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WHO’s work in Emergency Risk and Crisis Management (2015)

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At the sixty-eighth session of the World Health Assembly in May 2015, WHO Director-General Margaret Chan committed the Organization to creating a single, all-hazards emergency programme; to establishing a global health emergency workforce; and to raising a US$ 100 million contingency fund to enable rapid emergency response.

As I write this in October 2016, the programme, the workforce and the fund have become a reality, although they are still being built. While the new programme represents a major restructuring and a new approach to how WHO addresses emergencies — be that in prevention, preparedness, response or recovery — it was built on the foundations already in place. This includes the work of WHO’s Department of Emergency Risk Management and Humanitarian Response (ERM).

The department, now folded into the new programme, was responsible for managing all phases of WHO’s humanitarian work in relation to conflicts and disasters.

This report details the work of the ERM department in 2015, a year when the Organization provided assistance to more than 40 countries dealing with health emergencies, including seven simultaneous Grade 3 emergencies — the most in any single year on record.

These emergencies – in Central African Republic, Iraq, Nepal, South Sudan, Syria, and Yemen — placed unprecedented strains on the Organization at all levels.

The Ebola outbreak in West Africa represented the seventh of these Grade 3 emergencies, but was outside of ERM’s purview, and thus is not covered in this report.

The year also saw a third consecutive global increase in the number of people displaced by violence and persecution. The total came to over 65 million, most of whom remain in the Middle East and in Africa. WHO continued to coordinate health-sector responses to protracted crises, including in the Democratic Republic of the Congo, Myanmar, the Sahel sub-region of Africa, Somalia and Ukraine.

A disturbing increase in attacks on health workers has made helping at-risk populations an even greater challenge. A WHO report, Attacks on Health, found that from January 2014 to December 2015 there were 594 reported attacks on health care resulting in 959 deaths and 1561 injuries in 19 countries with emergencies.

WHO condemns these attacks in the strongest terms and will continue to advocate on behalf of health workers wherever and whenever they are under threat.

In addition to disease outbreaks and conflicts, natural hazards — earthquakes, typhoons, and floods — affected approximately 90 million people in 2015. The Nepal earthquake of April 2015 alone affected almost 6 million people. WHO and partners responded to the vast majority of these crises.

The new emergencies programme will build on successes such as the deployment in 2015 of a novel surveillance system for detecting infectious disease and monitoring trends, and partnerships that have been at the heart of WHO’s emergencies work for years, be they networks of experts or medical teams ready to deploy.

WHO also invests considerable efforts in helping countries to prepare for and mitigate the effects of emergencies: retrofitting hospitals so that they don’t collapse during earthquakes; training rapid response teams so that they can react quickly when an emergency occurs; establishing stockpiles of drugs, supplies and emergency kits; strengthening WHO’s readiness to respond to emergencies, in support of local health staff; and assisting with recovery efforts based on the principle of ‘building back better.’ The question is whether the resources and can be found and the global momentum can be built to do a great deal more of this advanced work. If so, future tolls to people and communities will be less severe when diseases spread, when disasters strike, and when conflicts break out. This is why WHO has changed how it operates.

It is clear that to meet the immediate health needs of crisis-affected populations, whilst at the same time tackling the root causes of their vulnerability, WHO must be part of a broader change in the way the international community prevents, prepares for, and responds to crises.

From the Sendai Framework for Disaster Risk Reduction, to the Sustainable Development Goals and the World Humanitarian Summit, there is now a groundswell of support for a profound reform of the way the world approaches crises, and it is in this context that WHO’s new Health Emergencies Programme has taken shape.

To perform effectively in all areas of work on emergencies, WHO needs predictable, long-term, sustainable funding. Our funding appeals for emergencies were largely underfinanced in 2015.

This must change.

Dr Richard J. Brennan

Director of Department of Emergency Operations, WHO Health Emergencies Programme

former Director of WHO’s Department of Emergency Risk Management and Humanitarian Response