WHO biweekly operational update 1-15 January 2021

General developments: political & security situation

• Guterres announces necessary steps for Libya ceasefire to hold, • The Libyan financial committee tasked with devising the 2021 unified budget of the country held a meeting in eastern Libyan town of in the presence of officials from the -based Government of National Accord. • Libyan GNA, Haftar's forces swap over 35 prisoners. • Italy appoints special envoy to Libya. • NATO Reaffirms Support To Libya And Concern About The Russian Presence. • LPDF's Advisory Committee meeting kicked off today in the Palais Des Nations in Geneva. • Libyan Economic Dialogue Meets to Follow up on Critical Economic Reforms. • Acting Special Representative of the Secretary-General Stephanie Williams announces the establishment of the LPDF's Advisory Committee. • The US Ambassador to Libya, Richard Norland has said that members of the Libyan Political Dialogue Forum (LPDF) Advisory Committee (AC) had been offered an opportunity to forge consensus on forming a new government. • Health workers call for urgent measures, say conditions in Health Ministry are catastrophic.

OPERATIONAL UPDATES

COVID-19

Pillar 1: Country‑level coordination, planning and monitoring

• Facilitated the production of the first COVID-19 national strategy based on the outcomes of the national workshop on 11 November 2020. • Participated in the in the regular meetings and provide technical support to the COVID-19 advisory committee in Sabha • Worked with the University of in preparing the COVID-19 scientific conference on 30th January 2021. • Met with the Supreme COVID-19 Committee in Benghazi, discussed 2021 procurement plan for COVID-19 diagnostic equipment, updated partners about the COVID-19 situation in Libya. • Presented health related consequences of the COVID-19 during the scientific day organized by Al Mukhtar University in Al Baida.

Pillar 2: Risk communication and community engagement

• Attended a meeting with WR at the NCDC to follow up on EWARN and response to COVID-19. • In cooperation with PHC and Mental health officers, conducted two 2-day workshops on COVID-19 in schools in Tripoli. Teachers and students between 9-12 year were taken through the basic procedures to recognize the symptoms of the disease to help preventing the spread. • Met with the Director of Communication to discuss the objectives and the agenda of the educational workshop on COVID-19 prevention measures for the NCDC-IEC professional in seven municipalities around Tripoli. • In close cooperation with the communication team at the regional office developed official response to the inquiries received from Libyan journalists on COVID-19 and the new vaccine. • Developed COVID-19 health promotion messages and posted them on the WCO’s social media platforms (in and English) about WHO’s COVID-19 activities (available at https://twitter.com/WHOLIBYA and https://www.facebook.com/WHOLIBYA/. • Provided presentation on COVID-19 recent updates including infection prevention measures at schools and orientation on risk of communication and community engagement to teachers and administrative staff at World International Language School in Janzour.

1

Pillar 3: Surveillance, rapid response teams and case investigation

• Continued to follow up with the National Centre for Disease Control (NCDC) on daily registered COVID-19 cases and the epidemiological situation and updated COVID19 Dynamic Infographic Dashboard for Libya with NCDC and WHO EMRO data sources. • Supported NCDC by conducting 3 workshops targeted surveillance officers involved in EWARN system, these workshops on using new application which included COVID-19 as one of priority diseases? The training attended by 59 surveillance officers covered south, west and mid regions. • Shared with MoH and NCDC update information on new SARS-CoV-2 variant. • Conducted regular follow up with NCDC newly detected COVID 19 cases and epidemiological situation progress in the country • Preparation in place for support to the NCDC COVID 19 data management team by training on data analaysis and interpretation

Pillar 5: National laboratories

• Supported COVID-19 lab network by conducting three training workshops in Tripoli focused on lab confirmation and biosafety/ biosecurity and are follows: o The first workshop was conducted between 15 to 17 December targeted Aljufra, Sert, Khoms, labs and attended by 20 participants. o The second workshop was conducted on 22 December for 3 days, targeted , Ghedames, , Yefren and labs and attended by 24 participants, o The third workshop was conducted on 29 December for three days, targeted Sabha, Ashati, , labs and attended by 25 participants.

Pillar 6: Infection Prevention and Control

• Followed up with the IPC consultants in the south the implementation of their action plan in the southern region. • Contracted IPC officers to follow-up the situation in 16 COVID isolation departments and triage centres, conduct IPC assessment at the facility level and identify the gaps and needs in those health facilities. • Organized 3 training sessions of 1 day each on IPC measures and trained more than 25 healthcare workers in health facilities provided COVID health care in coordination with the local health authorities. • Co-chaired IPC working group meeting with UNICEF and discuss the same at of coordination between the agencies. • Organized and facilitated the weekly meeting for IPC officers and discussion of their work plan in the next two months based on the IPC assessment.

Pillar 7: Case management

• Provided an update on COVID-19 bed capacity of the 2 main health facilities of isolation centers in Tripoli. • Provided the technical support to Sabha Medical Center in regard to the new isolation center that will be opened in the center.

Leadership

• Reviewed the WHO annual response for Libya 2020. • Finalized all PMDS’ for staff. • Followed up on the remaining audit recommendations for closure. • Prepared the cost for WHO Libya operations in 2021. • Prepared an overview of staff cost for 2021 and matched them to ongoing awards. • Prepared funding projections for 2021. • Reviewed plans for staff accommodation and advocated for WHO’s needs with UN heads of Agencies. • Reviewed a proposal for WHO support to cover acute health needs in .

2

• Met with Director of UNDP to discuss potential for a joint initiative to provide support for pressing health interventions in Sirte. • Prepared COVID vaccine plans for UN national and international staff. Met with UN chief medical officer in Libya to review criteria and plans. • Reviewed national plans for COVID vaccination. Met with DG of the NCDC to review policies, criteria and operational plans. • Worked with UNHCR and IOM on policy, criteria and operational plans for COVID vaccination of vaccination of refugees and migrants. • Met with NCC to provide direction and advocated for the inclusion of refugees, migrants and UN staff in the national vaccination plan. • Acted for DO and RC/ HC.

Coordination and Health Information Management

• Participated in the work of the established Basic Services Working Group under the Joint Technical Coordination Committee: presented health sector “development” related imperatives. • Presented Libya case in deep dive discussion within the “Accelerator Themed Working Group on Innovative Programming in Fragile and Vulnerable Settings”, organized by the Regional Office. • Provided surge support to the WHO emergency operations in Syria. • Completed Annual Cluster Coordination Performance Monitoring (CCPM) for health sector performance in 2020. 27 organizations (75% response rate) provided respective inputs. • Produced Health Sector Bulletin for December 2020. • Finalizing 2020 Health Sector Annual Report for Libya. • Followed up with the health sector and key donors on on COVID-19 vaccine introduction. • Followed up with UNHCR, WHO, IOM, MSF-H, UNICEF on the reported health concerns in Gargaresh community. • Worked with WHO leadership on necessary steps to cover migrants and refugees by the planned COVID-19 vaccination. • Continued technical discussions with the World Bank and the Regional Bank on the next steps for development of Health Workforce strategy and related steps. • Developed the following IM materials: o Annual WHO operational response, 2020, Libya o Summary of 2020 HRP key indicators reported through 4Ws, December 2020 o Map of Health sector partners operational presence across Libya, 2020 o health sector annual 2020 maps showing medical procedures provided and the health facilities supported. o Updated the link for Health sector interactive analysis for the 4Ws . o Daily update Libya dynamic COVID-19 Libya dashboard COVID-19 Libya dashboard. o Update of HIS unit EMRO by Libya December Emergency Response Monitoring indicators. o developed the 2021 Health Sector 4Ws data collection matrix.

HEALTH OPERATIONS

Sub-office Benghazi

• Met with Sirte hospital director, Sirte Mayor, and Sirte representative in the Parliament- discussed the urgent health needs in Sirte Municipality and a response action plan prepared and submitted and approved by WR. • Followed up with the Libyan Midwives’ Association (LMA) to draft a joint proposal and explore how to strengthen the Midwifery services in 2021. • Followed up with the International Activities Office of Bambino Gesu Hospital (BGH) in Rome to start preparation for resumption of WHO-BGH project to train Libyan doctors and nurses from Tripoli and Benghazi Children Hospitals. • Shared with the NCDC focal points of Neglected Tropical Diseases (NTD) the program and link of the NTD Roadmap 2030 which will be launched on 28 January 2021.

3

• Started practical arrangements and links between the national working group and Pasture Institute of Morocco to test the anti-scorpion antidote suitable for Libya. • Conducted a TC with ICRC to discuss the progress of the AMR program and way to coordinate in the line with national action plan.

Sub-office Sabha

• Finalized the selection process of EMTs members to cover 10 municipalities in the south. • Met with the DGs of 8 hospitals in the south to coordinate the deployment of EMTs as part of WHO EMT geographical coverage expansion. • Coordinated with Helpcode INGO providing the needed technical support to draft their proposal to support the medical services provision in and Ghat districts. • Met with south medical doctors association, a local NGO in Sabha, to draft a plan for MHPSS services to be implemented in the south.

EMT

• Prepared EMTs plan for 2021, approved by WR, funds secured to extend and expand the work of the EMTs.

EOC

• Finalized installation of IT equipment, furniture and fire-detection system in Al Bayda EOC. • Followed up with NCDC Sabha regarding the installation of Sabha EOC, the fire protection system will be installed next week. • Conducted assessment on health facility functionality in some areas. • Conducted virtual meeting with MoSA/ICO and Director of PwDs Affair in the Eastern area attended by OCHA and UNDP regarding the data provided and possibility to conduct an assessment on AT and the functionality of the rehabilitation centres. • Followed up on the confirmation of MoSA/SSF on the review of the Rapid Assessment of COVID-19 Disability Inclusive Health Response in EMR countries / COVID19-DAR SERVICES TOOL. • Attended EMRO conducted PHEOC webinar series.

PHC

• Convened an online meeting with HQ digital health and innovation unit and provided update on Libya involvement into mHealth program using mobile phone Short Messages Services (SMS). • Convened meeting with PHC institute director general and representative from pharmaceutical department and medical devices of MoH to agree and finalize procurement plan under PHC AICS funded project; Improving access of vulnerable population to quality primary health care services in conflict affected districts of Libya. • Followed with MoH-ICO on the nomination of MoH cancer focal point for the participation of the “Regional virtual consultation meeting on the Global Initiative on Childhood Cancer (GICC)”, 25-26 January 2021. • Organized 1-day workshop to lunch hypertension and COVID-19 SMS mobile phone awareness campaign during 2021 and provided an introduction on mHealth program initiative, BE HE@LTY, BE MOBILE to help combat noncommunicable diseases. Participants represented MoH, NCDC, PHC institute, Libyan cardiac society, COVID-19 technical advisory committee, Authority of communication and informatics and local mobile phone service providers. • Convened an online meeting with PHC institute and EMRO regional advisers from child and adolescent health unit. Discussed the adopted WHO Integrated Management of Neonatal and Child Illness (IMNCI) guideline and training manual based on the Libyan context and the preparation for the ToT training on IMNCI guidelines. • Convened meeting with PHC institute and MoH reproductive health focal point, discussed the finalization of the training module for physicians based on WHO RMNCH guidelines. • Convened an online meeting with PHC institute and EMRO regional advisers of primary health care, universal health care and health system unit. Discussed the enrolment of Libya into the regional initiative of the Regional Professional Diploma Program on Family Medicine. 4

• Shared with MoH and PHC institute and obtained clearance for the publication of a report on Identifying the Role of Private Health Sector in Response to COVID-19 in Libya. The report intiated by the the Regional Office.

GBV

• Conductd an introductory meeting with IOM GBV Focal Point to discuss possible collaboration options. • Carried out a follow up meeting with GIZ team to discuss concept note/action plan for collaboration work on Women Development and Training Centers . • Set up face-to-face meeting with MoH GBV Focal point to discuss coordination work between MoH, WHO and GIZ.

EPI/AFP/ Measles surveillance program

No update.

Mental Health

• Started implementing a two-year MHPSS project funded by FCDO – Foreign Commonwealth & Development Office (UK) to strengthen the community-based mental health care in Libya. The organization will capitalize on the trained human resource assets established through earlier projects, with the aim of bridging urgent gaps in mental health services in different Libyan regions. The planned interventions aim to strengthen the capacity of the MOH to provide for the needs of people with mental and substance use conditions in Libya, in coordination and collaboration with other sectors. The project “Strengthening the Coordination and Availability of Libyan Effective (SCALE) Mental Health Care in Primary Health Care Services” aims to target three geographical regions in Libya (south, west and east). • Following the high-level introduction meeting between WHO and the PHCI held on 24 December, discussions began between WHO, the MOH, the Ministry of Education, the NCDC and the FDA to ensure a smooth start-up of the program, particularly around the procurement of psychotropic medicines. • The recruitment of an M&E Officer is in process to assist the monitoring of the MHPSS program - among other things. • Conducteda a joint WHO/FCDO high level meeting to discuss the kick-off the of the program, the changes in context, anticipated challenges and mitigating measures, and the final logframe.

Disease surveillance

• Followed up with NCDC/ surveillance administration on functionality of EWARN new reporting application, all surveillance officers involved in EWARN started send their reports using the new application from first week of 2021. • Continued discussion with NCDC and IHP unit on EWARN evaluation and expansion, the preparation arrangement started, the targeted reporting sites list selected and the evaluators are identified. • Participated in two an Event-Based Surveillance (EBS) weekly meetings on 6 & 13 Jan 2021 with EMRO, CDC America and the NCDC to discuss the implementation of EBS in Libya.

TB

• Followed up on the first TB Operational Working Group held on 15 December with the NCDC, the EU Delegation, IOM and all stakeholders active in TB in Libya, WHO, IOM and the NCDC planned for the first TB screening campaigns in Detention Centres. • Published a joint WHO and IOM press release to launch the implementation of the program (Facebook: https://www.facebook.com/1219299178081299/posts/3908929662451557/?sfnsn=mo; https://m.facebo ok.com/story.php?story_fbid=1887746924719589&id=596199670540994&sfnsn=mo Twitter: https://twitter. com/wholibya/status/1346048026817736704?s=24 ; https://twitter.com/iom_libya/status/1346046591036239872 ?s=12) • Submitted monthly technical to the EUTF. .

5

• Reached agreement between WHO and IOM on the final design for the promotional material to be utilized by WHO and IOM, and finalised the design of the campaign material to be utilized during the screening campaigns by the NCDC, WHO and IOM. • Raised and placed all procurement of medicines, equipments and PPEs with estimated time of delivery around March 2021. • Identified a consultant jointly with the NCDC to update the TB guidelines. • Began discussions with the NCDC on the training schedule for the medical and laboratory staff, as well as for the community health workers.

Communications

• Developed and disseminate the joint WHO and IOM PR to welcome the contribution from the European Union to strengthen tuberculosis prevention, detection and treatment services across Libya. It is planned that the PR be published by both organizations simultaneously on the 4th of December 2021. http://bit.ly/2Mlf1hF • Met with the Directors of TB and Communication at NCDC to a agree on the final touches regarding the visibility materials on TB project. • Developed visibility messages and posted them in Arabic and English on the WCO’s social media platforms (available at https://twitter.com/WHOLIBYA and https://www.facebook.com/WHOLIBYA/.

Operational Support and Logistics

Out of Tripoli distribution

• Transported COVID-19 testing equipment from Bio Research lab in Tripoli to COVID-19 laboratory in Benghazi and Al Bayda. • Transported insulin from in Tripoli to Benghazi Medical center. • Distributed HIV drugs from WHO WH in Tripoli to Benghazi Center for Infectious Diseases and Immunity

City From City To Note Only- Transportation Tripoli Bio research lab Benghazi COVID-19 laboratory in COVID-19 testing Benghazi Medical Centre equipment Only- Transportation Tripoli Bio research lab Albayda COVID-19 laboratory in Al COVID-19 testing Bayda General hospital equipment Only- Transportation Tripoli National Oil Benghazi Benghazi Medical Center Insulin Corporation Germany Tripoli WHO WH Benghazi Benghazi Center for HIV Drugs Infectious Diseases and Immunity

• Inspected 6 ICU ambulance to be delivered next week to: a) two – Tripoli; b) two – Benghazi; c) one – Sirte; d) one - Sabha.

Received shipments

• Received at WHO WH Tripoli 350 Pack of Cephalexin 250mg (Pack OF 100 capsules).

Out of Benghazi distribution

Received shipments

• Received the 4th and 5th rotation to complete receiving all of the 3rd wave shipment from Dubai to BGZ. 5 rotations on 5 different days.

First 3 rotations 6

S. No. B/L no. No. of pallets Description 01 386-0007 9774 2 pallets NCDK basic KC module (1b) INSULIN 02 386-0007 9763 28 pallets PPE (Masks and face shields) 03 386-0007 9752 36 pallets Medicine (Ciprofloxacin, and Amoxycillin 04 386-0007 9800 31 out of 49 pallets PPE and lab. consumables 05 386-0007 9796 73 pallets NCD module (1C) renewable, IEHK basic renewable PPE

Rotation 4 and 5

S. No. B/L no. No. of pallets Description 01 386-0007 9800 18 out of 49 pallets PPE and lab. consumables 02 386-0010 2126 36 pallets Medical supplies not restricted Biomed. Equipment. Thermo 03 386-00102115 15 pallets Medical supplies not restricted (NCD 1b-General part)

KEY GAPS & CHALLENGES

Same as for the last reporting period.

RESPONSE PRIORITIES

Same as for the last reporting period.

7