Simulation exercise helps Western Pacific countries prepare for future outbreaks

Arboviruses, such as dengue, yellow fever, chikungunya and Zika, are all current public health threats in tropical and sub-tropical areas. If a new arbovirus outbreak were to emerge in the Western Pacific, how would countries verify, report and share information?

From 13 to 14 November 2024, 36 countries and areas in the World Health Organization (WHO) Western Pacific Region addressed this critical question during IHR Exercise Crystal, a simulation exercise designed to test their communication capacities as outlined in the International Health Regulations (2005), or IHR. The IHR is an international framework that helps countries develop, strengthen and maintain their surveillance, verification and response capacities for potential health threats.

Since 2008, IHR Exercise Crystal has been conducted annually in the Western Pacific Region. In this exercise, IHR national focal points and contact points respond in real time to incoming information about a simulated public health event. The exercise tests their ability to verify and share information, assess risks to public health, coordinate with other sectors and communicate with WHO.

Knowing when and how to communicate during a potential outbreak requires practice. “The IHR is the backbone of resilient health systems,” said Dr Gina Samaan, WHO Regional Emergencies Director for the Western Pacific. “Through IHR Exercise Crystal, countries in the Region practice effective IHR event communication, including notification, information sharing and event verification.”

Improving IHR communication capacities

This year’s scenario involved a potential outbreak of Oropouche virus, an arbovirus that thrives in conditions shaped by climate change, such as rising temperatures and increased humidity. Participating countries received simulated IHR communications from WHO about the fictitious outbreak and were tasked to respond in line with the IHR communication and coordination mandates.

Through this exercise, countries advanced their capacities in several key areas:

Multisectoral coordination was a primary focus, as participants coordinated with representatives from different sectors to collect information on public health measures taken in response to the evolving scenario. Effective coordination across sectors − such as in vector control, environmental health, laboratories, hospitals and border control − is critical in emergency response. The Director of the Bureau of Public Health, Ministry of Health and Human Services in Palau, Sherilynn Madraisau, emphasized the value of this annual exercise, which allowed experts from different sectors to learn how to work together. "Experts from across various sectors—vector, environment, laboratories, hospitals, agriculture, National Emergency Management Office, state government animal shelter and border control—participated in the IHR simulation exercise. Our vector control and environmental health colleagues worked alongside health department experts to respond to the scenario, giving us an opportunity to test communication channels across divisions and institutions.”

Timely communication systems were also tested. Rapid and effective communication is critical during an outbreak response. Participants practised notification and assessment of the fictious outbreak to ensure accurate and swift information sharing.

The exercise also served as an opportunity for learning and improving by giving participants an opportunity to practise IHR risk assessment, decision-making and communications, as well as to identify gaps and areas for improvement. The exercise is a useful “safe space” to practise these functions and to orientate and refresh staff to IHR communications. “This year's scenario involved a new disease that Malaysia hasn’t previously encountered, so it helped us to assess our laboratory capacities and identify areas that need further strengthening,” said Dr Thilaka Chinnayah, Director, Disease Control Division, Ministry of Health, Malaysia. By addressing these gaps through annual simulation exercises, countries in the Western Pacific are better prepared for future health threats.

Preparing for future pandemics

Recent international public health events – including mpox, the COVID-19 pandemic, Ebola and the H1N1 influenza pandemic – underscore the susceptibility of communities and societies to infectious disease threats. They also highlight the importance of effective collaboration, information sharing and strong communication across countries.

In the Asia Pacific, efforts to strengthen and maintain IHR communication functions are supported through the Asia Pacific Health Security Action Framework (APHSAF). The Framework emphasizes the importance of monitoring, evaluating and improving capacities through activities such as simulation exercises and reviews. IHR Exercise Crystal is a critical part of these efforts, enabling countries to practise communicating with WHO and each other in the event of an outbreak. By doing so, the exercise helps prevent outbreaks from escalating into epidemics, ultimately saving lives.

Please click here to read the original article.