The East African Partner States include Burundi, Kenya, Rwanda, South Sudan, Tanzania and Uganda. When a disease outbreak occurs across international borders or simultaneously within two or more East African partner states, the East African Community (EAC) Secretariat plays a coordinating role. As part of its regional contingency plans for public health security, the EAC Secretariat took part in a field simulation exercise, at Namanga which is located at the Kenya-Tanzania border in June 2019. The exercise was responding to a simulated “outbreak” of Rift Valley Fever.

In 2016, WHO established the International Health Regulations (2005) (IHR) monitoring and evaluation framework, which lists 4 critical components for assessing and monitoring IHR minimum core capacity: State Party annual assessments, joint external evaluations (JEEs), after-action reviews and simulation exercises. Monitoring and evaluation of IHR capacity foster effective planning, implementation, participation, communication and informed decision-making for better preparedness, readiness and response to public health emergencies.

More than 100 countries have gone through a Joint External Evaluation (JEE), one of the monitoring and evaluation practices developed in the last five years. A vital requirement of the JEE is the inclusion of multiple sectors during both the initial self-evaluation conducted by the host country itself, and an in-country assessment conducted by a team of external evaluators.

At the beginning of 2020, the recent outbreak of Ebola Virus Disease (EVD) in the Democratic Republic of Congo (DRC) had passed 3,000 cases and was still on-going, but its impact had slowed down. During the outbreak, a single instance of potential crossborder transmission took place in June 2019. Ugandan health officials in Kasese district identified three suspected cases of EVD; a young boy, his grandmother and his sibling. The trio had crossed into Uganda from the Mabalako Health Zone in the DRC and screening at the national border post indicated the boy was unwell.

In 2019, two severe cyclones hit Mozambique. Occurring six weeks apart, they affected 1.7 million people, caused fatalities, and destroyed health facilities, civil infrastructure, and crops. The degradation of sanitation facilities following the cyclones led to a cholera epidemic in the country, with 7,053 cases and 8 deaths reported. Following this, Mozambique conducted an After Action Review (AAR) to document lessons from the response to the two events and to better prepare for future natural disasters and emergencies.

In early 2014, Sierra Leone experienced its worst outbreak of Ebola virus disease (EVD) that killed 3,589 people. In the wake of this health emergency, the West African nation conducted its first Joint External Evaluation (JEE) to assess the country’s healthcare system and capacities for health security. The JEE’s results were then vital in shaping the National Action Plan for Health Security (NAPHS) for 2018-2022.

Several disease outbreaks and health emergencies in Africa and their risk factors could be prevented or mitigated, but the health systems in many countries in the WHO African Region are still weak. The International Health Regulations (2005) (IHR) urge States Parties to develop capacities for prevention, early detection and timely response to public health threats; however, many countries in the African Region have not achieved sustainable IHR capacity or a resilient health system.

On 1 August 2018, the Ministry of Health of the Democratic Republic of the Congo (DRC) declared an outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces. On 28 September 2018, WHO determined that the risk for spread of Ebola virus beyond the borders
of the DRC was very high.The high risk was attributed primarily to evolution of the outbreak in the 2 provinces, heavy cross-border flow of people, goods and services and the prolonged humanitarian crises and insecurity in the area.

Influenza pandemics are unpredictable but recurring events that can have serious consequences for human health and socioeconomic well-being worldwide. Advanced planning and preparedness are essential to mitigate the risk and impact of such pandemics. The most recent influenza pandemic occurred in 2009. Many lessons were learnt, and good practices in pandemic

The monitoring and evaluation framework of the International Health Regulations (2005) (IHR-MEF) is made up of 4 instruments: mandatory States Parties Annual Reporting (SPAR) and 3 voluntary instruments, voluntary external evaluation, after-action review (AAR) and simulation exercises (SimEx).