Simulation Exercise

A simulation exercise is a form of practice, training, monitoring or evaluation of capabilities involving the description or simulation of an emergency, to which a described or simulated response is made. Simulation exercises can help to develop, assess and test functional capabilities of emergency systems, procedures and mechanisms. 

Simulation exercises are training and quality assurance tools, which provide an evidence-based assessment for the monitoring, testing and strengthening of functional capacities to respond to outbreaks and public health emergencies. As a training tool, they allow participants to learn and practice emergency response procedures in a safe and controlled environment. As a quality assurance tool, exercises test and evaluate emergency policies, plans and procedures. Simulation exercises play a key role in the development and implementation of preparedness and response capacities at all levels (national, regional, community and global) and have been identified as a key component in the validation of core capacities under the IHR monitoring and evaluation framework (2015).

A simulation exercise is more effective and efficient when a simulated scenario is used that is close to reality. The scenario is a pre-planned storyline that drives an exercise, as well as the stimuli used to achieve exercise objectives. The scenario is designed to stimulate exercise participants to respond to certain events and can be presented through various means, including through fake press articles, face to face through actors, audio/visual material including video clips, etc.

WHO has developed some generic exercise scenario`s that are taking place in the fictitious country of GlobalLand, using short video clips that can be found on this page. Aside for examining health issues within a constrained environment such as a single event, simulation exercise scenarios are being developed that reflect a more complex ‘real world’ operational environment. This includes health events in natural disasters and complex emergencies and the role that health plays in wider emergency response.

Simulation exercise calendar

Upcoming

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1 December 2018 to 31 December 2018
Senegal DR Dec.2018
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1 December 2018 to 31 December 2018
Somalia TTX Oct.2018
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1 December 2018 to 31 December 2018
Sierra Leone TTX Dec.2018
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1 December 2018 to 31 December 2018
Morocco TTX Oct.2018
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3 December 2018 to 7 December 2018
Phillipines FX Dec.2018
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4 December 2018 to 6 December 2018
Switzerland FX Dec.2018
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12 December 2018 to 12 December 2018
Egypt FX Dec.2018
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20 December 2018 to 20 December 2018
Burundi FSX.2018
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1 January 2019 to 1 January 2019
Rwanda FSX Dec.2018
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8 January 2019 to 9 January 2019
Tanzania FSX Jan.2018
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28 January 2019 to 30 January 2019
Pakistan TTX Jan-Feb.2019
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1 February 2019 to 28 February 2019
Kyrgyzstan TTX Feb.2019
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4 February 2019 to 7 February 2019
United States FSX Feb.2019
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4 June 2019 to 7 June 2019
Kenya FSX June.2018
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4 June 2019 to 7 June 2019
Tanzania FSX June.2018

Toolbox

Videos

Simulation exercise activities

Region Country Dates Status Type Objective Key Findings Report
African Region Chad 29 November 2018 Conducted TTX EVD
Eastern Mediterranean Region Egypt 12 December 2018 Conducted FX POE on EVD imported case
All Regions Portugal 13 November 2018 Conducted TTX This simulation exercise has as main objectives: to share good practices of collaboration between the public health sector and the military health services to jointly prepare and respond to public health emergencies; identify a shared vision for global health security according to a multisectoral perspective; contribute to and support Portuguese speaking countries in the development of action plans for global health security; discuss guiding principles for collaboration between military health services and the public health sector, as well as with other relevant sectors.
Western Pacific Region Mongolia 30 October 2018 to 31 October 2018 Conducted TTX Pan Stop
Western Pacific Region Philippines 28 November 2018 Conducted TTX INFOSAN SimEx
South-East Asia Region India 27 November 2018 Conducted TTX INFOSAN SimEx
African Region Democratic Republic of Congo 25 July 2018 Conducted FSX EVD SimEx
All Regions Switzerland 4 December 2018 to 6 December 2018 Conducted FX Validate National Public Health Emergency Operation Centre functions
European Region Germany 7 November 2018 to 8 November 2018 Conducted FSX Frankfurt Airport ICAO SimEx
European Region Denmark 22 October 2018 to 25 October 2018 Conducted TTX Joint EURO/ECDC Exercise on poliovirus containment breach preparedness and risk communication 
African Region Senegal 25 October 2016 to 27 October 2016 Conducted Training TTX Facilitators training
Eastern Mediterranean Region Jordan 1 November 2016 to 30 November 2016 Conducted TTX, FX Cluster
European Region Bosnia and Herzegovina 24 September 2018 to 28 September 2018 Conducted Training TTX Training Module
European Region Switzerland 14 March 2018 to 15 March 2018 Conducted TTX To familiarize HWCOs with their roles and responsibilities in managing health emergencies
Western Pacific Region Viet Nam 25 April 2018 to 27 April 2018 Conducted TTX Validate advance national pandemic preparedness Vietmnam, Cambodia, Laos (3 Mekong countries)
Western Pacific Region Lao People's Democratic Republic 25 April 2018 to 27 April 2018 Conducted TTX Validate advance national pandemic preparedness Vietmnam, Cambodia, Laos (3 Mekong countries)
African Region Democratic Republic of Congo 28 June 2018 Conducted TTX EVD SimEx to test the readiness of team and equipment in Kinshasa
WHO-HQ United Kingdom of Great Britain and Northern Ireland 13 September 2018 to 14 September 2018 Conducted TTX Polio SimExThe purpose of the simulation is to advance the discussion of preparedness for outbreaks occurring some years after OPV cessation, and which have relevance for some near-term decisions around OPV stockpiles. Post cessation polio outbreak response. Exercise demonstrated need for a coordinated approach involving WHO and partners. SimEx also looked at vaccine development and deployment as well as the use and limitations of different vaccination approaches
African Region United Republic of Tanzania 13 August 2018 to 17 August 2018 Conducted TTX EVD SimEx
African Region United Republic of Tanzania 4 September 2018 to 5 September 2018 Conducted TTX Cross Border SimEx testing regional responses to public health emergencies.   Rift valley fever used as primary exercise vehicle  The exercise demonstrated that there are plans in place, including the presence of structures and systems for preparedness and response in the region. However, these are mainly focussed on a response at the national level and lack understanding and functioning between one or multiple Partner States. Therefore, further familiarisation and clarification is required to ensure operationalisation of existing plans and SOP’s to prevent and control any disease outbreak or events across countries. One Health approach needs to be promoted and more trainings and exercises should be developed to enhance readiness of Partner States to respond to emergencies that have cross border impact. PDF icon East Africa Community FINAL BOOK.pdf (3.36 MB)
African Region South Sudan 13 August 2018 to 15 August 2018 Conducted TTX EVD SimEx
Eastern Mediterranean Region Papua New Guinea 17 September 2018 to 21 September 2018 Conducted Test the response plan, incl IMS systems  through a water/food borne disease.   Part of food safety and security training for forthcoming APEC meeting to be held in Port Moresby in November.   Simulation in two parts, Food safety (Listeriosis Outbreak) and Security (deliberate poisoning event) Food safety agencies require support to develop basic understanding of health emergencies when related to food borne outbreaks. Relatively simple food safety issues can be managed but more complex emergencies are challenging. Require better SOP's and contingency plans along with more frequent testing
Western Pacific Region Viet Nam 1 May 2017 to 31 May 2017 Conducted DR Drill exercises on coordinated response to Avian Influenza A/H7N9 outbreak in Hanoi, Quang Ninh, Thai Nguyen and Lang Son provinces. Major objective was to test coordination of human health and animal health sector stakeholders at national and provincial levels in the context of H7N9. They were government's owned exercises. WHO did not support any exercise.
African Region Uganda 8 May 2017 to 12 May 2017 Conducted Training Exercise undertaken on the 26th October Training
African Region Uganda 7 October 2016 Conducted TTX Multihazard plan validation
Western Pacific Region Mongolia 1 September 2017 to 30 September 2017 Conducted DR Exercise to test response to chemical emreegencies  1 day exercise held to test surveillance and response to chemical emergencies.
Western Pacific Region Mongolia 1 May 2017 to 5 May 2017 Conducted FX Gobi Wolf 2017, a five-day disaster response exercise focused on interagency coordination.  Mongolia’s National Emergency Management Agency hosts the exercise with support from Mongolia’s armed forces. The exercise’s scenario featured a magnitude 7.5 earthquake in Umnugovi, or South Gobi, province along the border with China. The scenario and actions tested disaster management plans including earthquake preparedness plans at the national and local levels, and coordination of civil-military cooperation, and reception of international humanitarian assistance. GW 17 activities also included a table top exercise focusing on functional-area expertise in an office environment, a field training exercise at several locations around Dalanzadgad, and an after-action review to capture lessons learned during the exercise. The exercise was originally hosted from 2009 to 2012 and was reinstituted in 2015 as part of the Pacific Resilience series of humanitarian assistance/disaster relief exercises hosted by U.S. Army Pacific. Pacific Resilience tests host-nation defense support to civil authorities during disaster situations, the integration of foreign humanitarian assistance, and the strategic communication required to implement emergency-management plans. Gobi Wolf exercise involved participants from other countries that sent delegates include Bangladesh, Canada, Hungary, Japan, Nepal, New Zealand and South Korea.
Western Pacific Region Mongolia 1 August 2016 to 30 September 2016 Conducted DR Simulation exercise to test the Incident Management System in Umnugobi and Uvurkhangai provinces was held on August and September 2016.  Draft aimag emergency operations centre procedures were tested for information sharing, risk assessment, risk communication and the incident management system. The most recent exercise revealed that there was no coordinated surveillance or systematic risk assessment in place during peace time among sectors. The main area requiring improvement was the absence of a proper chain of command; decisions were mostly based on non-scientific considerations, public perception, acquired knowledge and experience rather than a risk assessment conducted by the technical team. Health and other sectors collaborated well during public health events. However, multisectoral response operations are not formalized and sectors provide joint response without clearly defined procedures
Western Pacific Region Mongolia 19 July 2016 to 25 July 2016 Conducted TTX  cross-border water safety programme  The main issues discussed around sanitary-epidemiological monitoring of the quality of transboundary rivers, harmonization of methods and laboratory quality control techniques and water safety, further development of laboratory facilities , collection of water samples on the territory of the Republic of Buryatia and Mongolia, assessing the risk to public health, to further strengthen cooperation between the two countries, conducting seminars for the exchange of experiences on laboratory tests, the development of proposals for the harmonization of methods and laboratory testing techniques, statistical and health effects assessment system due to pollution transboundary water bodies.
Western Pacific Region Mongolia 1 June 2016 to 30 June 2016 Conducted FX Plague SimEx Reviwed emerging diseases response capacity
Western Pacific Region Lao People's Democratic Republic 29 November 2017 to 30 November 2017 Conducted FX Avian Influenza exercise in Champasak Major objective was to test coordination of human health and animal health sector stakeholders at provincial level in the context of AI
Western Pacific Region Lao People's Democratic Republic 22 March 2016 to 24 March 2016 Conducted TTX Mekong Basin Diseases Surveillance -Table Top Exercise (MBDS-TTX) Lao MOH hosted this event, where other MBDS countries attended, major objective was to test coordination among MBDS countries as well as in country coordination, technical area of communication by using context of AI
Western Pacific Region Lao People's Democratic Republic 1 March 2017 to 31 March 2017 Conducted FSX Avian Influenza exercise in Luang Prabang Major objective was to test coordination of human health and animal health sector stakeholders at provincial level in the context of AI
Western Pacific Region China Conducted DR NHFPC Health Emergency Skill Competition NHFPC held a first-ever national competition on health emergency skills for all the provincial and sub-national teams, including different elements such as drills and table-top exercises. WHO senior official (Peter Graaff) was invited to attend the awarding ceremony in November. (Annex 7)
African Region Ghana 10 October 2016 to 14 October 2016 Conducted TTX RRT Greater Accra Regional Exercise Cholera
Western Pacific Region Cambodia 23 November 2017 Conducted TTX Influenza Simulation Exercise A table top exercise was conducted to strengthen influenza like illness surveillance, response and communication among animal and human health sectors (involving staff from high risk avian influenza provinces) at national and provincial level.
Western Pacific Region Cambodia 23 November 2016 Conducted TTX Simulation exercise for Risk Communication capacity on Zika Major objectives were (1) To practice and build capacity for outbreak communication with CDC, national and provincial staff (2) To test the operational communication between the different departments and levels (3) To learn and practice on working with the media and communities
Western Pacific Region Cambodia 16 November 2017 to 17 November 2017 Conducted TTX  Inter-Ministry Risk Communication Tabletop Exercise  Overall objective was to enhance the compentencies and practical skills of the inter-ministry risk communication on risk communications and more specifically to (1) Apply the principles and strategies of risk communication in a simulated series of events (2) Practice the role of the different Ministries in risk communications as part of the response to emergencies and (3) Identify some gaps in the current practice and address those gaps to improve future collaboration.
Western Pacific Region Cambodia 14 November 2017 to 21 November 2017 Conducted TTX Tabletop Exercise on Public Health Emergency Preparedness at Points of Entry Major objectives were to test the functionality of the Public Health Emergency Contingency Plan for Points of Entry and to strengthen coordination and communication mechanisms of stakeholders at national and provincial level.
African Region United Republic of Tanzania 14 May 2018 Conducted TTX Ebola SimEx. The purpose of the exercise was to test plans and procedures for national level response activation and to practice response coordination using IMS at national level.The objectives: - To test plans and procedures for national level response activation- To practice response coordination using IMS at national level Several areas for improvements were identified including: -Stremline information sharing between first point of comms to other departments -develop SoP for rapid risk assessment - update PHEOC SoP and All hazard ERP - Revisit all emergency response documents - Comms plans and SoP to be dismentanted to national, regional and district levels - practise more through SimEx
African Region Togo 20 August 2018 to 24 August 2018 Conducted Training TTX Training moduleSenior level involvement (ministers and Senior Advisors)
European Region Tajikistan 10 August 2018 to 11 August 2018 Conducted TTX Flood with Cholera / AWD Scoping Mission planned - no date set
European Region Denmark 22 October 2018 to 25 October 2018 Conducted TTX Joint WHO/Europe and ECDC exercise on poliovirus containment breach preparedness and risk communication, 
European Region Denmark 12 November 2018 to 16 November 2018 Conducted FX IHR NFP SimEx (Comms & EIS Access)
European Region Switzerland 27 April 2018 Conducted TTX Pandemic Vacination SimExAn internal WHO landscape analysis will be done to assess the current state of readiness to deploy vaccines during a future pandemic. This exercise’s primary objectives are to:A) Highlight strengths, progress and gaps in WHO’s pandemic influenza vaccine deployment readiness/ capacities since 2009 (*this exercise will not cover deployment of antivirals or diagnostics); B) Identify resources available for a pandemic influenza vaccine deployment repository; andC) Articulate next steps to improve WHO’s readiness /capacities for pandemic influenza vaccine deployment.
Eastern Mediterranean Region Morocco 16 January 2018 to 18 January 2018 Conducted Training TTX module
African Region Ghana 26 April 2018 to 28 April 2018 Conducted TTX  AFRO Regional Programme Management Meeting 56The general objective of the simulation exercise is to increase level of WR’s knowledge on health emergency preparedness and response in line with the new WHE reform.Specifically, the simulation exercise will:I. Allow participants to gain an understanding of IHR (2005) core capacities including compliance in order to facilitate a timely and effective Public Health emergency responseII. Increase awareness about WHO’s Emergency Response Framework and related tools and SOPs, as well as the WHO IMS and it functionsIII. Provide WRs the with an opportunity to discuss their roles, responsibilities and in the context of Public Health emergency response involving multiple sectors/partners IV. Familiarize the participants with global level coordination and collaboration in the context of a Public Health event requiring a multi sectoral, multi-agency and whole-of-government response. 
South-East Asia Region Thailand 29 January 2018 Conducted TTX Pandemic Simulation  On the 29th of January the CPI team conducted a short exercise for the World Bank PMAC meeting in Bangkok.   The central theme of the exercise was financing health crisis preparedness and response however the participants were challenged in three core areas; 1. Multi sector and multi agency preparedness 2. Financing of health emergencies, particularly pandemic emergencies, 3. Managing a coordinated approach across sectors
European Region Kyrgyzstan 16 April 2018 to 20 April 2018 Conducted TTX Flooding with AWD/Cholera Scoping Mission concluded 23/24 March
Western Pacific Region Cambodia 25 April 2018 to 27 April 2018 Conducted TTX Validate advance national pandemic preparedness Vietmnam, Cambodia, Laos (3 Mekong countries)
Region of the Americas Argentina 4 October 2018 Conducted TTX G20 Health SimEx (AMR)
African Region Senegal 8 May 2018 to 9 May 2018 Conducted FX Validate Public Health Emergency Operation Centre functions
African Region Nigeria 11 March 2018 to 17 March 2018 Conducted FSX IHR FSX  Yellow fever outbreak The Simex highlighted a lot of issues that will help strengthened the system however the exercise was conducted by NCDC with WHO acting as evaluators/observers. Other agencies and departments should be included in future exercises, e.g. Customs and immigration. The SimEx plan should have been more structured. Relevant documents were not shared or shared late. National level NCDC capacity for response was not fully tested. Pretesting of the various aspect of the Simex would have been beneficial. WHO document was used for the exercise but the WHO staff was not involved with the planning. Exercise containment was poor. Final report of the SIMEX pending from NCDC.
Eastern Mediterranean Region Jordan 28 January 2018 to 2 February 2018 Conducted TTX Validate Public Health Emergency Operation Centre functions
European Region Uzbekistan 23 November 2017 to 24 November 2017 Conducted
European Region Switzerland 1 November 2017 Conducted TTX To familiarize HWCOs with their roles and responsibilities in managing health emergencies, and demonstrate the linkages between health system strengthening and emergency preparedness and response.  
African Region South Africa 6 November 2017 to 10 November 2017 Conducted TTX The overall aim of the SADC Health Emergency Simulation Exercise is to promote awareness of the key issues surrounding global and regional health crisis management including response and to generate sustainable support among SADC Member States for the continuous improvement of epidemic preparedness and response capacities at the national and regional level
South-East Asia Region Indonesia 30 July 2017 to 4 August 2017 Conducted Orientation Pandemic Rsiks Management training As preparation for the pandemic Response exercise in September, an programme of exercises are being conducted including tabletop exercises and drills.
African Region Cameroon 7 September 2017 to 15 September 2017 Conducted FSX Cholera response
African Region Zimbabwe 22 May 2018 to 23 May 2018 Conducted TTX The purpose of the table top exercise (TTX) is to test Zimbabwe’s preparedness and response capacities as part of the IHR core capacities.Specific objectives1. To discuss roles and functions in the context of an infectious disease outbreak that requires a government response including EOC activation.2. Familiarize participants with coordination and communication mechanisms in the context of a Public Health event requiring a multi sectoral, multi-agency response.3. To acquaint participants with IHR (2005) core capacities in order to facilitate an appropriate and effective Public Health emergency response.
Eastern Mediterranean Region Egypt 21 November 2017 Conducted FSX For the arrival of an aircraft with a potentially infected cases by an epidemic disease (public health emergency) with the occurrence of a death on board an aircraft coming from a country with a pandemic disease, to an unaffected countryThrough a transit country unaffected by any recent epidemiological outbreaks
European Region Georgia 21 August 2017 to 22 August 2017 Conducted TTX To practice the regional component of the response system in addressing the regional impact (including a high number of IDPs and refugees) of a potential large-scale violent conflict
Eastern Mediterranean Region Occupied Palestinian Territory 4 March 2018 to 9 March 2018 Conducted TTX Validate I-A Contingency Plan
African Region Uganda 25 October 2017 to 27 October 2017 Conducted TTX GHSA, Planning mission conducted 11-15 September.Exercise undertaken on the 26th OctoberPurpose of the exercise was to enable information sharing through a Q&A structured session with senior level involvement (Ministers and Senior Advisors)Objective to insitgate discussion and information sharing within the diverse groups 1. Clear and open communication is important. Early transparent reporting engenders trust and allows for an earlier response which can limit the spread and improve outcomes 2. Collaboration at all levels is essential 3. Adequate funding mechanisms are important. The World Bank Pandemic Contingency Fund generated significant interest 4. The advantage of the clear leadership of multisector teams and the activation of an effective EOC was highlighted 5. Border closures were not identified as an effective strategy and most delegates agreed that screening and contact tracing at borders and building capacity for at-risk countries were more effective. Closing borders was seen as diverting critical resources, particularly security resources away from essential functions.
African Region Benin 17 October 2017 to 19 October 2017 Conducted Training TTX module. Simulation facilitators trained in the planning and conduct of a table top exercise, including WHO & MoH staff from Benin Comoro, Senegal, Gabon, Mauritania & Chad
European Region Armenia 16 October 2017 to 17 October 2017 Conducted TTX Training on Risk Communications.   Multiple hazard including earthquake leading to a radiological release from the countries nuclear reactor.  Exercise to test Risk Communications Simulation undertaken as part of the Emergency Risk Communications (ERC) training programme. Report from WHO Euro (Cory Coulliard)
African Region Ghana 1 August 2017 Conducted TTX Familiarize Participants with the business continutiy Plan (BCP)
African Region Uganda 11 May 2017 Conducted FX  To test and evaluate the capabilities of the Ugandan PHEOC in the management of the different phases of an emergency response as well as to inform the forthcoming JEE process. Alert management, rapid response team deployment, convening of the NTF and PHEOC activation and deactivation processes, multi-sector coordination, IMS set up, public communication, and operational information management, IHR coordination and communication, and task and resource tracking.
Eastern Mediterranean Region Pakistan 18 September 2017 to 22 September 2017 Conducted TTX Mass gathering TTX Risk analysis using the STAR tool. Mass gathering simulation taking into account the outcomes of the STAR tool and the current situation in Pakistan. Ashura and Arbaeen pilgrimage seen as primary canditate but simulation also targeted regional particvipation and tested linkages between regional government structures.. Examinined issues around food poisoning, attacks on gatherings and waste disposal after an incident. Participation at all levels including MoH, NDMO, Mil and Civl Defence. Buy in from Prime Ministers Office.
Eastern Mediterranean Region Iraq 19 August 2017 to 25 August 2017 Conducted TTX Mass gatherings TTX Risk analysis using the STAR tool. Mass gathering simulation taking into account the outcomes of the STAR tool and the current situation in Iraq. Core focus on Ashura and Arbaeen Pilgrimage. Examinined issues around food poisoning, attacks on mourners and waste disposal after an incident. Participation at all levels including MoH, NDMO, Mil and Civl Defence. Buy in from Prime Ministers Office.
South-East Asia Region Indonesia 24 October 2017 to 26 October 2017 Conducted TTX To improve the understanding and identify areas for collaboration between the public health sector and the military health services to jointly prepare for and respond to public health emergencies.- Clarify roles and responsibilities between public health sector and military health services in a natural and deliberate event - Recognize the importance of strong coordination mechanisms- Examine areas for collaboration in emergency preparedness and response - Identify communication and information sharing mechanisms.
European Region Turkmenistan 26 March 2017 to 31 March 2017 Conducted FX To test coordination and communication between health service stakeholders in the management of a suspect case of a non-endemic disease at the Olympic Village Games MOH operations centre and state sanitary-and-epidemiologic service operation, medical team and polyclinic, ambulance and dispatch centre, infectious diseases hospital and laboratory.
European Region Turkmenistan 26 March 2017 to 31 March 2017 Conducted FSX To test the management of a suspect case of a non-endemic disease at the Olympic Village of the Asian Indoor Games from detection to admission at a designated hospital in Ashgabat.  MOH operations centre and state sanitary-and-epidemiologic service operation, medical team and polyclinic, ambulance and dispatch centre, infectious diseases hospital and laboratory.
Eastern Mediterranean Region Tunisia 11 July 2017 to 13 July 2017 Conducted TTX OIE exercise: criminal acquisition and release of an animal pathogen 1. Multi sector and multi agency preparedness
African Region United Republic of Tanzania 30 March 2017 to 31 March 2017 Conducted TTX Test the national Cholera Plan DRAFT: Strengthen multi-sectoral collaboration during emergencies, develop communication channels in specific areas, train/inform participants from the community and health facilities on the SOPs prior to the exercise, and implement ongoing exercises.
Western Pacific Region Philippines 5 December 2017 to 6 December 2017 Conducted FX IHR communication exercise & EIS access
African Region Mauritania 16 November 2017 to 17 November 2017 Conducted FSX RRT cross border Ebola response
South-East Asia Region Indonesia 18 September 2017 to 20 September 2017 Conducted FSX Pandemic response (coordination) The full-scale exercice, which took place in South Tangerang Municipality of Banten Province, covered all components of pandemic risk management with the "whole society" involvement across sectors from the central level to the community, including command and coordination components, Medical Response, Surveillance, Laboratory, Risk Communication, Business Continuity Plan, perimeter control, pharmacy and non-pharmacy interventions, Public-Private partnership as well as civil-military cooperation in pandemic and emerging infection prevention. The simulation, based on a H7N9 virus, also exercised a poultry market closure, the activation of the Business Continuity Plan of BATAN nuclear installation and screening at Soekarno Hatta International Airport and Merak Port.  WHO country office played an active role in the simulated response with a mockup office setup on site; while other members of the WHO team directly supported the conduct, the facilitation and the evaluation of the exercice.
WHO-HQ Hungary 21 June 2017 to 22 June 2017 Conducted FX To evaluate I-A response coordination in a nuclear emergency Notification, verification and reporting procedures under IHR, WHO ERF for nuclear emergencies, WHO capability to provide assistance through WHO experts networks, and internal communication and coordination for public messaging
WHO-HQ Germany 19 May 2017 to 20 May 2017 Conducted TTX The Simulation Exercise aims to raise awareness of the challenges arising during international health crises and to introduce key concepts and conditions for their successful control. 
African Region Uganda 25 January 2017 Conducted DR  To practice and train the operational readiness of the National Rapid Response Team (NRRT) for Health Emergencies. Legislation and policy development, infrastructure and equipment, case investigation and management, donning and doffing PPE, disinfection and waste management, transport of patients, contact tracing, safe and dignified burials
European Region Turkmenistan 9 December 2016 Conducted TTX To develop and familiarize participants with plans for the detection and management of symptomatic individuals arriving at Ashgabat International Airport during the Asian Indoor Games
African Region Togo 12 September 2016 to 16 September 2016 Conducted TTX EPR validatoin
African Region Togo 10 February 2016 Conducted TTX EVD Response (IMS)
European Region Switzerland 27 February 2017 to 1 March 2017 Conducted TTX WR role in Emergencies and WHO Emergency Response Framework II Educational session on roles
European Region Switzerland 17 March 2016 Conducted TTX WHO Emergency Response Framework & IMS
African Region South Sudan 13 April 2015 to 18 April 2015 Conducted TTX EVD Response
African Region Sierra Leone 14 November 2015 to 29 November 2015 Conducted TTX Rapid response mechanism
African Region Sierra Leone 1 September 2016 to 31 October 2016 Conducted TTX EVD Response Plan Inter-Agency Coordination
African Region Sierra Leone 1 August 2016 to 31 August 2016 Conducted TTX EVD Response Plan MOH/WHO
African Region Senegal 17 November 2014 to 21 November 2014 Conducted TTX EVD Response (Checklist)
African Region Senegal 15 June 2015 Conducted TTX, DR EOC (DR/TTX)
African Region Senegal 31 August 2015 to 5 September 2015 Conducted FSX National procedures
Western Pacific Region Philippines 8 December 2016 to 9 December 2016 Conducted FX IHR communication exercise & EIS access
African Region Niger 14 December 2015 to 15 December 2015 Conducted FSX EVD Response 
African Region Mauritania 16 December 2016 to 17 December 2016 Conducted DR, FSX Assess the Health Centre (CHN) ability to diagnose and manage a case of hermorrhagic fever and coordination with MoH for case management (DR/FSX)
African Region Mauritania 2 December 2015 to 3 December 2015 Conducted FX Ebola Treatment Centre (DR/FX)
African Region Mauritania 4 October 2015 to 10 October 2015 Conducted EVD Response
African Region Mauritania 10 November 2014 to 16 November 2014 Conducted TTX EVD Response (Checklist)
African Region Mali 25 April 2016 to 5 May 2016 Conducted TTX Meningitis Response http://www.nhfpc.gov.cn/zhuz/ttyw/201711/560795168d474d8cb8754923f36e8567.shtml
African Region Mali 20 October 2014 to 24 October 2014 Conducted TTX EVD Response (Checklist)
African Region Mali 20 October 2014 to 24 October 2014 Conducted FSX Hospital-based patient transfer
African Region Mali 29 July 2015 to 30 July 2015 Conducted DR, FX EOC & EVD Response (FX/DR)
African Region Liberia 20 June 2016 to 24 June 2016 Conducted Orientation Exercise Overview + How to set up an exercise programme
African Region Kenya 17 October 2016 to 19 October 2016 Conducted Training TTX Facilitators training
South-East Asia Region Indonesia 27 June 2016 to 29 June 2016 Conducted TTX Preparedness Framework
African Region Guinea Bissau 1 May 2016 Conducted DR RRT
African Region Guinea 23 May 2016 to 27 May 2016 Conducted TTX RRT
African Region Guinea 17 March 2016 to 23 March 2016 Conducted TTX RRT
African Region Ghana 10 October 2016 to 14 October 2016 Conducted TTX RRT Eastern Regional Exercise Cholera
African Region Ghana 10 October 2016 to 14 October 2016 Conducted TTX RRT Brong Ahafo Regional Exercise Cholera
African Region Ghana 10 October 2016 to 14 October 2016 Conducted TTX RRT Western Regional Exercise Cholera
African Region Ghana 7 June 2015 to 12 June 2015 Conducted FSX Management of confirmed EVD Patient
African Region Ghana 5 July 2016 to 7 July 2016 Conducted Orientation Exercise Overview + How to set up an exercise programme
African Region Ghana 4 September 2016 to 9 September 2016 Conducted TTX Chemical Exercise
African Region Ghana 13 October 2015 to 15 October 2015 Conducted FX EOC+EVD Response 
African Region Ghana 10 November 2014 to 15 November 2014 Conducted TTX EVD Response (Checklist)
African Region Ghana 12 September 2016 to 15 September 2016 Conducted TTX Laboratory Exercise
African Region Ghana 9 June 2015 Conducted DR EVD Response (RRT focus)
African Region Gambia 17 November 2014 to 22 November 2014 Conducted TTX EVD Response (Checklist)
African Region Gambia 13 March 2015 to 18 March 2015 Conducted FSX Management of confirmed EVD Patient
African Region Gambia 1 February 2016 to 5 February 2016 Conducted TTX IMS
African Region Ethiopia 1 December 2014 to 8 December 2014 Conducted TTX EVD Response (Checklist)
African Region Ethiopia 1 May 2016 Conducted DR Conducted at Addis Internationa airport and ETU treatment center in Addis Ababa.
European Region Denmark 11 February 2017 Conducted TTX WR role in Emergencies and WHO Emergency Response Framework II
African Region Cote d'Ivoire 8 July 2015 to 9 July 2015 Conducted FSX EVD Response (Guiglo and Toulepleu)
African Region Cote d'Ivoire 6 October 2015 to 10 October 2015 Conducted FX EVD Response (ICM)
African Region Cote d'Ivoire 3 February 2016 to 5 February 2016 Conducted FSX EVD Response (Airport + RRT)
African Region Cote d'Ivoire 27 October 2014 to 31 October 2014 Conducted TTX EVD Response (Checklist)
African Region Cote d'Ivoire 20 July 2015 to 25 July 2015 Conducted FSX Coordination
African Region Cote d'Ivoire 11 May 2015 to 15 May 2015 Conducted FX EOC
African Region Cote d'Ivoire 30 November 2016 Conducted TTX Laboratory Exercise
African Region Cote d'Ivoire 1 November 2015 Conducted Coordination
African Region Chad 9 May 2016 to 13 May 2016 Conducted TTX Coordination
African Region Central African Republic 2 December 2014 to 8 December 2014 Conducted TTX EVD (imported + endogenous)
African Region Central African Republic 2 December 2014 to 8 December 2014 Conducted TTX EVD Response (Checklist)
African Region Central African Republic 10 November 2014 to 13 November 2014 Conducted FX
African Region Central African Republic 10 November 2014 to 13 November 2014 Conducted TTX
African Region Central African Republic 10 May 2016 to 13 May 2016 Conducted TTX Coordination (Rabies)
African Region Cameroon 10 November 2014 to 14 November 2014 Conducted TTX EVD Response (Checklist)
African Region Cameroon 10 November 2014 to 14 November 2014 Conducted FSX EVD Response (Checklist)
African Region Cameroon 1 January 2015 Conducted
African Region Burkina Faso 3 December 2014 to 7 December 2014 Conducted FSX EVD Response
African Region Burkina Faso 2 May 2016 to 6 May 2016 Conducted TTX Meningitis
African Region Burkina Faso 17 November 2014 to 24 November 2014 Conducted TTX EVD Response (Checklist)
African Region Burkina Faso 17 November 2014 to 24 November 2014 Conducted DR PPE
African Region Burkina Faso 14 July 2014 to 18 July 2014 Conducted Pandemic response
African Region Burkina Faso 26 October 2016 to 27 October 2016 Conducted FSX RRT (detetction, mobilization, case management, risk communication & coordination)
African Region Benin 17 November 2014 to 24 November 2014 Conducted TTX EVD Response (Checklist)
African Region Benin 10 November 2015 to 12 November 2015 Conducted DR Safe burial
African Region Benin 10 November 2015 to 12 November 2015 Conducted FX Coordination
African Region Benin 23 March 2015 Conducted TTX Coordination
African Region Democratic Republic of Congo 5 May 2016 Conducted TTX Yellow Fever Response (Coordination)
African Region Cote d'Ivoire 30 November 2016 Conducted TTX Laboratory Exercise

Preparedness cycle

Simulation exercises enable people to practice their roles and functions, and to gain experience in emergency settings. They are used to identify and eliminate issues before an actual emergency occurs and are therefore a key component in the emergency preparedness cycle. Exercise recommendations and corrective actions are essential to improve response systems and mechanisms to effectively manage emergencies. The components of the preparedness cycle are: planning, organizing, training, equipping, exercising, evaluating and taking corrective action. 

After Action Reviews/Lessons Learned activities from real events also feed into the cycle as illustrated below:

Simulation exercise types

Generally, there are four fundamental types of exercises that can be split in two categories:

 

Discussion-based exercises:

Table Top exercises (TTX): A Table Top exercise is a facilitated discussion of an emergency situation, generally in an informal, low-stress environment. It is designed to elicit constructive participant discussion, to identify and resolve problems and refine existing operational plans. This is the only type of simulation exercise that does not require an existing response plan in place.

 

Operations-based exercises:

 

Drill (DR): A drill is a coordinated, supervised exercise activity, normally used to test or train a single specific operation or function in a repeated fashion. A drill aims to practice and perfect one small part of the response plan and should be as realistic as possible, employing any equipment or apparatus for the specific function.

 

Functional exercises (FX): A functional exercise is a fully simulated interactive exercise that tests the capability of an organization to respond to a simulated event. The exercise tests multiple functions of the organization’s operational plan. It is a coordinated response to a situation in a time pressured, realistic situation. A functional exercise focuses on the coordination, integration, and interaction of an organization’s policies, procedures, roles and responsibilities before, during, or after the simulated event.

 


Full-scale/field exercises (FSX): A full-scale exercise simulates a real event as closely as possible and is designed to evaluate the operational capability of emergency management systems in a highly stressful environment, simulating actual response conditions. This includes the mobilization and movement of emergency personnel, equipment and resources. Ideally, the full-scale exercise should test and evaluate most functions of the emergency management plan or operational plan. Differing from the FX, a full-scale exercise typically involves multiple agencies and participants physically deployed in an exercise field location.

 


Field exercises: See full-scale exercise. A field exercise is one form of full-scale exercise, focusing on more specific capacities or series of capacities, such as procedures for Rapid Response Teams (RRT), laboratory analysis or other sample collection and transport.

Exercises are not one-time events, but should be undertaken as part of a carefully designed exercise program which ensures a common strategic objective is addressed. A comprehensive exercise program is made up of progressively complex exercises, which build upon the previous, until they are as close to reality as possible. This ‘building-block approach’ should start with basic exercises that test specific aspects of preparedness and response, followed by progressively complex exercises requiring additional preparation time and resources.

 

The figure below provides an illustration of the level of preparation and capacity needed for each exercise type.