic diseases.
Implement database/software to manage and coordinate joint animal-human surveillance for both epidemiology units and laboratory use, with linkages internationally.
Recommendation P3
Conduct a situation analysis to identify gaps relevant to AMR in Zanzibar.
Develop and implement the multi-sectoral national action plan on AMR with well-defined integrated surveillance strategy for detection and reporting of AMR, including from the animal health sector.
Establish and strengthen national reference laboratories for AMR testing in both sectors, which includes a component on raising awareness about AMR.
Recommendation P2
Establish a functional IHR multi-sectoral coordinating mechanism for Zanzibar, including the develop- ment of SOPs for enhancing the communication mechanism and linkages between relevant ministries/ sectors.
Develop terms of reference (ToRs) and build capacity for the National IHR Focal Point contact person/ unit in Zanzibar and strengthen the link to the NFP in mainland United Republic of Tanzania.
Conduct IHR advocacy among stakeholders and decision-makers.
Update system for multi-sectoral collaboration and develop action plans that incorporate lessons learned for each ministry.
Establish a formal system to share IHR-specific reports and information between human health, ani- mal health and other relevant sectors.
Recommendation P1
Conduct a comprehensive review of the existing legislation and policies related to implementing the IHR (2005), before the end of 2018.
Update or enact legislation to address the gaps in legislation identified through the comprehensive review.
Establish or vote on a sustainable budget line that would be used for emergencies and one that would provide routine funding for IHR implementation (i.e. create a funding mechanism).
Operationalize the funding mechanism to ensure the budget lines for routine and emergency funding are enforced
R.3.1 Case management
1
R.2.4 Case management procedures are implemented for IHR relevant hazards
2
R.2.3 Emergency Operations Program
2
R.2.2 Emergency Operations Center Operating Procedures and Plans
1
R.2.1 Public health and security authorities (e.g. law enforcement, border control, customs) are linked during a suspect or
1
R.1.2 Public health emergency operations centre (PHEOC)
1
D.2.3 Analysis and information sharing
1
D.2.1 Early warning surveillance function
2
D.1.4 Effective national diagnostic network
1
R4: Average Capacities Score(%)
13
R5: Average Capacities Score(%)
48
PoE: Average Capacities Score(%)
20
CE: Average Capacities Score(%)
20
RE: Average Capacities Score(%)
20
Recommendation Ce1
Review and develop necessary legislation, policy and plans to enable surveillance and response to chemical events and to further strengthen prevention.
.Develop or assemble guidelines, manuals and SOPs on surveillance, assessment and coordinated management (including information sharing) of chemical events; on chemical exposure/poisoning; and on safe waste disposal.
Provide chemical hazard training to staff tasked with responding to chemical emergencies.
Procure modern equipment, such as atomic absorption spectrometry (AAS), gas chromatography/mass spectroscopy (GC/MS), High-performance liquid chromatography (HPLC) and sufficient trained staff for laboratories to perform the necessary testing and monitoring.
Establish a poison control centre to maintain the knowledge base of chemicals and their health impact to direct an appropriate response.
Recommendation D1
Review and implement the Zanzibar Laboratory policy using the One Health approach.
Develop and implement a strategic plan that addresses specimen management, supply-chain management and QMS in all laboratories.
Improve testing capacity for the Integrated Disease Surveillance and Response (IDSR) framework priority diseases in all sectors.
Assessment End Date
Recommendation D3
Develop a robust functional disease surveillance system in both human and animal health sectors to be able to detect and report potential PHEICs that may occur within Zanzibar.
Strengthen linkages between Zanzibar and the IHR NFP on the mainland United Republic of Tanzania on IHR matters: - A representative from Zanzibar shall be part of the national IHR NFP; - Establish a National IHR Focal Point sub-centre in Zanzibar; - Build capacity of the Zanzibar NFP sub-centre with appropriate human resources, ICT capacity and training in IHR (2005); - Develop national SOPs/protocols and regulations that govern reporting to WHO that clearly specify the linkages between the NFP sub-centre in Zanzibar and the NFP on mainland United Republic of Tanzania.
Establish a multi-sectoral IHR coordination committee to promote joint decision-making and timely reporting to the NFP in response to a potential PHEIC for relevant zoonotic diseases.
Designate an OIE focal person in Zanzibar who will then link with the national OIE delegate in mainland United Republic of Tanzania to notify OIE on important epidemiological events occurring in Zanzibar.
Establish formal mechanisms for communication and information sharing between human health, animal health, security authorities and other relevant sectors.
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Recommendation D4
Conduct a needs assessment to establish gaps in human resource capacity available in both animal and human sectors to implement IHR core capacity requirements.
Develop and implement a comprehensive workforce strategy that takes into account both human and animal health HR needs.
Build the epidemiological capacity of the human and animal health workforce to detect, investigate and respond to public health emergencies: o MoH Zanzibar should proactively lobby for the inclusion of a veterinary track in the advanced FETP and make special consideration for the veterinarians from Zanzibar who apply; o MoH, Ministry of Agriculture, Livestock and Fisheries and Natural Resources and partners should take the initiative to mobilize resources to support veterinarians to undertake the two-year epidemiology course at Sokoine University of Agriculture; o Develop and implement a plan in collaboration with the FETP spread over the next two years to train a substantial number of in-service mid-level managers from both the human and animal health workforce in the short-term FETP-frontline epidemiology course to rapidly build Zanzibar’s capacity to detect and respond to public health emergencies.
CE.1 Mechanisms are established and functioning for detecting and responding to chemical events or emergencies
1
R.4.1 IPC programmes
1
Recommendation R3
Conduct joint training, drills and table-top simulation exercises involving all relevant stakeholders, such as: MoH, PoEs, security authorities, veterinary sector, etc. to test the functionality of systems to link public health and security agencies in response to a public health emergency.
Develop and cost the priority activities for linking public health and security agencies in the national action plan for health security.
Create a robust coordination mechanism in the incident management system, which includes: o identification or designation of relevant focal points of all relevant sectors; o establishment of protocols and SOPs which stipulates the roles and responsibilities of the focal points.
Establish an information sharing mechanism, between the relevant sectors.
Include security authorities in all public health emergency preparedness and response actions.
R.4.2 HCAI surveillance
1
Recommendation D2
Train health workers on IDSR and basic epidemiological skills at all levels in order to build a critical mass of health workers with the necessary skills for surveillance and response.
Strengthen the Surveillance coordination structures at national and district level with clear terms of reference.
Develop and implement an electronic surveillance system (e-IDSR) for real-time surveillance.
Strengthen the indicator-based surveillance system and develop an event-based surveillance system that includes a community-based surveillance component to complement the current surveillance system.
Strengthen capacity for data analysis at all levels and institutionalize data quality assessment/audit.
R.5.1 RCCE systems for emergencies
2
R.5.2 Risk communication
3
R.5.3 Community engagement
3
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
1
D.1.2 Laboratory quality system
1
D.1.3 Laboratory testing capacity modalities
1
RE.2 Enabling environment in place for management of radiological and nuclear emergencies
1
RE.1 Mechanisms are established and functioning for detecting and responding to radiological and nuclear emergencies.
1
PoE.1 Core capacity requirements at all times for PoEs (airports, ports and ground crossings)
1
PoE.2 Public health response at PoEs
1
P1: Average Capacities Score(%)
40
P2: Average Capacities Score(%)
40
P3: Average Capacities Score(%)
20
P4: Average Capacities Score(%)
40
P5: Average Capacities Score(%)
20
P6: Average Capacities Score(%)
30
P7: Average Capacities Score(%)
60
D1: Average Capacities Score(%)
20
D2: Average Capacities Score(%)
30
D3: Average Capacities Score(%)
0
D4: Average Capacities Score(%)
40
R1: Average Capacities Score(%)
20
R2: Average Capacities Score(%)
30
R3: Average Capacities Score(%)
20