A highly infectious strain of deadly bacteria has been released at a music festival and other public events in multiple countries—this is the fictional scenario that confronted participants in Exercise Crystal from 4 to 5 December.

Representatives from 29 countries and areas across the Western Pacific Region took part in the annual simulation exercise, testing their communication and coordination with the WHO during outbreaks or public health emergencies.

By guiding collective action, timely and transparent communication between countries and WHO can prevent outbreaks from becoming epidemics and save lives. In fact, the 196 state signatories to the International Health Regulations, also known as IHR (2005), are legally required to notify WHO of internationally significant public health events.

However, knowing when and how communication should take place requires practice. It also requires trust—countries need to know that sensitive information shared will be handled carefully and that WHO’s guidance and support will be useful.

“We host Exercise Crystal every year to help countries increase their familiarity with IHR communication and build relationships before a real-life emergency occurs,” said Dr Ailan Li, WHO Regional Emergency Director for the Western Pacific. “We came up with that name because crystals are valuable and transparent, just like good IHR communication.”

Simulations such as Exercise Crystal are a useful way to practice and strengthen IHR capacities, better preparing countries to respond to real-life public health emergencies. These exercises are an important component of the global IHR Monitoring and Evaluation Framework and the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies (APSED III).

Over the past decade, participants have stressed the utility of the exercise (see “Participant feedback on Exercise Crystal 2018” box below), citing increased facility with IHR communication. In the first year, just five countries and areas notified WHO of the simulated public health event within the expected timeframe. This year that number rose to 26.

For the full story and additional information please visit WHO Western Pacific website: https://www.who.int/westernpacific/news/ feature-stories/detail/exercise-crystal-ten-years-of-strengtheningcommunication- between-countries-and-who-during-emergencies