Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme

Turkey Mission Report 2–6 November 2019

Dr Felicity Harvey Professor Hiroyoshi Endo Mrs Precious Matsoso

ACKNOWLEDGEMENTS

The Independent Oversight and Advisory Committee (IOAC) for the WHO Health Emergencies Programme is grateful to the Government of the Republic of Turkey for hosting the visit of the IOAC delegation during 2–6 November 2019 and to the WHO Secretariat at Headquarters (HQ), the Regional Office for Europe (EURO), the Regional Office for the Eastern Mediterranean (EMRO), and the Country Office in Turkey for facilitating the field missions. Special thanks go to the participants for graciously accepting the invitation to meet with the IOAC delegation and providing important insights into WHO’s work on country preparedness and the current response to the Syrian crisis.

I. INTRODUCTION

1.1. Context

The Republic of Turkey is a transcontinental country with a population of 82 million and shared borders with eight countries including Iraq, Iran and Syria. Owing to the 9-year conflict in the Syrian Arab Republic, which threatens the lives of an estimated 4 million people in the northwest of the country, around 3.67 million Syrians are thought to be living in Turkey, including 2.3 million who are registered under Temporary Protection. This represents the largest number of refugees hosted in any country in the world.1 The critical needs of this large population have placed enormous pressure on the existing infrastructure and services in Turkey, particularly health services.

Turkey is located on the transit route to Europe from Asia and Africa and more than 200 million people per year are expected to travel via the new international airport in Istanbul starting from 2030. Turkey is prone to natural disasters such as floods, cyclones, earthquakes, tsunamis, landslides, and droughts, which could worsen in view of climate change. The country is also subject to outbreaks and epidemics of infectious diseases, as well as emerging and re-emerging diseases such as polio and measles. The complex geopolitical situation of the country, and the involvement of multiple actors across sectors, makes country preparedness and response capacity even more important.

1.2. Mission objectives and activities carried out

The mandate of the IOAC is to provide independent scrutiny of the WHO Health Emergencies (WHE) Programme and to monitor WHO’s performance in health emergencies. The objective of the Turkey visit was to review WHO’s work in assisting the Government’s response to the Syrian crisis and in strengthening country preparedness in Turkey. WHO established a Country Office in Ankara in 1959 and a field office for covering cross-border operations into Syria in Gaziantep in 2014.

The IOAC took a field trip to Gaziantep and met with the WHO team in charge of the cross-border operation in the northern part of Syria. During the visit to Gaziantep, the IOAC interviewed the Deputy Regional Humanitarian Coordinator for the Syrian Crisis, and the Director General for the European Civil Protection and Humanitarian Aid Operations (DG, ECHO), representatives of the International Organization for Migration (IOM), the UNHCR, the Organisation of Islamic Cooperation (OIC), UNICEF, Syria Relief & Development, and the WATAN Organization.

In Ankara, the IOAC delegation met with the Deputy Minister of Health; the Directors-General of the respective Ministry of Health (MOH) divisions for migration, emergency health care services, and public health directorates; the Director-General of foreign affairs; and the President of the national disaster management authority for Turkey. The IOAC delegation also consulted the UN Resident Coordinator and representatives of partner agencies. The mission included a site visit to one of Ankara’s refugee health training centres to appraise the effectiveness of WHO’s support of the Government’s approach to

1 Source : https://www.unhcr.org/globaltrends2018

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providing access to quality and equitable health care for the Syrian people living in Turkey. During the training centre visit, the delegation interviewed the head of the centre, Syrian health-care workers, Syrian patients, and the implementing partner ASAM (Association for Solidary with Asylum Seekers and Migrants).

See annex for visit programme.

II. SPECIFIC FINDINGS AND OBSERVATIONS

2.1. WHO Country Office in Turkey and the WHE Programme

The IOAC was briefed by the WHO Representative in Turkey that clear guidance was received from the Regional Office for Europe (EURO) regarding implementation of WHE Programme reform in 2016 and that the Country Office organigram is currently being adapted to the strategic directions of the 13th General Programme of Work (GPW13) under EURO guidance. The IOAC noted that the Country Business Model was used as a benchmark in defining the Country Office’s structure but that the Regional Office adopted a flexible approach to meet country-specific needs, giving due weight to emergency preparedness activities across the European Region, as well as response to emergencies.

The key areas of work with which the Country Office is supporting the MOH include non-communicable diseases (NCDs) and health promotion, mental health, migration and health, and refugee health and health security. The IOAC observed that there is fluid collaboration and support among the different units in the Country Office for its various projects and that the clear mandate for the WHE Programme has strengthened linkage among programmes.

Finance and resource mobilization

The WHO Country Office in Turkey holds the largest budget in the European Region, i.e. one third of the total budget, with $43.5 million of funding for 2019. Only $1 million of this was funded by assessed contributions and the rest was covered by voluntary contributions, which are being mobilized in-country in line with the Regional Office’s strategic direction. The IOAC commends the WHO Representative’s leadership in effectively engaging with in-country donor representatives: 65% of funding is raised at Country Office level, compared with 25% from HQ and 10% from EURO.

For the cross-border operations in Gaziantep, HQ has played a key role in fundraising within the framework of the Whole of Syria approach. The IOAC noted that the Country Office raised more than 90% of funding from in-country donors in Turkey. Fundraising for the Whole of Syria approach has been done in a coordinated manner among HQ, EMRO, EURO, Country Offices and operational hubs, with an agreed internal funding allocation of 67% (Syria hub), 30.6% (Gaziantep hub), and 2.4% (Amman hub until closure of operations in Amman during 2018) for unearmarked funding; this is being adjusted as per the changing operational requirements and decided by consensus among all hubs. In 2019 a total of US$44 million was received for the cross-border operations in Gaziantep from 11-12 donors including the UK, USAID, OCHA and Japan. This figure indicates that WHO’s performance with respect to the Syria

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crisis has gained credibility year by year, reflecting sustained confidence from donors. The initial budget of the office was $2.4 million in 2014, and the budget increased to $32 million in 2018. Commendably, more than 80% of the Whole of Syria budget has been used for activities. In managing financial uncertainty, WHO has shown the flexibility of constantly reviewing the organigram in Gaziantep as well as on a regular basis through Whole of Syria Strategic and Operational Reviews every 2–3 months.

During its mission to Turkey, the IOAC witnessed the critical role of the Country Office and the importance of the delegation of authority for the WHO Representative in mobilizing and deploying resources at the country level. The Country Office has successfully raised US$3 million for health security between 2018 and 2021 and is pushing the agenda for country preparedness. While welcoming the Transformation Agenda, staff noted that resource mobilization should be done in a coordinated manner and that the WHO Country Office is best placed to liaise with in-country donors. The IOAC is pleased to see that the Country Office’s fundraising authority has increased, but is concerned that the additional workload and potential risks of handling funds could be a disincentive for WHO Representatives. The WHO Representative took the initiative to provide staff with training for project management to reduce risk and increase management of the donor funds through the WHO online learning platform ilearn, but there is no systematic career development programme to incentivise such training. The IOAC recommends that WHO empowers WHO Representatives and acquires adequate capacity for resource mobilization, and programme and risk management skills training at the country level.

HR management

In the Country Office in Ankara, there are 38 positions: 21 national staff, nine international staff and eight non-staff (those on Special Service Agreements, consultants and volunteers). As well as noting the great diversity of staff in the Country Office, the IOAC observed that the proportion of staff working on the WHE Programme is high, owing to cross-border operations and the donor-funded programmes on refugee health and health security. Out of 38 positions based in Ankara, 24 positions have been allocated to the WHE Programme.

The field office in Gaziantep is run by a team of 26 staff including 17 professional positions. The IOAC noted an issue related to the HR policy to support staff working on emergencies from non-hardship duty stations. Cross-border operations in response to the Syria crisis are managed by the office in Gaziantep. But since Turkey is classified as a non-hardship duty station according to the UN hardship classifications, the staff in Gaziantep are not entitled to R&R or other packages for hardship duty stations set by the International Civil Service Commission.2 The IOAC recommends that WHO reviews the degree of hardship in offices working on emergencies, especially those carrying out cross-border operations (e.g. Gaziantep) and makes a management decision to compensate staff for this and for the additional workload involved.

The IOAC recognized WHO’s ability to surge capacity from the Country Office, EMRO, EURO and HQ and to deploy staff with speed and flexibility in line with the Emergency Response Framework (ERF).

2 See document (https://icsc.un.org/Home/GetDataFile/5496)

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However, there is a lack of policy for both internal surge capacity, and for the back-filling of posts that are left vacant due to emergency deployments or delays in contracting. WHO’s corporate capacity to surge in emergencies could be improved by stipulating policy provisions across the Organization, providing staff entitlements commensurate with workload during the deployment, rather than relying on supportive supervisors, and putting in place simple and clear procedures between the different offices involved in the internal surge, particularly for long-term deployments. Staff noted that it is costly and difficult to manage the global WHE roster and keep it updated with pre-assessed qualified candidates, both internal and external.

Under the WHO Representative’s leadership, core resources were deployed from the Ankara office to Gaziantep and two additional National Professional Officers (NPO) were hired for the Gaziantep office. The importance of an enabling function in emergencies is well understood in the Turkey Country Office and EURO: five staff, including one supply officer, are based in Gaziantep to support the cross-border operations. WHO is encouraged to involve administrative staff in technical planning with implementing partners to enhance monitoring and accountability.

The IOAC acknowledged EURO’s management efforts in providing learning experiences for NPOs by deploying them to different Country Offices. However, in the absence of a WHO career development policy and the rather small size of the Regional Office, opportunities for moving to a higher grade are still difficult for NPOs and the prospect of becoming international professionals is limited. Noting that NPOs can also be great assets for the MOHs of their respective nations, the IOAC recommends that a mobility and promotion policy should be developed for NPOs and applied across the Organization.

As part of the Transformation Agenda, WHO envisions a shift to a long-term and strategic HR plan from the heavy reliance on short-term contracts with multiple extensions, consultancies and Agreed Programmes of Work (APW). Whilst the IOAC acknowledges the good intentions behind the change, this transition could negatively affect the speed of the emergency response because staff might be left without immediately available solutions. This issue was noted in the Gaziantep office. The IOAC recommends that WHO identifies staffing gaps, and provides flexibility to minimize the disruption during the transitional period and to maintain scalability.

2.2. WHO’s leadership of the Whole of Syria approach and cross-border operations in Gaziantep WHO has shown impressive leadership in responding to the Syrian crisis through the Whole of Syria approach, which authorizes cross-line and cross-border access in order to reach people in need by the most direct routes, as mandated by the UN Security Council Resolutions on Syria.3

WHO’s Whole of Syria set-up is aligned with the OCHA response architecture and works closely with a Deputy Regional Humanitarian Coordinator in Gaziantep, a Humanitarian Coordinator in Damascus (Syria), and a Regional Humanitarian Coordinator in Amman (Jordan). The Deputy Regional Humanitarian Coordinator’s role is to oversee the whole operation into Syria, working with non- governmental organizations (NGOs), UN agencies, and facilitating partners.

3 UNSG RC

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The Whole of Syria approach has provided WHO with a feasible solution to operating in a complex humanitarian and health crisis: such a model should be documented and disseminated as a learning opportunity for others. Under the Whole of Syria approach, WHO is leading cross-border operations through joint planning and reporting of the Humanitarian Response Plan for the health sector and coordinating the implementing agencies on the ground. WHO is also closely working with other health cluster leads such as UNICEF on ensuring integration of nutrition into the emergency services of existing health-care facilities. WHO and UNICEF agreed to review the terms of reference of this operation.

The Gaziantep-based cross-border operations are an exemplar of WHO’s successful coordination role. The IOAC team noted excellent coordination and communication between WHO HQ, EURO and EMRO, and the Gaziantep field office. The ERF was fully activated in 2018 and the response is being led by the Gaziantep office with back-up by the two Regional Offices, which provide first-line operational support, and HQ, which coordinates WHO’s response and ensures coherent advocacy. Decisions are made based on need, with the guiding principle of access to all areas. The supportive WHO Representative in Turkey and the team lead in the Gaziantep office have clear roles and responsibilities and are running operations with a clear delegation of authority throughout. The IOAC was informed that monitoring of the Whole of Syria health sector response is harmonized across all hubs and the operational monitoring of WHO’s response.

WHO successfully managed the vaccination campaign for polio, providing more than 1.2 million doses of vaccine in September 2019 despite a very difficult operational environment at the time. WHO also supported the establishment of three tuberculosis centres with a full package of services and has addressed mental health needs.

Implementing partners in Syria noted that when WHO started to work in Gaziantep, remarkable progress was seen with regard to the health system, primary health-care service delivery, and salaries of community health-care workers. Partners appreciated WHO’s technical expertise in capacity building activities but noted that it could be strengthened.

More than 160 letters of agreement have been signed per year with local and international NGOs. Staff noted that the due diligence process for agreements can be fast-tracked but there is no systematic approach nor waiver for the partners with a proven record. However, operational partnerships on the ground have seen great improvement. Partners commended WHO for its health cluster leadership in Gaziantep, providing strong coordination and technical and operational support to the implementing partners. Partners commented that they saw great value in the health cluster in terms of rationalizing the use of the resources based on needs and capacity assessment in the field.

Partners noted that despite the massive need and the collapsed health system, the health cluster is one of the strongest clusters in Gaziantep. The IOAC heard that there had been tension among Syrian NGOs and partners in the past years and that WHO as cluster leader played a key role in building a solid foundation under difficult circumstances, professionalizing the response of the NGOs. However, the IOAC observed that the health sector has no co-leader and suggests co-leadership of the cluster systems with NGOs. Partners recognized WHO’s technical leadership in providing tools such as the Early Warning, Alert and Response System (EWARS), the Health Resources Availability Monitoring System (HeRAMS), and the

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Surveillance System of Attacks on Healthcare (SSA). The potential value and usefulness of such tools are widely recognized by various stakeholders. More than 40 partners have enrolled in HeRAMS, reporting on a voluntary basis through their accounts online. The IOAC is cautious about the quality of the data provided and the verification process. Accurate information is a prerequisite for making evidence-based decisions and rational use of resources. The IOAC noted that WHO uses different networks in the field to triangulate information provided by the partners and that donors engage with an external agency for third- party monitoring of utilization of supplies. The IOAC emphasizes that a strong and systematic verification process should be put in place for both supplies and clinical service delivery. WHO played an important role in advocating against attacks on health care in Syria to the UN Security Council, Inter-Agency Standing Committee (IASC) partners and donors by providing a surveillance system for attacks on health care. However, there is an expectation from partners that WHO should play a leadership role in the verification of information provided by partners on the ground, and be more proactive in its advocacy and communication to the public. Internal standard operating procedures for risk communication should be strengthened.

WHO and the health cluster have done a great job, and have solid contingency plans, but the Organization is not well funded to deliver on them. Some donors have put restrictions on the specific areas to benefit from their funding, for political reasons or interests. Additionally, siloed approaches and territorial issues hamper joint planning and rational distribution of resources for health service delivery. Since the beginning of 2019, the Turkish Government has implemented additional measures to regulate the movement of people in the Turkish-Syrian border areas. This impacts on WHO’s operations, including the health worker training programme.

2.3. WHO’s support to the national authorities in health provision to Syrian people in Turkey

The IOAC reviewed WHO’s work in support of the Turkish Government to address the gaps in health service provision to Syrian people in Turkey. Two key characteristics of the Turkish response effort – the refugees living in communities and the government-financed approach – strongly differentiate it from many other refugee-hosting countries, where the tendency is to direct the refugees into camps supported by humanitarian agencies. There are 117 migrant health centres operating, yet with the movement of migrants and increased numbers of people staying longer in local communities, a lack of commensurate increase in supportive infrastructure, and to an extent cultural barrier, WHO’s role in supporting the Turkish Government with health service delivery for Syrians in the country has been increasing.

WHO’s support for the Turkish government in the provision of health services to Syrian populations living in Turkey has been exemplary: it assisted the MOH in the training of more than 2600 Syrian health-care workers who are now employed by the MOH to provide primary care services to fellow Syrians. Syrian health-care workers have special workforce status granted by the Turkish MOH and are on the payroll of the MOH, funded by the EU.

WHO’s training and service provision support takes place across seven Refugee Health Training Centres (RHTCs), one of which is located in Ankara. The refugee training centre in Ankara also acts as a primary health-care centre offering 50-80 consultations per doctor on a daily basis. The IOAC noted that Syria has traditionally focused on secondary care and that the Turkish model has introduced the concept of primary

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health care as well as community health workers. In addition, the centre has departments of paediatrics, obstetrics and gynaecology, a rehabilitation facility, and also offers psychological support implemented by the MOH via an NGO which is funded through WHO. The Syrian health-care workers can refer to secondary-level Turkish hospitals when needed. The mental health training delivered at the refugee training centre was also welcomed by the Turkish MOH for its own populations and it is now being offered to Turkish health professionals as well. This model helped the MOH to further strengthen Turkey’s universal health coverage by enabling the inclusion of mental health and physiotherapy within the primary health-care system.

During the mission, the IOAC was alarmed by some issues, such as child marriage and early pregnancy, which do not fall directly under WHO’s purview but have a serious impact on health. A team of four Turkish field social workers who speak Arabic provides support, but also keeps a record of child abuse, child marriage, and other data and provides social services and child legal protection as required. The project started in 2016, and over 36 000 counselling sessions have been performed over 2 years.

The NGO staff noted its close collaboration with WHO thanks to the good relationship with the Country Office focal person and the well-defined coordination framework. The IOAC was informed that the UN Country Team in Turkey is involved in policy dialogue with the Government and is supporting with donor funding of a number of activities related to this topic, while WHO as part of the UN Country Team at country level provides advocacy support from the public health perspective. A UN-wide joint response would be important to capitalize on current efforts and achieve necessary impact.

Given that about 3.6 million Syrian people live across Turkey, the IOAC found the refugee training and provision model to be an innovative and sustainable approach to managing a high demand for services that could ease cultural and language barriers in other refugees settings. IOAC recommends that documenting the approach as a success is important. The key success factors are a service provision model that involves Syrian health-care workers, funding availability, and WHO Country Office leadership backed by the Regional Office.

The IOAC commends the Turkish Government’s commitment to the refugee health programme and recognizes that it is also leading operational research to verify the impact and effectiveness of the training programme through a large-scale survey. Challenges for the refugee health programme include the political context, relationships with local governments, the future geopolitical situation for Syrian refugees, as well as slow WHO administration processes.

2.4. WHO’s role in country preparedness and readiness

The IOAC reviewed WHO’s work in support of the Turkish Government at national and subnational levels for country preparation and readiness for acute natural disasters as well as pandemic diseases. The latter could become more likely in view of the newly opened Istanbul airport being one of the largest international hubs in the world. The IOAC also assessed WHO’s health security project, funded by the EU through the WHO Country Office, which aims to strengthen the International Health Regulations (IHR) core capacity of the country.

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Turkey has a well-developed disaster management system under the Disaster and Emergency Management Authority (AFAD). The AFAD is responsible for risk assessments, legislation, development plans, disaster insurance, security of public buildings, urban transformation and training (of 12 million people, including children) and response. At the beginning of the Syrian crisis, the AFAD was also in charge of coordination and refugee activities under the Prime Minister’s office. The AFAD has more than 5900 staff and the capacity to surge 35 000 staff in emergency situations. Response efforts include medical rescue teams, and new equipment including air ambulances and sea ambulances provided free of charge for both Turkish people and foreigners. Turkey has very well-developed emergency care services due to its abundance of natural disasters (earthquakes, flooding, landslides, avalanches etc.) The President of AFAD reports directly to the Minister of Internal Affairs.

The AFAD fully appreciates the need to work together with other countries over natural disasters. There is an expectation that WHO should play a role in using such networks for training opportunities in the global health context, in sharing data and experiences, including post-disaster disease control, and in undertaking capacity assessment by means of a certificate system to identify gaps. The IOAC was briefed that Turkey’s National Medical Rescue Team is undertaking the Emergency Medical Team certification process. WHO’s current work on preparedness involves health system issues, but emergency care services do not feature in this work. This omission should be explored further. EURO is embarking on an initiative to support the linking of emergency preparedness to the emergency services.

The IOAC noted that health security is the country’s priority and multiple ministries are involved under leadership of the MOH. WHO is currently supporting the Government in implementing the Health Security Project to strengthen emergency preparedness and response capacities. The MOH recognized that WHO provided technical support in the strategic planning, budgeting and coordinating partners involved in the Health Security Project. For the period of 2018-2021 the project has a focus on early warning and response systems, a Field Epidemiology Training Programme (FETP) and laboratory components. The IOAC noted that the project has total budget of EUR3.3 million which is co-funded by the EU (90%) and WHO (10%) and cautions WHO to prioritize country need rather than donor-based target outcomes and to ensure full accountability and costing of the expertise provided from the global and regional level to benefit the country project outcomes.

The IOAC is pleased to see that IHR promotion has been done through every avenue. The UN Country Team working group on emergency response and preparedness (ERP) was formed in 2018 and WHO was assigned the responsibility of leading the ERP results group. This working group will be the platform for response in future emergencies. WHO is considered one of the key UN Country Team members with a good relationship with the Government. This is a strong signal that the profile of preparedness and of the IHR (2005) is raised among UN partners. The IOAC congratulates the UN Country Team leadership on promoting country preparedness.

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III. CONCLUDING REMARKS

The IOAC congratulates WHO on its impressive progress with the WHE Programme and the health cluster, and its work to support the Turkish Government with the Syrian crisis and country preparedness. The IOAC recognizes that WHO’s model to support the MOH in providing health-care services to Syrian people living in Turkey has proven successful at building up primary health care and in introducing the community health worker approach.

Turkey is perhaps one of the best examples of WHO’s performance in terms of the strong relationship with the MOH, solid collaboration with partners and for the quality of ongoing projects. WHO’s work in Turkey has been highly appreciated by the Government, UN Country Teams, other UN agencies and national and international NGOs.

Partners noted a dramatic change in WHO over time from being a normative organization to an operational agency managing emergencies. The WHE Programme has brought attention to emergency response and preparedness at the country level and reaffirmed the Organization’s “no regrets” policy with its improved clarity of roles and responsibilities, reporting lines, and delegations of authority among HQ, Regional and Country Offices, and the Incident Management Teams.

Business processes for HR, procurement, and finance remain the main obstacle to effective emergency responses. Additionally, the IOAC is concerned about financial sustainability as the Syrian crisis becomes protracted. National and international political support will be critical to ensure continuous provision of essential health-care services to the Syrian people both living in Turkey and in Syria.

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Annex. IOAC visit programme in Turkey, 2–6 November 2019

Time Item Description Venue Saturday Travel to Istanbul Arrival of IOAC members and WHO staff Istanbul 2 November Airport Sunday 3 November: WHO’s response to humanitarian and health needs of north-west Syria 06:05 – 08:00 Transit to Gaziantep The team will be received at Gaziantep Airport through Istanbul Airport VIP modality and driven directly from the airport to the – Gaziantep WHO Office Airport 08:45 – 09:15 Arrival at WHO Office and refreshments WHO Office, Gaziantep 09:15 – 09:30 Opening remarks Welcome remarks from WHO Representative, EURO WHO Office, Regional Emergencies Director, and IOAC Chair Gaziantep 09:30 – 10:15 Briefing – WHO Current humanitarian situation in north-west Syria, WHO Office, Gaziantep Field Office outline of field office set-up, WHO response operations Gaziantep and WoS response and the Whole-of-Syria (WoS) approach (EMRO/EURO, HQ and hubs) by Dr Jorge Martinez, Turkey Health Cluster Coordinator and Head of Office a.i. 10:15 – 11:30 Thematic discussions on Q&A sessions with key technical leads on technical areas: WHO Office, WHO operations • Health Cluster and partner coordination Gaziantep • Attacks on healthcare • Health information • Infectious disease surveillance and response, polio • Primary healthcare and mental health • Secondary care • Logistics and third-party monitoring • Administration and finance • Donor relations and reporting 11:30 – 12:00 Donor engagement Meeting Mr. Alaeddin Hanci, Programme Assistant Syria WHO Office, Team, European Commission DG ECHO Gaziantep

12:00 – 13:20 Partner interactions and Meetings with national and international non- WHO Office, operations governmental organizations (NGOs), health cluster Gaziantep partners and implementing partners: • Dr. Abdulselam Daif, Turkey Country Director, Syria Relief and Development. • Dr. Orwa Al Abdulla, Health Program Manager, WATAN / Former Bahar Organization. • Dr. Bakhodir Rahimov, OIC, UNICEF. 13:20 – 14:45 Working lunch with WHO Gaziantep team

14:45 – 15:30 WHO leadership in health Mr. Mark Cutts, Deputy Regional Humanitarian WHO Office, response and UN Coordinator (DRHC) for Syria Gaziantep. engagement 15:30 – 15:40 Close and departure Transit to Gaziantep Airport and onward travel to Ankara Gaziantep airport 20:00 – 21:00 Transit to Ankara Transportation and check-in at Monec Hotel, Ankara Monec Hotel, Ankara

Monday 4 November: WHO Turkey’s health emergencies programme and support to Ministry of Health 08:45 Transit WHO office

09:15 – 10:00 Meeting with WCO staff Briefing by the WR and meeting with WCO Staff WHO Office, Ankara 10:00 – 12:15 Turkey country profile Presentation of evolving national, regional strategic / WHO Office, and key WHE geopolitical context; health security profile, and country Ankara programmes level WHE programmes • Refugee Health Project, Dr. Altin Malaj, Coordinator • Health Security Project, Dr Irshad Shaikh, WHO Emergency coordinator

12:15 – 13:15 Working lunch 13:15 – 13:45 Transit Ministry of Health (MOH) 14:00 – 17:00 WHO’s work in support Meetings with H.E. Deputy Health Minister of Health and MOH premises of the Turkish key MOH officials: Government at national • Dr Emine Alp Mese, H.E. Deputy Minister of Health and subnational level • DG and DDG, Emergency Health Care Services Directorate, MOH • DG and DDG, Public Health Directorate, MOH • DG, Foreign Affairs, MOH • Director, Migrants Division, MOH 17:15 – 17:45 Transit to Monec hotel WHO driver will pick-up team from MOH 19:15 Informal working dinner and day 1 & 2 review Hotel Monec Tuesday 5 November: Field visits, UN Country team and partner interactions 08:45 Transit WHO office 09:00 – 11:00 Field visit Refugee Health Training Centre (RHTC) and meeting RHTC in with local implementing partner in Refugee Health Alemdag 11:45 – 12:15 UN Country Team Meeting with UN Resident Coordinator UN RC Office 12:30 – 13:30 Working lunch 13:30 Transit to AFAD Disaster Management Authority 14:00 – 15:00 Disaster preparedness and Meeting with President, AFAD (Disaster Management AFAD premises response in Turkey Authority) 15:00 – 15:30 Transit WHO Office 15:30 – 16:30 Response readiness Meeting with members of UN inter-agency Working WHO Office, across the UN system. Group on Emergency Preparedness Ankara 17:00 Transit to Monec hotel WHO premises

19:30 Official reception for IOAC members with WHO staff, heads of UN agencies and Hotel Monec relevant diplomatic missions Wednesday 6 November: Wrap-up and departure 09:00 – 12.00 IOAC debriefing session Hotel Monec End of the mission