Joint External Evaluation of IHR Core Capacities of the State of Qatar

Mission report: 29 May – 2 June 2016

Joint External Evaluation of IHR Core Capacities of the STATE OF QATAR

Mission report: 29 May – 2 June 2016 WHO/WHE/CPI/2017.6

© World Health Organization 2017 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization (http://www.wipo.int/amc/en/mediation/rules). Suggested citation. Joint External Evaluation of IHR Core Capacities of the State of Qatar. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. Design and layout by Jean-Claude Fattier Printed by the WHO Document Production Services, Geneva, Switzerland ACKNOWLEDGEMENTS

The WHO JEE Secretariat would like to acknowledge the following, whose support and commitment to the principles of the International Health Regulations (2005) have ensured a successful outcome to this JEE mission: • The Government and national experts of Qatar for their support of, and work in, preparing for the JEE mission. • The governments of Egypt, Finland, Pakistan, the United Kingdom and the United States of America, for providing technical experts for the peer review process. • The Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE), and the International Civil Aviation Authority (ICAO) for their contribution of experts and expertise. • The governments of Germany and Finland for their financial support to this mission. • The following WHO entities: WHO Country Office of Pakistan, WHO Regional Office for Eastern Mediterranean, WHO HQ Country Health Emergencies Preparedness and IHR Department, WHO HQ Public Health, Environmental and Social Determinants Department. • Global Health Security Agenda Initiative for their collaboration and support.

Contents

Abbreviations------iv Executive summary – Findings from the Joint External Evaluation------1 Qatar Scores------4 PREVENT—————————————————————————— 7 National legislation, policy and financing------7 IHR coordination, communication and advocacy------11 Antimicrobial resistance------14 Zoonotic diseases------18 Food safety------21 Biosafety and biosecurity------25 Immunization------28 DETECT————————————————————————— 31 National laboratory system------31 Real-time surveillance------34 Reporting------38 Workforce development------41 RESPOND ———————————————————————— 44 Preparedness------44 Emergency response operations------48 Linking public health and security authorities------52 Medical countermeasures and personnel deployment------55 Risk communication------58 OTHER—————————————————————————— 63 Points of entry------63 Chemical events------68 Radiation emergencies------72

Annex 1: Joint external evaluation background------76 vi Joint External Evaluation WHO VPD SSC SOP RCPD PVS PHCC PEC OIE NFP MoPH MoME MERS-CoV JEE IPC INFOSAN IHR ICAO IAEA HMC Authority Safety Food HIV GCC FSA FETP FAO EPR EOC CFL CDD stewardship antimicrobial CDC resistance antimicrobial CBRN AMS AMR Abbreviations

World HealthOrganization Radiation andChemicalsProtectionDepartment Ministry ofMunicipalityandEnvironment Middle Eastrespiratory syndromecoronavirus International Food Safety Authorities Network vaccine preventabledisease Ship SanitationCertificates standard operating procedures Performance of Veterinary Services Primary HealthCareCorporation Permanent EmergencyCommittee World Organisationfor Animal Health National Focal Point Ministry ofPublicHealth(formerlyknownastheSupreme CouncilofHealth) Joint ExternalEvaluation infection preventionandcontrol International HealthRegulations(2005) International Civil Aviation Organization Energy Agency International Atomic Hamad MedicalCorporation human immunodeficiencyvirus Gulf Cooperation Council Field Epidemiology Training Programme Food and Agriculture OrganizationoftheUnitedNations Emergency PreparednessandResponsePlan Emergency Operations Centre Central Food Laboratory Civil DefenseDepartment Centre forDiseaseControloftheMoPHQatar chemical, biological, radiological andnuclear 1 public healthresponseto threats. themes that require attention to ensure national capacity to prevent, detect and mount a comprehensive the 19IHRtechnicalareas. Inaddition, thissummary highlightssomeofthemostimportantcross-cutting strengthening, technicalareascores, andfinally makes recommendationsforpriorityactionseachof The assessmentreport describes Qatar’s currentstrengthsand best practices, areas that still need as preparations fortheFIFA (Fédération Internationale deFootball Association) World Cup inQatar2022. timing oftheJEEisoptimalconsideringcurrentrapid developmentofhealthandothersectorsaswell required bytheIHR. Globally, itistheseventhcountrytovolunteerandcompleteJEEprocess. The Qatar hasdemonstrated avery strongcommitmenttotheglobalhealthsecurityandcorecapacities under the Animal HealthDepartment withintheMoME. National IHRFocal Point. The Focal Point forthe World Organisationfor Animal Health(OIE)isestablished airport, MessaeidandRasLafanseaports, and Abu Samra groundcrossing. The countryhasdesignateda Ministry ofIndustryandQatarPetroleum Corporation. MainPoE tothecountryinclude Dohainternational of theMinistryInterior, Ministry ofMunicipalityandEnvironment(MoME), MoPH, MinistryofDefense, particularly biological, chemicalandnuclearhazards. ChemicalsafetyinQataristhecombinedresponsibility National EmergencyPreparednessandResponse(EPR)PlanalignedtotheIHRcoveringallhazards, Qatar hasaspecialinterministerialCommitteeforEmergencyandDisasterManagementaswell sector hasincreasedinsizeandthenumberofservicesitprovides. hospitals, clinics, pharmacies, laboratories andauxiliarymedicalpractices. Recently, theprivate health-care care CentresCorporation (PHCC). The MoPHalsosupervises allprivate health-careinstitutions, including are thecountry’s principalhealth-careproviders: HamadMedicalCorporation (HMC)andPrimaryHealth- and regulationofthehealth-caresystem. Itsupervisesthetwogovernment-ownedorganizationsthat the SupremeCouncilofHealth. The MoPHhasacomprehensiverange ofpowersfortheadministration priorities. Qatarihealth-caregovernanceisexercisedthroughtheMinistryofPublicHealth(MoPH), formerly Vision 2030, in particular the human development pillar, sets human health as one of the Government’s top economy, infrastructure andpopulationgrowth, withahighnumberofmigrant workers. The QatarNational Qatar hasthehighestpercapitaincomeinworld. The countryisexperiencing arapidly developing areas oftheIHRasdescribedinJEEtool. for priorityactionsjointlydevelopedbytheexternalteamandtheirQataripeerscovering19technical to key ministries, health-carefacilitiesandpointsofentry(PoE). This reportpresentstherecommendations technical presentationscoveredtheself-assessmentresults, jointmultisectoral discussionsandsitevisits 2016. to2 June Interactiverepresenting internationalorganizationscarriedoutthemissionfrom27 May consisting ofindividualsselectedonthebasistheirrecognizedtechnicalexpertise, andadvisors national priorities; andtoallocateresourcesbasedonthefindings. Amultisectoral, internationalteam to prioritizeopportunitiesforenhancedpreparedness, detectionandresponsecapacity, includingsetting (JEE) tool. The JEEallowscountriestoidentifythemosturgentneedswithintheirhealthsecuritysystem; World HealthOrganization(WHO)InternationalRegulations(2005)(IHR)JointExternalEvaluation This jointassessmentoftheStateQatarbynationalandexternalexpertswas conductedusingthe EvaluationExternal Joint the –Findings from Executive summary

who.int) andthe GlobalHealthSecurity Agenda (https://ghsagenda.org). This reportwillbepublishedonthewebsitesofMinistry Public HealthofQatar(www.moph.gov.qa), the World HealthOrganization(www. 1 1 of IHR Core Capacities of the State of Qatar 2 Joint External Evaluation overarching issuesforconsideration bytheGovernmentofQatar. tools andregistriestofacilitaterapid collection, exchangeandanalysisofhealthdata. These areconsidered coordination ofnationalpublicandprivate sectorresources; andestablishmentofnewelectronicreporting to fostertheOneHealthapproachhealthsecurityofhumans, animalsandfood; developmentand During thereviewof19technicalareas, threerecurringthemesemerged: multisectoral engagement Major cross-cutting themes 1. 2. 3. 4.

capabilities related to chemical and nuclear threats as well as functions related to PoE. national laboratory resources. Extensive multisectoral collaboration could also enhance national to zoonoticpriority diseases, surveillance of antimicrobial resistance and (AMR) coordination of Health approaches that promote formal intersectoral mechanisms are needed for the response including other such as sectors trade, transportation, tourism, commerce and maritime. Other One Ministry of Interior, Qatar Petroleum Corporation, HMC and PHCC, could strengthened be by should reactivated. be The Committee, currently with representatives from the MoPH, MoME, IHR Multisectoral Committee established by the Government and endorsed by an Amiri Decree framework and formalizing the roles and responsibilities of different stakeholders. The National and informal collaboration could improved further be by implementing a comprehensive legislative Permanent Emergency Committee (PEC) and joint EPR planning. However, the existing networks work to build multisectoral effective collaboration and coordination as demonstrated by the health, animal health, and food environmentsecurity Qatar sectors. has already done significant Enhance significantly multisectoral engagement, communication coordinationand public of of public health personnel at the different administrative levels. Epidemiology Training Programme (FETP) or similar would help enhance the IHR-related capacity point of view, improved retention policies, career path planning and establishment of a Field current reactive system into proactive risk analysis and management. From the human resources of the new food law together with the establishment of afood authority would transform the to ensure that proper screening, vaccination and treatment are services in place. Endorsement disease burden and low vaccination coverage, the public and private should sectors work together thesystems. migrant As workforce arrives often from countries with arelatively high communicable as for biosafety and biosecurity, and nominated AMR, reference laboratories and joint reporting Crescent, requires clear national coordination with approved national policies and plans, such role of the private and semi-governmental sector providers, service including the Qatari Red Traditionally HMC and PHCC have provided the majority ofHowever, services. the increasing health-care and laboratory facilities as well as highly skilled technicaland workforce. experts Develop and coordinate national public and private resources. sector Qatar has high very quality Integration of different surveillance systems would both human serve and animal health. AMR. including data, laboratory and outbreaks disease of vaccination coverage, surveillance studies. In terms of the JEE technical areas, new electronic systems could significantly improve sources of data such as population and immigration registries for comprehensive analysis and care system. This allows real-time surveillance and reporting activities as well as linking to other patient registries covering clinical and laboratory data from all levels of the and health- sectors analysis of health data. New information technology has enabled the development of electronic Establish new electronic reporting tools and registries to facilitate rapid collection, exchange and naturally or caused by deliberate or accidental events. Through participation active in the JEE resources to prevent, and detect rapidly respond to public health threats, whether occurring evaluation three every to five yearswill facilitate the development of nationalcapabilities and Qatar’s commitment to an annual self-evaluation using the JEE tool together with an external

Services, andServices, the response to international evaluations of the Ebola response. reform and restructuring of the IHR monitoring process, the OIE Performance of Veterinary processes such as the Sendai Framework for Disaster Risk Reduction, WHO’s emergency response through identified the JEE onceother actions process, implemented,international priority support other countries of the Gulf Cooperation Council (GCC) and the Eastern Mediterranean region. The process, Qatar is also avaluable setting example of practises best in improving health to security 3 of IHR Core Capacities of the State of Qatar 4 Joint External Evaluation Table 1. Scores ofQataragainsttheIHRJoint ExternalEvaluation with thejustificationforeachparty’s position. External Evaluation Team Leadwilldecideonthefinalscoreandthisbenotedinreport, along between theexternalteamandhostcountryexpertsoramongexperts, the and hostcountryexpertsseekingagreement. Shouldtherebesignificantandirreconcilabledisagreement strengthening, andthepriorityactions–shouldbecollaborative, withexternalevaluation teammembers team. The entireevaluation – inparticular the discussions around thescore, the strengths, areasthatneed The host country may suggest a score at this time or during the on-site consultation with the external information ontheircapabilitiesbasedtheindicatorsandtechnicalquestionsincludedinJEEtool. step intheJEEprocess, andinpreparation foranexternalevaluation, hostcountriesareasked toprovide The JointExternalEvaluation processisapeer-to-peer review. Incompleting theself-evaluation, thefirst Note onscoringoftechnicalareas oftheJEEtool Qatar Scores munication andadvocacy munication Biosafety andbiosecurity Antimicrobial resistance IHR coordination, com- National legislation, policy andfinancing policy National laboratory Zoonotic diseases Immunization

Capacities Food safety system

foodborne diseaseandfoodcontamination P.5.1 andresponding fordetecting Mechanismsare to establishedandfunctioning P.7.1 Vaccine coverage of national programme (measles)aspart P.4.1 systems zoonotic inplace Surveillance forpriority diseases/pathogens D.1.1 diseases testing ofpriority Laboratory fordetection D.1.4 system quality Laboratory D.1.3 and laboratory-based diagnostics Effective modern point-of-care D.1.2 Specimenreferral system andtransport P.7.2 National vaccine access anddelivery P.6.2 training andpractices andbiosecurity Biosafety and functional P.4.3 Mechanismsforresponding to zoonoses andpotential zoonoses are established P.4.2 Veterinary oranimalhealthworkforce P.3.4 Antimicrobial stewardship activities P.3.3 associated Health-care prevention infection andcontrol programmes P.3.2 caused by AMR pathogens ofinfections Surveillance tion, policiesandadministrative arrangements to enablecompliance withtheIHR P.1.2 The state candemonstrate that ithasadjusted andaligneditsdomesticlegisla- government instruments inplace are sufficient forimplementation ofIHR P.1.1 Legislation, laws, regulations, administrative requirements, policiesorother animal, andagriculture facilities P.6.1 system isinplace andbiosecurity forhuman, biosafety Whole-of-government P.3.1 Antimicrobial resistance (AMR) detection relevant intheimplementation sectors ofIHR P.2.1 mechanismisestablishedforthecoordination Afunctional andintegration of Indicators Score 4 3 4 4 4 4 5 3 3 3 3 3 3 2 3 3 3 3 3 1

Linking publichealthand Workforce Development Radiation emergencies Real-time surveillance dia/onehealth/ interdependent andboundtothehealth oftheecosystemsinwhichtheyexist. World Organisation for Animal Health, www.oie.int/en/for-the-me- The “One Health” conceptwas introducedatthebeginningof2000s. Inafew words, itsummarizesthathumanhealthandanimalare Medical countermea- Medical Emergency response Emergency Points of entry (PoE)Points ofentry Risk communication sures andpersonnel security authorities security Chemical eventsChemical Preparedness deployment operations Reporting customs) are linkedor confirmed biologicalevent duringasuspect authorities,R.3.1 Public (e.g. healthandsecurity law enforcement, border control, D.4.1 Humanresources are available to implement IHRcore requirements capacity R.5.1 Risk communicationR.5.1 Risk systems (plans, mechanisms, etc.) R.2.1 Capacityto activate operations emergency radiological andnuclearemergencies andrespondingRE.1 Mechanismsarefor detecting to established and functioning PoE.1 Routinecapacitiesare establishedat PoE PoE.2 Effective publichealth response at points ofentry listening andrumourmanagementR.5.5 Dynamic R.5.4 Communication engagementcommunities withaffected R.5.3 Public communication communicationR.5.2 Internal andcoordination andpartner health emergency R.4.2 System isinplace forsendingandreceiving healthpersonnelduringapublic R.2.4 Case management procedures are implemented forIHRrelevant hazards. operationsR.2.3 Emergency programme OperationsR.2.2 Emergency Centre operating procedures andplans publichealthrisksandresourcesR.1.2 Priority are mappedandutilized D.4.3 Workforcestrategy programme inplace D.4.2 Field Epidemiology Training Programme orotherappliedepidemiologytraining D.3.2 network andprotocols Reporting incountry D.2.4 Syndromic systems surveillance D.2.3 data Analysisofsurveillance D.2.2 Interoperable, interconnected, real-time electronic system reporting RE.2 Enabling environment isinplace formanagement ofradiation emergencies CE.2 Enabling environment isinplace formanagement ofchemicalevents and Agriculture Organization (FAO) and World Organisation forAnimalHealth (OIE) D.3.1 System forefficient tothe reporting (WHO), World Health Organization Food chemical events oremergencies andresponding fordetecting CE.1 Mechanismsare to establishedandfunctioning Plan isdeveloped andimplemented R.1.1 Multi-hazard National Public Health Preparedness Emergency andResponse public healthemergency R.4.1 System isinplace forsendingandreceiving medicalcountermeasures duringa D.2.1 Indicator- andevent-based systems surveillance 3 4 4 4 4 3 3 4 4 4 4 3 3 4 3 3 3 3 3 3 3 3 3 3 3 3 4 5 3 5 of IHR Core Capacities of the State of Qatar

States Parties should have an adequate legal framework to support and enable the implementation of of implementation the enable and support to framework legal adequate an have should Parties States 2 direction. for improvement. Qatariscommittedtofullyimplementing theIHRandhastaken importantstepsinthis be toconductalegalandregulatoryassessmentonall subject areasinvolvedintheIHRtoidentify by one or more legal instruments. The bestpractice toensureacomprehensivelegalframework would to besufficientlycomprehensivefulfilIHR. Thesedeficienciesinlawscanbeandshouldaddressed However, asisthecaseinallcountries, therewillbeareasforimprovementthenational legallandscape provide thenecessarylegalfoundationforIHRimplementation. such asregulations, Amiri decreesorotheradministrative measuresadoptedbythegovernmentthatcan legal systemprovidesinstrumentsotherthanlegislativemeasurestobeapprovedbyParliament, framework includeslawsandregulatorymeasuresgoverningmanysubjectareas. Overall, Qatar’s current Qatar has a legalandregulatoryframework to support and enable the implementation of IHR. The legal Qatar levelofcapabilities Target resources arealsoimportant. policies whichidentifynationalstructuresandresponsibilitiesaswelltheallocationofadequatefinancial can alsofacilitatecoordinationamongthedifferententitiesinvolvedintheirimplementation. Inaddition, serve toinstitutionalizeandstrengthentheroleofIHR(2005)operations withintheStateParty. It facilitate IHR implementation and maintenance in amore effective manner. Implementing legislation could specifically required, Statesmaystillchoosetorevisesomeregulationsorotherinstrumentsinorder of theIHR(2005)mayrequirenewormodifiedlegislation. Evenifneworrevisedlegislationmaynotbe The IHR(2005)provideobligationsandrightsforStatesParties. InsomeStatesParties, implementation Introduction FINANCING AND NATIONAL LEGISLATION, POLICY PREVENT all of their obligations and rights to comply with and implement the IHR (2005). In some States Parties, Parties, States some In (2005). IHR the implement and with comply to rights and obligations their of all implementation of the IHR (2005) may require new or modified legislation. Even where new or revised revised or new where Even legislation. modified or new require may (2005) IHR the of implementation legislation may not be specifically required under the State Party’s legal system, States may still choose choose still may States system, legal Party’s State the under required specifically be not may legislation to revise some legislation, regulations or other instruments in order to facilitate their implementation and and implementation their facilitate to order in instruments other or regulations legislation, some revise to maintenance in a more efficient, effective or beneficial manner. State parties should ensure provision of of provision ensure should parties State manner. beneficial or effective efficient, more a in maintenance adequate funding for IHR implementation through national budget or other mechanism. other or budget national through implementation IHR for funding adequate

essential publichealth measures. The NIH, asassessed bytheEET, doesnotcurrentlyfulfilallcriticaltaskscharacteristic ofapublichealthinstituteorfor theimplementationof 7 of IHR Core Capacities of the State of Qatar PREVENT PREVENT 8 Joint External Evaluation 2. • 1. implement theIHR, therecommendationsforpriorityactionsarefollowing. Taking intoaccountthelevelofcapabilitiesQataranddeepinvolvementpublicsectorto Recommendations forpriorityactions of theIHRNFP willbedictatedbytheprovisions oftheIHRandinclude thefollowingroles: point establishedbytheMoPH whowillactasExecutiveSecretarytotheCommittee. The specificpowers system. Article 6ofCabinetdecision18/2015provides thattheNationalCommitteeshallhaveafocal The termsofreference the IHRnationalfocalpoint(NFP)arewelldefinedwithin awellconnected Medical Corporation, PHCCandQatarPetroleum (Article 1ofCabinetdecision18/2015). Qatar, includingrepresentativesfromMoPH, MinistryofInterior, theMinistryofEnvironment, Hamad Cabinet decision18/2015establishedtheinterministerial NationalCommitteetoimplementtheIHRin practices Strengths/best food). hit byinfections; (e)Law8/1990and4/2014related tofoodsafety(Article3identifiesprohibited 14/2003 relatedtotheorganizationofquarantine (Article6prohibitstheimportofanimalsfromcountries 2005; (c)Law1/1985relatedtoanimalhealthandcombating animaldiseases(Articles2to8); (d)Law communicable diseases; (b)CabinetdecisionNo. 18/2015 Article 6relatedtotheimplementationofIHR (a) CentreforDiseaseControl(CDC)Law17/1990 Articles 3and4relatedtohealthprocedures toprevent governmental instrumentsexistthatgovernpublichealthsurveillanceandresponse, aspartofthefollowing: Score 4: Demonstrated capacity. Legislation, regulations, administrative requirementsandother instruments inplaceare sufficientforimplementationofIHR P.1.1 Legislation, laws, regulations, administrative requirements, policiesorothergovernment Indicators andscores • • 3. • and (c) to submit an annual to related WHO report to the implementation of the IHR. strategies and mechanisms required to respond to risks that could potentially threaten public health; establish the executive plan of implementation of IHR; (b) to review and develop the preventive According to 2of Cabinet Article decision 18/2015, the specific goals of the Committee are: (a) to drafted for food safety and fordrafted related food safety (interior, sectors environment, public health, Qatar petroleum). meet the IHR provisions. Following meetings with the persons in charge, new legislation has now been The provisions of IHR require each State to review their national legislation and adapt to it if necessary 14/2003 quarantine. to related Law consumption; Law17/1990 on the prevention of diseases; Law1/1985 related to animal health; and of the IHR,e.g.to aspects Law8/1990 on regulation and monitoring of food intended for human Qatar engages into studies significantconduct and to efforts endorse laws and decrees related legal, official document to facilitate coordination andexchange of information among all parties. and private companies, anational framework law could include all the procedures required in asingle Considering the legal provisions and annexes of the IHR to implemented be by public employees sector Draft anationalframework lawandbylaws. Reactivate theIHRCommitteeestablishedbyCabinet. Develop orreview laws, decrees orCabinetdecisionstosupportimplementationofIHR.

the implementationofIHR(Article 6§2and3). Cabinet decisionNo. 18/2015 ontheestablishmentofIHRNFPandCommittee isinplacetofacilitate regulations, administrative requirements, andother governmentalinstrumentsforIHRimplementation. Score 3. Developed capacity. The assessment identified adjustments to be made in relevant legislation, policies andadministrative arrangements toenablecompliancewiththeIHR(2005) P.1.2 The statecandemonstrate thatithasadjustedandaligneditsdomesticlegislation, • • strengthening/challenges need that Areas submit aquarterlyreportregardingtheemergencyplanandotherspecificrecommendations. policies andlegislationtomanageemergencies; coordinatewithotherinstitutionsandcommittees; and emergency situations; managethetraining programmes; evaluate thefinancialcosts; proposeappropriate of thehealthsector; determinethenecessaryrequirements; elaborate thenational policytorespond of thedecreetoidentifyandanalysehealthrisksincountry; identifytheweakpointsofeachpart PHCC, Al Ahli and Al Emadihospitals. The Committeehasspecificresponsibilityaccordingto Article3 Medical Corporation, QatarRedCrescentSociety, MinistryofInterior, QatarPetroleum, Qatariarmedforces, Ministerial Decree13/2012. This interministerialcommitteeincludesrepresentatives oftheMoPH, Hamad In 2012, QatarestablishedtheNationalHealthCommitteeforEmergencyandDisasterManagement • • • • • • • • Cabinet of the Health Ministers of GCC countries is in charge of this mission. Standard Technical Regulation for Standards Food (new edition in press). of the The Executive Office countries with regard to public health emergencies as well as the importation of goods under GCC protocolsThere are agreements, cross-border memoranda or neighbouring with understanding of infectious diseases in GCC countries with alist of notifiable diseases. Committee is in charge of the mission 2§2). (Article Alaw needs to to drafted be prevent animal governmental instruments was carried for some laws, which are now being updated. The IHR other and requirements, administrative relevantlegislation, regulationsor of assessment The Management. coordinate and exchange information with the National Health Committee for Emergency and Disaster thesupervise implementation of IHR at PoE; situation; the coordinate with others administrations in the State to collect the requested information to evaluate situations; cooperate to with WHO sustain the programme of intervention to avoid diseases and other health events that may constitute apublic health emergency in the State’s territory; respond from sources to requests reports to WHO verify other than notifications or consultation of events; such to response in implemented measure anyhealth well as as international of concern emergency allnotify focal WHO points of any event occurring in Qatar that may constitute a public health implementation; their on communications urgent cooperate with the focal WHO points directly concerned with the IHR including important and/or concerned; parties implement the recommendations and decisions of the Committee and assure coordination among all 9 of IHR Core Capacities of the State of Qatar PREVENT 10 PREVENT

Joint External Evaluation • • • strengthening/challenges need that Areas • practices Strengths/best • • • • • • • • documentation Relevant National Committee to implement the IHR (2005) 1of Cabinet (Article decision 18/2015. ensuresThe country coordination of the legal and regulatory through sectors frameworks the between PEC (established in 1998 under 6§10 Article of Cabinet decision 18/2015). Areas covered by national legislation other than the IHR NFP (designation and operation) fall under the implementation of IHR. Updated legislation is for food being safety (CDC drafted Law17/1990). More use should made be of relevant legislation and policies in various involved sectors in the Ministry of Public Health, and Qatar Petroleum). Afull review of all existing laws is under way. coordination and cooperation among the related (Ministry sectors of Interior, Ministry of Environment, power authority, including the IHR NFP and Committee. Their main role is to enhance multisectoral law,food safety and cross-border agreements. Several committees exist by Amiri Decrees with full Some laws have been (or are currently being) reviewed and updated including the public health law, Decree LawNo. 17/1990 about prevention of communicable diseases. Law No. 14/2003 related to quarantine. lawDraft related to animal diseases in the GCC. Ministerial DecreeNo. 13/1992 about the implementation list to Law1/1985 on animal diseases. 1/1985 No. Law health. animal on Management. Disaster and Emergency Ministerial DecreeNo. 13/2012 related to the formation of the National Health Committee for Law No. 8/1990 on Regulation of monitoring of food intended for human consumption. Cabinet decision No. 18/2015 on the formation of the National Committee for implementing IHR 2005. The effective implementation of the IHR (2005) requires multisectoral/multidisciplinary approaches through through approaches multisectoral/multidisciplinary requires (2005) IHR the of implementation effective The mechanisms are notdocumentedbutarebeing followedbypractice. other relevant sectorsregardingpotentialzoonoticrisks and urgentzoonoticeventsisinplace. These informal information exchange between animal and human health surveillance units, laboratories, and international concernisusually sharedduringthemeetingofPECinatimelymanner. Also, timelybut all relevant totheimplementationofIHRcapacities. Information onpublichealtheventsofpotential involvement inthePEC. The PECisheadedbytheMinistry ofInteriorandincludesmembersfrom16sectors; The IHRNFPhasthecapacitytoreceiveandshareinformation internally, duetoitsseniorposition and however, noreallifeeventstookplacetotesttheirfunctionality. to improvepreparednessandcoordinationwithsectors thatdealwithchemicalandradiation events; life examplesandhavebeenfurtherenhanced. Several drillsandsimulationexerciseswereconducted and food sectors and with the PoE, mainly Hamad International Airport, have been tested through real- with chemical and radiation events. Coordination and communication among the public health, animal, communication needtobedocumentedandstandardized, andfurtherenhancedwithsectorsthatdeal health, animalhealth, andfoodsectorsbutmechanisms andprocessesforintersectoral collaboration and not atthesamelevel. Informalcommunicationandcoordinationseemtobestrongamongthepublic Communication andcoordinationbetweenthedifferentstakeholders andwiththeIHRNFPexistbut 2014, theysuspendedtheirmeetings. implementation of the IHR. However, after the announcementthat Qatar had met IHRobligationsinJune PoE. The committeeandtaskforcesusedtomeetmonthlyonanadhocbasis tofollowuponthe the committeeinareasoffood, chemical, nuclearandradiology safety, communicablediseasesand Multisectoral Committee. Technical taskforceshavealsobeenestablishedtoprovidetechnicaladvice of IHRcapacitiessuchastrade, transportation, tourism, commerce, andmaritimearenotpartoftheIHR HMC, PHCCandMinistryofInterior. Representativesfromothersectorsrelevant fortheimplementation It includesrepresentativesfromthedifferentunitsunderMoPH, MoME, QatarPetroleum Corporation, Decree. The CommitteeisheadedbytheDirectorofPublicHealthand ofEPRasanalternate. A national IHR Multisectoral Committee has been established by the Cabinet and endorsed by an Amiri NFP areidentifiedbutnotfullyimplemented. to WHO andarecontinuouslyupdatedannuallyconfirmed. The rolesandresponsibilitiesoftheIHR Head ofSurveillanceandOutbreak. The contactinformationoftheIHRNFPrepresentatives wereprovided The IHRNFPalsoincludestheManagerofHealthPromotionandCommunicableDisease Acting Director ofthePublicHealthDepartmentservesaschairpersonIHRImplementationCommittee. Department undertheMoPH. The DirectoroftheEPRDepartmentservesasprimaryIHRNFPand The IHRNFPistheEmergencyPreparednessandResponse(EPR)DepartmentPublicHealth Qatar levelofcapabilities Target ADVOCACY AND COMMUNICATION COORDINATION, IHR national partnerships for effective alert and response systems. Coordination of nationwide resources, resources, nationwide of Coordination systems. response and alert effective for partnerships national including the sustainable functioning of a National IHR Focal Point (NFP), which is a national centre for IHR IHR for centre national a is which (NFP), Point Focal IHR National a of functioning sustainable the including (2005) communications, is a key requisite for IHR (2005) implementation. The NFP should be accessible accessible be should NFP The implementation. (2005) IHR for requisite key a is communications, (2005) at all times to communicate with the WHO IHR Regional Contact Points and with all relevant sectors sectors relevant all with and Points Contact Regional IHR WHO the with communicate to times all at and other stakeholders in the country. States Parties should provide WHO with contact details of NFPs, NFPs, of details contact with WHO provide should Parties States country. the in stakeholders other and continuously update and annually confirm them. confirm annually and update continuously 11 of IHR Core Capacities of the State of Qatar PREVENT 12 PREVENT

Joint External Evaluation • • • • • Recommendations forpriorityactions NFP anditsfunctionswerenotwellknowntopersonnelatthedifferentadministrative levelsofeachsector. of advocacyactivitiesaboutIHRandtheirimplementationfornewcomers. ItalsoappearedthattheIHR the jointexternalevaluation mission. This canbeattributedtotheturnoveramongpersonnelandlack Insufficient awareness aboutIHR was observedduringthenationaltraining thattookplacetopreparefor • • • strengthening/challenges need that Areas • • • • • practices Strengths/best neither developednorsharedwiththedifferentstakeholders. to incorporate lessonslearntfromthesemechanisms. UpdatesonthestatusofIHR implementationare and communicationmechanismsaretestedthroughreal-timeexercises. Currently, thereisnoactionplan endorsed byan Amiri DecreetoaddressIHRrequirements. Multisectoral andmultidisciplinarycoordination Score 3: Developedcapacity. A lawandaMultisectoral CommitteehavebeenestablishedbytheCabinetand sectors intheimplementationofIHR P.2.1 A functionalmechanismisestablishedforthecoordination andintegration ofrelevant Indicators andscores capacities an with allocated budget. IHR of ensure sustainability and accelerate to implementation action national plan a of Develop of the differentfor developing sectors IHR capacities. commitment obtain and awareness raise to audiences different targeting activities advocacy Conduct sectors. relevant Develop and widely disseminate biannual on implementation reports of the IHR capacities among the Evaluate the functionality of the and IHR effectiveness NFP. tourism,transportation, commerce and maritime. Reactivate the IHR Multisectoral Committee and expand representation to other such as sectors trade, A national plan of actionto enhance the implementation of IHR in Qatar needs to developed. be including among decision-makers sectors. non-health of There is a lack of awareness of IHR and their implementation among the different stakeholders available. yet not are implementation, IHR of updates and capacities, implementation. Hence amechanism for monitoring the implementation and sustainability of IHR The IHR Multisectoral Committee is not yet and active does not include all relevant sectors to IHR response to the potential importation of Ebola and Zika viruses. syndrome coronavirus (MERS-CoV) outbreak and preparedness activities put in place to enhance in place but are not standardized or documented. This was tested during aMiddle East respiratory Coordination and communication the public between health and the animal are and food sectors Functions, roles and responsibilities of the IHR NFP are clearly defined. representation. AmiriAn Decreehas established the IHR NFP and IHR Multisectoral Committee with high level A law is in place to facilitate the implementation of IHR. IHR NFPAn is designated at national level with several to guarantee staff 24/7 availability. • • • documentation Relevant Amiri Decree on establishment of the IHR Multisectoral Committee. Amiri Decree on the designation and function of the IHR NFP. Law. IHR 13 of IHR Core Capacities of the State of Qatar PREVENT 14 PREVENT

Joint External Evaluation Support work being coordinated by WHO, FAO, and OIE to develop an integrated and global package of of package global and integrated an develop to OIE and FAO, WHO, by coordinated being work Support economic growth, publichealth, agriculture, economicsecurity, andnationalsecurity. of newcountermeasurescapablethwarting infectioninhumans. This situationthreatenspatientcare, Over the past decade, however, AMR is growing at an alarming rate and is outpacing the development of resistancewas slowandthepharmaceuticalindustrycontinuedtocreatenewantibiotics. resist being killed by antimicrobial agents. For many decades, the problem was manageable as the growth Bacteria andothermicrobesevolveinresponsetotheirenvironmentinevitablydevelopmechanisms Introduction ANTIMICROBIAL RESISTANCE • • • • Recommendations forpriorityactions Stewardship programmes arelimitedandfutureexpansionisessential. HMC willmake iteasytoassignsentinelsurveillancesitesforreportingatnationalandinternationallevels. awareness of the AMR issue needs to be promoted. The availability of AMR capacity and surveillance at laboratory capacityandsurveillancealignmentwiththehumanhealthfoodsectors. General public close collaboration withallstakeholders. The animalhealth sectorfor AMR needsenhancementintermsof in thefuture. The national AMR actionplan, based on theGlobal Action Plan, needstobedevelopedin activities. The conceptofaOneHealthapproachfor AMR needstobeenhancedensurecontainment No formalized structure is currently available to ensure nationwide implementation of AMR, IPC or AMS antimicrobial stewardship (AMS)arepresentatvarying levels atHamadMedicalCorporation hospitals. Various AMR capacitiesfordetection, surveillance, infectionpreventionandcontrol(IPC)programmes and Qatar levelofcapabilities Target activities to combat antimicrobial resistance, spanning human, animal, agricultural, food and environmental environmental and food agricultural, animal, human, spanning resistance, antimicrobial combat to activities aspects (i.e. a One Health approach), including: a) Each country has its own national comprehensive plan plan comprehensive national own its has country Each a) including: approach), Health One a (i.e. aspects to combat antimicrobial resistance; b) Strengthen surveillance and laboratory capacity at the national and and national the at capacity laboratory and surveillance Strengthen b) resistance; antimicrobial combat to international level following agreed international standards developed in the framework of the Global Global the of framework the in developed standards international agreed following level international Action Plan, considering existing standards and; c) Improved conservation of existing treatments and and treatments existing of conservation Improved c) and; standards existing considering Plan, Action collaboration to support the sustainable development of new antibiotics, alternative treatments, preventive preventive treatments, alternative antibiotics, new of development sustainable the support to collaboration measures and rapid, point-of-care diagnostics, including systems to preserve new antibiotics. new preserve to systems including diagnostics, point-of-care rapid, and measures and food sectors. Strengthen laboratory AMR for detection capacity and establish surveillance within the animal health defined roles and responsibilities to develop national IPC AMR andplans. Formalize the development of the national (AMS ofis the programme) part AMR AMR/IPC unit with Consider assigning an HMC laboratory to function as the national reference AMR laboratory for Qatar. national by approval authorities. conduct anational evaluation AMR and subsequentlydevelop an integrated planaction AMR for human health, agriculture, animal health, food, environment, and industry. This committee should Convene anational committee AMR through engagement of all and stakeholders sectors including • Areas thatneedstrengthening/challenges • practices Strengths/best strengthening toreflectthe AMR profileofthecountry. passive surveillanceoftheanimalsectorfor AMR prioritypathogensexists. The OneHealthapproachneeds MoPH. Nationalintegrated plans forhumanandanimalsector AMR surveillancearestillnotinplace. Limited although theydonotfunctioninthecapacityofassignedsentinelsitesandhavenolinktocentral Score 3: Developedcapacity. HMChospitalshaveconducted surveillanceofinfectionsforsometime, P.3.2 Surveillanceofinfections causedby AMR pathogens • • strengthening/challenges need that Areas • • • practices Strengths/best to bestrengthened. MoPH and WHO, the ranking will likely rise. The capacitiesof AMR surveillance at theanimalsectorneed HMC laboratory (eveninaninterimcapacity)asanationalreferencelaboratory toreport AMR datatothe access to AMR datafromhospitalandprimaryhealthcarelevels. Onceadecisionistaken toassignthe AMR pathogens, thecapacityavailable atHMCfor AMR detectionisexcellent. The HMClaboratory has Score 3: Developedcapacity. Although therearenonationalplansfordetectionandreportingofpriority P.3.1 Antimicrobial resistance detection Indicators andscores • Communicable Disease Department and the Quality and Patient Department. Safety coordinated through anational structure (IPC/AMR) within the MoPH, i.e. the Health Protection and A national plan for surveillance of infections caused by pathogens AMR needs to developed be and in 8out of 13 hospitals in the without country being sentinel surveillance sites. are identified and their susceptibility patternsstudied. Therefore, AMR surveillance data are available pathogens programmes, surveillance two the Through 2000. since surveillance community-acquired Eight hospitals at HMC have been conducting health active care-associated infection surveillance and of theThe capacity animal laboratory sector needs to enhanced be surveillance. AMR toactive support pathogensAMR approved by national authorities. HMC laboratory would then responsible be to develop anational plan for detection and reporting of plans on how to change the scope of the HMC laboratory need to developed be and implemented. The laboratory, or to build anew national public health laboratory incorporating In the AMR. former case, A decision needs to taken be on whether to assign the HMC laboratory as anational reference AMR to adding some functions allowing at it national to act capacity. The available of the capacity HMC laboratory as anational canserve reference AMR laboratory subject centres in Qatar. The HMC laboratory the also testing supports of clinical isolates sent through 22 primary health care for community-acquired and nosocomial pathogens in 8out of 11 hospitals in the country. The HMC laboratory is an advanced internationally accredited laboratory conducting surveillance AMR Implement programmes AMR within both the animal and public health sectors. 15 of IHR Core Capacities of the State of Qatar PREVENT 16 PREVENT

Joint External Evaluation IPC programmes. Small-scaleactivitiesexistintheanimalsectoronhygienicmeasuresandprecautions. programme started at HMC hospitals, the hospitalsdo not function as designated health-care facilities for programme existsatHMChospitalsbutnocoordinationwiththenationallevel). EventhoughtheIPC be approvedbeforeitmovesforward towards havinganationalIPCprogramme (alongstandingIPC MRSA, CDetctoHealthProtectionandCommunicableDiseaseControl. An MoPHdetailedstructuremust with MoPH. IPCreportshealthcare-associatedinfectionsoncommunicableandotherdiseasesincluding Score 3: Developedcapacity. IPCsystemsareinplacewithinHMCandthePHCC, butnotfullyintegrated P.3.3 Healthcare-associated infectionprevention andcontrol programmes • • • strengthening/challenges need that Areas • • • practices Strengths/best centres. as AMS MoPH. The activitiesofthestewardship arelimitedandthe HMChospitalsarenotassignedordesignated or approved. AMS activities started very recently at HMC hospitals with no central coordination with the Score 2: Limitedcapacity. Nonationalplansforantimicrobial stewardship activitieshavebeendeveloped P.3.4 Antimicrobial stewardship activities • • strengthening/challenges need that Areas • practices Strengths/best surveillance sites are available in the animal health sector. The veterinary is sector only conducting minimal passive surveillance, AMR and no sentinel AMR Surveillance sites need to designated be for reporting human data. AMR nationwide implementation. implementation. nationwide A national plan for AMS programmes needs to developed be by the national IPC unit to ensure providers. care health- targeting programmes education and use, antibiotic of monitoring regular perform committees, AMS programmes have been available at HMC for almost ayear, where they have antimicrobial steering Hospitals at HMC have an antimicrobial implemented. policy physicians. Legislation is available that prevents antibiotic dispensing without prescription through licensed available. made were farms hygienic in and measures biosecurity on information No nationwidefurther use. authorities. Available IPC resources at HMC need to revised be and updated by the central IPC unit for Department willSafety develop anational IPC plan and strategy to approved be by the national and primary care centres in Qatar. The national IPC/AMR/AMS unit within the Quality and Patient A national structure should created be to coordinate and oversee the IPC programmes in all hospitals IPC activities to all hospitals and primary health care facilities in Qatar. and resources (guidelines, policies, procedures). Available IPC resources could used be when expanding A strong longstanding IPC programme in exists 8of the 13 HMC hospitals in Qatar with IPC experts • • • • documentation Relevant • • • • IPC guidelines of private hospitals. Corporation. Medical Hamad of Antibiogram surveillanceHAI guidelines of Hamad Medical Corporation. IPC policies and procedures of Hamad Medical Corporation. No stewardship programmes have been implemented in the animal health sector. Currently there is no legislation regarding prescription of antibiotics for animal health. promotion. growth for farms in used are Antibiotics The number of hospitals with an AMS programme needs to expanded. be 17 of IHR Core Capacities of the State of Qatar PREVENT 18 PREVENT

Joint External Evaluation Adopted measured behaviours, policies and/or practices that minimize the transmission of zoonotic zoonotic of transmission the minimize that practices and/or policies behaviours, measured Adopted zoonotic. infectious diseasesaffectinghumansisofanimalorigin; approximately 60%ofallhumanpathogensare or inanimatevectorsmaybeneededtotransfer themicrobe. Approximately 75%ofrecentlyemerging These diseasesarecausedbybacteria, viruses, parasites, andfungithatarecarriedbyanimals; andinsect Zoonotic diseasesarecommunicableandmicrobesspreadingbetweenanimalshumans. Introduction DISEASES ZOONOTIC and controlofzoonoticdiseases. there arenoformalstructures ormechanismstoupgrade and sustaincollaboration foreffective surveillance sectors aswellwithother sectors(municipalitiesandwildlife), especiallyforcertain prioritydiseases, Despite goodcollaboration and day-to-daycommunicationbetweenthepublichealthandveterinary appropriate quarantine facilities. live animalsthroughthemainportsofentry. However, thequarantine andbordersecuritysystemhasfew with HealthControlsection. The Departmentmonitorsandmaintainsagooddatabaseforallimportof in poultry, as well as bovine tuberculosis(primarilyslaughterhouse-based)in livestock, in coordination AHS implementssurveillanceprogrammes forbrucellosisinlivestock, avianinfluenzaandsalmonellosis for theotherprioritizeddiseases. jointly developedandisbeingimplemented. There isaplantodevelopwrittensurveillanceprogrammes health importance, andperceivedriskorimpact. An actionplanforjointsurveillance ofMERS-CoVwas health sectors. These diseaseswereprioritizedbasedontheirepidemicpotential, economicand/orpublic CoV andrabies aspriorityzoonoticdiseasesforcollaborative activitiesbetweenthehumanandanimal The Department of Public Health and AHS have jointly identified brucellosis, bovine tuberculosis, MERS- avian influenzaandbrucellosis. Collaboration betweenthepublichealthsectorandveterinaryhasbeentested inthepastfor has beenstrengthenedwithinrecentyearstocoordinatesurveillanceandresponseMERS-CoVcases. including outbreakinvestigationandresponsetozoonoticeventsemergencies. This collaboration communication, informationsharingandmeetingsforjointplanningimplementationofsurveillance, Collaboration betweenthe animal and public health sectors functions through regularbut informal retail outlets, controloffoodstuffs, andmonitoringofworkers infoodestablishments. such astheMunicipalities(HealthControlsection)areinchargeofmeatinspectionatslaughterhousesand Control) andtheMoMEDepartmentof Animal HealthResources, respectively. Othergovernmentagencies with theMoPHDepartmentofPublicHealth(whichincludesProtectionandCommunicableDisease Responsibility inQatarforthepreventionandcontrolofzoonoticdiseaseshumansanimalslies Qatar levelofcapabilities Target diseases from animals into human populations. human into animals from diseases in moreadvanced epidemiologytraining. surveillance andresponseto emergingzoonoticevents. There arealsoplansforveterinarystafftotake part Score 3: P.4.2 Veterinary oranimalhealth workforce • • • • strengthening/challenges need that Areas • • • practices Strengths/best systems forallpriorityzoonoticdiseases. are coordinatingsurveillanceactivitiesforMER-CoV. Furthereffortsareneededtoformalizesurveillance priority zoonotic diseases (bovine tuberculosis, brucellosis, MERS-CoV and rabies) for surveillance and Score 3: Developedcapacity. The publichealthandanimalsectorshavejointlyidentifiedfour P.4.1 Surveillancesystemsin place forpriorityzoonoticdiseases/pathogens Indicators andscores • • • • • • Recommendations forpriorityactions Surveillance in AHS capacity is limited due to laboratory procurement constraints. There is limited infrastructure for animal quarantine. formal. or systematic not Data sharing, collaboration and communication are among the public health and sectors veterinary structures for collaboration. agreed diseases priority have not been formalized due to lack of agreed and policy formal mechanisms/ Joint planning, implementation of surveillance, and investigation and response to outbreaks of the AHS has asurveillance programme for some zoonotic diseases of public health importance. diseases. priority other the for plans action and programmes surveillance Joint surveillance guidelines and protocols exist for MERS-CoV and there are plans to develop written bovine tuberculosis, MERS-CoV and rabies. Collaborative activities are being carried out for the jointly agreed zoonotic priority diseases: brucellosis, Engage with the OIE Performance of Veterinary (PVS) Services follow-up evaluation and gap analysis. procedures. security border and infrastructure quarantine veterinary Upgrade of this section AMR report. activities conducted in the public health and to sector complement actions priority presented in the Develop amonitoring and surveillance system for in AMR the veterinary in harmony sector with FETP. as such programmes training joint in staff veterinary integrate and Strengthen for epidemiology, capacity surveillance and outbreak investigations for zoonotic diseases diseases. priority identified for plans response and surveillance joint written Develop zoonotic diseases (Onepriority Health). Establish formal intersectoral mechanisms for joint surveillance, risk assessment and response to Developed capacity. There isagoodcollaboration forjointtraining onoutbreakinvestigation, 19 of IHR Core Capacities of the State of Qatar PREVENT 20 PREVENT

Joint External Evaluation has beentestedinthepastbutnotregularlyupdated. investigations andresponsetozoonoticevents. A nationalcontingencyplanforavian influenzaexistsand zoonotic events(MERS-CoVandbrucellosis). Formal mechanismsneedtobeputinplaceforjointoutbreak Score 3: Developedcapacity. The publichealthandanimalsectorshavemanagedeffectivelysome functional P.4.3 Mechanismsforresponding tozoonosesandpotentialare establishedand • • strengthening/challenges need that Areas • • • practices Strengths/best • • • • • • • • documentation Relevant • • strengthening/challenges need that Areas • • • • practices Strengths/best among sectors. Insufficient joint planning strategiesor for developing an overall zoonoses exist workforcecapacity public health sectors. Insufficient epidemiological skills for zoonotic diseases are available bothin the animal health and but more veterinary are needed. staff veterinary centres) tothe public support health to address sector one zoonotic disease event at atime, Some technical veterinary is capacity available within AHS (at national level and in the subnational veterinarians. epidemiology, including training on advanced The MoPH has organized joint training on surveillance and response to zoonotic disease events with There are some veterinarians working in the MoPH. Avian influenza simulation exercise document, 2007. simulationAvianexercisedocument, influenza Avian influenza early detection and preparednessstrategy, 2006. Contingency plan against avian influenza in the State of Qatar, 2006. ofReport the OIE evaluation of the Performance of Veterinary 2008. Services, and protocolsReports on surveillance and investigation of MERS-CoV cases. Law, 2003. Quarantine Veterinary 86/1986. Law Health Animal animal quarantine. on reports monthly and Immediate There is no national emergency response plan to zoonotic events in the animal health sector. suspected zoonotic disease outbreak apartfrom MERS-CoV. There is no strategy or formal mechanism for multidisciplinary interagency response in the event of a There is regular communication functional and collaboration among sectors. avian influenza (2006) exists and hasbeen tested twothrough joint simulationexercises in the past. The national preparedness and contingency plan including documented procedures for response to respond to outbreaks of zoonotic events. Emergency operations teams are in place in both the public health and veterinary that sectors jointly There joint are effective investigations and responses to specific zoonotic outbreaks (e.g. MERS-CoV). State parties should have surveillance and response capacity for food and water borne diseases’ risk or or risk diseases’ borne water and food for capacity response and surveillance have should parties State Food Safety Authority (FSA)thatwouldbe thesoleauthoritytomanage foodsafetyfrom ‘farm to table’, In the2013IHR Assessment MissionReport, Qatarstated itwas intheprocessofestablishing anew application. Qatar isaware thatitscurrentstatutoryauthorityforfood safetyneedsmoreclaritytoavoidinconsistent inspections. establishment inspection. The Governmentisconsideringpartneringwiththeprivate sectoronthird-party work attheborderpoints, butthiswillchangeandthey willneedmorestaffinotherrolessuchasfood Of the7000samplestaken attheportslastyear, 2%wererejected. Currently, mostoftheirinspectors inspection service. Oneareainwhichtheyareproactive isinmicrobiologicalsamplingofimportedfood. At theportsofentry, thereisahigh, currentpriorityattachedtoachievingISO17020accreditationfor their and storage outlets. There isgoodcollaboration withMoPHinthisregard. of foodprocessingestablishments, meatinspectionat slaughterhousesandcontroloffoodstuffsinretail departments inMoME. The HealthMonitoringDepartmentinthisMinistryisresponsiblefortheinspection Disease Control; CDCincludesdifferentgroupswithintheMoPH, andtheFood Safetyand Animal Health a jointresponsetooutbreaks, identifiedandverifiedbytheSurveillanceDepartmentofQatarCentrefor There isoverall goodcontrolofthenationalsystem. Comparedtothe2013IHR Assessment, thereisnow including virologyandparasitology, molecularbiology, radiation andwater testing. has been in place for 45 years. Bacteriology capacity iseffectiveand the laboratory is building on this, to supportthefoodsafetyregionalplanandpromotetechnicalcollaboration between countries. The CFL participate inthePulseNetMiddleEastnetwork, amolecularsurveillancenetworkforfoodborneillnesses, Central Food Laboratory (CFL)withintheHMChasbegunseeking ISO17025accreditation. HMC and CFL food laboratory formonitoringallincomingfoodproductsfromportsandlocalestablishments. The social media; thepubliccancontactMoPHviaitswebsiteor “hotline.” Qatarhasahighlyqualified community arealsostrong. Inaddition, foodcomplaintsarereceiveddirectlyfromconsumersthrough reporting, consumerfoodcomplaints, entericdiseasesurveillanceandinvestigation. Linkagestotheclinical Technical expertiseinpublichealthaspectsoffoodsafetyisstrongmanyareas, e.g. notifiabledisease Qatar levelofcapabilities Target prevention ofhumancases(orfurthercases)needtobeputinplace. the sourceofanevent, basedonariskassessment, suitableriskmanagementoptionsthatensurethe throughout thefoodchaincontinuummustbedeveloped. Ifepidemiologicalanalysisidentifiesfoodas outbreak anditscontainmentiscriticalforcontrol. Riskmanagementcapacitywithregardtocontrol likelihood ofinternationalincidentsinvolvingcontaminatedfood. The identificationofthesourcean developed countries. The rapid globalizationoffoodproductionandtrade hasincreasedthepotential Food- and waterborne diarrhoeal diseases are leading causes of illness and death, particularly in less Introduction SAFETY FOOD events. It requires effective communication and collaboration among the sectors responsible for food safety safety food for responsible sectors the among collaboration and communication effective requires It events. and safe water and sanitation. and water safe and 21 of IHR Core Capacities of the State of Qatar PREVENT 22 PREVENT

Joint External Evaluation not withtheirfoodsafetystaff), andthePort ofEntrystaff. This foodsafetyevaluation isbasedprimarilyondiscussionsoftheJEEteamwithMoPH, AHS, MoME(but CDC). The FSAimplementationisexpectedwithinfiveyears. have strongcollaboration withothersectors, includingMoMEforanimalhealth, andMoPH(e.g. withQatar monitoring. A foodsafetylawhasbeenupdatedandawaits endorsement. The newlawwillrequireFSAto chart was shared. The reorganizationwillclarifyrolesamonggovernmentagenciesinvolvedinfoodsafety licensing, surveillance, riskassessment, outbreakresponseandpolicydevelopment. A draft organizational of foodsafety. FSA functions will includelaboratories, import/export, localandimported food product and world-classstandardsthatareevidence-basedmovefromreactivetoproactivemanagement functions oftheagencies, includingfinancialresourcecommitment, toachieveinternationalbestpractices for thismajortransition fromthecurrentmulti-agencysystemtoFSA. This processwillintegrate the managed fromwithintheMoPHwithapproximately 500staff. There ishigh-levelpoliticalcommitment investigations. Food bacteriology andfoodchemistryisquitegood. (including diagnostics)isstronger thanthecapacityforviral, parasitic andradiologic surveillanceand reported directlytothemunicipality. Laboratory capacity forbacterialsurveillanceandinvestigations inspection andmonitoringoffoodwhenthereareconsumer complaintsorwhensuspectedillnessesare been formalized, andthereappearstobesomeuncertainty aboutwhathappensatthelocallevelregarding organizational unitsaregood. However, coordinationofthenationalsystemwith local levelhasnot foodborne illness. Under these circumstances collaboration and communication among theresponding systems. There isactivecase managementandepidemiologicalinvestigationofhumancasessuspected with bothdiseasecontrolandenvironmentalinvestigations, atleastwhenrecognizedthroughthenational technology appearup-to-date. There isalsoarobustjointresponsetosuspectedfoodborneillnessreports via notifiablediseasereportingandconsumerfoodcomplaints isrobust. Food andclinicallaboratory Score 3: Developedcapacity. Foodborne diseaseinfrastructure isverygood. Outbreak/event detection disease andfoodcontamination P.5.1 Mechanismsare establishedandfunctioningfordetecting andresponding tofoodborne Indicators andscores • • • • • • • • Recommendations forpriorityactions activities. activities. Establish interdisciplinary training for outbreak investigation and other collaborative food safety Consider routine after-action reviews of MoPH and MoME outbreak responses. detaining for proof of or product closing food establishments. Harmonize outbreak investigation and policy MoPH practice and between MoME, e.g. standard table” risk and management. assessments Consider aprocess for formal sharing of illness and outbreak data to inform risk-based “entry port-to- Consider the appointment of intersectoral liaison officers. chain. food the along programmes hygiene and safety food of implementation for collaboration Reinforce intersectoral Establish the national food authority including a5-year actionplan with allocated resources. Accelerate endorsement of the new food law and related administrative measures. • • • • documentation Relevant • • • • • • • • • • • • • strengthening/challenges need that Areas • • • • practices Strengths/best Municipalities Standards for Restaurants and Other Food Establishments. Food Other and Restaurants for Standards Municipalities Notification. Committee Permanent GCC Food and Gulf Coop Council Standards Technical Regulation for Standards Food (revision in press). Qatar LawNo 8, Food 1990, No 4-2014. formalor risk assessment. A goal over time will SOPs for be joint activities such as outbreak or food contamination investigations (e.g. outbreak investigation, food testing, food establishment inspection). professionals will increase mutual understanding and for respect the others’ contribution to food safety Interdisciplinary training for disease control staff, laboratory staff, food inspectors, and animal health interfaces. regulatory food and health, animal Qatar should consider assigning full-time, intersectoral liaison officials to work at the disease control, if and when the food or clinical labs do more molecular subtyping. To address these challenges: of information sharing, benefits The coordination collaborationand will become increasingly important and investigation prevention. detection Outbreak is secondary contamination. The FSA’s focus will on be primary prevention, and monitoring food and food establishments to prevent professionalsregulatory and therefore is different prioritiesconflict. can Within the MoPH’s broad mission of public health, the work of disease control professionals and food Some challenges in coordination/communication will likely remain the after establishment of the FSA. Training and certification of more food inspectors and food handlers is needed. response. (SOPs) unify willhelp procedures operating standard joint Developing health of the food industry. help minimize tension some of the expected balancing between human health against the economic communication and clarifyroles and responsibilities. Having the FSA reside within the MoPH will also The establishment of the single FSA based on current plans should improve coordination and needed. Personal and professional communication is good, but institutionalized organizational linkages are units. There is insufficient coordination and communication diseasebetween control and food regulatory Qatar participates in the International Authorities Safety Food (INFOSAN). Network public health community. humanActive foodborne illness and outbreak data are analysed, summarized and distributed to the investigations. environmental and health public joint with events food to occur responses Robust for illnesses, but not all commit to critical evaluation of consumer complaints of foodborne illness. The approach to consumer complaints is noteworthy. Many health authorities have monitoring good Robust foodborne disease surveillance via both reportable diseases and consumer complaints exists. 23 of IHR Core Capacities of the State of Qatar PREVENT 24 PREVENT

Joint External Evaluation • • • Environment (http://www.mme.gov.qa/cui/view.dox?id=1086&siteID=2&contentID=1108).Environment Mandate and functions of the Municipal Control Department of the Ministry of Municipality and OrganizationalDraft Chart for planned Authority. Safety Food Water, Standards. European SourcesExternal such as the Standards Food Australia New Zealand, Guidelines WHO CODEX, for A whole-of-government national biosafety and biosecurity system is in place, ensuring that especially especially that ensuring place, in is system biosecurity and biosafety national whole-of-government A • • Recommendationsforpriorityactions committee. in place, butbiosecurityremainslimitedinitsimplementation. Nevertheless, HMCdoeshaveabiosafety In theHamadMedicalCorporation andCentral Food laboratories, biosafetypoliciesand programmes are laboratory level, thereisnoformal inventoryofthepathogensworked on. Qatar hascurrentlynonationalbiosafetyandbiosecurity legislation, regulationorguidelines. At the information remainsecure. occupationally acquiredinfections, whilebiosecurityensuresthatbiologicalmaterialsandrelevant sensitive or intentionalmisuse. Therefore, biosafetyhasproceduresandpractices inplacetopreventexposureand refers totheprotectionofmicrobialagents, toxins orresearch-relatedinformationfromloss, theft, diversion individuals andtheenvironmentfromexposuretopotentiallyhazardousbiologicalagents. Biosecurity Biosafety andbiosecurityarerelated, butnotidenticalconcepts. Biosafetyreferstotheprotectionof Qatar levelofcapabilities Target the environment. infectious agentsagainstthosewhowoulddeliberately misusethemtoharmpeople, animals, plants, or and biosecuritytoprotectresearchersthecommunity. Biosecurityisimportantinordertosecure to workwithinfectiousagentshaveraised concernsregardingtheneedtoensureproperbiosafety natural anddeliberate origin. At thesametime, theexpansionofinfrastructure andresourcesdedicated tools thatareneededtodetect, diagnose, recognize, andrespondtooutbreaksofinfectiousdiseaseboth Research withinfectiousagentsiscriticalforthedevelopmentandavailability ofpublichealthandmedical diseases. set oftools—suchasdrugs, diagnostics, andvaccines—to countertheeverevolvingthreatofinfectious Working withpathogensinthelaboratory isvitaltoensuringthattheglobalcommunitypossessarobust Introduction AND BIOSECURITY BIOSAFETY dangerous pathogens are identified, held, secured and monitored in a minimal number of facilities facilities of number minimal a in monitored and secured held, identified, are pathogens dangerous according to best practices; biological risk management training and educational outreach are conducted conducted are outreach educational and training management risk biological practices; best to according to promote a shared culture of responsibility, reduce dual use risks, mitigate biological proliferation and and proliferation biological mitigate risks, use dual reduce responsibility, of culture shared a promote to deliberate use threats, and ensure safe transfer of biological agents; and country-specific biosafety and and biosafety country-specific and agents; biological of transfer safe ensure and threats, use deliberate biosecurity legislation, laboratory licensing, and pathogen control measures are in place as appropriate. as place in are measures control pathogen and licensing, laboratory legislation, biosecurity mitigation plans in the facilities housing thoseagents. implement and risk assessments perform concern, of agents/pathogens of inventory an Undertake legislation. biosecurity and national biosafety Implement 25 of IHR Core Capacities of the State of Qatar PREVENT 26 PREVENT

Joint External Evaluation Score 3: Developedcapacity. and agriculture facilities P.6.1 Whole-of-government biosafetyandbiosecuritysystemisinplaceforhuman, animal, Indicators andscores • • • • strengthening/challenges need that Areas • • • • practices Strengths/best Score 3: Developedcapacity. P.6.2 Biosafetyandbiosecurity training andpractices • • • • strengthening/challenges need that Areas • • • • • • practices Strengths/best Improve for trainingall laboratories. in biosecurity at all levels throughout the country, including at private laboratories. sector about practices, best and to develop and implement biosafety and biosecurity policies and guidelines Establish anational biosafety and biosecurity team to enhance collaboration and information sharing with dangerous pathogens and toxins, and pathogens dangerous with Sustained academic training should developed be on biosafety and biosecurity for those who work A train-the-trainers programme needs to developed be and implemented for biosecurity. regulations. Nations Staff are trained in public laboratories on the transport of infectious substances according to United sector. public the in toxins and pathogens Qatar has atraining programme in place at most facilities housing or working with dangerous Biosafety training is also provided of medical as apart school education. Biosafety training is offeredfor and laboratoryof is the knowledge part staff for individual licensing. toxins. and pathogens dangerous Up-to-date records and pathogen inventories should improved be within facilities that store or process should improved. be oversightThe and biosecurity monitoring of biosafety of Regulations need to developed be to cover all existing gaps in biosafety and address biosecurity. implemented. and developed be to legislation needs biosecurity and National biosafety oversightAn monitoring and enforcement mechanisms is implemented for private laboratories. such as polymerase chain reaction. Tools and resources todiagnostics support that preclude culturing dangerous pathogens are in place Dangerous pathogens and toxins are worked on in adetermined number select of facilities. The Central laboratory Food also has abiosafety policy. A laboratory health programme and safety is in place at HMC, covering the biosafety. A biosafety committee at exists HMC. • • • documentation Relevant • VIR- FS-001-004-000 Biosafety in handlingVIR- FS-001-004-000 specimens with novel influenzaviruses. VIR-FS-001-001-000 Virology Lab Safety. Program HMC. – Health and Safety LMP-FS-001-000-000-Laboratory Further training should developed be for the private sector. 27 of IHR Core Capacities of the State of Qatar PREVENT 28 PREVENT

Joint External Evaluation to ensurethepropercontrolof VPDs atthepopulationlevel. outreach immunization services andproof ofimmunizationstatus prior toarrival inQatarmaybe required Qatar from countries with a high incidenceof VPDs may increase the riskfor disease outbreaks. Improved as somenon-orunder-vaccinated populationgroupsmaystillexist. The foreign-bornworkforcearrivingin show constantlyhighvaccination coverage, thepopulationlevelprotectionagainst VPDs isstilluncertain as wellsemi-governmentalserviceprovidershasgrown substantially. Although administrative data need forimmunizationactivitieshasincreasedrapidly duringrecentyears, andtherole oftheprivate sector the 22primaryhealthcareclinics. Duetoimmigration andrapid turnoveroftheforeign-bornworkforce, the diseases (VPDs). The PrimaryHealthCareCorporation carries outmostoftheimmunizationactivitiesat supervision, monitoringandtraining activitiesaswelloutbreakinvestigationofvaccine preventable and distributionofvaccines iscentralized andmanagedbythe MoPH, whichisalsoinchargeofnational Programme mustcarryoutmandatoryimmunizationstatuscheck-upsatschoolentry. The procurement Based onDecreeLaw17(1990)thepreventionofcommunicablediseases, theNationalImmunization rubella eliminationby2015withtheincidenceofmeaslesstillat26.5permillionin2014. in outbreaksofvaccine-preventable diseases. However, Qatardidnotachievethetargetofmeaslesand coverage rates amongdefinedpopulations, successfulsupplementary vaccination campaignsandreduction Some ofthesuccessfuloutcomesNationalImmunizationProgramme include high immunization Plan.Global Vaccine Action the WHO with globally withseveral life-savingvaccines recentlyintroduced. The National Vaccination Planisfullyaligned A functioning national vaccine delivery system—with nationwide reach, effective distribution, access for for access distribution, effective reach, nationwide system—with delivery vaccine national functioning A Target deaths ayearglobally. ways tosavelivesandpreventdisease. Immunizationsareestimatedtopreventmorethantwo-million Immunization isoneofthemostsuccessfulglobalhealthinterventionsandcost-effective Introduction IMMUNIZATION 1 • Recommendations forpriorityactions 15 targetdiseases. diphtheria, tetanusandpoliostartedin1975. The QatarNationalImmunization Programme nowcovers Routine immunizationinQatarbeganthe1950s, andthefirstnationallyfundedinfantprogramme for Qatar levelofcapabilities marginalized populations, adequate cold chain, and ongoing quality control—that is able to respond to to respond to able is control—that quality ongoing and chain, cold adequate populations, marginalized new disease threats. disease new

rotavirus, rubella, tetanus, tuberculosis, andvaricella. diphtheria, hepatitis A, hepatitisB, Haemophilusinfluenzaetype b, influenza, measles, mumps, pertussis, pneumococcalinfections, poliomyelitis, covering all vaccines administered in Qatar. in administered vaccines all covering Develop an electronic central vaccination linked registry to the population and immigration data 1 The Programme iscurrentlyoneofthemostcomprehensive immunizationprogrammes • • • • • • • strengthening/challenges need that Areas • • • • practices Strengths/best October 2016. supplementary vaccination campaignsin2002, 2007and2011, andisplanning anewcampaignin vaccine hasbeenabove95%forthepast10years. Inaddition, theMoPH hasconductedmeasles Score 5: Sustainablecapacity. Basedonadministrative data, coverage oftwodosesmeasles-containing P.7.1 Vaccine coverage (measles)aspartof nationalprogramme Indicators andscores • chain management. Develop collaboration all between stakeholders to improve forecasting of vaccine demand and supply teams. Immunization on Programme Expanded and investigation Continue improving outbreak investigation of with VPDs clear roles and responsibilities of outbreak coordination. The increasing role of the private and semi-governmental sector clinics may reduce national level Centralized electronic vaccination is registry currently being developed but is not yet operational. vaccine wastage. of The need for coverage and sero-epidemiological should surveys evaluated, be including the calculation the real denominator for the target population. The accuracy of vaccination coverage data needs to improved, be including difficulties in estimating are needed to reducedEfforts the burden of especially VPDs, measles, rubella and varicella. on vaccinology, includes representative from the MoPH, HMC, PHCC and other relevant sectors. The National Immunization Technical Group Advisory (NITAG), the and active top technical expertise populations. defined among sustained is coverage immunization High burden disease and mortality varicella significant prevent to vaccine conjugate and vaccine vaccine, vaccine, polio pneumococcal rotavirus e.g. burden, inactivated disease and mortality significant prevent to vaccines new introduce to evident is commitment Government extensive,An scientificallysound and well-funded national immunization programmeexists. c. b. a. coverage: vaccination population-level Continue improving visa toQatar. Medical Centres Association orotherauthorizationbodiesforforeigncitizensseekingawork Develop apolicytoobtainvaccination certificatesfromGulfCooperation Council Approved private sectors. Enforce amandatoryvaccination policypriortoday-careandschoolentryinthepublic ach immunizationservicestoreachthesepopulations. and sero-epidemiologicalsurveysaswellestimationofvaccine wastage, andestablishoutre- Define non-andunder-vaccinated populationsusingappropriatemethodssuchas vaccination 29 of IHR Core Capacities of the State of Qatar PREVENT 30 PREVENT

Joint External Evaluation • • practices Strengths/best exists toreachandprovidevaccination tothemarginalizedpopulations. November 2015demonstrated 66%overall capacityinninetechnicalareas. Currentlynoroutinesystem monitored byboththeMoPHandPHCC. The WHO effectivevaccine managementassessmentmissionin are managed by the MoPH. Cold-chain management at PHCC levelis tested annually and frequently reaches allprimaryhealthcareclinics. Vaccine demandandforecasting, aswellemergencystocks, Score 4: Demonstrated capacity. Qatarhas a centralized vaccine procurementand delivery systemthat P.7.2 Nationalvaccineaccessanddelivery • • • • • • • • documentation Relevant • • • strengthening/challenges need that Areas prevented prolonged stockout situations at the central level. The well-functioning central procurement system with asix months emergency stock of vaccines has evaluation by the Programme MoPH Expanded on Immunization team and the PHCC. Strong infrastructure and cold-chain is in place, including continuous supervision, monitoring and Polio Outbreak Simulation Exercise in Qatar, April 2016. Immunization PHCC Report Well baby clinics, March 2016. Surveillance of Communicable report Diseases in Primary Healthcare Corporation in Qatar –2015. 2015 system. monitoring Qatar. diseases preventable vaccine summary: global WHO Tdap 2016.The report vaccination campaign May 2011. Mediterranean, Eastern Review of the Programme Expanded on Immunization in State of Qatar, Regional WHO for the Office 2015. Review of Measles Elimination Programme in Qatar, Regional WHO for the Eastern Office Mediterranean, National Immunization Strategy Proposal for Qatar, 2015–2016. limited. Outreach activities and for proper vaccination advocacy of non and under-vaccinated populations are quality of the vaccine transportation system from the point to of the entry clinic. Despite strong cold-chain management at primary health care centres, no assessment of exists the services. governmental Procurement and vaccine forecasting should also cover vaccines used in the private and semi- sector Real-time biosurveillance with a national laboratory system and effective modern point-of-care and and point-of-care modern effective and system laboratory national a with biosurveillance Real-time • • strengthening/challenges need that Areas • • practices Strengths/best Score 4: Demonstrated capacity. D.1.1 Laboratory testing fordetectionofprioritydiseases laboratory systemwas notundertaken. Note: thisscoringwas doneonthebasisofpublichealthlaboratory system. An evaluation ofthenationalanimalhealth Indicators andscores • • Recommendations forpriorityactions human and animal disease outbreaks, there is a need for better coordination of laboratories at central level. population. However, toimprove oversightandthenationallaboratory capacitytopreventanddetect Qatar’s nationallaboratory capacityisgood, especiallyin thepublicsector, whichcovers80%ofthe Qatar levelofcapabilities Target education; andpartnershipscommunication. and specializedtesting; laboratory oversight; emergencyresponse; publichealthresearch; training and food safety including disease prevention, control, and surveillance; integrated data management; reference can serveasafocalpointfornationalsystem, throughtheircorefunctionsforhuman, veterinaryand response, environmentalmonitoring, anddiseasesurveillance. Stateandlocalpublichealthlaboratories Public healthlaboratories provideessentialservicesincludingdiseaseandoutbreakdetection, emergency Introduction NATIONAL LABORATORY SYSTEM DETECT laboratory-based diagnostics. laboratory-based A national system for quality assurance should implemented, be targeting first private laboratories. Reference laboratories diseases.designated should officially be priority the for laboratoriesPublic in international participate sector testing. proficiency tuberculosis). salmonella, and plasmodia, influenza, (HIV), virus immunodeficiency The laboratory system in place at least can detect 5of the 10 core identified tests by the IHR (human Set up an official system:laboratory a public health laboratoryOR public health functions. unit. coordination national laboratory a up Set 31 of IHR Core Capacities of the State of Qatar DETECT 32 DETECT

Joint External Evaluation Areas that need strengthening/challenges need that Areas • • • practices Strengths/best Score 4: Demonstrated capacity. D.1.2 Specimenreferral andtransport system • • strengthening/challenges need that Areas • • • practices Strengths/best Score 3; Developedcapacity. D.1.4 Laboratory QualitySystem • strengthening/challenges need that Areas • • • • practices Strengths/best Score 4: Demonstrated capacity. D.1.3 Effectivemodernpointofcare andlaboratory baseddiagnostics • • International transport regulations are followed are and trained. staff A specimen transportation mechanism for exists the public sector. Corporation. referralLaboratory linkage is implemented for the public (HMC) sector and the Primary Health Care The licensing process needs to to extended be all public and private laboratories. sector The laboratories under MoME need to to supported be attain international accreditation. A system of licensing of private health laboratories is in place. laboratoriesPublic in international participate sector testing. proficiency 17025. by WHO; other laboratories under MoPH are preparing for international accreditation, such as ISO standards such as the College of American Pathologists or the National Influenza Centre, are recognized international to according accredited Council Health, Supreme of the under laboratories Public sector unit that will ensure that all public health functions are covered. Tests for public health purposes should established be through apublic health laboratory or coordination tuberculosis and is developing malaria point-of-care testing. PHCC has implemented point-of-care diagnostics for diseases priority country such as and HIV chain reaction (PCR) in laboratories. selected Proficiency is shown in classical diagnostic techniques including bacteriology,serology andpolymerase Tier-specific diagnostic testingstrategies exist in the publicsector. All health facilities of the public are sector linked level to the next of health facility. Reference laboratories need to officially be designated and an official laboratory tieredsystem set up. A formal mechanism for the timely sharing of human data between and animal health is lacking. • • • documentation Relevant Markers of 1/18/2016 at HMC and Serology 22 2016. February 3/7/2016, of Respiratory Disease, Infectious Viral evaluation reports: pathologists American College of HMC. at laboratories virology and microbiology for certificates accreditation Pathologists American College of certificate WHO of recognition for National Influenza Centre. 33 of IHR Core Capacities of the State of Qatar DETECT 34 DETECT

Joint External Evaluation Strengthened foundational indicator- and event-based surveillance systems that are able to detect detect to able are that systems surveillance event-based and indicator- foundational Strengthened Target biological events. leading an integrated bio-surveillance effort that facilitates early warning and situational awareness of The purposeofreal-timesurveillanceistoadvance thesafety, security, andresilienceoftheNationby Introduction REAL-TIME SURVEILLANCE within theMoPHsystemmeans thattheperformanceisadequate; however, thereisaneedtobuild notified bycallsontheHealth ProtectionandCommunicableDiseaseControlhotline. This closenetwork base and personal relationships of its officers. Most of the work is still manualandmost outbreaks are In summary, themain communicabledisease surveillance systemmanaged by MoPH isbasedonthe skill- respiratory syndrome, andcholera –acutediarrhoeawithdehydration syndrome). clinical diagnosisforsuspectedcasesisconsideredreporting (e.g. acuteflaccidparalysis, severeacute The State ofQatarhas a good syndromic surveillance system in placeforspecific priority diseases, where data improveinthelongrun. with allstakeholders: onlybydoingthis, receiving feedbackandlinkingitwithaction, willthequalityof Analysis andreportingofsurveillancedataneedtobe done onaweeklyandmonthlybasisshared certain situations, theseneedtobestandardizedand integrated, systemwide, withepidemiologicaldata. integration throughstandardized toolsfromthelaboratory side. Although laboratory dataareavailable in of 2016. Quarterlyandyearlyreportsarepreparedfor internaluse. Howeverthereisaneedfordata The datacollectedareanalysedandquarterlyreportswillbesharedwithstakeholders fromtheend communicable diseaseandmeetnationaldemandsby2022. purchase alicenseandsecureitsimplementationduring2017–2019inordertoreducetheburdenof evaluated. The MoPHplanstopurchasepublichealthsurveillance systemsoftware, andhasapproval to is currentlybeingimplemented, itsaccessisstilllimitedandusefordiseasesurveillancehasyettobe The currentQataridiseasesurveillancesystemisheavilyreliantonmanualinput. While Cerner®software stakeholder involvement. surveillance isanewphenomenonintheearlystagesofimplementation, andrequiresmoretraining and level. Indicator-based surveillancehasbeenfunctioning inthecountryforsometime, whileevent-based with theveterinariansector. There areatleasttwofocalpersonsfordiseasesurveillanceeachfacility syndromes) andstandardizedformsareavailable. Prioritydiseaseexerciseshavebeen donecollaboratively The StateofQatarhassetupagoodfoundationdiseasesurveillance. A notifiable list(67diseases/ Qatar levelofcapabilities events of significance for public health, animal health and health security; improved communication and and communication improved security; health and health animal health, public for significance of events collaboration across sectors and between sub-national, national and international levels of authority authority of levels international and national sub-national, between and sectors across collaboration regarding surveillance of events of public health significance; improved country and regional capacity capacity regional and country improved significance; health public of events of surveillance regarding to analyse and link data from and between strengthened, real-time surveillance systems, including including systems, surveillance real-time strengthened, between and from data link and analyse to interoperable, interconnected electronic reporting systems. This can include epidemiologic, clinical, clinical, epidemiologic, include can This systems. reporting electronic interconnected interoperable, laboratory, environmental testing, product safety and quality, and bioinformatics data; and advancement in in advancement and data; bioinformatics and quality, and safety product testing, environmental laboratory, fulfilling the core capacity requirements for surveillance in accordance with the IHR and the OIE standards. OIE the and IHR the with accordance in surveillance for requirements capacity core the fulfilling • • practices Strengths/best caution. moving towards aninteroperable systemwithreal-timedataaccess, ascoreof3instead2isgivenwith interoperable system, access to different sectors is limited and at varying levels. As the country is quickly Score 3: Developedcapacity. Scorejustificationisachallengeinthiscategory. WhileQatarhasan D.2.2 Inter-operable, interconnected, electronic real-time reporting system • • • strengthening/challenges need that Areas • • • practices Strengths/best require training forallstakeholders. reportable diseasesandfocalpersonsatreportingsites. Event-basedsurveillanceisrelativelynewandwill Score 4: Demonstrated capacity. Qatarhasafunctioningindicator-based surveillancesystemwith60+ D.2.1 Indicatorandeventbasedsurveillancesystems Indicators andscores • • • • • Recommendations forpriorityactions This couldalsoimpedeformalizationofthecurrentdiseasesurveillancesystem. guidance documents, including the proposedCentreforDiseaseControl law, still need officialapproval. and outbreakresponseneedsregular, specializedon-the-jobtraining forstaffconcernedstaff. Mostofthe disease surveillancesystemsneedtobeintegrated andlabisthemajormissinglink. Diseasesurveillance upon thisstructurewithmorestandardizedproceduresandautomatedinformationpathways. The different There is aplan to purchase public health surveillance during system software 2017–2019. isCerner® in the software process of being implemented. Data validation needs to done be regularly and through aformalized structure. SOPs and guidance documentations need to approved be and shared with stakeholders. The CDC law should endorsed be as soonas possible. Each health facility or more has focal two persons for surveillance (a nurse and atechnician). Standardized forms exist for data collection (immediate/as soon as possible/weekly). Indicator- and event-based surveillance systems are in place topublic detect health threats. out acomprehensive,Carry in-depth evaluation of the future disease surveillance system. Endorse the new CDC law. manual and surveillance guidelines are still awaiting review and comments by some stakeholders. Finalize and issue guidance documents, e.g. approved guidelines and bulletins, CDC definition case response. outbreak and surveillance Build capacity, hire professional and organize staff specialty training courses for current in staff systems. surveillance zoonotic and health the Integrate 35 of IHR Core Capacities of the State of Qatar DETECT 36 DETECT

Joint External Evaluation with stakeholders. from the end of 2016; however there is a greater need for regular monthly and weekly reports to be shared reporting needsamoreformalstructurewithfeedbackcomponent. MoPHplanstoissuequarterlyreports Score 3: Developedcapacity. Qatarhassetupagoodsurveillancesystem, althoughitsanalysisand D.2.3 Analysis ofsurveillancedata • • • • • strengthening/challenges need that Areas • • strengthening/challenges need that Areas • • • practices Strengths/best priority diseases. Score 4: D.2.4 Syndromic surveillancesystems • • • • • strengthening/challenges need that Areas • • practices Strengths/best Feedback at the peripheral level is sketchy and needs to improved be for quality good data. Continuous training involved of staff with surveillance activities should ensured. be interoperable. be to need systems surveillance related other and Veterinarian, laboratory human, The current system is heavily reliant on manual input and analysis. needs. current meets longer no system surveillance national disease current The No electronic reporting is yet available. No regular system of sharing surveillance data exists. stakeholders. concerned with isshared information surveillance disease Certain Certain disease data are linked when with laboratory available. reports dehydrationsyndrome). with diarrhoea and congenital rubella syndrome; acute flaccid paralysis;severe acute respiratorysyndrome; acute Syndromic surveillance is in place for specific priority diseases (rash investigation – measles, rubella Reporting needs to shared be with different sectors. Feedback mechanisms needs to be strengthened. Staff at all levels need more training opportunities in disease surveillance. Reporting needs to more be regular at weekly/monthly intervals. forms. should reports Laboratory integrated be into the surveillance system with starting standardized lab Monthly and quarterly analyses are carried out internally. the General Assistant Secretary for Medical Affairs. Annual and are quarterly issued; reports the annual health is report produced under the direction of Demonstrated capacity. Qatarhasafunctioningsyndromicsurveillancesystemcoveringmany • • • • • • documentation Relevant Event-based surveillance guidelines and SOPs; event-based surveillance trip report. trip surveillance event-based SOPs; and guidelines surveillance Event-based (draft). framework CDC CDC Lawof Qatar 1990. Form. Notification Communicable Diseases guidelines definition Case (draft). (draft). guidelines Surveillance 37 of IHR Core Capacities of the State of Qatar DETECT 38 DETECT

Joint External Evaluation Timely and accurate reporting of public health events according to WHO requirements and consistent consistent and requirements WHO to according events health public of reporting accurate and Timely events reducestheriskofdiseasesandtheirinternationalspread. and nuclearagentsareofincreasingconcern. Collaborative multidisciplinaryreportingonpublichealth and animalhealthsystems. Also, threatsrelatedtoaccidentalordeliberate releaseofchemical, radiological pathogens continuetoevolveandadaptnewhostsenvironments, imposingaburdenonhuman Health threats at the human–animal–ecosystem interface have increased over the past decades, as Introduction REPORTING • • • Recommendations forpriorityactions communicates withcounterpartsinothercountriesconcerning publichealthevents. the IHRNFPinthesecountriesorthroughsecretariat oftheGulfCountriesCouncil. The IHRNFPalso 8 oftheIHR. Qatarhasneighbouringcountryreporting requirementstotheGulfcountrieseitherthrough The IHRNFPconsultswith WHO aboutthenotificationandresponsetopublichealtheventsasper Article radiation originmightbedelayed. sectors. Henceriskassessmentandreportingofpublichealtheventsunknownoriginorchemical (Annex 2oftheIHR)isusedbyMoPH; howeveritisneitherknownnorexercisedbyallrelevant were reportedto WHO bytheIHRNFPinatimelymanneraccordancewithIHR. The decisioninstrument international concernto WHO. The countryhastodateexperiencedinfectiousandzoonoticevents, which One ofthemainfunctionsIHRNFP, aspertheIHRlaw, isreportingpublichealtheventsofpotential reporting. is beingdoneinpractice butnotbasedonwrittenprotocols, whichmayputatrisk timelydecisionsand on foodsafetyissuesofmicrobiologicaloriginissharedbyFood SafetyDepartmentwiththeIHRNFP. This IHR NFP andOIEcontact points exchange information related to zoonotic events, when needed. Information Health. (IAEA) focalpointsareestablished. The INFOSANFocal Point isestablished within theMinistryofPublic Environment. Within MoMEdepartmentsthatdealwithradiation, theInternational Atomic Energy Agency for OIEisestablishedunderthe Animal HealthDepartmentwithintheMinistryof Municipalityandthe The countryhasdesignatedaNationalIHRFocal Point, whichiscurrentlyoperational. The Focal Point Qatar levelofcapabilities Target coordination with FAO, OIE, IAEA and other relevant international organizations enhances the likelihood of of likelihood the enhances organizations international relevant other and IAEA OIE, FAO, with coordination rapid and coordinated response to these public health events, nationally and globally. globally. and nationally events, health public these to response coordinated and rapid emergencies of international concern. international of concern. emergencies Train and expand the use of the decision instrument 2of (Annex IHR) to identifypotential public health events. radiological and nuclear particularly origin, Ensure of capacity sufficient human resources out risk carry to assessments for events of unknown NFP and FAO, points. contact OIE and IAEA Establish formal protocols for the reporting mechanism, and information exchange the IHR between standardized. tested. Mechanismsforinformation exchangeamongthedifferentsectorsarein placebutnotformally real chemicalorradiation eventshaveoccurredinthecountry sotimelyreal-lifereportinghasnotbeen of FAO, OIEand IAEAarealsomandatedtoreporttheirrespectiveagenciesonnotifiableevents. No timely way infectious, zoonotic andfoodbornediseaseofpotentialconcern. The nationalfocalpoints public healthemergenciesofinternationalconcern, including atPoE. The IHRNFPreportsto WHO ina Score 4: Demonstrated capacity. Multisectoral coordinationis in placetorespondpotentialandreal D.3.2 Reportingnetworkandprotocols incountry • • • strengthening/challenges need that Areas • • • • • • practices Strengths/best assess theriskofeventsunknownoriginorchemicalradiation naturemaynotbesufficient. has accesstocapacityconductriskassessmentsfortheabove-mentionedevents; howevercapacityto report to WHO notifiableeventsunderIHR, mainlyinfectious, zoonotic, andfoodbornedisease. The country on publichealtheventsofpotentialnationalorinternationalconcern. The IHRNFPhastheauthorityto focal points. IHRNFPisrepresentedinthePermanent EmergencyCommitteethatreceivesallnotifications Score 4: Demonstrated capacity. The countryhasafunctioningIHRNFPandFAO, OIEandIAEA D.3.1 Systemforefficient reporting to WHO, FAO andOIE Indicators andscores • • OIE and IAEA focal points. OIE and IAEA There should more be regular, and more formal information sharing mechanism among the IHR,FAO, potential international of concern. events health public There is broad unfamiliarity and lack of use of the decision instrument 2of (Annex IHR) to identify of chemical and radiation origin and events of unknown origin. National human resources is insufficient capacity to riskconduct assessments for public health events diseases; they have communication adirect link with the MoPH including the IHR NFP. Health facilities located at the areof points the of national entry part surveillance of communicable the assess the country support risk of public health events of different origins. hasThe country sufficient financial resources, which facilitates access to internationalexpertise to health events of national or international concern related to these sectors. Strong coordination among exists the health, animal to and identifypotential food sectors public and reference laboratories for the confirmation of public health events are also available. National to laboratory exists confirm capacity some pathogens; networking and access to international Focal points for FAO, are also OIE and IAEA available with clear terms of reference. IHR NFP is defined in with the clearcountry terms of reference. reporting of chemical and radiation events to through WHO the IHR NFP. Conduct simulation exercises to test for the early capacity detection, risk assessment and timely origin to WHO.non-infectious Ensure availability on of public reporting capacity health events of potential international concern of 39 of IHR Core Capacities of the State of Qatar DETECT 40 DETECT

Joint External Evaluation • • • • • practices Strengths/best • • • • • documentation Relevant • • strengthening/challenges need that Areas zoonotic, and foodborne diseases), including at PoE. SOPs for rapid response teams are clearly defined for response to notifiable diseases (infectious, county. the into imported occurring in the and country of preparedness measures related to public health events that could be Strong transparency is demonstrated by the Government in information sharing of public health events the or other country countries. which facilitates discussion among relevant and decisions sectors on public health events occurring in Committee, Emergency Permanent the through stakeholders different with Coordination isestablished particularly infectious, zoonotic, and foodborne diseases in atimely manner. IHR NFP is the authority potentialto report public health events of international concern to WHO, information on public health events occurring in the country. IHR NFP is amember of the Permanent Emergency Committee, which facilitates sharing and receiving disease. Updated of the draft Communicable Disease Law, involved sectors in the surveillance of communicable Terms of reference of the OIE, FAO focal points. and IAEA Terms of reference of IHR NFP. membership. and Amiri Decree for the establishment of the Permanent Emergency Committee with terms of reference IHR Lawon notification of public health events WHO.to hence the inability to meet timely reporting of such events to through WHO the IHR NFP. hasThe country never experienced areal public health event related to chemical or radiation origin; response to public health events occurring in the country. There is a lack of regular and formal information sharing mechanisms that include feedback on the State parties should have skilled and competent health personnel for sustainable and functional public public functional and sustainable for personnel health competent and skilled have should parties State • • • Recommendations forpriorityactions career structurewithaseparate careerstructureavailable forQataricitizens. 5.1 isbeingimplementedandtracked. The teamwas alsoinformedthatcurrent “Medical law” providesa Although theJEEteamwas not abletoreviewit, theywereinformedthattheNational Workforce Strategy available fornursesandsomeallied healthprofessionals. years) providesthebasiclevelofepidemiologyandsome fieldtraining. Manyofthesecoursesarealso University (fee-basedfornon-citizens). An Arab BoardinCommunityMedicinetraining programme (4 Masters and a PhD programme in epidemiology/public health are alsoavailable from the Qatar Foundation of instruction on these areas). To date, 22 officers have been/are being trained in this programme. A have verylimitedfocusondiseasesurveillanceandoutbreakresponse(asix-monthcoursehasfourdays the LiverpoolSchoolofPublicHealthand Tropical Medicineandotherinstitutions. These programmes There isnoFETPinthecountry, althoughshort-term publichealthtraining programmes areavailable from now, hasbeenatanindividuallevel. conference willhelpformalizecommunicationchannelsamongthepublichealthworkforcewhich, until Health Conferencein2016isamajorinitialsteptoidentifyandbringpublichealthofficialstogether. This trained epidemiologistsavailable inthecountryandwherethey areplaced. The FirstQatarNationalPublic be usedtotrack thepublichealthworkforce. Despitethis, itisdifficulttoascertain theexactnumberof impact programme” tracks all specialist courses provided to clinical and non-clinical employees and could Corporation andthePrimaryHealthCareCorporation arein asimilarsituation. The “Assessing learning has mostofthiscapacityatthenationallevel. Otherhealthsectororganizationslike theHamadMedical rare andthosewhoperformthefunctionsofepidemiologistsworkunderdifferentjob titles. The MoPH allied healthprofessionals, dataonthepublichealthworkforcearedifficulttoobtain. Epidemiologistsare of seniordecision-makers inthecountry. While Qatarhasagoodnumberofphysicians, nursesandother of theentirehumanresourcessystemisbeingfinancedbyStateQatar, withthecompletesupport Qatar hasfinalizedapublichealthstrategy, althoughtheJEEteam was notabletoreviewit. Strengthening Qatar levelofcapabilities Target training, scientificskills, andsubject-matterexpertise. by developingandmaintainingthehighlyqualifiedpublichealthworkforcewithappropriatetechnical Workforce developmentisimportantinordertodevelopasustainablepublichealthsystemovertime Introduction DEVELOPMENT WORKFORCE health surveillance and response at all levels of the health system and the effective implementation of the the of implementation effective the and system health the of levels all at response and surveillance health IHR (2005). IHR Establish a ore form structured of communication among epidemiologists and public health officials. Establish a training programme focused on disease surveillance and outbreak response. Develop andincluding astrategy retain to attract experts, acareer path. 41 of IHR Core Capacities of the State of Qatar DETECT 42 DETECT

Joint External Evaluation • • • practices Strengths/best formal structures, e.g. towithstandchangesinpersonal. multidisciplinary teams and an informal system of contacts which could help in setting up the needed and otherpublichealthofficialsacrossdifferentstakeholders, Qatarhasdemonstrated capacityinforming Score 4: Demonstrated capacity. Despitedifficultyinascertainingtheactualnumberofepidemiologists D.4.1 Humanresources are availabletoimplementIHRcore capacityrequirements Indicators andscores implemented consistently acrossallpublic healthworkers, health workforce. However this policy, ifit is beingpracticed, needstoberegularlyreviewed, updated and document. Howeverinterviews withstaffshedlightonapolicythatmayhave optionsforthepublic Score 3: Developedcapacity. The JEEteamwas notabletoreviewthepublichealthworkforce strategy D.4.3 Workforcestrategy • • • strengthening/challenges need that Areas • • • • • practices Strengths/best six-month shortcoursethatcouldbeconsideredasabasicappliedprogramme. Score 3: programme inplace D.4.2 FieldEpidemiology Training Programme orotherappliedepidemiology training • • • strengthening/challenges need that Areas Each local level on epidemiology, has owncapacity its management, case laboratory, etc. Multidisciplinary joint teams are organized according of health to the hazard. type Current is IHR available capacity in the at country different levels of the health system. Structured information sharing among epidemiologists should be formalized. be should epidemiologists sharing among information Structured epidemiology). organizations(field/applied different by courses short There is no long-term or focussed training on disease surveillance and outbreak response, except for in epidemiology ofThe shortage experts and public health needs to addressed. be MoPH understands the need for applied epidemiology programmes and plans to initiate them soon. for non-citizens). (fee-based University Masters and PhD programmes are available in epidemiology/public health in the Qatar Foundation A short-term public health training programme is available by the Liverpool School and others. Personal training plans are by supported MoPH. development. availableand are learning Resources for ensured. be should sectors different in levels and different at capacities IHR developing in Interest A system to respond to health hazards needs to formalized. be Information aboutis IHR fragmented capacity and needs to channelled. be Developed capacity. NoFETPisavailable inthecountry, althoughtheLiverpoolSchooloffersa • documentation Relevant • • • strengthening/challenges need that Areas • • practices Strengths/best No documentation is listed for this capacity. Historically, there are no retention policies or incentives, although this seems to gradually be improving. There is ahigh turnover of technical staff. limited. are paths Career The Public Health Strategy is to launched be soon. The national workforce strategy 5.1 is believed to implemented be and tracked. 43 of IHR Core Capacities of the State of Qatar DETECT 44 RESPOND

Joint External Evaluation The effective implementation of the IHR (2005) requires /multidisciplinary approaches through national national through approaches /multidisciplinary requires (2005) IHR the of implementation effective The operations attheintermediateandcommunity/primaryresponselevelsduringapublichealthemergency. and maintenancesofavailable resources, includingnationalstockpilesandthecapacitytosupport nuclear hazards. Othercomponentsofpreparednessincludemappingpotentialhazards, theidentification response levelpublichealthemergencyplansforrelevant biological, chemical, radiological and Preparedness includesthedevelopmentandmaintenanceofnational, intermediateandcommunity/primary Introduction PREPAREDNESS RESPOND in thecountry may affectthepublichealth emergencymanagementoperations. according toagreedtriggers toactivate theplan. Otherorganizational changesandofleadership sectoral partners contribute to managingpublic healthemergenciesofnational and international concern PHCC, MinistryofInterior, Defense, Police, Environment, QatarPetroleum, QatarRedCrescentSociety. Such by theplansofitssectoral andmultisectoral partneragencies. These includeHMC, the Ambulance Service, The MoPHhasalsodevelopedtheNationalHealthEmergency ManagementPlanlinked toandcomplemented emergencies. communication, coordinationandcollaboration withthe WHO IHRcontactpointsincasesofpublichealth programme andplanforpublic healthemergenciesofinternationalconcern, aswellmaintaining Health withthespecialroleofbeingIHRNFP. The role includesoverseeingimplementationofthe emergencies anddisasters, namelytheEPRDepartment. IthasalsodesignatedtheDepartmentofPublic The MoPHhascreatedadedicatedofficeincharge ofcoordinatingresponsestoalltypeshealth Focal Point and/orFocal Persons havebeendesignated withintheMoPH. which areoperationalized andimplementedmultisectorally, sectorally, andorganizationally. A National all hazardswithspecialconsideration forchemical, biological, radiological andnuclear(CBRN)threats, Qatar hasestablishedtheNationalEmergencyPreparednessandResponsePlanalignedtoIHR, covering biological hazards/emergencies. according toidentifiedhazardsthatfallundertheirmandates, suchastheMoPHleadagencyfor to manage their risks, and has defined thedesignation process and roles of committeemember agencies Supreme CouncilofHealth). PEChasidentifiedpotentialhazardsanddesignatedleadco-leadagencies a multisectoral body whereinhealth is oneof the sectors under the leadershipof the MoPH (formerly The Permanent EmergencyCommitteewas establishedbytheCouncilofMinisters in1998and. Itis Qatar levelofcapabilities Target partnerships for effective alert and response systems. Coordination of nationwide resources, including including resources, nationwide of Coordination systems. response and alert effective for partnerships the sustainable functioning of a National IHR Focal Point (NFP), which is a national centre for IHR (2005) (2005) IHR for centre national a is which (NFP), Point Focal IHR National a of functioning sustainable the communications, is a key requisite for IHR (2005) implementation. The NFP should be accessible at all all at accessible be should NFP The implementation. (2005) IHR for requisite key a is communications, times to communicate with the WHO IHR Regional Contact Points and with all relevant sectors and other other and sectors relevant all with and Points Contact Regional IHR WHO the with communicate to times stakeholders in the country. States Parties should provide WHO with contact details of NFPs, continuously continuously NFPs, of details contact with WHO provide should Parties States country. the in stakeholders update and annually confirm them. confirm annually and update • practices Strengths/best Score 4: Demonstrated capacity. developed andimplemented R.1.1 Multi-hazard NationalPublicHealthEmergency Preparedness andResponse Planis Indicators andscores • • 5. • • • 4. • • 3. • • • 2. • 1. Recommendations forpriorityactions organizational plans. There is aNational Health Emergency Management Plan or Public Health hasThe country aNational Emergency Preparedness and Response Plan integrating sectoral and planning/testing. emergency (cross-sectoral) joint Encourage legislation. IHR Develop coordination. Improve etc.) building needs in the field of public health emergency management (training, drills, logistical support, Explore the possibility of providing technical assistance to the private based on their sector capacity- management. disaster and emergency in functions and roles, clear tasks, delegated with sector private the Include Create an inventory of CBRN-related stockpiles and develop guidelines for their use and mobilization. end-users. of needs the and operations, response emergency actual Establish and regularly monitor stockpiles based on updates from risk assessments, experience from of systems; and to optimize the results of the post-drill/exercise evaluations for updating the Plan. this Plan in their organizational plans; to test the functioning of sectoral plans and the interoperability health of the sector need to develop aNational Public Health Emergency Management Plan, or integrate The MoPH should also take the lead in conducting sectoral drills to heighten awareness across the international national concern. and/or of emergencies managinghealth public in roles testing and regular updating of the organizational plans, integrating strategies, activities and their The MoPH should take the lead in advocating and supporting the development, signing, approving, implementation. and operationalization legitimize their Management Plan to leaders, especially new ones, to gain their approval, as well as their signature to Emergency PublicHealth Plan Management or Emergency National EPRHealth plan and the Advocate compliance development. 2005its to IHR corecapacities the new brands of organizations; the organizational restructuring, new leadership, new systems, and the plans should reviewedbe and updated taking into account current changes such as the terminologies; Policy development More inclusivehealthsectornetwork Implement theNationalLogisticsManagementSystem Plan advocacy Plan review andupdating 45 of IHR Core Capacities of the State of Qatar RESPOND 46 RESPOND

Joint External Evaluation • • • • practices Strengths/best Score 4: Demonstrated capacity. R.1.2 Prioritypublichealthrisksandresources are mappedandutilized • • • • • • strengthening/challenges need that Areas • • • • • management operations. operations. management emergency health public support to Department, Material Management and Corporation Medical A system for stockpiling and distribution of health-related logistics under exists the leadership of Hamad levels. organizational and sectoral, national, Capacity assessment with concomitant resource mapping is conducted at various levels from the risk management committee managed by the GCC secretariat. Hazards mapping and classification at regional (GCC) and levelcountry is done by the disaster/crises – Risk assessment including exists hazard analysis identifying national risk profiles level. Organizational changes hinder the endorsement and integration of the National EPR Plan at the PEC Coordination and communications of existing plans should improved be with health members. sector Various plans are being implemented, tested, reviewed and/or updated despite not being signed. awaits new leadership in the MoPH. Plan has been approved by the health members consultation sector after and reviews but final approval Management Emergency PublicHealth Plan/National Management Emergency National Health The (replacing the PEC) which is mandated to endorse the plan. The National Plan is developed but awaits formal installation of the Supreme Council of Civil Defense reorganization. and leadership of turnover of because approved await levels various Plans at updating. The plans already developed are in various stages of implementation and regularity of testing and Centre and Global WHO Outbreak and Response Alert in which Network, Qatar is amember). Resource gaps are being addressed through access to assistance from regional sources (GCC Logistics system. management logistics their equipment, etc.) from national and intermediate levels toresponse support at the local level of as part There are procedures and plans to relocate or mobilize resources or stockpiles (drugs, medicines, concern, limitations. with Local surge is available capacity to respond to public health emergencies of national and international consultation –have multi-hazard coverage and specifically include IHR-related hazards at PoE. These plans at various levels –applying as awhole to society and developed through multisectoral Ambulance Service, unifiedwith the multisectoral National EPR Plan. Emergency Management Plan that incorporates plans of health members sector such as PHCC, HMC, –

in crafting their EPR plans. Risk assessment assessment and capacity are tools applied by the national and sectoral members lead agencies to manage identified risks. Hazard and risk analysis is done by PEC for contingency planning and designating lead and co- • documentation Relevant • • • • • strengthening/challenges need that Areas • • • Qatar National Health Emergency Management Plan, Management 2015 Emergency National Health Qatar (draft). Legislation is needed to address IHR operational concerns. Simulation exercises since are necessary the lacks exposure country to major emergency. funds. emergency to immediate access limitedand availability isonly There Coordination, communication and information sharing among stakeholders improved. must be resources. Stockpiles are limited for CBRN substances (in development) but have annual reviews and update of management operations, while the private covers ownfinancial sector its needs. Government funds are provided for the public totheir support sector public health emergency with limited participation of the private sector. has been identifiedA poolof experts across the government health togethersector with databases available. are resources Guidelines and plans have been developed on logistics management and resource mobilization, and 47 of IHR Core Capacities of the State of Qatar RESPOND 48 RESPOND

Joint External Evaluation Countries will have a public health Emergency Operation Center (EOC) functioning according to minimum minimum to according functioning (EOC) Center Operation Emergency health public a have will Countries support decision-makingandimplementation, coordination, andcollaboration. during aresponsetoanemergencyorexercise. They alsoprovideotheressentialfunctionsto exercises. EOCsprovidecommunicationandinformationtoolsservicesamanagementsystem information andresourcesforstrategic managementofpublichealthemergenciesandemergency A publichealthemergencyoperations center(EOC)isacentral locationforcoordinatingoperational Introduction OPERATIONS RESPONSE EMERGENCY • 2. • • • • 1. Recommendations forpriorityactions 24/7. located withinthepublichealthoremergencymanagement-relatedoffice, andfunctionaloperational operationalization. However, thereareagenciesthathavenodedicatedEOCphysicalstructure; insteaditis staff areavailable tomanageEOCoperations anddrillsare conductedtotestEOCfunctionalityand in theNationalHealthEmergencyManagement(Response)Planandhealthsectoral plans. Trained The procedurestoactivate andoperationalize EOCintimes ofpublichealthemergenciesareembodied any publichealthemergency24/7andrespondsimmediatelyifnecessary. the EOCsofnongovernmentorganizationssuchasQatarPetroleum. The MoPH EOC monitorsreportsfor PHCC, andMoPH, theSystem Wide IncidentCommandCentreatHamadMedical Corporation, aswell response. There areestablishedEOCsatgovernmentagenciessuchastheMinistry ofCivilDefense, MoME, emergencies, andcascadingtheinformationtoallconcernedagenciesforimmediateappropriate point ofcontactavailable 24/7attheNationalCommandCentreresponsibleforreceiving allreportsof The countryhasanationalEOCoperating procedureandprotocol. At thenationallevelthereisafunctional Qatar levelofcapabilities Target common standards; maintaining trained, functioning, rapid response teams and “real-time” biosurveillance biosurveillance “real-time” and teams response rapid functioning, trained, maintaining standards; common laboratory networks and information systems; and trained EOC staff capable of activating a coordinated coordinated a activating of capable staff EOC trained and systems; information and networks laboratory emergency response within 120 minutes of the identification of a public health emergency. health public a of identification the of minutes 120 within response emergency health sector. health Improve coordination and information sharing health and between others sector such as the animal Improve coordination and other sectors and information health sectors sharing between Establish and strengthen the integrated information management system. Recruit additional trained staff. operations. communication systems, technologies, lifelines, as well as resources including financial to support trained human resources, dedicated facilities, organized EOC staff/response teams, information and MoPH shall initiate and promote the institutionalization of EOCs with policy, guidelines, protocols, Capacity toactivateandoperationalize EOC Capacity toactivateemergency operations • 3. • • 2. • • 1. practices Strengths/best test functionalityofthesystem. of procedures and protocols; point of contact; trained EOC staff on response activation; and an exercise to response. This referstothecapacityofcountryinitiateandescalateemergency operations interms sources; communicationsequipment; andstaffthataretrained andcapableofcoordinating anemergency The EOCshouldinclude: informationsystemstoconnectpublichealthdecision-makers toappropriatedata Score 4: Demonstrated capacity. The indicatorreferstopublichealthemergencyoperations forthecountry. R.2.1 Capacityto Activate Emergency Operations Indicators andscores • • • • 4. • • 3. • • Hospital, MoME and as well as Civil Defense, among others. operating procedures for public health emergency response in as MoPH, observed Hamad Medical manningThe staff the EOCs are trained on emergency management and oriented on the EOC standard necessary. if immediate response activate The MoPH EOC is functional 24/7 to monitor related reports to public health emergencies and to receiving of all emergency, reports and cascading to all concerned agencies for immediate response. The National Command Centre (999) is the national point of available contact 24/7 responsible for (Response) Management Plan. Emergency National Health the activation,An escalation, de-escalation and stop operation process, based on set criteria, are found in response. emergency health public in agencies responding notification, response activation, and communication flow. These include the roles of the concerned alerting, emergency, reporting of systems containing exists Plans Response organizational An Enhance the Response Plan insurge its management. capacity sectors. Improve coordination and sharing of practices best and information the health between and other emergencies. IHR-related of management for resources improve and Train staff appropriate operations. to support other and procedures management case standard Develop aCBRN programme with policy, structure, facility development, human resources, technology, strengthening the Response Plan. Enhance in managing of thestaff capacity exercises and optimizing lessons for updating and risks. managing disaster and emergencies, to immediate response information, and handling data Develop training programmes for EOC staff, responders and managers to enhance their capacities in system. management information the Strengthen Review EOC personnel complementarity and hire additional trained if necessary. staff Trained EOCstaffteamonemergency managementandpublichealthemergency SOPs EOC pointofcontact Procedures andprotocols toactivateemergency operations exist Case managementprocedures forIHR-relevant hazards Emergency Operations Programme 49 of IHR Core Capacities of the State of Qatar RESPOND 50 RESPOND

Joint External Evaluation top exerciseandsimulationscansupplementthefunctionalexercises. multisectoral coordination. Functionalexercisesshouldbeheldonanannualbasis; additional drills, table- operations systems and staff to coordinate a large response affecting multiple communities, and involving and flexible to address emerging disease threats. Exercises should test the capacity of the emergency Score 4: Demonstrated capacity. Emergency operations plans should be developed that can be scalable R.2.2 Emergency Operations CenterOperating Procedures andPlans • • • • strengthening/challenges need that Areas • • 4. • strengthening/challenges need that Areas • • • practices Strengths/best More staff trainingMore staff is needed. agencies. sector informationThe management strengthening, needs including system information sharing health with There is agrowing need for competent staff. others have physical structure but are not functional 24/7 (activated 24/7 only if there is an emergency). structure (located within the public health or emergency management office) but functional 24/7; Existing EOCs show various functionality in the health with some having sector no dedicated physical PHCC). (i.e. areas hospitals, operation in Command Systems Training available Incident are in programmes response to apublic health emergency, if necessary. of apublic health emergency. MoPH has response teams that could provide and immediate support ofPart the training is of EOC the activation staff of response actions within hours upon notification two representation from the human health sector, which should to extended be the animal health sector. The National Health Disaster Management Committee, currently under reform, only includes – finance). and planning, logistics operations, key structural and operational elements for basic roles (including incident management or command, A plan for public communication and liaising partner and coordination is available. The plan describes finance). and logistics planning, operations, command, or management Incident (including roles basic and elements operational structure, system command incident the IncidentAn Management System structure or equivalent is available. Aplan is also in place describing triggers for activation and levels of operations. to activate and operationalize EOC are embodied in the Health Emergency (Response) Plans including protocols and Procedures exist. System Management Incident the for protocols and Plan, procedures Dedicated, trained EOCstaffcanactivatearesponse withintwohours – – –

public health (the National Committee for Health Disaster Management). There is amultisectoral commission or amultidisciplinary emergency response department for as appropriate (i.e. National Health Disaster Management Committee) is in place. Thestructure to convene participants from ministries and other national and multinational partners Plan. Management Command centres are available in all health facilities integrated in the National Health Emergency The EOC in Public Health is available with needed equipment. • documentation Relevant • • strengthening/challenges need that Areas • • • • practices Strengths/best Score 3: Developedcapacity. R.2.4 Casemanagementprocedures are implementedforIHRrelevant hazards • • strengthening/challenges need that Areas • • • • practices Strengths/best Score 3: Developedcapacity. R.2.3 Emergency Operations Program • • Qatar National Health Emergency Management Plan, Management 2015 Emergency National Health Qatar (draft). There is an inadequate number of trained especially staff in the areas of IHR-related hazards (CBRN). are limited and need to expanded. be Resources and systems, e.g. coordination and collaboration in the areas of IHR-related hazards (CBRN), Appropriate are available staff who are trained in management case of IHR-related emergencies. SOPs). and ambulances A patient referral and transportation mechanism is available with adequate resources (designated of potentially infectious patients at the local level and points of entry. SOPs (according to national or international guidelines) are available for the management and transport levels. system Available management case guidelines for diseases priority and IHR-relevant hazards exist at all health operations. management emergency support to exist mobilization logistics and planning functions Limited Many table-top exercises are conducted regularly at facility level, but few at national level. emergency. publichealth a of identification Qatar has the capability of activating the EOC and coordinating aresponse within 2hours from plans. management completed as aresult of exercises or activations are available in the records of changes in emergency Summaries of any improvement in the plans, after-action or lessons learnt reports, documents Table-top exercise have been completed to test systems and decision-making. Drills and exercises are in place to test EOC operations. integrated,An responsive and user-friendly information management system is also needed. There is aneed for additional trained and manpower. staff 51 of IHR Core Capacities of the State of Qatar RESPOND 52 RESPOND

Joint External Evaluation In the event of a biological, chemical or radiation event of suspected or confirmed deliberate origin, a a origin, deliberate confirmed or suspected of event radiation or chemical biological, a of event the In health events. engagement oflawenforcement hasbeensubstantialintheinvestigationandresponse tosomepublic necessitated amultisectoral responseinvolvingboth national andinternationalstakeholders. The Qatar hasfacedinfectious diseaseoutbreaks(e.g. A(H1N1) influenzaandMERS-CoV). These have regularly. preparedness and response. A regionalplan and mappingofhazardsat regional levelarealsoupdated A coordinationmechanismalsoexistsinthecountry withtheotherGulfcountriesforemergency integral partoftheNationalPlan. accordingly. Sectoral plansalsoexit, includingforpublichealthpreparedness andresponsebutnotasan place andaccessibletoallsectors. A drillexerciseisconductedonannualbasisandthePlanreviewed The rolesandresponsibilitiesofeachsectorareidentified inthisPlan. Also, SOPsforthePlanarein Council forCivilDefense. have recentlybeenupdated, endorsementofthePlanawaiting theofficialestablishment oftheSupreme following thereviewofhazards’mapping. While thehazards’mappingandso NationalEPRPlan and theirmostlikely sources, areidentified. ANationalPlanforEPRisinplace andusuallyupdated A mappingofhazardsisconductedregularlyinthecountryandpotentialrisks, includingdiseaseoutbreaks (minsters). The CouncilwillbeledbyH.M. the Amir oftheStateQatarandwillhavehigh level ofrepresentation The SupremeCouncilfor Civil Defense is being established by the Cabinet to take over this Committee . take theleadinresponsetoeventscoordinationwithotherconcernedsectors. take decisionsrelatedtoeventsoccurringinthecountry, includingpublichealthevents. Relevant sectors reference areclearlydefined. Membersmeetregularlyandonanadhoc basistoshareinformationand director generals anddirectors)from16sectorsincludingsecurity, police, andthearmy. Itstermsof army inwar time. The CommitteeisledbytheMinister ofInteriorandhas25members(undersecretaries, disasters andemergenciesincludingpublichealthevents, inpeacetime. This responsibility isshiftedtothe The Permanent EmergencyCommitteehasthemandatetocoordinateresponseawidespectrumof Qatar levelofcapabilities Target order tominimizelossoflife, orinjury, andforoptimalpublicsafetysecurity. law enforcementwillneedtoquicklycoordinateitsresponsewithpublichealthandmedicalofficialsin (e.g., theanthrax terroristattacks)ornaturally occurring(e.g., flupandemics). Inapublichealthemergency, Public healthemergenciesposespecialchallengesforlawenforcement, whetherthethreatismanmade Introduction LINKING PUBLIC HEALTH AND SECURITY AUTHORITIES SECURITY HEALTH AND PUBLIC LINKING country will be able to conduct a rapid, response, including the capacity to link public health and law law and health public link to capacity the including response, rapid, a conduct to able be will country enforcement, and to provide and/or request effective and timely international assistance, including to to including assistance, international timely and effective request and/or provide to and enforcement, investigate alleged use events. use alleged investigate • practices Strengths/best been formallyused. ad hocbasis. Protocolsexistbetweenpublichealthand securityauthoritieswithinthecountryandhave among membersforupdatesandthedecision-makingprocess. The Committeemeetsregularlyandonan power andauthorityhigh-levelrepresentation. There isstrongcoordinationandinformationsharing coordinating the response to major events including public health events. The Committee acts with full Score 5: Sustainablecapacity. The Permanent EmergencyCommitteeledbyMinistry ofInterioris are linked during asuspectorconfirmedbiologicalevent R.3.1 PublicHealthandSecurity Authorities, (e.g. LawEnforcement, Border Control, Customs) Indicators andscores • • • • • • Recommendations forpriorityactions Chemical andBiological Weapons. United Nationsagencies, andtheUNSecretaryGeneral’s MechanismforInvestigationof Alleged Useof Protocols alsoincludetermsofengagementwithinternationalentitiesandmechanisms, suchasInterpol, joint riskassessments, coordinatedcontrolactivitiesandlawenforcement. hazards, andintentionaluseofbiologicalagents. These allrequireinformationsharing, jointinvestigations, include diseaseoutbreaks, eventsatPoE, quarantine issues, foodcontamination, chemicalandradiation and othersectors, whicharespecifictothe various typesofhealtheventsandhazards. Specificevents resources, rolesandresponsibilitiesofhealthlawenforcementsecurityagencies, foreignaffairs within theframework ofthenationalcontingencyplanandclearlydefineauthorities, commitmentof the neededcoordinationforapromptandappropriateresponseareinplace. The SOPsaredeveloped animal health, foodsafety, andlawenforcementsecurityagencies: protocolssuchasSOPstoaccelerate The existingstructuresinQatarmaynotrequiretheneedtodevelopprotocolsbetweenpublichealth, local transmission ofthevirus. strategies progressivelydevelopedtojointlyinvestigatehumanandanimalcasesminimizetheriskof hazard. SincethereportingofMERS-CoVcasesin2014, importantlessonshavebeenlearntandinnovative the supportandengagementof law enforcement agenciesfor assistance with managingahealtheventor Within thegovernmentalstructure, thepublicandanimalhealthsystemsatalllevelsareabletorequest simulation exercise and drills, and regular reviews real after events using external experts. terms of reference, members who are well communicated through technology, regular conduct of The Permanent Emergency Committee has high-level representation from 16 well sectors, defined responses. and investigations and drills exercises, training Provide joint training for public health personnel and security at all levels on the SOPs, and on joint Put in place amechanism to facilitate sharing of feedback on conducted training at the different levels. Operationalize plans at different administrative levels to ensure their functionality, when needed. building. capacity- ensure institutional to transfer senior-to-subordinate and knowledge Enhance peer-to-peer seniority. levels of different the at personnel Ensure access to national and sector-specific plans and joint assessment protocols by all concerned plans. response and Endorse the national contingency plan and ensure integration of sector-specific emergency preparedness 53 of IHR Core Capacities of the State of Qatar RESPOND 54 RESPOND

Joint External Evaluation • • • • • • • • • documentation Relevant • • strengthening/challenges need that Areas security or armysecurity to assist with any event requiring law enforcement. The national system and structure of the enables country the civil government to call in the police, agencies. commitment of resources, roles and responsibilities of health and law enforcement and security response to emergencies including public health emergencies. clearly SOPs The thedefine authorities, SOPs are in place to guide the actions of different stakeholders in a highly coordinated, multisectoral event. hazardous The PEC has clear protocols that engage the police or the army when there is adisaster or major Strong coordination and collaboration exist with the media. etc.). terms of reference and functionality, but higher level representation (Amir, minsters, minsters, deputy The Supreme Council for Civil Defense is being established to take over this Committee, with the same the different hazards. hazards. different the to response and investigation sharing, information for procedures operating standard and Protocols plan. contingency National Terms of reference and structure of the Supreme Council of Civil Defense. Committee Emergency Permanent the of Terms structure and reference of enforcement. Joint training the different including between sectors, law enforcement and security, need further enhancement. further There are no major limitations; however, knowledge transfer and operationalization of plans need A national framework for transferring (sending and receiving) medical countermeasures and public health health public and countermeasures medical receiving) and (sending transferring for framework national A • • 2. • • • • • • 1. Recommendations forpriorityactions not yetdrafted itsNationalPersonnel DeploymentPlan. With regardstothesendingandreceivinghealthpersonnelduringpublicemergencies, Qatarhas agreements, suchasthosewiththeGCCLogisticsCentreinKuwait. threats exists. To sendandreceivecountermeasuresfromexternalsources, Qatar followsexistingregional of development, although a limited stockpile of countermeasures for IHR-related hazards such as CBRN preparedness planofhealthfacilities. A nationalstockpiletoincludecountermeasures isstillintheprocess by theHMCthroughitsMaterialManagementDepartmentbasedonneedsreflectedinemergency its neighbouringcountries. The stockpileofmedicallogisticsiscentrally storedanddistributednationwide Qatar hasnopharmaceuticalcompaniesandmustresorttoimportationofitsmedicallogisticsneedsfrom Qatar levelofcapabilities Target emergency forresponse. health. Inaddition, itisimportanttohavetrained personnelwhocandeployincaseofapublichealth catastrophic infectiousdiseasethreats. InvestmentsinMCMcreateopportunitiestoimproveoverall public Medical Countermeasures(MCM)arevitaltonationalsecurityandprotectnationsfrompotentially Introduction DEPLOYMENT PERSONNEL AND COUNTERMEASURES MEDICAL and medical personnel among international partners during public health emergencies. health public during partners international among personnel medical and team) for national, external or international deployment purposes. international deployment or team) national, for external (contingent team response national multidisciplinary equipped and trained integrated, an Organize international national concern. and of emergencies health public during humanitarian response Develop anational deployment and policy plan regarding sending local and receiving foreign teams for Develop aformal on policy the management of foreign donations. Develop policy/ guidelines for the management and utilization of aCBRN-related stockpile. Establish integrated stockpiling of CBRN-related logistics among health members. sector Establish anational stockpile for health to include countermeasures for IHR-related hazards like CBRN. such as memoranda of understanding, especially with external partners. system, management countermeasure the govern to policies/guidelines/SOPs national health Develop the country’s access in times of need. Create an inventory and map of countermeasure resources locally, regionally, and internationally for Sending andreceiving healthpersonnel during publichealthemergencies Sending andreceiving medicalcountermeasures duringpublichealthemergencies

55 of IHR Core Capacities of the State of Qatar RESPOND 56 RESPOND

Joint External Evaluation Score 4: Demonstrated capacity. health emergency R.4.1 Systemisinplaceforsendingandreceiving medicalcountermeasures duringapublic Indicators andscores • • • • • • practices Strengths/best Score 3: Developedcapacity. emergency R.4.2 Systemisinplaceforsendingandreceiving healthpersonnel duringapublichealth • • • strengthening/challenges need that Areas • • • • • • practices Strengths/best local and international and partners systems especially in the area of health-related CBRN management. MOPH should take the lead in coordination, collaboration, building network and interoperability with foreign international or humanitarian response organizations. Strengthen partnerships with the Global WHO Outbreak and Response Alert and other Network Management Plan. Management The local and international mutual aid assistance system is contained in the National Health Emergency deployment. international for organized be can teams Trained multidisciplinary (e.g.emergencies personnel). for credentials issuing The Plan includes aguide in receiving health personnel (local/international) during public health coordination. The Response Plan includes a system to throughaccess external and MoPH-PEC services experts countermeasures. acquisition of emergency available the and for accessible be to need Funds National stockpiles for special IHR-related needs, such as CBRN hazards, should expanded. be understanding, especially with external partners. There is aneed for policy/guidelines/SOPs to govern the countermeasure system, e.g. memoranda of Arrangements are in place for regional countermeasures sharing (GCC Centre in Kuwait). isA network established with the GCC Logistics Centre in Kuwait. emergencies. health public during countermeasures provide to manufacturers with exist Agreements exists. Materials (HMC Department) countermeasures Management of stockpile A operations. emergency health public support to isestablished system management logistics A (CBRN). concerns security A system is in place to access, send, receive and distribute medical countermeasures, and manage • documentation Relevant • • • strengthening/challenges need that Areas Qatar National Health Emergency Management Plan, Management 2015 Emergency National Health Qatar (draft). emergencies. health public There is aneed for regulatory measures to receive external or foreign humanitarian assistance during strengthening. New partnerships and collaboration with international for partners humanitarian assistance need A National personnel deployment plan needs to drafted. be 57 of IHR Core Capacities of the State of Qatar RESPOND 58 RESPOND

Joint External Evaluation State parties should have risk communication capacity which is multi-level and multi-faced real time time real multi-faced and multi-level is which capacity communication risk have should parties State communications plansneedtobetestedandupdatedasneeded. decision makingareessentialforbuildingtrustbetweenauthorities, populationsandpartners. Emergency mechanisms shouldbeestablished. Inaddition, thetimelyreleaseofinformationandtransparency in and stakeholders inthecountryneedtobeidentified, andfunctionalcoordinationcommunication levels. Disseminatingtheinformationthroughappropriatechannelsisessential. Communicationpartners prevention andcontrolactionthroughcommunity-basedinterventionsatindividual, familyandcommunity voice oftheaffectedpopulation. Communicationsofthiskindpromotetheestablishmentappropriate political andeconomicaspectsassociatedwiththeeventshouldbetaken intoaccount, aswellthe For any communication about risk caused by a specificeventto be effective, thesocial, religious, cultural, the disseminationofinformationtopublicabouthealthrisksandevents, suchasoutbreaksofdiseases. the capacitytocopewithanunfoldingpublichealthemergency. An essentialpartofriskcommunicationis define risks, identifyhazards, assessvulnerabilities andpromotecommunityresilience, therebypromoting Risk communicationsshouldbeamulti-levelandmulti-facetedprocesswhichaimsathelpingstakeholders Introduction Risk communication model forrisk communication practice. mistakes thatresultinpoor publichealthoutcomes. ItwillalsohelpQatarremain ontargettobeaglobal development, solidmechanisms tosupportsuchastrategy willhelpavoidcommunicationresponse approaches, andisendorsed bytherelevant national authorities. At thisstage ofQatar’s healthsector and expandsonexistingcapacities, focusesonbridginggapswithlocalresearch andevidence-based Qatar’s nextstepshouldbetodevelopacomprehensive riskcommunicationstrategy thatconnects of Qatar’s population. as thehard-to-reachsinglemaleworkers, theseactivities shouldbeintegrated intothecompletepicture While thereare ‘best practice’ communityengagementprogrammes forQatar’s diversepopulation, such Communication Officeshouldbesoonfollowedbyanendorsed healthsectorriskcommunicationstrategy. newly coordinatedcommunicationmanagementanda nationwidedecreeestablishingaGovernment endorsed plansthatdonotaddresstheentirehealthsector. A recentMoPHreorganization, coupledwith Qatar’s healthsectorriskcommunication capacityhasreliedoninformalprocessesandagreementsor upon. exercises. Researchshouldalsobeconductedtoensurethatcommunicationiseffectiveandcanacted evidence-based approachesandtestthesystemthroughheath-sectornationalemergencyresponse communication systembutmustnowcoordinatetheirresources, addressgapsinthesystemthrough priority actions. Qatar’s healthsectoranditspartnershavemanyoftheassetsneeded forarobustrisk Past riskcommunicationcapacityassessmentswerevoluntaryandidentifiedstrengths, challengesand For several years, Qatar has shown a proactive approach to risk communication capacity-building. Qatar levelofcapabilities Target exchange of information, advice and opinion between experts and officials or people who face a threat or or threat a face who people or officials and experts between opinion and advice information, of exchange hazard to their survival, health or economic or social well-being so that they can take informed decisions to to decisions informed take can they that so well-being social or economic or health survival, their to hazard mitigate the effects of the threat or hazard and take protective and preventive action. It includes a mix of of mix a includes It action. preventive and protective take and hazard or threat the of effects the mitigate communication and engagement strategies like media and social media communication, mass awareness awareness mass communication, media social and media like strategies engagement and communication campaigns, health promotion, social mobilization, stakeholder engagement and community engagement. community and engagement stakeholder mobilization, social promotion, health campaigns, • • • • practices Strengths/best and endorsedacrosshealthsector, theranking willlikely rise. health-related communication coordination, should serve as a model for further expansion. Once expanded information needs. The Taskforce forHealthEducation andCommunication, amultisectoral committeefor hire staff, unify public messaging and have a functional risk communication system to target population MoPH andPHCC. MoPHhasseveral plansandstrategies needapproval tomoveforward inorderto Score 3: R.5.1 RiskCommunicationSystems(plans, mechanisms, etc.) Indicators andscores • • • • • Recommendations forpriorityactions Communication Coordination between MoPH, HMC and PHCC. and HMC MoPH, Communication Coordination between unified risk communication plans: the Government CommunicationOffice (2015) and the Director of The following management changes and government-wide agreements may help address the need for and used as the basis for ahealth emergency risk sector communication plan. Communication Lead’ and public communication outreach functions. This Plan could broadenedbe HMC has adetailed Major Incident Communications Plan that includes a‘Media and Family communication coordination, should as amodel serve for expansion. further TaskforceThe for Health Education and Communication, for health-related multisectoral a committee The MoPH has proactively addressed risk communication as aresponse measure. emergencies. for volunteers engagement community for programme certificate a providing community engagement processes; partnering with alocal university to conduct audience research; Strengthen Qatar’s community engagement by training outreach efforts field epidemiologists on /campaigns. programmes information health informed decisions and take action; address systematic gaps by using practices best from other or new analysis research to ensure audiences are receiving information in ways that allow them to make audience etc.; conduct circumstances, language, to due literacy, work/life information health to access lack that segments population identify to measures engagement community and communication Following thiscontinue public engagement capacities. mapping to address process, community Map Qatar’s target audiences including the nearly 70% of non-native population with existing exercises. national emergency and sector health Test through response risk communication emergencies. Centre during Information Joint the to activated temporary from surge other staff communication units, universities and external to partners be evaluation and health communication/education; training based programme; ongoing competency includes dedicated full-time with education staff and experience in risk communication, programme Create arisk communication response unit within the MoPH that echoes the above strategy and non-emergencies. for emergencies;capacity and astrengthened hotline, website, and social media for emergencies and structure as an activated Joint Information Centre that monitors and evaluates response; its surge public audiences through preferred/trusted channels with consistent messaging; connection with EOC all plans address to coordinated materials development; emergency for budget contingency and Develop ahealth risk sector communication strategy that includes dedicated staff, sustained budget Developed capacity. Justification: Systemsare inplacewithinHMCbutnotyetunifiedwith 59 of IHR Core Capacities of the State of Qatar RESPOND 60 RESPOND

Joint External Evaluation expansion. Onceexpandedandendorsedacrossthehealthsector, theranking willlikely rise. exercises. The Taskforce forHealthEducationand Communicationshouldserveasamodelforfurther many challenges. The nextstepswillbetotestpartnershipcommunication throughjointemergency Bureau inadditiontocoordinatedmanagementofMoPH, HMCandPHCCcommunicationwilladdress Score 3: R.5.2 InternalandPartner CommunicationandCoordination • • • • strengthening/challenges need that Areas • • • practices Strengths/best communication principlesandanendorsedstrategy. operational communicationsdepartments butshouldmovetoacoordinatedstrategy basedonrisk Score 3: Developedcapacity. Justification: MoPH, HMC, PHCCandQatarRedCrescentSocietyhave R.5.3 PublicCommunication • • strengthening/challenges need that Areas • • practices Strengths/best communication plan hired and staff to fill these roles. Risk communicator roles and responsibilities need to determined be within the health risk sector agreements. sector health Risk communication plans and systems need to included be in national emergency response plans and system. communication such as reputational management. Capacities should integrated be to address the health risk sector units such as the MOPH, HMC and PHCC but remain focused on separate organizational objectives Communication capacity,and plans staff (some endorsed, some not) exist within health sector reorganization. sector health recent plans have within been written the MOPH but have not been endorsed and may outdated be with There is no endorsed health sector-wide risk communication plan or strategy. Risk communication MoPH has regular on popular outreach television efforts programmes. lack of transparency, it a‘strength’ canbe in terms of ensuring consistent communication messages. Qatar has afairly controlled media. While not considered practice’ ‘best globally due to tendencies for Qatar, being ageographically small country, makes it easier to reach communities during an emergency. exercises. emergency joint through tested be must Communication partnerships identified and connected to a broader heath risksector communication plan. Taskforce for Health Education and Communication in this is start agood area but capacities must be There is uncharted communication in several capacity health and organizations. partner sector The coordination MoPH, HMC between and PHCC. coordination, e.g. the Government Communication (2015) Office and the Director of Communication Recent decrees and management changes may address the need for unified partner communication expanded as ahealth response sector and body formalized as such. coordination agreements and health threat communication plans. This is practice abest and should be The Taskforce for Communication and Health Education has terms of reference with response and Developed capacity. Justification: Adoption of the forthcoming Government Communication • • • • • strengthening/challenges need that Areas • • • practices Strengths/best approach bycoordinatingwithpartnerstoreachat-riskpopulations. foreign worker populations. The systemthenneedstofocusonaudienceresearch andamoredecentralized exist in Qatar but a mapping of audiences and activities is needed to identify gaps among hard-to-reach Score: 3-Developedcapacity. Justification: Manycommunityengagementactivitiesatdifferentlevels R.5.4 CommunicationEngagementwith Affected Communities • • • strengthening/challenges need that Areas up. levels and whether or not existing information is understood and recommendations followed canbe literacy resources, information health preferred/trusted determine to research engagement community conduct community engagement research, perhaps by partnering with alocal university to conduct approaches upon. acted can be The most effective should replicated. be MOPH needs assistance to Community engagement approaches should tested be to determine if information is understood and techniques. event and therefore should trained appropriate be on risk communication engagement and community Qatar MoPH recognizes that field its epidemiology force often is the onfirst the scene during an and their families. resources that allow individuals to make informed decisions for the health and well-being of themselves Engagement activities are not currently sufficiently coordinated to ensure that information uses trusted missed. Community should engagement mapped be against efforts Qatar’s populations to identifysegments To date, the health promotion within section the MoPH has little or no emergency response capacity. communication individuals with in population Qatar. or segments A new disease surveillance system is due to launched be in 2017, which may allow for two-way organizations. nongovernmental dedicated Hard-to-reach populations may accessible be through mandatory health processes registry and outreach efforts. populationstargeted some hotlines, with information, and education communication materials and community program, Qatar Red Crescent Society, Qatar Petroleum and other that partners have Qatar has community engagement and practices best capacity within MOPH, HMC, PHCC, Kulluna future response efforts. reviews to contribute to the overall science base for risk communication while improving upon Qatar’s the event and other response measures timeline. This would allow for evaluation during after-action response to rumours, tracking of social media interactions, etc.) should logged be and tracked alongside Public communication response (press releases, products transcripts of interviews, website messaging, manner. effective in order to ensure that health recommendations reach target populations in arapid, efficient and cost- Audience research should conducted be to determine preferred and trusted communication channels risk communication health a on sector plan. utilize television, print media, radio, internet and social media but should now coordinated be based MoPH, HMC, PHCC and other have partners operational public communication that departments 61 of IHR Core Capacities of the State of Qatar RESPOND 62 RESPOND

Joint External Evaluation Strengths/best practices Strengths/best and responseactionstobemanagedatthesourceofrumourwithevidence-basedinformation. numerous sources(hotlines, communityengagement, partners, etc.)andcoordinatedintodecision-making Score 3: Developedcapacity. Justification: Rumoursandmisinformationshouldbegatheredfrom R.5.5 DynamicListeningandRumourManagement • • • • • • • • • documentation Relevant • strengthening/challenges need that Areas • local university undergraduate health education majors and Masters in Public Health students. PublicHealth in Masters and majors education health undergraduate university local include to emergencies for volunteers of engagement community for programme certificate a provide could MoPH emergencies. during engagement community for ensured be should capacity Surge 2015. Qatar Supreme Council of Health (formerly MOPH) Risk Communications April, Assessment Report Qatar Assessment Mission- EVD Report. Short National EPR plan for MERS_draft_Oct_17th_2015. IHR Assessment Mission, Qatar, 2013. 2015. Diseases, Winter & Education: Hajj Health Plan. Communications Incident Major HMC Amiri Decision No. 15, No. Article 5(2015) Establishment of the Government Communication Office. Sub-Taskforce 3. Health Education and Communication Taskforce, 2015. be addressed through a coordinated health response sector with evidence-based information. rumours and misinformation from all sources (hotlines, community engagement, etc.) partners, should misconceived perceptions and potentially harmful rumours about health recommendations. Such Some health hotlines, sector e.g. MOPH and HMC, receive complaints, reputational issues and potentially harmful rumours. to receive information public the from misunderstandings on regarding health recommendations and Several health organizations sector have hotlines and regular touch points with hard-to-reach populations States Parties should designate and maintain the core capacities at the international airports and ports (and (and ports and airports international the at capacities core the maintain and designate should Parties States (and ports and airports international the at capacities core the maintain and designate should Parties States to appropriatemedicalfacilities (betheseattheportitselfortoanearbyhospital). Responsetimesforthe For thethreeseaports, itwas evidentthatareferral systemwas inplaceforthesafetransfer ofilltravellers Qatar levelofcapabilities Target addressed. for theStateofQatar but alsonewchallengesfrom a publichealth perspective, which willneedtobe report arevalid forconsideration forbothofthesedevelopments. They willprovide bothopportunities cruise shipport, withaprojected80cruiseshipsvisitingannuallyby2020. The recommendations inthis open in2017, movingcargotraffic away fromDoha Port. Secondly, Doha Port willdevelopasadedicated relevant for consideration as part of the overall recommendations. Firstly, a new seaport (Hamad Port) will Although themissionfocusedoncapacityattimeoffieldvisit, twonotabledevelopmentsare • • • • • • Arabia. IthassixrecognizedPoE thatsupportinternationaltraffic, andfourseaports: The StateofQatarisapeninsularjuttingoutintothePersian GulfandsharingalandborderwithSaudi Level ofCapabilities: Qatar Target a variety ofpublichealthrisks. public healthreasons, designatedgroundcrossings), implementingspecificmeasuresrequiredtomanage required tomaintaincorecapacitiesatdesignatedinternationalairportsandports(andwherejustifiedfor effective applicationofhealthmeasurestopreventtheinternationalspreaddisease. StatesParties are All corecapacitiesandpotentialhazardsmanagementapplytopointsofentrythusenablethe Introduction ENTRY OF POINTS where justified for public health reasons, a State Party may designate ground crossings) which implement implement which crossings) ground designate may Party State a reasons, health public for justified where implement which crossings) ground designate may Party State a reasons, health public for justified where specific public health measures required to manage a variety of public health risks. health public of variety a manage to required measures health public specific risks. health public of variety a manage to required measures health public specific Abu SamraAbu ground crossing, the main land point entry to Qatar at the border with Saudi Arabia. Airways; Qatar of airport hub the and airport international major a Airport, International Hamad RuwaisAl ,usedvessels by dhow-type seaport for smaller cargo trade; (Qatar Port Ras Laffan Petroleum), used by vessels in the oil/gas sector; container ships delivering goods to the designated Mesaieed industrial area; Mesaieed (Qatar Port Petroleum), used by vessels in the oil/gas together sector with general cargo and (MwaniDoha Port Ports), used by general cargo ships and container vessels; 63 of IHR Core Capacities of the State of Qatar OTHER 64 OTHER

Joint External Evaluation one ispermittedtoboardthevesselunlessitconfirmed fitbythehealthauthorities. Mesaieed Port shall not grant entry to vessel and shall notify the health authorities to screen the vessel; no to nine health questions: NO means no health risks, and in the case of any YES to a health risk question, port hastosubmitacopyoftheInternationalMaritime Declaration ofHealth. This declaration responds Mesaieed Port complieswiththeInternationalMaritime Declaration ofHealthaseveryvesselcallingtothe surge capacityofthesystems, anissueraised byonestakeholder asneedingtobeaddressed. exercises havebeencarriedout. Itisthusnotpossibletoevaluate fullytheeffectiveness ofthePoE andthe The StateofQatarhasnothadtofaceamajorpublichealthemergencydate, thoughsimulation to ensurethecontrolofhealthissuesrelatedtravel ofliveanimalsanddeadhuman bodies. cargo terminalhasrepresentationsfromtheMinistryof Agriculture andMoMEnecessary procedures The airportwildlifesectionhasproceduresforvectorcontrolonaregularbasisbyspecializedcontractors. The of communicablediseasesconcern. equipped withthermalcameras forscreeningofarrivingpassengersfromareasthathave suspectedcases with modernambulancesandtrained stafftoaddresspublichealthemergencies. The airportterminalis The airportrescueandfirestationsoperated andmanagedbytheCivil Aviation Authorityarewellequipped equipment. There areproceduresinplaceforthetransfer ofillpassengerstothecentral hospitalatDoha. Hamad internationalairportincludesthreeclinicsrunbytheHMCwithsufficientmedicalstaffand appropriate training. that public health emergency drills were carried out on a regular basis and that relevant staff have received requirements formanagementofpublichealtheventsairtravel. The airportauthoritydemonstrated into consideration theIHRrequirementsaswellInternationalCivil Aviation Organization(ICAO) Emergency Planiswelldevelopedincludingaspecificchapteronpublichealthemergencieswhichtakes management that maintains it well-equipped with trained personnel and necessary tools. The Aerodrome Hamad International Airport, was openedduring2014withhighqualityfacilities. The airportisoperated by development. could beheldupasanexampleofbestpractice. However, preventativemeasuresareanareathatneeds to tacklingemergenciesandprovidingarobustmedicalresponse: a “can do” approach, whichthis inspection ofconveyances (shipsandaircraft). The currentstrengthofthecountryisclearwhenitcomes There was also no evidence of systematic surveillance of vectors and reservoirs at PoE or programmed then disseminatedtoallkey stakeholders forintegration withexistingemergencyplans. services. The NationalHealthEmergencyPlancouldbeacatalystforthis, butneedstobeapprovedand formal structureofrolesandresponsibilitiesbetweenallstakeholders andintegration betweenallrelevant However, despitethelevelofknowledgedemonstrated attheports, therewas lessevidence ofaclear notify theMoPHofsuspectedcasesandseekadditionalguidanceapotentialpublichealthemergency. through totheemergencyservices. There was alsodemonstrable knowledgeoftheneedforportsto were in place from the initialpointsofreceipt suspected cases (principally the Vessel ControlCentres) This meantthat, notonlyurgentcasescouldberespondedtoveryquickly, butthatclearreportinglines emergency attendanceofambulancesandtrained staffwerestatedtobewithin10minutesofcallreceipt. • • Recommendations forpriorityactions outbreak on acruise ship). public health emergencies but other health events that may put pressure on resources (e.g. anorovirus Leading from this, identifyany lack of resources to tackle necessary surge capacity, considering not just integrate it within other plans to provide all-hazards an effective response when required. Approve the National Health Emergency Plan, test and disseminate it to all key stakeholders, and • • • • • practices Strengths/best the scoreof3prevails. 4 isdeemedtobemetattheairport, butasseparate scoresarenotappropriateina national evaluation, inspection programme for vessels for sanitationpurposes is in place, either legally or inpractice. Indicator indicator 4(vectorcontrolprograms andsurveillance)isnotinplaceatallseaport PoEs. Similarly, no Score 3: PoE.1 Routinecapacitiesare establishedatPoE Indicators andscores • • • • • • • • • MoPH needs to discuss the issue assess the best solution with the ports, and authorize the service considered that such may aservice provided be by Ministry of Transport inspectors. In either case, advised they had access to private companies that could provide such inspection services; Doha Port and issue SSCs. Different models may suitable be For example, for different ports. Qatar Petroleum There is adesire (and technical capability) to provide for seaports an inspection for service ships contractors that are affiliated to thewildlife managementsection. A regular programme for control vector is implemented at Hamad International by specialized Airport at theports. traffic Sufficient resourcesseemed be to in place to dealemergencieswith expected andtype level for the of boat. flatbed a ambulance on emergency need for removal of asuspected Ebola virus victim at Industrial Ras Laffan was City to provide an A clear “can do” approach was given by stakeholders in interviews. For example, asolution to the working practices are in place to deal with ill travellers to reported PoEs. Qatar has astrong and established medical system that canrespond quickly to emergencies and clear communicable disease could interim be conditions as and when needed. recommendedThe WHO exit screening in addition screening to entry for travellers with asuspected Provide basic and recurrent training to MoPH personnel involved in PoE inspection and oversight. Enhance the regulatory role and of the supervisory MoPH to implement IHR in ports. recognized by MoPH to issue such certificates. extension certificates, and to approve the designated to delegateports Qatari companies that are MoPH to request to WHO assign designated to issue Qatari SSCs/sanitation ports exemption or role.supervisory Therefore, availability of sufficient qualified and trained isessential. staff established system for IHR implementation, the Government should assume the regulatory and and national health regulations and recommendations. Although Qatar PoE operators have awell- The MoPH should enhance oversight its functions at PoEs to ensure implementation of the international risks. the assessed Risk assess PoEs for likely reservoirs, vector and implement asuitable inspection programme to control SSCs. issue to Authorizations based on the national legislation should given be to appropriate and stakeholders ports Certificates (SSCs) of will type certificate whichand beeach port authorized toissue. Separately, the IHR NFP for should which of seaports they WHO notify wish to receive Ship Sanitation decision. There is no technical reason inspected why cannot the four meet the ports core capacities. The IHR NFP should designated of all WHO notify ports under IHR andall notify key stakeholders of this Developed capacity. The firstthreetechnicalindicatorsareagreedtohavebeenmet. However, 65 of IHR Core Capacities of the State of Qatar OTHER 66 OTHER

Joint External Evaluation to testtheeffectivenessandidentifyanyweaknesses address. health eventsatports, simulationexercisescouldbecarriedoutwithallpartiesintegrated intosuchplans public healtheventsatPoEs (Question5)cannotyetbefullycarriedout. Intheabsenceofspecificpublic an all-hazardsperspective. Itfollowsthattheevaluation oftheeffectiveness Plan inrespondingto Emergency Plan)isrecognizedbytheself-assessmentasrequiringmoreintegration with otherplansfrom in thisarea, questions1, 3and4areconsideredtobemet. Question2(integration oftheNationalHealth Score 3: Developedcapacity. This scoreisbasedonthejustificationthat, ofthefirstfourtechnicalquestions PoE.2 EffectivePublicHealthResponseatPoints ofEntry • • • strengthening/challenges need that Areas • • • • • practices Strengths/best a regular programme to ensure availability of routine capacity. needsThe country to have qualified trainedpersonnel out inspections carry to throughat the airports Program). Sanitation provide and support technical experience in these fields (e.g. the EU SHIPSAN project, US ACT Vessel emergency of international concern). could to Links built be start with organizations that could also is seized to prepared better be for outbreaks of illness (and not necessarily those of apublic health the new Hamad into putting By Port. place amonitoring and inspection process now, the opportunity challenges and opportunities will arise with the opening of the new cruise terminal at and Doha Port found or notified (e.g. Legionellacases on vessels).While the JEE focuses on the currentcapacity, other from authorized and ports) ameans to obtain information on potential risks that may not otherwise be isservice in demand by both shipping lines and operators (SSCs need to issued be six every months Linked to this is out vessel the need inspections to for carry ship at seaports sanitation purposes. This useful in this respect). (the newly published guide WHO on surveillance and other airports PoE at will of seaports, vectors be a programme of assessment and monitoring for and vectors potential reservoirs should implemented be large financial investment, rather a need for coordination inspection for routine processes. Specifically, potential risk and ensure appropriate resources and responses applied. canbe This is not necessarily a Greater emphasis now needs to placed be upon surveillance at PoEs that canhelp inform the level of The airport hasThe airport procedures for transfer of ill travellers to appropriate medical facilities (HMC). that takes into consideration the and WHO ICAO requirements. The Aerodrome Emergency Plan includes acomprehensive chapter to address public health emergencies Written working procedures are in place were and at clearly eachstaff port knowledgeable on them. andin rapid the city response times in emergencies are achievable. Mesaieed where Port required. The location of means Doha Port that rapid access to medical facilities Medical facilities at are Ras modern, Laffan well equipped and capable of taking diverted from cases what to do and who to contact. Strong medical and capability capacity exist in Qatar along with on-the-ground good knowledge of established with regard to ship inspections, but perhaps less for so the airline sector. cost-recoveredbe from the conveyance operator 41 (Article of the IHR 2005). This system is well Withto to helprespect resources, officers. support health (including checks inspection of vessels)can (e.g. e-learning) and technical forums exist (e.g. and Ground Airports Crossing Ports, PAGNet) Network, accordingly. AnumberWHO course a attended on of officers SSC in Qatar in 2013, and other training • • • • • • • • • documentation Relevant • • strengthening/challenges need that Areas • Presentation from Qatar Petroleum –“Implementation of IHR (2005) in Mesaieed Port”. Agenda for Ship WHO Sanitation Inspection Training Course, Doha, 2013. HandbookWHO on Vector Surveillance and and Control Ground Airports Crossings. at Ports, HandbookWHO on the Inspection of Ships and Issuance of Ship Sanitation Certificates. Qatar Petroleum Medical Algorithms. Plan. Facility Security Port Doha Plan. Emergency Hamad International Airport Plan. Emergency National Health Regulations (2005).International Health responding to public health events at the airport. Ensure availability of trained qualifiedpersonnel from MoPH to evaluate of the PoEs effectiveness in for different necessary be but hazards/ports overall, MoPH should coordinate public health matters. where there are national issues security or matters of commercial confidentiality). Different models may However, some areas of the Plan may need the greater involvement of some stakeholders (for example of understanding, where necessary. MoPH will need to have aclear role in overseeing this process. to all relevant stakeholders and integration its within their separate plans, SOPs and memoranda formalized. This will require the formalizing and dissemination of the National Health Emergency Plan Coordination is needed at MoPH to ensure that roles and responsibilities of all stakeholders are available inside the passenger terminal on a24/7 basis. ambulance paramedic service seven paramedic staff; bike teams are medical also and golf two carts HMC hospital. In addition, landside and airside are covered ambulance by two units manned by HMC includesThe airport three medical clinics run by HMC to ensure proper coordination with the central 67 of IHR Core Capacities of the State of Qatar OTHER 68 OTHER

Joint External Evaluation State parties should have surveillance and response capacity for chemical risk or events which requires requires which events or risk chemical for capacity response and surveillance have should parties State transportation andsafedisposalincludinghealthprotection. effective communication and collaboration among the sectors responsible for chemical safety, industries, parties arethereforerequiredtohavesurveillanceandresponsecapacityforchemicalriskoreventsthrough sectors and infrastructure requires timely mobilization of a coordinated multi-agency response. The State Prevention ofuncontrolledhazardouschemicaleventsposingasignificantthreattopublichealth, service Introduction EVENTS CHEMICAL including drills, aremandatoryforHMC staffdealingwithsuchpatients. need andnatureofthechemical orradiation injury. Hazardoussubstanceandcasemanagementtraining, Degree indisastermanagement. There isafacilitytodecontaminate andisolatepatientsdependingonthe Management Team ofHMC. The DisasterManagement Team consistsoftwoqualifiedstaffwithaMaster’s hospital plan for case management of chemical andradiation injuries and are developed by the Disaster doctors and nurses that are rotated and assigned to a major incident team. The SOPs align with the overall protocol, atleasttwo ‘major incident’teamsareassigned onadailybasisintheHMC, comprisingastaffof through CDD, bythe Ambulance ServiceandEmergencyMedicalofHMC. Undertheestablished The alertisgenerated through theemergencynumber ‘999’ andisdirectlyrespondedtointhefirstinstance, Emergency DepartmentofHMCtohandlesuchcases. responds accordingly. Competentandskilledpersonnelareavailable inthe Ambulance Serviceand guidelines andprotocolsdevelopedbyMoMEforcategorization ofthenaturechemicalinjuryand The CivilDefenseDepartment(CDD)isthefirstresponder inanykindofchemicalevent; itfollowsthe chemical events, hasbeendevelopedbyMoMEunder theoverall directionofthePEC. response tochemicalevents, guidelinesormanualsonthesurveillance, assessmentandmanagementof stockpiles andchemicalwaste isalsoundertaken. Inlinewithothersectors, a plan forsurveillanceand import, storage facility and use of chemicals in Qatar. The regulatory monitoring of these entities, leftover Chemical DepartmentintheMoME. The ChemicalDepartmentisalsoresponsible forissuinglicensing organizational frameworks havebeendefinedandformulated. The Lawiscurrentlybeingupdatedbythe Comprehensive legislationisinplaceLaw30of2002underwhichoperational proceduresand Pollutants, andtheStrategic Approach toInternational ChemicalsManagement, etc. havebeenratified. Convention onPriorInformedConsentProcedure, theStockholmConventiononPersistent Organic The globaltreatiesandconventionsconcerninghazardouschemicalschemicalsafetylike theRotterdam established. and coordinationforactivitiesinthecontextofchemicaleventsmanagementisprocessbeing composed ofmembersfromthedifferentrelevant stakeholders. Adequate andrequisitecommunication A nationalintersectoral committee, thePermanent EmergencyCommittee, hasbeenestablished Qatar Petroleum Corporation, MinistryofIndustryandMoPH. Chemical safetyinQatarisajointresponsibilitybetweenMinistryofInterior, MoME, MinistryofDefense, Qatar levelofcapabilities Target effective communication and collaboration among the sectors responsible for chemical safety, industries, industries, safety, chemical for responsible sectors the among collaboration and communication effective transportation and safe disposal. safe and transportation • • • • • • practices Strengths/best Score 3: Developedcapacity. events oremergencies CE.1 Mechanismsare established and functioningfordetectingresponding tochemical Indicators andscores • • • Recommendations forpriorityactions utilizing infrastructure andexperiencesavailable inthecountry. In general, the systematic approach has yet to be adopted in the management of chemical sectors by in HMCissufficientformedicalpersonneltorespondemergencies. Qatar; however, inemergencysituations suppliesarebroughtinfromotherGCCcountries. Surgecapacity of thenationalemergencypreparednessandresponserequirement. There isnopharmaceuticalsectorin Strategic stockpilesofessentialmedicinesandotherneededdrugsaremaintainedinthecountryaspart also beendevelopedbyQatarPetroleum Corporation. The NationalChemicalManagementProfilehasbeendefinedbyMoME; aseparate chemicalprofilehas sectors torapidly detectandcontainaccidental, natural ordeliberate releases. protocol betweenrelevant industry, regulatoryauthorities, emergencyresponders/servicesandhealth chemicals bytheMoPH. There was insufficientinformationonintegrated surveillanceandearlyalerting pollutants isalsoundertaken bythecentral laboratory inMoME. Food productsaremonitoredforhazardous Surveillance andenvironmentalmonitoringforairquality, water andsoiltomonitorpersistentorganic data client-basedsystemforpatientprofiling. between theCDD, MoMEandMoPHisnotinplace. On6May2016, HMCoperationalized theCerner® injuries totheMoPH. However, anestablishedreportingmechanismforinformationexchangeandsharing The trauma centreinHMCcollectsandsubmitsdataonroadtraffic accidents, chemicaland radiation where theExecutive(on-callseniordoctor)willcategorizeincidentasmajororminor. The NationalCommandCentreofthe Ambulance ServicedecidesandinformsontheincidenttoHMC is available in both the MoME and MoPH. system; laboratory or access capacity to this for confirmation and analysis chemicalof priority events Surveillance System but currently no surveillance data on chemical events are being in reported this on to chemicalCapacity report exits events as event-based surveillance in the National Qatari Disease Chemical and radiological events are being to reported the Ministry of Interior and HMC. management. and assessment surveillance, their on manuals or Chemical surveillance is in place for chemical events, intoxication, and poisonings, including guidelines isestablished. Committee Emergency Permanent ratified. have been conventions/agreements Key international chemical Comprehensive legislation under exists Law30 of 2002. health. environmental Enhance laboratory for detection capacity and analysis of hazardous chemicals human affecting and monitoring. and surveillance incident chemical Develop Improve information sharing different between stakeholders, MoME and MoPH. 69 of IHR Core Capacities of the State of Qatar OTHER 70 OTHER

Joint External Evaluation Score 3: Developedcapacity. CE.2 Enablingenvironment isinplaceformanagementofchemicalEvents • • • • • • • • • • • • strengthening/challenges need that Areas • • • • • • • practices Strengths/best reviewed and safe options for waste management should be developed and established. and developed management waste should be for options safe and reviewed of and awaste security Safety disposal system and facilities for hazardous chemicals need to be potentially significant risks to public health. inventoryAn and risk profiling shouldcarriedbe out of chemicalstockpiles and industries that present however, aproposal for apoison centre has been submitted for approval. Neither a chemical poison centre nor a chemical information position centre in exists the country; DDT). dichlorodiphenyltrichloroethane; (levels of The is alack of research on the presence of harmful levels of chemicals in food, soil, air and water providers. health-care and Awareness on chemical and advocacy hazards is needed among the general public, first responders analysis. should capacity Laboratory improved be in both the MoME and the health for detection sector and approach to develop practices good in proactively managing chemical threats. security Coordination should include industries, trade, regulation, and planning to ensure amulti-agency of HMC to ensure amulti-agency approach to manage chemical and radiation threats and injuries. Joint training is needed for acoordinated response of MoPH, MoME and the Emergency Department exist in health-care responders and chemical incident/frontline responders. Competency-based training is needed for CDD to respond to chemicals events. Competency gaps also stakeholders. However, information sharing is hampered by confidentiality andsensitivity differentbetween encouraged. be should relevantentities between discussions joint sharingand information Increased Human resources are insufficient to meet the needs for chemicalsafety. radiation injuries. The Emergency Department of HMC is the only reference health facility for dealing with chemical and emergencies. in needs mobilized enhanced during promptly be can financial resources Sufficient Chemical assessment safety are surveys carried out. isavailable hospitals. poisoning at chemical handle to unit emergency An There is acoordinated response to significant industrial accident/chemical events. communication and advocacy campaigns for the public. the for campaigns advocacy and communication Data on disease surveillance and chemical reported events are utilized by the MoPH to develop requisite together with regards to chemical events. several coordinating bodies, including MoME, CDD, Ministry of Defense and PEC. These entities work Legislation on chemicals provides comprehensive legal coverage with interagency operability between PEC is in place for overall coordination and oversight different between sectors. • • • documentation Relevant • • • • • • strengthening/challenges need that Areas • • • • • • • MoME databases.MoME Risk Mapping. for Databases Plans. Emergency Sectoral a toxicology system alert within MoME or MoPH and hospitals. Telephone based/online toxicology should services advisory set be up, along with the establishment of toxicology. quantitative and toxicology. This could include the development of alaboratory facility capable of performing qualitative There is an urgent need for training for on health-care chemical staff risk assessments and medical rapid identification of acute, fast-evolving as well as protracted chemical events. environmental surveillance, including those in place for quality monitoring of drinking water, to provide facilitiesLab available at public, private and research should sectors linked be with national know-how. and logistics necessary the with resourced patients, poison At least one hospital should considered be as areference facility to handle chemically contaminated or Risk-based contingency plans should developed be with input from public health professionals. services. coordinating entities involved in chemicals, surveillance, emergency response and provision of health integratedAn coordination mechanism is needed for systematic information sharing the between management. disaster There are national coordinating bodies for pesticide management, safety environment protection and times. all at available Qatar is linked to international chemical and toxicological and achemical networks, database is auditAn evaluation system is in place. There is provision for mobilization of an emergency budget. Nationalavailable.is ChemicalsA Profile Management actionplanAn for public health in exists the event safety of chemical incidents/emergencies. including an inventory of major hazard sites and health facilities. emergencyAn response plan that defines the roles and responsibilities of relevant agencies is in place, 71 of IHR Core Capacities of the State of Qatar OTHER 72 OTHER

Joint External Evaluation 1 State parties should have surveillance and response capacity for radio-nuclear hazards/events/emergencies. hazards/events/emergencies. radio-nuclear for capacity response and surveillance have should parties State Target management. It requireseffectivecommunicationandcollaboration amongthesectorsresponsibleforradio-nuclear State partiesshouldhavesurveillanceandresponsecapacityforradio-nuclear hazards/events/emergencies. Introduction EMERGENCIES RADIATION safety standardsissuedbytheInternational Atomic Energy Agency. requirements for nuclear emergency preparedness and response, as described in the jointly sponsored Qatar hasthenecessaryinfrastructure andlegalbasisforimplementinginternational standardsand Qatar levelofcapabilities It requires effective communication and collaboration among the sectors responsible for radio-nuclear radio-nuclear for responsible sectors the among collaboration and communication effective requires It • • may include: is crucial. The interviewed colleaguesatMoMEindicatedthatradiation risksofmainconcernforQatar infrastructure fornuclearsafety andensurecompliancewithinternationalrequirementsfornuclearsafety Since Qatarisinterestedinenteringthenuclearage, cooperation withIAEAtostrengthennational entry pointofthewater desalination facility. Monitoring oftheradioactivity concentration indrinkingwater isnotroutinelydonenationwide, butatone the CFLwas equippedandstaff weretrained toanalysedrinkingwater withaliquidscintillation counter. compliance withpermittedradioactivity levelsestablishedbynationalregulations. Through thisproject, so thatitcananalysefoodanddrinkingwater toensureitisfreefromradioactive contaminationandin IAEA Technical Cooperation project QAT/5/004. The project focused on enhancements to the Laboratory The technicalcapabilityoftheCentral Food Laboratory, operated bytheMoPH, issupportedthrough rather thanroutinemonitoringofradioactivity infood. water havebeenputinplace. According toRCPDself-reporting, monitoringisdoneonanadhocbasis protection is a priority. National arrangements to monitor radioactivity levels in imported food anddrinking Qatar ishighlydependentonimportedfoodandthereforemanagementofsafetytoensureconsumer response inthefield, butdonothaveafieldresponseroleper se. MoME’s EmergencyOperation CentreandRCPDdeveloprelevant policies, plans, protocolsandsupervise &contentID=3838). A fulllistofitsfunctionsisavailable ontheirwebsite(www.mme.gov.qa/cui/view.dox?id=1453&siteID=2 by Decree31of2002, currentlybeingupdated); (ii)licensing; (iii)EPRoversightand(iv)policydevelopment. The MoMe Radiation andChemicalsProtectionDepartment(RCPD)has the following roles: (i) regulation, management.

Energy Agency; 2015. Energy Agency; Preparednessandresponseforanuclear orradiological emergency– General safetyrequirements(No. GSRPart 7). Vienna: International Atomic a nuclear submarine accident scenario; accident submarine nuclear a origin); non-nuclear of those and malevolent events accidents, use, transportation (industrial, medical emergencies radiological 1

• • • • • Recommendations forpriorityactions National CommandCentrethatwillbesetupinsuchanevent. In caseofanemergency, RCPDwillnothandle public communicationasthisfunctionisdelegatedtothe • • • Training onEPRisavailable throughvarious vehicles: technical capabilitieslackinginQatar(verbalcommunication). to beavailable, butbilateral/regional arrangements arereportedtobeinplaceformutualassistance In termsofothernationalcapacities, internalcontaminationmonitoringlaboratories andskillsdonotseem exercises basedonaradiation emergencyscenario(e.g. 2009regionalexercisewithBahrain). sheltering. Training forfirstresponders was reportedtobe providedonaregularbasis, aswelldrillsand such us conducting a survey, setting up aperimeter, triagingpeople, decontaminating, evacuation and staff expertiseandknowledgeaboutthefirstresponsecountermeasuresincaseof radiation emergencies, The interviewwiththestaffofCivilDefenseDepartmentMinistryInteriorindicatedadequate means toevaluate thesearrangements, asdocumentationwas notmadeavailable tothereviewers. for preparednessandresponsetoradiological emergenciesandnuclearaccidents. The JEEmissionhadno arrangements existandarecompatible, consistentwith, andintegrated intheoverall GCC’s regionalplan The nationalplanforpreparednessandresponsewas notavailable inEnglish. Itwas indicatedthatnational the technicalparameters ofthenuclearinstallation, whicharenotcurrentlyavailable. the simulation/modellingofvarious scenariosofanuclearpowerplantaccident. This wouldneedinputon accident attheplantinUnited Arab Emirates wouldrequiresupporttoemergencyplanningthrough It was indicatedduringtheinterviewwithRCPDthatimprovingplanningforapotentialnuclear • Assistance Network; REMPAN,Assistance Network; WHO-BioDoseNet). And Preparedness Medical RadiationEmergency (WHO opportunities cooperation and learning Establish for access links with networks global to expertise, knowledge, expert exchange of information, pentaacetate; Ca-DTPA, zinc-Diethylenetriamine pentaacetate; Zn-DTPA, Prussian blue etc.). update for agents used for treatment of internal contamination (calcium-Diethylenetriamine radiation emergencies: sharing) for regional for (or arrangements stockpile national strategic a Develop biodosimetry, internal contamination assessment, and dose reconstruction. Develop individual dosimetry laboratory (national capacity or regional), including cytogenetic injuries). combined to high-doseexposed radiation (acute radiation syndrome, local injuries, internal contamination, medical care to injured or contaminated patients; and advanced clinical management of persons Train health workers to strengthen the following capacities: awareness, diagnosis of aradiation injury, emergencies. Strengthen cross-sector, regional, and international coordination in areas relevant to radiation staff. Department Hamad Hospital’s Emergency Civil Defense regular conducts training and exercises for first responders, including for CBRN substances; technicalIAEA cooperation project on national capacity-building in Qatar; into exploitation in 2017. a nuclear accident at the future Baraka nuclear power plant in the United Arab Emirates that will come 73 of IHR Core Capacities of the State of Qatar OTHER 74 OTHER

Joint External Evaluation Score 3: Developedcapacity RE.2 Enablingenvironment isinplaceformanagementofRadiationEmergencies • • • • • • including thefollowingstrengths/bestpractices: The hostcountrydemonstrated acertainlevelofdevelopedcapacitytorespondradiation emergencies, practices Strengths/best Score 3: Developedcapacity. radiological andnuclearemergencies RE.1 Mechanismsare establishedandfunctioningfordetectingresponding to Indicators andscores • • • • • • • • • practices Strengths/best CBRN training programmes are available, and exercises are conducted regularly. over-exposed persons, with dedicated facilities and trained human resources. The designated health care facility (Hamad Hospital) has astrongto provide capacity clinical care for IAEA). with CFL identifyand has to measure detect, capacity concentrations radioactivity in food (in cooperation response. of phase pre-hospital National civil defense and emergency medical play services important role in the first response and national regulatory authority –the MoME Radiation and Chemical Protection Department. isotope identification, assessment, notification protocols) is in place under the responsibility of the Adequate monitoring (including and response infrastructure national a radiation monitoring system, assessment, by supported appropriate legislation (Law 31, 2002). A national response plan and sector-specific plans, SOPs and arrangementsexist, based on risk Funding for EPR capacity-building activities isavailable. activities EPR capacity-building for Funding capacity. throughput high available facilitiesare with health-care Advanced development. resource build national forand monitoring, managing capacities detection radiation emergencies, and human International cooperation is in place and ISR with to IAEA strengthen projects preparedness and are established within GCC. The national EPR plan is integrated at the regional level in the GCC plan, and joint exercise programmes system. management emergency hazards all- country’s into the well integrated are emergencies radio-nuclear to responding for Arrangements A risk-mapping and threat assessment was done as and abasis serves for EPR. formally established, included in PEC. Focal points and channels for coordination of emergency response with the health authorities are EPR implementation. There is commitment of the Government and acomprehensive national legislation basis supporting 2005; and Revised International Health Regulations (IHR 2005) –2007. internationalAn legal framework emergency conventions exists: two (notification and assistance) – • • • • • • documentation Relevant • • • • • • • RE.2) and (RE.1 • strengthening/challenges need that Areas pdf). pdf). 2015, IAEA, Vienna, – 7 available http://www-pub.iaea.org/MTCD/publications/PDF/P_1708_web. at: Part Requirements Safety Generic emergency. radiological or nuclear a for response and Preparedness http://www.who.int/ionizing_radiation/a_e/biodosenet/en/. at: BioDoseNet about Information REMPAN http://www.who.int/ionizing_radiation/a_e/rempan/en/. about at: Information NCLCollectionStore/_Public/38/085/38085260.pdf?r=1). Radiation Protection LawNo. 31, 2002 is being updated (http://www.iaea.org/inis/collection/ http://www-pub.iaea.org/MTCD/Publications/PDF/EPR-Biodosimetry%202011_web.pdf. http://www.mme.gov.qa/cui/view.dox?id=1453&siteID=2&contentID=3838. functions: Full of list (DTPAs, Prussian blue etc.) The national stockpile does not yet include certain agents for management of internal contamination programmes. training through strengthened be internal contamination, combined injuries), and long-term follow-up of over-exposed persons, should in the areaExpertise of clinical management of radiation injuries (acute or cutaneous radiation syndrome, to regional or international resources, or by developing national in Qatar. capacity Internal improved to be contamination bylinking needs assessmentand monitoring capacity laboratory (i.e. laboratory the cytogenetic of the Canadian University College Atlantic of North in Doha). biodosimetry for but is exists cytogenetic capacity Laboratory not yet factored in the national response clarification. further need The roles and responsibilities within existing SOPs for linking pre-hospital and hospital responses may implications. and Non-health stakeholders sector demonstrated somewhat low awareness of IHR and requirements its mechanisms are in development, they will strengthening. need further Cross-sector coordination is crucial for efficient response to radiation emergencies;while functional Civil Defense. infrastructure is currently in the transition period from PEC to the new body, the Supreme Council for Recent developments triggered the need to update national legislation (Law No. 31), and response 75 of IHR Core Capacities of the State of Qatar OTHER 76

Joint External Evaluation 16. 15. 14. 13. 12. 11. 10. 9. 8. 7. 6. 5. 4. 3. 2. 1. External evaluationteammembers Doha, Qatar: 29May–2June2016 Mission placeanddates Annex 1: evaluation Joint background external • • Objectives Melinda Frost, RiskCommunicationConsultant Joanna Zwetyenga, Laboratory biosafetyandBiosecuritySpecialistQualityManagementSystem Martin Walker, Port HealthOfficer, UK Office Cairo Adel Ramlawi, RegionalOfficer, Aerodromes, CAPSCARegionalCoordinator, ICAO MIDRegional Marilyn Go, Former Director, Asian DisasterPreparednessCentre, Hyam Mallat, Attorney atLawandLegal Advisor Maha Talaat, Director, InfectionPreventionandControlProgram, GDDR,P/US-NAMRU-3 Arthur Liang, Rana Jawad Asghar, DirectorofFieldEpidemiology Training Programme, Pakistan Ahmed ElIdrissi, Senior Animal HealthOfficer, Food and AgricultureOrganizationheadquarters Farah Sabih, Technical Officer, WHOOffice, Pakistan Zhanat Carr, Scientist, Interventions forHealthyEnvironment, WHO headquarters WHO headquarters Elizabeth Mumford, Technical Officer, GlobalPreparedness, SurveillanceandResponse(Zoonosis), Eastern Mediterranean Dalia Samhouri, Technical Officer, EpidemiologySurveillanceandIHR, WHORegionalOfficeforthe partment ofHealthProtection Taneli Puumalainen, Headof Vaccination Programme, NationalInstituteforHealthand Welfare, De- headquarters Rajesh Sreedharan, Technical Officer, IHRcapacityassessment, Development andMaintenance, WHO Review all related documents. related all Review entry. of points at including the implementationAssess of the IHR capacities for surveillance and response to public health events • • • Limitations andassumptions • • • • • • • Preparation andimplementationofthemission position. will decidetheoutcome; thiswillbenotedinthefinalreportalongwithjustificationforeachparty’s host countryexpertsoramongtheexternalexperts, theexternalevaluation teamleader Should therebesignificantandirreconcilabledisagreementbetweentheexternalteammembers experts seekingfullagreementonallaspectsofthefinalreportfindingsandrecommendations. and thepriorityactionsshouldbecollaborative, withexternalevaluation teammembersandhostcountry discussions aroundthescores, thestrengths, theareasthatneedstrengthening, bestpractices, challenges the hostcountryexpertsandexternalevaluation teammembers. The entireexternalevaluation, including The joint external evaluation process is a peer-to-peer review. As such, it is a collaborative effort between The JEEprocess • • by Qatar and assessment team. assessment and Qatar by Information provided by Qatar has been discussed and an assessment rating was mutually agreed to The assessment is not an audit and information provided by Qatar is not independently verified. The results of this assessment will made be publicly available. managed.could be The assessment was limited to one whichweek, limited the amount and depth of information that the requirements of the 19 technical areas. and highlighting the main strengths, gaps and actions priority needed to the to country support meet A press release was published in the local newspapers describing the participation of Qatar in the JEE place to present the outcomes of the JEE, practices best and actions. priority A debriefing meetingwith senior officials and nationaltechnical teams involved in the evaluationtook actions. priority A national meeting with all stakeholders was conducted to reach aconsensus on the scores and information. Meetings with the relevant stakeholders and fieldvisits were conducted to validate the collected review. for Background documents were collected and shared with the JEE team along with the complete JEE tool process. the for responsibilities and requirements self-reporting on guidance with the information and resources to participate necessary successfully in the JEE process, including A national training course was conducted on 22–23 May 2016 to provide national stakeholders review the agenda, responsibilities, and logistics. Prior to the visit, teleconferences were held with assessment team members and the Qatar host to for globalcapacities health security Recommend actions priority to update and finalize the national plan to achieve and maintain IHR Develop describing areport the progress and gaps in implementing the IHR capacities. 77 of IHR Core Capacities of the State of Qatar 78

Joint External Evaluation Key hostcountryparticipantsandinstitutions Dr Saleh AlMeri Saleh Dr Dr Arshad Dr SethumadhavanMr Sudeep Radha Mr MohammedIbrahim Mr YosefAl-Khulaifi HazemDr M.Ghobashy AlMamounMohamedAbeidAbdullah Dr JohnRoberts Arthur Dr MohamedAbdelrahmanDr Yousif Nour Al-Dehaim Brigadier HamadOthman Albayat Soha Dr Ms SheilaCantos GodwinBalasingam Dr Mr Tariq Eldeen Salah Mr Khalid Yousef AhmedAl-Sulaiti Sanjay Doiphode Dr Labban Ms Rana Ms Fatima KamelAlOtoum Ali Bashir Dr Youssef NahlaHassanSharafDr MohamedBriouig Dr HananAlMujalli Dr JameelaAliAlAjmi Dr AhmedElDr Sayed AimanElberdinyDr ShaziaNadeem Dr HamadAlRomaihi Dr MohammedAlHajri Dr MohammedAl Dr Thani Name

Emergency Department, HamadMedicalCorporation Department, Emergency Qatar RedCrescent Society andEnvironment ofMunicipality Chemicals Unit, Ministry andEnvironment ofMunicipality Agricultural Research Ministry Department, andEnvironment ofMunicipality Ministry Animal Health Department, ofInterior Ministry Medical AffairsDepartment, Qatar Airways ofPublic Health Public Ministry Health Department, General,Secretary Permanent Committee Emergency ofPublic Health Public Ministry Health Department, PlanningandAdministrationEmergency HamadInternational Department, Airport ofPublic Health Public Ministry Health Department, of Public LegalHealth Ministry AffairsDepartment, ofPublic Health Public Ministry Health Department, ofLabMedicineandPathology,Department HamadMedicalCorporation Corporate HSEandQuality, Qatar Petroleum ofPublic Health Public Ministry Health Department, Paediatric Centre Emergency Health Care Management AndPatient MoPH Quality Department, Safety Qatar Ports Management Company, Mwani Qatar Health Care Clinical AffairDepartment, Primary Corporation ControlInfection HamadMedicalCorporation Department, ControlDisease ofPublic Health Unit, Ministry ofPublic andOutbreak Health Unit,Surveillance Ministry ofPublic andOutbreak Health Unit,Surveillance Ministry Health Promotion ofPublic Health andCommunicable Ministry Diseases, Health Director, ofPublic Preparedness Emergency Ministry andResponseDepartment, Director, ofPublic Health PublicMinistry Health Department, Undersecretary, ofPublic Health Ministry Affiliation

Joint External Evaluation of IHR Core Capacities of the State of Qatar

Mission report: 29 May – 2 June 2016

WHO/WHE/CPI/2017.6