GLOSSARY of Health Emergency and Disaster Risk Management Terminology

GLOSSARY of Health Emergency and Disaster Risk Management Terminology Glossary of Health Emergency and Disaster Risk Management Terminology ISBN 978-92-4-000369-9

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TABLE OF CONTENTS

PREFACE vi

ACKNOWLEDGEMENTS vii

ABBREVIATIONS ix

1. INTRODUCTION 1

2. METHODOLOGY 3

3. GLOSSARY 6

4. THESAURUS 39

REFERENCES 41

ANNEX 1. OTHER GLOSSARIES 46

ANNEX 2. WHO CLASSIFICATION OF HAZARDS 47 HEALTH EDRM GLOSSARY HEALTH vi

PREFACE

This Glossary is designed for the policymakers, prac- In any field, the terminology and respective definitions titioners and other stakeholders who work in the many will, of course, continue to evolve over time; WHO fields that contribute to reducing the health risks and therefore envisages that in future years this Glossary consequences of all types of emergencies and disas- will be subject to rigorous review and revision to en- ters. It was developed to remedy the lack of standard- sure that it keeps pace with changes in Health EDRM ized terminology in the field of Health Emergency and and related fields and continues to be the valuable Disaster Risk Management (Health EDRM), which had tool that it is today. become apparent during the process of establishing the WHO Health Emergencies Programme and devel- It is hoped that the common usage and shared under- oping the Health EDRM Framework. standing of terms facilitated by the use of this Glos- sary will enable all actors, sectors and communities Given the multi-disciplinary and cross-sectoral nature to work together more effectively, both within and of the field, the lack of clarity risked causing misun- between countries, so that all people are able to ex- derstanding, confusion and an ongoing proliferation perience the highest possible standard of health and of undefined terms. This Glossary of Health Emer- well-being, through stronger community and country gency and Disaster Risk Management Terminology resilience, health security, universal health coverage was therefore developed to address the need for a and sustainable development. standardized terminology to inform and describe the policies and practices associated with Health EDRM and to serve as a companion document for the Health EDRM Framework.

A wide range of subject matter experts – from Mem- ber States, United Nations agencies and nongovernmental organizations, professional associations and academia and WHO departments at HQ and its Re- gional Offices – have contributed to the development of this Glossary, both directly through virtual consul- tations and in a face-to-face technical workshop held in November 2018, and indirectly through the publication of the many sources that this Glossary draws upon. HEALTH EDRM GLOSSARY HEALTH vii

ACKNOWLEDGEMENTS

WHO thanks the Governments of Australia, Finland, Indonesia; John Simpson, United Kingdom; Theresa Republic of Korea and the United Kingdom for their Tam, Canada. financial support for the development of the Frame- work and the Glossary. Experts from intergovernmental and partner organizations: Vincent Lee Anami, International The development of the Glossary has drawn upon Medical Corps (IMC), Kenya; Paul Arbon, Torrens WHO’s work with partners and countries led by WHO Resilience Institute, Australia; Frank Archer, Monash country and regional offices and their respective re- University, Australia; Marvin Birnbaum, World gional emergency directors: Ibrahima Socé Fall (Af- Association for Disaster and Emergency Medicine, rican Region), Ciro Ugarte (Region of the Americas), USA; David Bradt, Johns Hopkins University, USA; Roderico Ofrin (South-East Asia Region), Nedret Lourdes Chamorro, European Union; Emily Chan, Emiroglu (European Region), Michel Thieren (Eastern Chinese University of Hong Kong, Hong Kong Mediterranean Region), and Li Ailan (Western Pacific Special Administrative Region (SAR), China; Gloria Region). Chan, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Massimo Ciotti, Finalization of the Framework and the Glossary was European Centre for Disease Prevention and Control, achieved under the leadership of Mike Ryan, Jaouad Sweden; Andrew Collins, Northumbria University, Mahjour, Stella Chungong and Qudsia Huda at WHO United Kingdom; Ioana Creitaru, United Nations headquarters. The contributions of Jonathan Abra- Development Programme, Switzerland; Bill Douglas, hams, who coordinated the development of the Glos- Consultant, Canada; Marcel Dubouloz, Consultant, sary, Jaz Lapitan and the lead consultant, Peter Koob, Switzerland; Mélissa Généreux, Sherbrooke University, are also gratefully acknowledged. Canada; John Harding, United Nations Office for Disaster Risk Reduction, Switzerland; Teodoro WHO wishes to recognize the following experts and Herbosa, University of the Philippines, Philippines; partner organizations for their contributions to the Hossein Kalali, United Nations Development Health EDRM Framework and to the Glossary. Programme, USA; Mark Keim, DisasterDoc, USA; Wirya Khim, Food and Agriculture Organization of the National experts: Walid Abu Jalala, Qatar; Salim Al United Nations (FAO), Switzerland; Kaisa Kontunen, Wahaibi, Oman; Sergio Alvarez, Peru; Ali Ardalan, Islamic International Organization for Migration, Switzerland; Republic of Iran; Haithem El Bashir, Sudan; Paul Gully, Peter Koob, Consultant, Australia; Daniel Kull, World Canada; Didier Houssin, France; Alistair Humphrey, Bank, Switzerland; Shuhei Nomura, University of New Zealand; Ute Jugert, Germany; Margaret Kitt, USA; Tokyo, Japan; Michel le Pechoux, United Nations Mollie Mahany, USA; Ahamada Msa Mliva, Comoros; Children’s Fund, Switzerland; Czarina Leung, Hong Virginia Murray, United Kingdom; Guilherme Franco Kong SAR, China; Gabriel Leung, Hong Kong SAR, Netto, Brazil; Sae Ochi, Japan; Somiya Okoud, Sudan; China; Lidia Mayner, Flinders University, Australia; Peng Lim Steven Ooi, Singapore; Ravindran Palliri, Michael Mosselmans, World Food Programme, Italy; India; Thierry Paux, France; Mihail Pîsla, Republic of Elizabeth Newnham, Harvard University, Australia; Moldova; Ossama Rasslan, Egypt; Nobhojit Roy, India; Loy Rego, Asian Disaster Preparedness Center, Mehmet Akif Saatcioglu, Turkey; Sri Henni Setiawati, Thailand; Panu Saaristo, International Federation of HEALTH EDRM GLOSSARY HEALTH viii

Red Cross and Red Crescent Societies, Switzerland; Rashford, Gerald Rockenschaub, Guenael Rodier, Alex Valérie Scherrer, CBM, Belgium; Rahul Sengupta, Ross, Cathy Roth, Dalia Samhouri, Irshad Shaikh, United Nations Office for Disaster Risk Reduction, Iman Shankiti, Rajesh Sreedharan, Ludy Suryantoro, Germany; Margareta Wahlstrom, United Nations Joanna Tempowski, Lisa Thomas, Angelika Tritscher, Office for Disaster Risk Reduction, Switzerland; Heini Utunen, Willem Van Lerberghe, Liviu Vedrasco, Chadia Wannous, United Nations System Influenza Elena Villalobos Prats, Kai von Harbou, Michel Yao, Coordination, Switzerland. Nevio Zagaria, Wenqing Zhang.

Experts from WHO: Usman Abdulmumini, Onyema Ajuebor, Yahaya Ali Ahmed, Nada Alward, Bruce Aylward, Nicholas Banatvala, Maurizio Barbeschi, Samir Ben Yahmed, Rayana Bouhaka, David Brett- Major, Sylvie Briand, Nilesh Buddh, Alex Camacho, Diarmid Campbell-Lendrum, Zhanat Carr, Frederik Copper, Paul Cox, Stephane de La Rocque, Xavier De Radigues, Linda Doull, Osman Elmahal Mohammed, Ute Enderlein, Florence Fuchs, Keiji Fukuda, Michelle Gayer, Andre Griekspoor, Kersten Gutschmidt, Fahmy Hanna, David Harper, Dirk Horemans, Gabit Ismailov, Hamid Syed Jafari, Kalula Kalambay, Kande-Bure Kamara, Nirmal Kandel, Youssouf Kanoute, Ryoma Kayano, Hyo-Jeong Kim, Rebecca Knowles, Helena Krug, Ben Lane, Vernon Lee, Jian Li, Matthew Lim, Tarande Manzila, Adelheid Marschang, Susana Martinez Schmickrath, Elizabeth Mason, Margaret Montgomery, Elizabeth Mumford, Altaf Musani, Maria Neira, Tara Neville, Dorit Nitzan, Ngoy Nsenga, Isabelle Nuttall, Olushayo Olu, Heather Papowitz, Yingxin Pei, Charles Penn, William Perea, Arturo Pesigan, Jean-Luc Poncelet, Pravarsha Prakash, Jukka Pukkila, Adrienne HEALTH EDRM GLOSSARY HEALTH ix

ABBREVIATIONS

CRED Centre for Research on the Epidemiology of Disasters EDRM emergency and disaster risk management ENSO El Niño-Southern Oscillation EOC emergency operations centre ERF Emergency Response Framework (WHO) FAO Food and Agriculture Organization of the United Nations IAEA International Atomic Energy Agency IASC Inter-Agency Standing Committee ICRC International Committee of the Red Cross IHR International Health Regulations IMO International Maritime Organization IPCC Intergovernmental Panel on Climate Change IRDR Integrated Research on Disaster Risk IPCS International Programme on Chemical Safety ISO International Organization for Standardization NGO nongovernmental organization OCHA United Nations Office for the Coordination of Humanitarian Affairs OECD Organisation for Economic Co-operation and Development OIE World Organisation for Animal Health UN United Nations UNGA United Nations General Assembly UNHCR United Nations High Commissioner for Refugees US CDC United States Centers for Disease Control and Prevention WHE WHO Health Emergencies Programme HEALTH EDRM GLOSSARY HEALTH

1 1 INTRODUCTION

1.1 BACKGROUND AND RATIONALE Health EDRM. The Framework also responds to In recent years there has been increased focus the key challenge of addressing the fragment- on policy, practice and research in Health ed and reactive approaches to managing these Emergency and Disaster Risk Management risks that all too often have contributed to less (Health EDRM) – a diverse field which brings than optimal outcomes – including significant together a wide range of functions in health numbers of deaths, illness, injury, disability and and other sectors aimed at improving health other health effects, disruption to health sys- outcomes for the people across the world who tems and services, and social, economic and are at risk of emergencies and disasters. environmental impacts.

WHO has undergone significant internal By drawing on achievements and experiences organizational change to strengthen from the disciplines of risk management, emer- the Organization’s capacity to manage gency management, epidemic preparedness emergencies, and in 2017 established the and response, and health systems strengthen- WHO Health Emergencies Programme, which ing, Health EDRM consolidates contemporary has integrated diverse functions across WHO approaches and practice into one conceptu- for a multitude of emergency risks. This al framework in order to address current and transformation has been reinforced in WHO’s emerging risks to public health and the need 13th General Programme of Work 2019-2023, for effective utilization and management of re- which includes the protection of people’s sources. Health EDRM emphasizes assessing, health from emergencies as one of the main communicating and reducing risks across the priority areas for the Organization. continuum of prevention, preparedness, readiness, response and recovery, and building In 2019, WHO published the Health EDRM the resilience of communities, countries and Framework (WHO 2019m), which was health systems. It provides a common lan- developed to provide guidance to ministries guage and a comprehensive approach that can of health and other stakeholders on how the be adapted and applied by many actors and capacities and systems of countries and stakeholders in health and other sectors who communities – across health and other sectors are working to reduce health risks and conse- – can be strengthened in order to reduce the quences of emergencies and disasters. health risks and consequences associated with emergencies and disasters of all types. The Framework describes key risk management concepts, guiding principles, and the The Framework aims to respond to the chal- components and functions of effective Health lenge posed to public health at country and EDRM, and provides guidance on implemen- community levels by a diverse range of risks tation. It aims to assist countries in taking due to vulnerabilities to many natural, biologi- joint and coherent action to implement the cal, technological and societal hazards and the IHR (2005), the Sendai Framework, the Par- need to strengthen multisectoral capacities for is Agreement, the Sustainable Development HEALTH EDRM GLOSSARY HEALTH 2

Goals (SDGs) and other related national, re- 2005 (Annex 1) – none represented the full gional and global strategies and frameworks. spectrum of concepts and terminology in Ultimately, the expected outcome of applying Health EDRM. This was the rationale for Health EDRM is that “countries and commu- the development of the Glossary of Health nities have stronger capacities and systems Emergency and Disaster Risk Management across health and other sectors resulting in the Terminology. reduction of the health risks and consequences associated with all types of emergencies 1.2 PURPOSE and disasters” and help to realise the Health The Glossary of Health Emergency and EDRM vision of “the highest possible standard Disaster Risk Management Terminology is of health and well-being for all people at risk intended to address the need for a standardized of emergencies, and stronger community and terminology in Health EDRM by consolidating country resilience, health security, universal existing glossaries and definitions into a single, health coverage and sustainable development” comprehensive reference tool for policy- (WHO 2019m). makers, practitioners and other stakeholders. It aims to promote common understanding and Perhaps unsurprisingly given the diverse common usage of Health EDRM terms. The range of fields involved in delivering Health Glossary has several applications in Health EDRM, in the course of developing the Health EDRM, including: EDRM Framework it became clear that there ll policy, planning, practice and communication was a troublesome lack of clarity even among within the health sector and with other sec- experts and practitioners around the use of tors, communities and other stakeholders terminology related to Health EDRM, with ll data standards and indicators for assess- different meanings being ascribed to simi- ment, planning, monitoring, reporting and lar terms, and similar meanings to different evaluation in health emergency risk man- terms. agement ll technical guidance and assistance to prac- Similar-sounding terms have different titioners and policy-makers at all levels and definitions in different disciplines or contexts. ll learning, research and knowledge manage- Some terms have specific technical meanings ment. that differ from the layperson’s usage. While the terminology may serve the interest of an 1.3 SCOPE individual specialist area, the lack of uniformity The Glossary includes terms and definitions can cause misunderstanding and confusion, that are likely to be encountered and common- especially in multi-disciplinary and cross- ly required by policy-makers and practitioners sectoral work. in Health EDRM, i.e. the systematic analysis and management of health risks, posed by Although several relevant glossaries were emergencies and disasters, through a combi- already available – such as the dedicated nation of: glossary contained in the Report of the open- ll hazard and vulnerability reduction to pre- ended intergovernmental expert working vent and mitigate risks group on indicators and terminology relating ll preparedness to disaster risk reduction (endorsed by the UN ll response, and General Assembly in February 2017), and the ll recovery measures. glossary in the International Health Regulations HEALTH EDRM GLOSSARY HEALTH 3 2 METHODOLOGY

2.1 PRINCIPLES FOR were assessed against these criteria. DEVELOPMENT OF Once the glossaries had been selected for THE GLOSSARY inclusion, the next step was to determine which The development of the Glossary was based on terms from each glossary should be included. the principle that it should have an explicit and A thesaurus was developed of the terms recognisable scope, should meet the needs that appeared in the selected glossaries (see of its audience, and should not contain new below). The Health EDRM terms drawn from terms or definitions – although some terms or the selected existing glossaries were compiled definitions may require minor amendment to to form an initial draft. Multiple definitions were ensure internal consistency or provide further mostly removed; where multiple definitions explanation. were required, these were assembled in a logical order. The Glossary should include terms and definitions that are: Virtual consultation ll likely to be required in communications on In order to refine and finalize the Glossary, Health EDRM technical experts from WHE departments ll specialist in nature, not commonly-under- at HQ and Regional Office levels, other key stood terms, e.g. ‘organization’ HQ departments and subject matter experts ll written in concise and plain language from Member States, UN agencies and amenable to translation into the other offi- nongovernmental organizations, professional cial WHO languages, and associations and academia were invited to ll clear and consistent in distinctions within a participate in a virtual consultation and a face- coherent set of concepts. to-face technical workshop.

Lastly, it should use a rigorous, evidence-based Participants in the virtual consultation were and rational system to achieve these principles. consulted by correspondence, and were asked to provide feedback on: 2.2 STAGES OF DEVELOPMENT ll other factors that should be considered regarding the inclusion and exclusion criteria Draft from existing glossaries for glossaries and terms The first stage in the development of the Glos- ll other terms that should be added sary was to compile a draft. ll terms that should be removed.

A list was composed of relevant existing glos- The terms and key issues that had been raised saries, and the purpose and scope of each were by respondents and during the virtual consul- determined in order to inform their assess- tation process were integrated into a revised ment. Criteria were developed to determine version of the Glossary. which existing glossaries should be considered for inclusion, and the existing glossaries HEALTH EDRM GLOSSARY HEALTH 4

Face-to-face technical workshop 2.4 CRITERIA FOR THE SELECTION Lastly, the revised version of the Glossary was OF TERMS AND DEFINITIONS discussed at a face-to-face technical workshop Definitions are direct quotes from selected of multi-stakeholder experts held in Geneva glossaries, except where minor adjustments in November 2018. Workshop participants were deemed necessary to make certain defi- reviewed the definitions and accompanying nitions succinct and internally consistent. Fur- explanatory notes and made recommendations ther explanation is provided in the explanatory for an agreed final list of terms, definitions and notes that accompany the definitions for some explanatory notes, which were incorporated of the terms. into the final version of the Glossary. Some terms from the selected glossaries were 2.3 CRITERIA FOR THE SELECTION excluded from this Glossary because they: OF EXISTING GLOSSARIES ll did not meet the principles in section 2.1 The Glossary is based on terms and definitions above drawn from existing glossaries, selected ac- ll are generic terms that do not require spe- cording to the following criteria. cialist definitions, e.g. ‘organization’, ‘air- port’ Existing glossaries were included if they: ll are terms that are applied predominantly in ll contain terms likely to be useful in policy, a specialized area rather than in the field of planning, practice and communications on Health EDRM more generally Health EDRM ll were cited in an existing glossary for the ll are internationally-agreed at the highest sole purpose of interpretation of the text, levels and ll are intended for a multi-sectoral audience ll do not fit the scope of the Glossary, e.g. ‘in- and contain multi-sectoral terms and defi- vasive’. nitions ll have an appropriate scope and coverage, Multiple terms and definitions that occurred and as single entries in some glossaries were ll have an internal consistency of terms and disaggregated and cross-referenced in the definitions. Glossary. For example, in the Report of the open-ended intergovernmental expert working Existing glossaries were excluded if they: group on indicators and terminology relating ll are not recent and current to disaster risk reduction (UNGA 2016), the ll are not internationally agreed. entry for ‘affected’ includes ‘directly affected’ and ‘indirectly affected’: these have been listed For example, a number of glossaries developed separately in the Glossary as ‘affected, directly’ at national level by individual WHO Member and ‘affected, indirectly’. States were excluded as they were not internationally agreed. Internationally agreed glos- 2.5 WHAT IS THE DIFFERENCE saries have the additional advantage of being BETWEEN A GLOSSARY, available in the United Nations official languag- DICTIONARY AND es, namely Arabic, Chinese, English, French, THESAURUS? Russian and Spanish. Glossaries, dictionaries and thesauruses have different purposes and scopes. A ‘glossary’ is a list of terms with definitions, relating to a specific HEALTH EDRM GLOSSARY HEALTH 5

subject, text or purpose and arranged in a logical “See …” either refers the reader to a primary sequence, such as alphabetically. A ‘dictionary’ term and definition, or refers the reader to is a list of terms for a given language with another publication if the term and definition is definitions or the equivalent words in a different beyond the scope of this Glossary. language, often also providing information about pronunciation, origin, and usage. A ‘thesaurus’ “See also …” refers the reader to related terms is a list of terms in groups of related concepts. and definitions as a cross reference. This publication contains both a glossary and a thesaurus as defined above. “Synonym(s)” refers the reader to a synonym of or alternative term to the listed term, with an 2.6 GLOSSARY EXPLANATORY explanation if required. NOTES To the extent possible, whilst respecting the 2.7 THESAURUS EXPLANATORY original references, terms have been listed as NOTES singular not plural. Terms and definitions have The thesaurus was a tool used to develop the been quoted from authoritative references Glossary, by grouping like terms within con- with necessary interpolations indicated by […]. cepts and determining: Existing definitions have been used except ll the internal consistency and coherence of where minor adjustments have been made existing glossaries to ensure succinctness of the definition and ll whether the terms and definitions relate internal consistency with other terms; in these only to interpretation of the text, and cases, a note has been provided. New terms ll whether the terms and definitions were of have not been invented. Where a given term has value in the Glossary. more than one definition, these are numbered. It is published here as a reference tool to help The following order of references has been readers find the most appropriate term for their used to prioritise definitions: purpose. ll United Nations, General Assembly. Report of the open-ended intergovernmental ex- The thesaurus groups terms in a series of pert working group on indicators and ter- related concepts to offer the reader an overall minology relating to disaster risk reduction. understanding of the terms in the Glossary. 2016 (UNGA 2016). The thesaurus lists terms in five large groups ll WHO. International Health Regulations of related concepts, under a head term, e.g. 2005, third edition (WHO 2016). “risk”. Within these five large groups, terms are ll other WHO publications where some terms grouped at smaller conceptual levels, under a add value. secondary head term, e.g. “hazard”. ll Intergovernmental Panel on Climate Change (IPCC). Managing the risks of extreme events and disasters to advance climate change adaptation. A special report of working groups I and II of the Intergovernmental Panel on Climate Change (IPCC 2012). ll ISO publications where some terms add value, and ll other internationally-agreed sources. HEALTH EDRM GLOSSARY HEALTH 6 3 GLOSSARY

Acceptable risk and/or mitigation measures to protect the health The extent to which a [disaster] risk is deemed of the public (WHO 2014). acceptable or tolerable depends on existing social, economic, political, cultural, technical and Affected environmental conditions. 1. People who are affected, either directly or indi- Note: In engineering terms, acceptable risk is also rectly, by a hazardous event (UNGA 2016). used to assess and define the structural and non- 2. Persons, baggage, cargo, containers, convey- structural measures that are needed in order to ances, goods, postal parcels or human remains reduce possible harm to people, property, services that are infected or contaminated, or carry sources and systems to a chosen tolerated level, according of infection or contamination, to constitute a pub- to codes or “accepted practice”, which are based lic health risk (WHO 2016). on known probabilities of hazards and other 3. People requiring immediate assistance during factors (UNGA 2016). a period of emergency, i.e. requiring basic survival ww See ‘risk’, ‘tolerable health risk’. needs such as food, water, shelter, sanitation and immediate medical assistance (Centre for Access to health services Research on the Epidemiology of Disasters [CRED] The perceptions and experiences of people as to 2009). their ease in reaching health services or health ww See ‘directly affected’, ‘indirectly affected’. facilities in terms of location, time and ease of approach (WHO 2011). After-action report Document describing the response to an inci- Action plan dent and findings relating to performance of the Often called an ‘incident action plan’, this is a [health system] response during an incident (WHO statement of intent that is specific to an incident or 2015b). event. It details the response strategies, objectives, resources to be applied and tactical actions to be After-action review taken (WHO 2015a). After an activation, operation or exercise has been completed, a process involving a structured Activation level facilitated discussion to review what should have A level of readiness or emergency response happened, what actually happened, and why describing [an emergency operations centre’s] (WHO 2015a). activities in response to predetermined criteria related to the severity of an incident (WHO Alert 2015a). 1. The first notification that a public health event with adverse consequences may occur or may be Acute health emergency/ acute public health event occurring. Any event [or emergency] that represents an Note: The context for this definition is usually immediate threat to human health and requires associated with biological hazards. The term prompt action, i.e. implementation of response ‘warning’ or ‘public warning’, as part of a multi- HEALTH EDRM GLOSSARY HEALTH 7

level alerting system, is often used for other types example using antibiotics for viral infections such of hazards (WHO 2012). as cold or flu, or sharing antibiotics. Low-quality 2. Messages or information communicated to medicines, wrong prescriptions and poor infec- partners, communities and the public to help in- tion prevention and control also encourage the form about, prevent the spread of, or control an development and spread of drug resistance (WHO acute public health event. 2019n). Note: An alert refers to a public health event that has been (i) verified and (ii) risk assessed and (iii) Anthropogenic hazards requires an intervention (an investigation, a re- [Hazards that] are induced entirely or predomi- sponse or a communication) (WHO 2014). nantly by human activities and choices. Synonym: 3. Part of public warning that captures attention ‘human-induced hazards’. of first responders and people at risk in a develop- Note: Anthropogenic hazards include techno- ing emergency situation (ISO 22300:2018). logical, societal and socionatural hazards. In ww See ‘early warning system’, ‘public warning’. the context of the Sendai Framework, this term does not include the occurrence or risk of armed All-hazards approach conflicts and other situations of social instabil- An approach to the management of the entire ity or tension which are subject to international spectrum of emergency risks and events based on humanitarian law and national legislation (UNGA the recognition that there are common elements 2016). [and common capacities required] in the manage- ww See ‘socionatural hazards’, ‘technological ment of these risks, including in the responses to hazards’. virtually all emergencies. ww See Annex 2. WHO Classification of Hazards. Note: The development of common or generic capacities that can be applied to all risks. These Assisting agency generic capacities are complemented by specific An agency or organization providing personnel, measures for the unique characteristics of each services, or other resources to the agency with risk or event. Standardizing a management sys- lead responsibility for incident management tem to address the common elements, greater ca- (WHO 2015a). pacity is generated along with specific measures to address the unique characteristics of each Biological hazards event (WHO 2015a). [Hazards] of organic origin or conveyed by biological vectors, including pathogenic microorgan- Antimicrobial resistance isms, toxins and bioactive substances. The ability of a microorganism (such as bacteria, Note: Examples are bacteria, viruses or para- viruses, and some parasites) to stop an antimicro- sites, as well as venomous wildlife and insects, bial (such as antibiotics, antivirals and antimalar- poisonous plants and mosquitoes carrying dis- ials) from working against it. ease-causing agents (UNGA 2016). Note: Antimicrobial resistance is the broader term ww See Annex 2. WHO Classification of Hazards. for resistance in different types of microorganisms and encompasses resistance to antibacteri- Bioterrorism al, antiviral, antiparasitic and antifungal drugs. As The intentional use of micro-organisms, toxins, a result, standard treatments become ineffective, genetic material or substances derived from liv- infections persist and may spread to others. Anti- ing organisms to produce death or disease in hu- microbial resistance occurs naturally but is facil- mans, animals or plants (WHO 2015b). itated by the inappropriate use of medicines, for HEALTH EDRM GLOSSARY HEALTH 8

Build back better Capacity building The use of the recovery, rehabilitation and recon- ww See ‘capacity development’. struction phases after a disaster to increase the resilience of nations and communities through Capacity, coping integrating disaster risk reduction measures into ww See ‘coping capacity’. the restoration of physical infrastructure and societal systems, and into the revitalization of live- Capacity development lihoods, economies and the environment (UNGA The process by which people, organizations and 2016). society systematically stimulate and develop their capacities over time to achieve social and Business continuity management economic goals, including through improvement An organization-wide discipline and a complete of knowledge, skills, systems and institutions. set of processes that identifies potential impacts Note: Capacity development is a concept that ex- which threaten an organization. It provides a ca- tends the term of capacity-building to encompass pability for an effective response that safeguards all aspects of creating and sustaining capacity the interests of its major stakeholders and repu- growth over time. It involves learning and various tation (ISO 22301:2012). types of training, but also continuous efforts to develop institutions, political awareness, financial Business continuity plan resources, technology systems and the wider en- A document that describes how an organization abling environment (UNGA 2016). will maintain and restore critical operational functions and services to a predetermined acceptable Case level in the event of an occurrence that disrupts its A person identified as having a particular disease, operational capabilities (WHO 2015a). health disorder, or condition under surveillance or investigation. Capability Note: Cases may be further classified as con- Possessing the demonstrable ability to perform a firmed, suspect, or probable (WHO 2015b). particular task (WHO 2015a). Case definition Capacity 1. A set of diagnostic criteria that must be fulfilled Combination of all the strengths, attributes and in order to identify a case of a particular disease. resources available within an organization, com- Note: Case definitions can be based on clinical, munity or society to manage and reduce disaster laboratory, epidemiological, or combined clinical risks and strengthen resilience. and laboratory criteria. When a set of criteria Note: Capacity may include infrastructure, institu- is standardized for purposes of identifying a tions, human knowledge and skills, and collective particular disease, then it is referred to as ‘standard attributes such as social relationships, leadership case definition’. A surveillance case definition is and management (UNGA 2016). one that is standardized and used to obtain an accurate detection of all cases of the targeted Capacity assessment disease or condition in a given population, while The process by which the capacity of a group, excluding the detection of other similar conditions organization or society is reviewed against desired (WH0 2019a). goals, where existing capacities are identified for 2. A standard case definition is an agreed set of maintenance or strengthening, and capacity gaps criteria used to describe if a person has a particular are identified for further action (UNGA 2016). disease or was exposed to a particular pathogen. HEALTH EDRM GLOSSARY HEALTH 9

Note: Case definitions are used to label a case, Chemical incident such as suspected, probable, confirmed. Standard An uncontrolled release of a chemical from its definitions ensure that every case is detected and containment. reported in the same way. Once a case meets Note: Chemical incidents may result in harm to the standard case definition for notification, it is public health and the environment. They usual- labelled as a suspect case. Sometimes a broader ly trigger a public health response, including for syndromic case definition is used to improve the example, assessment of risk and/or provision of likelihood of finding cases of interest, although advice to authorities and the public. Chemical in- other similar diseases might also be detected. cidents may refer to anthropogenic events such During case investigation, clinical criteria, as the explosion at a factory which stores or uses laboratory testing and epidemiological information chemicals, contamination of the food or water are used to confirm the case (WH0 2018c). supply with a chemical, an oil spill, a leak in a storage unit during transportation, an outbreak of dis- Case fatality ratio or rate (CFR) ease that is (likely to be) associated with chemical A measure of the severity of a disease and defined exposure or a deliberate event where chemicals as the proportion of cases of a specified disease are used to harm people (WHO 2009a). or condition which are fatal within a specified time (WH0 2019j). Civil protection Measures taken and systems implemented to Casualty preserve the lives and health of citizens, their Any human accessing health or medical services, properties and their environment from undesired including mental health services and medical events (ISO 22300:2018). forensics/mortuary care (for fatalities), as a result of a hazard impact (WHO 2007). Climate change Note: The term ‘casualties’ may refer to the sum A change in the state of the climate that can be of the dead, missing, ill and injured. identified (for example by using statistical tests) by changes in the mean and/or the variability of Chain of command its properties and that persists for an extended A series of command, control, executive, or man- period, typically decades or longer (IPCC 2012). agement positions in hierarchical order of authority (WHO 2015a). Climate change adaptation ww See ‘incident management system’. In human systems, the process of adjustment to actual or expected climate and its effects, Chemical hazard in order to moderate harm or exploit beneficial Inherent property of a chemical having the poten- opportunities. In natural systems, the process tial to cause adverse effects when an organism, of adjustment to actual climate and its effects; system, or population is exposed to that chemical human intervention may facilitate adjustment to (adapted from IPCS 2004). expected climate (IPCC 2012).

Chemical event Climate change mitigation A manifestation of a disease or an occurrence A human intervention to reduce the sources or that creates a potential for a disease as result of enhance the sinks of greenhouse gases (IPCC exposure to or contamination by a chemical agent 2012). (WHO 2010a). HEALTH EDRM GLOSSARY HEALTH 10

Climatological hazards Communicable disease ww See ‘hydrometeorological hazards’. 1. An illness due to a specific infectious agent or ww See Annex 2. WHO Classification of Hazards. its toxic products that arises through transmission of that agent or its products from an infected Clusters person, animal or reservoir to a susceptible host, Groups of humanitarian organizations, both either directly or indirectly through an intermediate UN and non-UN, in each of the main sectors plan or animal host, vector or the inanimate of humanitarian action (water, health, shelter, environment (WHO 2018a). logistics, etc.). 2. An illness caused by a specific infectious Note: Clusters are designated by the Inter-Agen- agent or its toxic products and transmitted from cy Standing Committee (IASC) and have clear re- an infected person, animal or the environment sponsibilities for coordination (UNHCR 2015). (for example through water, food, fomites) to a ww See ‘health cluster’. susceptible host. Transmission can be direct or indirect (WHO 2019k). Cold debrief ww See also ‘epidemic’, ‘outbreak’, ‘pandemic’, and A debriefing session held after a period of time ‘case’, ‘casualty’, ‘incidence’, ‘prevalence’ and has passed following an exercise or incident, in ‘suspect’. order to discuss, with the benefit of hindsight, any observations and issues that may have been Communication, public overlooked during a hot wash (WHO 2015a). ww See ‘public communication’. Synonym: ‘cold wash’. ww See ‘hot debrief’. Community Specific group of people, often living in a defined Collaboration (intersectoral) geographical area, who share a common culture, The process of joint planning, construction, im- values and norms, are arranged in a social struc- plementation and monitoring by ministries and ture according to relationships which the commu- authorities belonging to different public sectors, nity has developed over a period of time. including sharing of resources in order to enable Note: Members of a community gain their personal each ministry or body to carry out their respon- and social identity by sharing common beliefs, sibilities that were mutually agreed upon (WHO values and norms which have been developed by Health & Environment Lexicon). the community in the past and may be modified in the future. They exhibit some awareness of their Command identity as a group and share common needs and 1. The act of managing, directing, ordering, or a commitment to meeting them (WHO 1998). controlling by virtue of explicit statutory, regulatory, or delegated authority (WHO 2015a). Community surveillance 2. The common short name for ‘incident com- Starting point for event notification at the commu- mand’, involving making decisions, implementing nity level, generally done by a community worker; plans manage an incident, and controlling their it can be active (looking for cases) or passive (re- effects (WHO 2015a). porting cases) (WHO 2010a).

Command and control system Community-based disaster risk management ww See ‘incident management system’. Promotes the involvement of potentially affected communities in disaster risk management at the local level. This includes community assessments HEALTH EDRM GLOSSARY HEALTH 11

of hazards, vulnerabilities and capacities, and their a coherent management response (WHO 2015a). involvement in planning, implementation, monitoring and evaluation of local action for disaster Consequence risk reduction [management] (UNGA 2016). 1. The downstream effects that result from an action or condition that may be negative or positive. Competence Note: A negative public health consequence Ability to apply knowledge and skills to achieve causes or contributes to ill health. Consequences intended results (ISO 22300:2018). may include social, technical and scientific, economic, environmental, ethical, or policy and Complex emergency political effects (WHO 2012). A disaster complicated by civil violence, govern- 2. Outcome of an event affecting objectives (ISO ment instability, macroeconomic collapse, pop- 31000:2018). ulation migration, elusive political solutions, etc., in which any emergency response has to be con- Contact tracing ducted in a difficult political and security environ- The identification and follow-up of persons who ment, potentially involving a multi-sectoral, inter- may have come into contact with an infected national response that goes beyond the mandate person or infectious materials (based on WHO or capacity of any single agency (WHO 2015a). 2019b).

Comprehensive approach (to emergency and disas- Contamination ter risk management) The presence of an infectious or toxic agent of Comprises a range of measures across preven- matter on a human or animal body surface, in or tion and mitigation; preparedness; response; and on a product prepared for consumption or on other recovery (WHO 2015a). inanimate objects, including conveyances, that Synonym: ‘emergency management cycle’. may constitute a public health risk (WHO 2016).

Comprehensive emergency management pro- Context gramme As applied to emergency risk management, con- A corporate or government programme that com- text is described by a number of factors related mits resources to a range of measures to imple- to the setting, circumstances and environment of ment prevention and mitigation; preparedness; risks and events. response; and recovery (also disaster (risk) man- Note: The cultural, social, political, legal, regulato- agement programme). ry, financial, technological, economic, natural and Note: Typically, this programme includes the full competitive environment—whether local, national, range of capacities for managing risks associated regional or international—and those factors relat- with emergencies and disasters (WHO 2015a). ed to the governance, organizational structure, Synonyms: comprehensive emergency and di- roles, accountabilities, policies, objectives, and saster risk management, comprehensive disaster strategies that are in place to achieve those ob- management. jectives. They also include the capabilities of and relationships between the internal and external Concept of operations actors and stakeholders (WHO 2015a). A section or statement in an agency emergency plan that identifies policies, role and responsibili- Contingency planning ties, and how the structural or functional elements A management process that analyses disaster of the organization will work together to produce risks and establishes arrangements in advance HEALTH EDRM GLOSSARY HEALTH 12

to enable timely, effective and appropriate re- Coping capacity sponses. The ability of people, organizations and systems Note: Contingency planning usually refers to plan- using available skills and resources, to manage ning for specific scenarios or events that results in adverse conditions, risk or disasters. organized and coordinated courses of action with Note: The capacity to cope requires continuing clearly identified institutional roles and resources, awareness, resources and good management, information processes and operational arrange- both in normal times as well as during disasters or ments for specific actors at times of need. Based adverse conditions. Coping capacities contribute on scenarios of possible emergency conditions to the reduction of disaster risks (UNGA 2016). or hazardous events, it allows key actors to envi- sion, anticipate and solve problems that can arise Crisis during disasters. Contingency planning is an im- 1. An unstable or crucial time or state of affairs in portant part of overall preparedness. Contingency which a decisive change is impending, especially plans need to be regularly updated and exercised one where a highly undesirable outcome is dis- (UNGA 2016). tinctly possible (WHO 2015b). 2. Unstable condition involving an impending Control abrupt or significant change that requires urgent The application of authority, combined with the attention and action to protect life, assets, property capability to manage resources, in order to achieve or the environment (ISO 22300:2018). defined objectives. Note: Refers to the overall direction of the activities, Critical infrastructure agencies or individuals concerned and operates The physical structures, facilities, networks and horizontally across all agencies/organizations, other assets which provide services that are functions and individuals (WHO 2015a). essential to the social and economic functioning of a community or society (UNGA 2016). Cooperating agency An agency supplying assistance other than direct Critical systems (in hospitals) operational or support functions or resources to Within a hospital, critical systems include the the incident management effort (WHO 2015a). electrical, telecommunications, water supply, fire protection, waste management, fuel storage and Coordination medical gases and heating, ventilation and air 1. Management processes to ensure integration conditioning (HVAC) systems. (unity) of effort. Coordination relates primarily to Note: The failure or disruption of critical systems resources, and operates vertically (within an or- can stop or impede the functioning of the hospi- ganization) as a function of the authority to com- tals (WHO 2015a). mand, and horizontally (across organizations) as a function of the authority to control (WHO 2015a). DA LYs 2. Way in which different organizations (public ww See ‘disability-adjusted life years’. or private) or parts of the same organization work or act together in order to achieve a common Damage (event, emergency, disaster) objective (ISO 22300:2018, ISO 22320:2011). Occurs during and immediately after the [hazardous event or] disaster. Coordination centre Note: This is usually measured in physical units ww See ‘emergency coordination centre’. (e.g. square meters of housing, kilometres of roads, etc.), and describes the total or partial de- HEALTH EDRM GLOSSARY HEALTH 13

struction of physical assets, the disruption of ba- Directly affected sic services and damages to sources of livelihood Those who have suffered injury, illness or other in the affected area (UNGA 2016). health effects; who were evacuated, displaced, relocated or have suffered direct damage to their Damage, disaster livelihoods, economic, physical, social, cultural ww See ‘disaster damage’. and environmental assets (UNGA 2016). ww See ‘affected’. Dead Persons confirmed as dead and persons missing Disability and presumed dead (CRED 2009). A limitation in a functional domain that arises ww See ‘casualty’, ‘mortality’. from the interaction between a person’s intrinsic capacity, and environmental and personal factors Debrief (WHO 2011). A critical examination of a completed operation or Note: Disability – or difficulties in functioning – is exercise in order to evaluate actions (WHO 2015a). neither purely biological or purely social. Disability ww See also ‘cold debrief’, ‘hot debrief’. can occur at three levels: impairments, activity lim- itations, and participation restrictions. An impair- Decontamination ment is a problem in body function or structure; A procedure whereby health measures are taken an activity limitation is a difficulty encountered by to eliminate an infectious or toxic agent or mat- an individual in executing a task or action; while a ter on a human or animal body surface, in or on a participation restriction is a problem experienced product prepared for consumption or on other in- by an individual in involvement in life situations animate objects, including conveyances that may (WHO 2019a). constitute a public health risk (WHO 2010a). ww See ’people with disability’.

Direct economic loss Disability-adjusted life years (DALYs) The monetary value of total or partial destruction Population metric of life years lost to disease due of physical assets existing in the affected area. to both morbidity and mortality (WHO 2016b). Note: [For the purposes of Sendai Framework reporting], direct economic loss is nearly Disaster equivalent to physical damage. Direct economic A serious disruption of the functioning of a com- losses usually happen during the event or within munity or a society at any scale due to hazardous the first few hours after the event and are often events interacting with conditions of exposure, assessed soon after the event to estimate vulnerability and capacity, leading to one or more recovery cost and claim insurance payments. of the following: human, material, economic and These are tangible and relatively easy to measure. environmental losses and impacts. Examples of physical assets that are the basis for Note: The effect of the disaster may be immedi- calculating direct economic loss include homes, ate and localized, but is often widespread and can schools, hospitals, commercial and governmental last for a long period of time. The effect may test buildings, transport, energy, telecommunications or exceed the capacity of a community or society infrastructures and other infrastructure; business to cope using its own resources, and therefore assets and industrial plants; and production such may require assistance from external sources, as crops, livestock and production infrastructure. which could include neighbouring jurisdictions, or They may also encompass environmental assets those at the national or international levels (UNGA and cultural heritage (UNGA 2016). 2016). HEALTH EDRM GLOSSARY HEALTH 14

ww See ‘emergency’, ‘slow-onset disaster’, ‘sud- Disaster risk den-onset disaster’. The potential loss of life, injury, or destroyed or damaged assets which could occur to a system, Disaster impact society or a community in a specific period of time, The total effect, including negative effects (e.g. determined probabilistically as a function of haz- economic losses) and positive effects (e.g. eco- ard, exposure, vulnerability and capacity. nomic gains), of a hazardous event or a disaster. Note: The definition of disaster risk reflects the Note: The term includes economic, human and concept of hazardous events and disasters as the environmental impacts, and may include death, outcome of continuously present conditions of risk. injuries, disease and other negative effects on Disaster risk comprises different types of potential human physical, mental and social well-being losses which are often difficult to quantify. Never- (UNGA 2016). theless, with knowledge of the prevailing hazards Synonyms: ‘event impact’, ‘emergency impact’. and the patterns of population and socioeconomic ww See ‘consequence’, ‘impact’. development, disaster risks can be assessed and mapped, in broad terms at least. It is important to Disaster loss database consider the social and economic contexts in which A set of systematically collected records about disaster risks occur and that people do not neces- [hazardous event or] disaster occurrence, dam- sarily share the same perceptions of risk and their ages, losses and impacts, compliant with the Sen- underlying risk factors (UNGA 2016). This defini- dai Framework for Disaster Risk Reduction 2015- tion can apply to “risk” associated with hazardous 2030 monitoring minimum requirements (UNGA events, emergencies and disasters. 2016). ww See ‘risk’, ‘extensive disaster risk’, ‘intensive disaster risk’, ‘underlying disaster risk drivers’. Disaster management The organization, planning and application of Disaster risk assessment measures preparing for, responding to and recov- A qualitative or quantitative approach to determine ering from disasters. the nature and extent of disaster risk by analysing Note: Disaster management may not completely potential hazards and evaluating existing condi- avert or eliminate the threats; it focuses on cre- tions of exposure and vulnerability [and capacity] ating and implementing preparedness and other that together could harm people, property, ser- plans to decrease the impact of disasters and vices, livelihoods and the environment on which “build back better. Failure to create and apply a they depend. plan could lead to damage to life, assets and lost Note: Disaster risk assessments include: the revenue (UNGA 2016). identification of hazards; a review of the technical ww See ‘emergency management’. characteristics of hazards such as their location, intensity, frequency and probability; the analysis of Disaster response exposure and vulnerability, including the physical, Actions taken directly before, during or immedi- social, health, environmental and economic di- ately after a disaster in order to save lives, reduce mensions; and the evaluation of the effectiveness health impacts, ensure public safety and meet the of prevailing and alternative coping capacities with basic subsistence needs of the people affected respect to likely risk scenarios (UNGA 2016). (UNGA 2016). ww See ’emergency risk assessment’. Synonym: ‘emergency response’. ww See ‘response’. Disaster risk drivers, underlying ww See ‘underlying disaster risk drivers’. HEALTH EDRM GLOSSARY HEALTH 15

Disaster risk governance present. The time frame and responsibilities for The system of institutions, mechanisms, policy implementation and the sources of funding should and legal frameworks and other arrangements be specified in the plan. Linkages to sustainable to guide, coordinate and oversee disaster risk development and climate change adaptation plans reduction and related areas of policy. should be made where possible (UNGA 2016). Note: Good governance needs to be transparent, inclusive, collective and efficient to reduce existing Disaster risk management, community-based disaster risks and avoid creating new ones (UNGA ww See ‘community-based disaster risk manage- 2016). ment’.

Disaster risk information Disaster risk reduction Comprehensive information on all dimensions of [Activities] aimed at preventing new and reducing disaster risk, including hazards, exposure, vulner- existing disaster risk and managing residual risk, ability and capacity, related to persons, communi- all of which contribute to strengthening resilience ties, organizations and countries and their assets. and therefore to the achievement of sustainable Note: Disaster risk information includes all studies, development. information and mapping required to understand Note: Disaster risk reduction is the policy objective the disaster risk drivers and underlying risk factors of disaster risk management, and its goals and (UNGA 2016). objectives are defined in disaster risk reduction strategies and plans (UNGA 2016). Disaster risk management ww See ‘disaster risk reduction strategies and The application of disaster risk reduction policies policies’. and strategies to prevent new disaster risk, reduce existing disaster risk and manage residual risk, Disaster risk reduction strategies and policies contributing to the strengthening of resilience and Strategies and policies [that] define goals and reduction of disaster losses (UNGA 2016). objectives across different timescales and with ww See ‘community-based disaster risk manage- concrete targets, indicators and timeframes. ment’, ‘disaster risk governance’, ‘disaster risk Note: In line with the Sendai Framework for information’, ‘disaster risk management plans’, Disaster Risk Reduction 2015-2030, these should ‘health emergency and disaster risk manage- be aimed at preventing the creation of disaster risk, ment’. the reduction of existing risk and the strengthening of economic, social, health and environmental Disaster risk management plans resilience (UNGA 2016). [Plans that] set out the goals and specific objectives for reducing disaster risks together with re- Disease lated actions to accomplish these objectives. An illness or medical condition, irrespective of or- Note: They should be guided by the Sendai Frame- igin or source, that presents or could present sig- work for Disaster Risk Reduction 2015-2030 [and nificant harm to human (WHO 2010a, WHO 2016). other relevant global, regional and national frameworks.] They should be considered and coordinat- Disease prevention ed within relevant development plans, resource al- Disease prevention covers measures not only to locations and programme activities. National-level prevent the occurrence of disease, such as risk plans need to be specific to each level of admin- factor reduction, but also to arrest its progress and istrative responsibility and adapted to the different reduce its consequences once established (WHO social and geographical circumstances that are 1998). HEALTH EDRM GLOSSARY HEALTH 16

Disinsection 2. A specific procedure in disease surveillance The procedure whereby health measures are tak- to detect any abnormal occurrence or departure en to control or kill the insect vectors of human from the usual or normally observed frequency of diseases present in baggage, cargo, containers, phenomena as early as possible (WHO 2018a). conveyances, goods and postal parcels (WHO ww See ‘multi-hazard early warning systems’. 2010a). Early warning and response (EWAR) Drill The organized mechanism to detect as early as A coordinated, supervised exercise activity, nor- possible any abnormal occurrence or any diver- mally used to test a single specific operation or gence from the usual or normally observed fre- function in a repeated fashion. quency of phenomena. Note: The purpose of a drill is to practise specif- Note: This definition is often used on the context ic skills, operations or functions, as an individual of biological hazards (WHO 2010a). or in a team. The drill practices and perfects one small part of the response plan, and should be as Economic loss realistic as possible, employing any equipment or Total economic impact that consists of direct apparatus necessary to carry out the function be- economic loss and indirect economic loss (UNGA ing drilled (WHO 2009, WHO 2017c). 2016). ww See also ‘economic loss, direct’ and ‘economic Early warning system loss, indirect’. 1. An integrated system of hazard monitoring, forecasting and prediction, disaster risk assess- El Niño-southern oscillation (ENSO) ment, communication and preparedness activities [An] oceanic event identified with a basin-wide systems and processes that enables individuals, warming of the tropical Pacific Ocean east of the communities, governments, businesses and oth- dateline, associated with a fluctuation of a global- ers to take timely action to reduce disaster risks in scale tropical and subtropical surface pressure advance of hazardous events. pattern and coupled with an atmosphere-ocean Note: Effective “end-to-end” and “people-centred” phenomenon, with preferred time scales of 2 to early warning systems may include four interrelat- about 7 years. ed key elements: (1) disaster risk knowledge based Note: An ENSO event has a great impact on the on the systematic collection of data and disaster wind, sea surface temperature, and precipitation risk assessments; (2) detection, monitoring, anal- patterns in the tropical Pacific. ENSO has climatic ysis and forecasting of the hazards and possible effects throughout the Pacific region and in many consequences; (3) dissemination and communi- other parts of the world. The warm phase of ENSO cation, by an official source, of authoritative, timely, is called El Niño and the cold phase is called La accurate and actionable warnings and associated Niña (IPCC 2012). information on likelihood and impact; and (4) preparedness at all levels to respond to the warnings Emergency received. These four interrelated components need A type of event or imminent threat that produces to be coordinated within and across sectors and or has the potential to produce a range of conse- multiple levels for the system to work effectively quences, and which requires coordinated action, and to include a feedback mechanism for contin- usually urgent and often non-routine. uous improvement. Failure in one component or a Note: ‘emergency’, is sometimes used inter- lack of coordination across them could lead to the changeably with the term ‘disaster’ as, for exam- failure of the whole system (UNGA 2016). ple, in the context of biological and technological HEALTH EDRM GLOSSARY HEALTH 17

hazards or health emergencies, which, however, 2016). can also relate to hazardous events that do not 2. Overall approach to preventing emergencies result in the serious disruption of the functioning and managing those that occur. of a community or society. Emergencies have Note: In general, emergency management utilizes effects that may be considered on a continu- a risk-management approach to prevention, pre- um from local emergencies with limited conse- paredness, response and recovery before, during quences to wide area disasters with catastrophic and after potentially destabilizing and/or disrup- consequences. ‘Incidents’ or ‘events’ are often tive events (ISO 22320:2011). referred to as ‘emergencies’, with the terms used ww See ‘disaster management’. interchangeably, but not all incidents or events are emergencies (UNGA 2016). Emergency medical team (EMT) ww See ‘complex emergency’, ‘disaster’, ‘health Groups of health professionals (doctors, nurses, emergency’, ‘humanitarian emergency’, ‘pro- paramedics, etc.) that treat patients affected by tracted emergency’. an emergency or disaster.” Note: They come from government, charities Emergency (risk) management agency or organization (NGOs), militaries and international organizations An organization, often a government agency, spe- such as the International Red Cross/Red Crescent cifically mandated to provide a single point of ac- movement. They work to comply with the classi- countability for the coordination of multi-sectoral fication and minimum standards set by WHO and and interagency emergency activities, including its partners, and come trained and self-sufficient risk assessment, prevention, mitigation, prepared- so as not to burden the national system (WHO ness, response and recovery activities within a 2017a). particular area (WHO 2015a). Synonym: ‘disaster (risk) management organiza- Emergency operations centre (EOC) tion’. The facility from which a jurisdiction or agency coordinates its response to major emergencies/ Emergency coordination centre disasters (WHO 2015b). A type of EOC that has no direct, tactical or operational function, but which serves as a point of con- Emergency response plan trol and coordination for the strategic allocation A document that describes how an agency or or- of resources and management of policy issues. ganization will manage its responses to emergen- (WHO 2015a) cies of various types. Note: It provides a description of the objectives, Emergency management cycle policy and concept of operations for the response ww See ‘comprehensive approach’. to an emergency; and the structure, authorities and responsibilities for a systematic, co-ordinated Emergency management and effective response. In this context, emergency 1. Sometimes [used] interchangeably, with the plans are agency or jurisdiction-specific, and de- term disaster management, particularly in the tail the resources, capacities and capabilities that context of biological and technological hazards the jurisdiction, agency or organization will employ and for health emergencies. in its response (WHO 2017a). Note: While there is a large degree of overlap, an emergency can also relate to hazardous events Engagement, community that do not result in the serious disruption of the ww See ‘community engagement’. functioning of a community or society (UNGA HEALTH EDRM GLOSSARY HEALTH 18

Environmental hazards early warning objective (WHO 2014). 1. [Hazards that] may include chemical, natural and biological hazards. They can be created by en- Epidemic threshold vironmental degradation or physical or chemical The critical number or density of susceptible hosts pollution in the air, water and soil. required for an epidemic to occur. The epidemic Note: Many of the processes and phenomena threshold is used to confirm the emergence of that fall into this category may be termed drivers an epidemic so as to step-up appropriate control of hazard and risk rather than hazards in them- measures (WHO 2019i). selves, such as soil degradation, deforestation, loss of biodiversity, salinization and sea-level rise Epidemiology (UNGA 2016). The study of the distribution and determinants of 2. A chemical or physical agent capable of caus- health-related states or events in populations and ing harm to the ecosystem or natural resources the application of this study to control health prob- (WHO 2009). lems (WHO 2009). ww See Annex 2. WHO Classification of Hazards. Evacuation Environmental health Moving people and assets temporarily to safer 1. Comprises those aspects of human health, in- places before, during or after the occurrence of a cluding quality of life, that are determined by phys- hazardous event in order to protect them. ical, chemical, biological, social, and psychosocial Note: Evacuation plans refer to the arrangements factors in the environment. established in advance to enable the moving of Note: Environmental health also refers to the theory people and assets temporarily to safer places be- and practice of assessing, correcting, controlling, fore, during or after the occurrence of a hazardous and preventing those factors in the environment event. Evacuation plans may include plans for re- that can potentially affect adversely the health of turn of evacuees and options to shelter in place present and future generations (WHO 2009). (UNGA 2016).

Epidemic Event-based surveillance 1. The occurrence in a community or region 1. The organized collection, monitoring, assess- of cases of an illness, specific health-related ment and interpretation of mainly unstructured ad behaviour, or other health-related events clearly in hoc information regarding health events or risks, excess of normal expectancy. which may represent an acute risk to human Note: The community or region and the period health. in which the cases occur are specified precisely. Note: Event-based surveillance is a functional The number of cases indicating the presence of an component of early warning, alert and response. epidemic varies according to the agent, size, and This information can be rumours and other ad type of population exposed, previous experience hoc reports transmitted through formal channels or lack of exposure to the disease, and time and (i.e. established routine reporting systems) and place of occurrence (WHO 1999). informal channels (i.e. the media, health workers 2. The occurrence of a number of cases of a dis- and reports from NGOs), including events related ease that is unusually large or unexpected for a to the occurrence of disease in humans and events given place and time (Connolly M & WHO 2005). related to potential human exposure (WHO 2010a, WHO 2014). Epidemic intelligence ww See ‘surveillance’. The systematic collection, analysis and communication of any information to detect, verify, assess Event and investigate events and health risks with an ww See ‘hazardous event’, ‘public health event’. HEALTH EDRM GLOSSARY HEALTH 19

Exercise Extensive disaster risk 1. A form of practice, training, monitoring or eval- The risk of low-severity, high-frequency hazard- uation of capabilities involving the description or ous events and disasters, mainly but not exclu- simulation of an emergency, to which a described sively associated with highly localized hazards. or simulated response is made (WHO 2017c). Note: Extensive disaster risk is usually high where 2. Process to train for, assess, practise and communities are exposed to, and vulnerable to, improve performance in an organization (ISO recurring localized floods, landslides, storms or 22300:2018). drought. Extensive disaster risk is often exacer- Note: Exercises help determine a valid indication bated by poverty, urbanization and environmental of future system performance under certain con- degradation (UNGA 2016). ditions, and to identify potential system improve- ww See ‘disaster risk’, ‘intensive disaster risk’. ments (WHO 2015b). EWAR Exercise project ww See ‘early warning and response’. A standard approach for building and implementing any exercise consisting of three phases: Field exercise pre-exercise planning, material development and ww See ‘full-scale exercise’. set-up; exercise conduct; and post-exercise reporting and handover phase. Food safety Note: An exercise programme consists of a pro- 1. Assurance that food will not cause harm to gression of increasingly complex exercises de- the consumer when it is prepared and/or eaten signed to increase understanding of, practice, and according to its intended use (FAO & WHO 2016). evaluate different emergency management capa- 2. Handling, storing and preparing food to pre- bilities (WHO 2017c, WHO 2015a). vent infection and help to make sure that our food keeps enough nutrients for us to have a healthy Exposure diet (FAO 2004). 1. The situation of people, infrastructure, housing, production capacities and other tangible assets Food insecurity located in hazard prone areas. A situation that exists when people lack secure ac- Note: Measures of exposure can include the num- cess to sufficient amounts of safe and nutritious ber of people or types of assets in an area. These food for normal growth and development and an can be combined with the specific vulnerability and active and healthy life. capacity of the exposed elements to any particular Note: It may be caused by the unavailability of hazard to estimate the quantitative risks associated food, insufficient purchasing power, inappropriate with that hazard in the area of interest (UNGA 2016). distribution, or inadequate use of food at the 2. Contact of a chemical, physical or biological household level. Food insecurity, poor conditions agent with the outer boundary of an organism (e.g. of health and sanitation, and inappropriate care through inhalation, ingestion or dermal [skin] con- and feeding practices are the major causes of tact) (WHO 2016b). poor nutritional status. Food insecurity may be chronic, seasonal or transitory (FAO 2000). Exposure assessment or analysis ww See ‘risk assessment’. Food security Exposure route A situation that exists when all people, at all times, The pathway or route by which a person is ex- have physical, social and economic access to posed to a hazard (WHO 2016b). sufficient, safe and nutritious food that meets their HEALTH EDRM GLOSSARY HEALTH 20

dietary needs and food preferences for an active cedures, roles and responsibilities before, during, and healthy life (FAO 2000). or after the simulated event (WHO 2017c).

Fragile states Gender-based violence States that lack either the capacity, or the will ww See ‘sexual and gender-based violence.’ (or both), to deliver core state functions for the majority of the people, including the poor. Geological or geophysical hazards Note: The most important functions of the state [Hazards that] originate from internal earth pro- for poverty reduction are territorial control, safety cesses. Examples are earthquakes, volcanic activity and security, capacity to manage public resources, and emissions, and related geophysical processes delivery of basic services, and the ability to protect such as mass movements, landslides, rockslides, and support the ways in which the poorest people surface collapses and debris or mud flows. sustain themselves (WHO 2011). Note: Hydrometeorological factors are important contributors to some of these processes. Tsuna- Full-scale exercise (FSX) mis are difficult to categorize: although they are An exercise that simulates a real event as closely triggered by undersea earthquakes and other geo- as possible and is designed to evaluate the oper- logical events, they essentially become an oceanic ational capability of emergency management sys- process that is manifested as a coastal water-re- tems in a highly stressful environment, simulating lated hazard (UNGA 2016). actual response conditions, including the mobi- ww See Annex 2. WHO Classification of Hazards. lization and movement of emergency personnel, equipment and resources. Global health security Note: The purpose of a full-scale exercise is to test/ The activities required, both proactive and re- evaluate most of the functions of an emergency active, to minimize vulnerability to acute public plan in the most realistic manner possible. Ideal- health events that endanger the collective health ly, the full-scale exercise should test and evaluate of populations living across geographical regions most functions of the emergency management and international boundaries (WHO 2007b). plan or operational plan. Differing from the functional exercise (FX), a full-scale exercise typically Hazard involves multiple agencies and participants physi- 1. A process, phenomenon or human activity cally deployed in a field location (WHO 2017c). that may cause loss of life, injury or other health Synonym: ‘field exercise’. impacts, property damage, social and economic disruption or environmental degradation. Functional exercise (FX) Note: This may include the latent property or the A fully-simulated, interactive exercise that tests inherent capability of an agent or substance which the capability of an organization to respond to a makes it capable of causing adverse effects to simulated event. The exercise tests multiple func- people or the environment under conditions of tions of the organization’s operational plan. exposure (UNGA 2016, WHO 2009). Note: The purpose of an FX is to test or validate 2. Source of potential harm (ISO 22300:2018). the response capability of specific functions or ww See ‘anthropogenic hazard’, ‘biological haz- departments in an organization to a situation in ard’, ‘chemical hazard’, ‘environmental hazard’, a time-pressured, realistic situation. A functional ‘geological or geophysical hazard’, ‘hydromete- exercise focuses on the coordination, integration, orological hazard’, ‘natural hazard’, ‘socionatu- and interaction of an organization’s policies, pro- ral hazard’, ‘technological hazard’, ‘zoonoses’. HEALTH EDRM GLOSSARY HEALTH 21

Hazard assessment or analysis Health emergency ww See ‘risk assessment’. A type of event or imminent threat that produces or has the potential to produce a range of health Hazardous event consequences, and which requires coordinated 1. The manifestation of a hazard in a particular action, usually urgent and often non-routine. place during a particular period of time. Note: A health emergency may pose a substantial Note: Severe hazardous events can lead to a risk of significant morbidity or mortality in a com- disaster as a result of the combination of hazard munity (WHO 2015a). occurrence and other risk factors (UNGA 2016). ww See ‘public health event’, ‘public health emer- ww See ‘public health event’. gency of international concern’, ‘mass casualty incident’. Hazard monitoring function Activities to obtain evidence-based information Health emergency and disaster risk management on hazards in a defined area used to make de- The systematic analysis and management of health cisions about the need for public warning (ISO risks, posed by actual or potential hazardous events, 22300:2018). including emergencies and disasters, through a combination of hazard, exposure and vulnerability Health reduction to prevent and mitigate risks, prepared- A state of complete physical, mental and social ness, response, and recovery (WHO 2017b). well-being, and not merely the absence of disease ww See ‘disaster risk management’. or infirmity (WHO 1948). Health impact assessment Health care facility 1. The estimation of the effects of any specific Hospitals of all sizes and types; specialized med- action (plans, policies or programmes) in any given ical services; primary health care clinics; general environment on the health of a defined population practitioner’s surgery, etc. (WHO 2007). (WHO 2016b). Note: Recommendations are produced for de- Health care-associated infection cisionmakers and stakeholders, with the aim of An infection occurring in a patient during the maximizing the proposal’s positive health effects process of care in a hospital or other health care and minimizing the negative health effects (WHO facility, which was not present or incubating at the 2009). time of admission. Note: Health care-associated infections can also Health outcome appear after discharge. They represent the most A change in the health status of an individual, frequent adverse event associated with patient group or population which is attributable to a care (WHO 2016). planned intervention or series of interventions Synonym: ‘nosocomial infection’. (WHO 1998).

Health cluster Health policy A mechanism for coordinated assessments, joint A general statement of understanding to guide analyses, the development of agreed overall priori- decision making that results from an agreement ties, objectives and a health crisis response strategy, or consensus among relevant partners on the and the monitoring and evaluation of the implemen- issues to be addressed and on the approaches or tation and impact of that strategy (WHO 2009b). strategies to deal with them (WHO 2011). ww See ‘health promotion’, ‘One Health’. HEALTH EDRM GLOSSARY HEALTH 22

Health promotion necessary to protect and promote humanitarian The process of enabling people to increase control principles, avoid competition, minimize incon- over, and to improve their health. sistency, and when appropriate pursue common Note: Health promotion represents a comprehen- goals. Basic strategies range from coexistence to sive social and political process, it not only embrac- cooperation. es actions directed at strengthening the skills and Note: Coordination is a shared responsibility facil- capabilities of individuals, but also action directed itated by liaison and common training. This defi- towards changing social, environmental and eco- nition could be extended to interaction between nomic conditions so as to alleviate their impact on civilian and military actors at national and local public and individual health (WHO 1998). levels for all types of emergencies (OCHA 2019).

Health sector Human-induced hazards Organized public and private health services (in- ww See ‘anthropogenic hazards’. cluding health promotion, disease prevention, diagnostic, treatment and care services), the Hydrometeorological hazards policies and activities of health departments and Hazards of atmospheric, hydrological or oceano- ministries, health related nongovernment organi- graphic origin. zations and community groups, and professional Note: Examples are tropical cyclones (also known associations (WHO 1998). as typhoons and hurricanes), floods (including flash floods), drought, heatwaves and cold spells Health system and coastal storm surges. Hydrometeorological The people, institutions and resources, arranged conditions may also be a factor in other hazards together in accordance with established policies, such as landslides, wildland fires, locust plagues, to improve the health of the population they serve, epidemics and in the transport and dispersal of while responding to people’s legitimate expecta- toxic substances and volcanic eruption material tions and protecting them against the cost of ill- (UNGA 2016). health through a variety of activities whose prima- ww See Annex 2 WHO Classification of Hazards. ry intent is to improve health (WHO 2011). Hygiene Hot debrief The conditions and practices that help maintain A debriefing session held immediately after an health and prevent spread of disease including exercise or incident to identify the strengths and handwashing, menstrual hygiene management weaknesses of plans, policies and procedures. and food hygiene (WHO & UN Water 2019). Note: In a hot debrief, participants and the exercise management team provide immediate feedback Impact or a debriefing event. Individuals share perspec- Evaluated consequence of a particular outcome tives on strengths, weaknesses, and areas for im- (ISO 22300:2018). provement which are incorporated in the exercise ww See ‘consequence’, ‘disaster damage’, ‘disas- report (WHO 2015a, WHO 2017c). ter impact’, ‘disaster loss database’. Synonym: ‘hot wash’. ww See ‘debrief’, ‘cold debrief’. Incidence The number of instances (rate of occurrence) of Humanitarian civil-military coordination illness commencing, or of persons falling ill during Dialogue and interaction between civilian and mil- a given period in a specified population, thus con- itary actors in humanitarian emergencies that is veying information about the risk of contracting a HEALTH EDRM GLOSSARY HEALTH 23

disease (based on WHO 2013). loss includes microeconomic impacts (e.g. reve- ww See ‘prevalence’. nue declines owing to business interruption), me- soeconomic impacts (e.g. revenue declines ow- Incident ing to impacts on natural assets, interruptions to 1. An action, event or phenomenon which may supply chains or temporary unemployment) and cause loss of life or injury, property damage, social macroeconomic impacts (e.g. price increases, in- and economic disruption, and/or environmental creases in government debt, negative impact on degradation (WHO 2015b). stock market prices and decline in GDP). 2. [Event or] situation that can be, or could lead Note: Indirect losses can occur inside or outside to, a disruption, loss, emergency or crisis (ISO of the hazard area and often have a time lag. As a 22300:2018). result, they may be intangible or difficult to measure (UNGA 2016). Incident action plan ww See ‘action plan’. Indirectly affected People who have suffered consequences, other Incident, chemical than or in addition to direct effects, over time, ww See ‘chemical incident’. due to disruption or changes in economy, critical infrastructure, basic services, commerce or work, Incident command system or social, health and psychological consequences ww See ‘incident management system’. (UNGA 2016). ww See ‘affected’. Incident management system System that defines the roles and responsibil- Infection ities of personnel and the operating procedures The entry and development or multiplication of to be used in the management of incidents (ISO an infectious agent in the body of humans and 22300:2018). animals that may constitute a public health risk (WHO 2010a, WHO 2016). Indicator-based surveillance (IBS) 1. The systematic (regular) collection, monitoring, Infection control analysis and interpretation of structured data, i.e. ww See ‘infection prevention & control’. of indicators produced by a number of well-identified, mostly health-based, formal sources (WHO Infection prevention & control 2014). 1. A practical and proven set of organizational 2. The routine reporting of cases of disease, in- and technical approaches and measures to cluding notifiable diseases surveillance systems, prevent the spread of avoidable infections and sentinel surveillance, laboratory-based surveil- antimicrobial resistance within both community lance, etc. and health care settings (WHO 2019c). Note: This routine reporting is commonly health- 2. The practical discipline concerned with pre- care facility based, with reporting done on a week- venting health care-associated infection. ly or monthly basis (WHO 2010a). Note: The purpose of infection prevention and control in health care is as follows: to prevent the Indirect economic loss occurrence of health care-associated infections A decline in economic value added as a conse- in patients, health care workers, visitors and other quence of direct economic loss and/or human persons associated with health care settings; to and environmental impacts. Indirect economic prepare health care facilities for the early detection HEALTH EDRM GLOSSARY HEALTH 24

and management of epidemics and to organize a high levels of vulnerability to these hazards (UNGA prompt and effective response; to contribute to a 2016). coordinated response to control community-ac- quired infectious diseases, endemic or epidemic, Interested party that may be “amplified” via health care; to contrib- Person or organization that can affect, be affected ute to preventing the emergence of antimicrobi- by, or perceive itself to be affected by a decision or al resistance and/or dissemination of resistant activity (ISO 22300:2018). strains of microorganisms; and to minimize the Synonym: ‘stakeholder’. environmental impact of these infections or their management (WHO 2014c). International Health Regulations (IHR) (2005) [Regulations] designed to prevent the internation- Injury al spread of disease adopted by the Fifty-eighth The physical or physiological bodily harm World Health Assembly on 23 May 2005 and resulting from interaction of the body with energy which entered into force on 15 June 2007. The (mechanical, thermal, electrical, chemical or purpose and scope of the IHR (2005) are to pre- radiant, or due to extreme pressure) in an amount, vent, protect against, control and provide a pub- or at a rate of transfer, that exceeds physical or lic health response to the international spread of physiological tolerance. disease in ways that are commensurate with and Note: Injury can also result from lack of vital restricted to public health risks and which avoid elements, such as oxygen. Poisoning by and toxic unnecessary interference with international traffic effects of substances are included, as is damage and trade (WHO 2016). of or due to implanted devices. Maltreatment syndromes are included even if physical or Internally displaced persons (IDPs) physiological bodily harm has not been reported. Persons or groups of persons who have been Injury usually has rapid onset in response to a well- forced or obliged to flee or to leave their homes defined event (e.g. a car crash, striking the ground or places of habitual residence, in particular as a after falling, drinking a strongly alkaline liquid, result of, or in order to, avoid the effects of armed an overdose of a medication, a burn sustained conflicts, situations of generalized violence, viola- during a surgical procedure). These events are tions of human rights or natural or human-made often referred to as external causes of injury. The disasters, and who have not crossed an interna- injurious energy can, however, originate from the tionally recognized State border (UNHCR 2011). injured person and/or from his or her immediate environment (e.g. a person running on a hot day Interoperability sustains heat exhaustion), and injury can be Ability of diverse systems and organizations to caused by the injured person (i.e. intentional self- work together (ISO 22300:2018). harm) (WHO 2018b). Intersectoral collaboration Intensive disaster risk ww See ‘collaboration, intersectoral’. The risk of high-severity, mid- to low-frequency disasters, mainly associated with major hazards. Isolation Note: Intensive disaster risk is mainly a charac- Separation of ill or contaminated persons or af- teristic of large cities or densely populated areas fected baggage, containers, conveyances, goods that are not only exposed to intense hazards such or postal parcels from others in such a manner as as strong earthquakes, active volcanoes, heavy to prevent the spread of infection or contamina- floods, tsunamis or major storms but also have tion (WHO 2010a, WHO 2016). HEALTH EDRM GLOSSARY HEALTH 25

Jurisdiction Malnutrition An organization (level of government or designated Deficiencies, excesses or imbalances in a person’s agency) with the authority and responsibility to intake of energy and/or nutrients (WHO 2008). provide particular functions and services within a ww See ‘nutrition’. defined area (WHO 2015a). Mass casualty incident Lead agency An event which generates more patients at one Agency or sector responsible for managing specif- time than locally available resources can manage ic types of emergencies (WHO 2015a). using routine procedures. Note: It requires exceptional emergency arrange- Leadership ments and additional or extraordinary assistance The process of engaging others and fostering (WHO 2007). constructive processes for working together, and sustaining collaborative interaction to guide activ- Mass casualty management system ities and achieve objectives (WHO 2015a). A coherent and interrelated set of established procedures, policies, and plans that contribute to Lessons learned the shared objectives of optimizing the baseline Identified issues for which remedial actions may capacity to deal with patient populations expected be implemented, in order to improve performance in a mass casualty incident, and efficiently (WHO 2015a). increasing this capacity during the response to a mass casualty incident (WHO 2007). Level of event A structured process, internal to an organization, Mass gathering that evaluates the extent, complexity and probable An organized or unplanned event can be classified duration of an incident with reference to the as a mass gathering if the number of people response resources that will be required (WHO attending is sufficient to strain the planning and 2017a). response resources of the community, State or nation hosting the event. Level of risk Note: A gathering of persons usually defined as Magnitude of a risk or combination of risks, ex- more than a specified number of persons (which pressed in terms the combination of consequenc- may be as few as 1,000 persons although much es and their likelihood (ISO 31000:2009). of the available literature describes gatherings exceeding 25,000 persons) at a specific location Likelihood for a specific purpose (a social function, large Chance of something happening (ISO 31000:2018). public event or sports competition) for a defined ww See ‘probability.’ period of time (WHO 2015b).

Logistics Mental health and psychosocial support The aspect of emergency (risk) management that Any type of local or outside support that aims to deals with the procurement, distribution, mainte- protect or promote psychosocial wellbeing and/or nance, replacement and repatriation of material prevent or treat mental disorder. and human resources, including the provision of Note: Traditionally, mental health care has been support infrastructure and services to response used by health professionals to describe special- staff (WHO 2015a). ized interventions to treat individuals diagnosed HEALTH EDRM GLOSSARY HEALTH 26

with mental health conditions. Psychosocial sup- (monitoring the implementation of the plan of port and psychosocial interventions are terms action) and of the overall performance of surveil- used by a broader range of workers in the emer- lance and response systems (WHO 2014). gency response field to refer to activities that support both the psychological and social health of in- Morbidity dividuals and communities as a whole rather than The relative incidence of a particular disease. In focusing specifically on treating mental health common clinical usage, any disease state, includ- conditions (IASC 2007). ing diagnosis and complications, is referred to as morbidity (WHO 2009). Missing person 1. A person whose whereabouts are unknown to Morbidity rate his/her relatives and/or who, on the basis of re- The rate of disease or proportion of diseased peo- liable information, has been reported missing in ple in a population (WHO 2009). accordance with the national legislation in con- nection with an international or non-international Mortality armed conflict, a situation of internal violence or The number of deaths occurring in a given period disturbances, natural catastrophes or any other in a specified population. situation that may require the intervention of a Note: Mortality can be expressed as an absolute competent State authority (ICRC 2009). number of deaths per year or as a rate per 100,000 2. Persons whose status during or after an emer- persons per year (WHO & IARC 2016). gency is not known (CRED 2009). Synonym: `missing`. Mortality ratio ww See ‘casualty’. The ratio of deaths in an area to the population of that area, within a particular period of time. Mitigation Note: The death rate in a population or locality The lessening or limitation of the adverse impacts (WHO 2009). of hazards and related disasters. Note: The adverse impacts of hazards, in partic- Multi-agency coordination centre ular natural hazards, often cannot be prevented A form of large-scale, high-level multiagency and fully, but their scale or severity can be substan- multi-jurisdictional coordination among affected tially lessened by various strategies and actions. agencies that is removed from routine event man- Mitigation measures include engineering tech- agement activities. niques and hazard-resistant construction as well Note: This is the highest level of strategic coordi- as improved environmental and social policies nation and involves the executive and policy levels and public awareness. It should be noted that, in of the participating agencies as well as political climate change policy, “mitigation” is defined dif- representatives from affected and participating ferently, and is the term used for the reduction of jurisdictions (WHO 2015a). greenhouse gas emissions that are the source of climate change (UNGA 2016). Multi-hazard The selection of multiple major hazards that the Monitoring country faces, and the specific contexts where haz- In the context of surveillance and response refers ardous events may occur simultaneously, cascad- to the routine and continuous tracking of the im- ingly or cumulatively over time, and taking into ac- plementation of planned surveillance activities count the potential interrelated effects (UNGA 2016). HEALTH EDRM GLOSSARY HEALTH 27

Multi-hazard early warning systems National platform for disaster risk reduction Systems [that] address several hazards and/or A generic term for national mechanisms for coor- impacts of similar or different type in contexts dination and policy guidance on disaster risk re- where hazardous events may occur alone, simul- duction that are multisectoral and interdisciplinary taneously, cascadingly or cumulatively over time, in nature, with public, private and civil society par- and taking into account the potential interrelated ticipation involving all concerned entities within a effects. country. Note: A multi-hazard early warning system with Note: Effective government coordination forums the ability to warn of one or more hazards increas- are composed of relevant stakeholders at nation- es the efficiency and consistency of warnings al and local levels and have a designated national through coordinated and compatible mechanisms focal point. For such mechanisms to have a strong and capacities, involving multiple disciplines for foundation in national institutional frameworks, updated and accurate hazards identification and further key elements and responsibilities should monitoring for multiple hazards (UNGA 2016). be established through laws, regulations, standards and procedures, including: clearly assigned Mutual aid agreement responsibilities and authority; building awareness Pre-arranged understanding between two or more and knowledge of disaster risk through the shar- entities to render assistance to each other (ISO ing and dissemination of non-sensitive disaster 22300:2018). risk information and data; contributing to and coordinating reports on local and national disaster Natech risk; coordinating public awareness campaigns A chemical accident, including spills of oil and oil on disaster risk; facilitating and supporting local products, triggered by a natural hazard or natural multisectoral cooperation (e.g. among local gov- disaster (such as extreme temperatures, high ernments); and contributing to the determination winds, floods, storms, earthquakes, or wildfires) of and reporting on national and local disaster risk (OECD 2015). management plans and all policies relevant for disaster risk management (UNGA 2016). National disaster management agency (or authority) The national government agency that is responsi- Natural hazards ble for coordinating disaster or emergency man- [Hazards that are] predominantly associated with agement policy and practice. natural processes and phenomena (UNGA 2016). Note: There is no common definition for this agency or organization as the name and scope of Notifiable disease functions varies across countries and is usually A disease that, by statutory/legal requirements, defined by national legislation or policies. must be reported to a public health or other com- Synonyms: ‘national disaster management or- petent authority in the pertinent jurisdiction when ganization’, ‘national emergency management the diagnosis is made (WHO 2018a). agency’. Notification National IHR Focal Point 1. The processes by which cases or outbreaks The national centre, designated by each State Par- are brought to the knowledge of health authorities ty, which shall be accessible at all times for com- (WHO 2018a). munications with WHO IHR Contact Points under Note: A notifiable disease is a disease that requires these Regulations [IHR] (WHO 2016). notification, i.e. it must be reported to a public HEALTH EDRM GLOSSARY HEALTH 28

health authority when a diagnosis is made. Note: Typically defined as two or more people with 2. Part of public warning that provides essential the same health condition, at the same time and in information to people at risk regarding the the same place (WHO 2015b). decisions and actions necessary to cope with an emergency situation (ISO 22300:2018). Pandemic 1. Worldwide spread of a new disease (WHO Nuclear emergency 2010b). An emergency in which there is, or is perceived 2. A worldwide outbreak of a disease in humans to be, a hazard due to the energy resulting from in numbers clearly in excess of normal (WHO a nuclear chain reaction or from the decay of the 2015b). products of a chain reaction (IAEA 2019). ww See ‘radiation emergency’ and ‘radiological Pathogens emergency’. Disease-causing organisms (e.g. bacteria, hel- minths, protozoa or viruses) (WHO 2016b). Nutrition The intake of food, considered in relation to the People at risk body’s dietary needs (WHO 2019d, WHO 2019e). Individuals who may be affected by an incident [or ww See ‘malnutrition’, ‘undernutrition’. a hazardous event] (ISO 22300:2018).

One Health People-centred care 1. An approach to address a health threat at the Care that is focused and organized around the human-animal-environment interface based on health needs and expectations of people and collaboration, communication, and coordination communities rather than on diseases. across all relevant sectors and disciplines, with Note: People-centred care extends the concept of the ultimate goal of achieving optimal health out- patient-centred to individuals, families, commu- comes for both people and animals; a One Health nities and society. Whereas patient-centred care approach is applicable at the subnational, nation- is commonly understood as focusing on the indi- al, regional, and global level (WHO, FAO and World vidual seeking care (the patient), people-centred Organisation for Animal Health [OIE] 2019). care encompasses these clinical encounters and 2. An approach to designing and implementing also includes attention to the health of people in programmes, policies, legislation and research in their communities and their crucial role in shaping which multiple sectors communicate and work health policy and health services (WHO 2011). together to achieve better public health outcomes (WHO 2018a). Personal protective equipment (PPE) 3. Human health and animal health are interde- 1. Protective clothing (gowns, gloves, boots pendent and bound to the health of the ecosys- etc.) and equipment (masks, shields, respirators, tems in which they exist (OIE 2019). earplugs etc.) necessary to shield or isolate a person from biological, chemical, physical, sonic Operational readiness and thermal exposure (WHO 2015a). ww See ‘readiness’. 2. Specialized clothing and equipment designed to create a barrier against health and safety haz- Outbreak ards. Often used synonymously with “epidemic”, usual- Note: Examples include safety goggles, blast shields, ly to indicate localised as opposed to generalised hard hats, hearing protectors, gloves, respirators, epidemics. aprons, and work boots (WHO 2009, WHO 2010a). HEALTH EDRM GLOSSARY HEALTH 29

People with disability and associated training and field exercises. These Those who have long-term physical, mental, intel- must be supported by formal institutional, legal lectual or sensory impairments which, in interac- and budgetary capacities. The related term “readi- tion with various barriers, may hinder their full and ness” describes the ability to quickly and appropri- effective participation in society on an equal basis ately respond when required (UNGA 2016). with others (UN 2006). ww See ‘disability’. Preparedness plan (emergency) [A plan that] establishes arrangements in advance Plans to enable timely, effective and appropriate Generic reference to documents designed to iden- responses to specific potential hazardous events tify, at various levels, responsibility for a range of or emerging disaster situations that might threaten activities and intended objectives, strategies and society or the environment (UNGA 2016). tactics (WHO 2015a). ww See ‘contingency planning’, ‘action plan’. Prevalence The number of cases in a defined population at a Planning, contingency specific point in time (WHO 2009). ww See ‘contingency planning’. ww See ‘incidence’.

Point of entry Prevention A passage for [international] entry or exit of trav- Activities and measures to avoid existing and new ellers, baggage, cargo, containers, conveyances, disaster risks. goods and postal parcels as well as agencies and Note: Prevention (i.e. disaster prevention) express- areas providing services to them on entry or exit es the concept and intention to completely avoid (WHO 2016). potential adverse impacts of hazardous events. While certain disaster risks cannot be eliminated, PPE prevention aims at reducing vulnerability and ex- ww See ‘personal protective equipment’. posure in such contexts where, as a result, the risk of disaster is removed. Examples include dams Preparedness (emergency) or embankments that eliminate flood risks, land- The knowledge and capacities developed by gov- use regulations that do not permit any settlement ernments, response and recovery organizations, in high-risk zones, seismic engineering designs communities and individuals to effectively antici- that ensure the survival and function of a critical pate, respond to and recover from the impacts of building in any likely earthquake and immunization likely, imminent or current disasters. against vaccine-preventable diseases. Prevention Note: Preparedness action is carried out within the measures can also be taken during or after a haz- context of disaster risk management and aims to ardous event or disaster to prevent secondary build the capacities needed to efficiently man- hazards or their consequences, such as measures age all types of emergencies and achieve orderly to prevent the contamination of water (UNGA transitions from response to sustained recovery. 2016). In public health, primary prevention aims Preparedness is based on a sound analysis of di- to prevent disease or injury before it occurs by pre- saster risks and good linkages with early warning venting exposures to hazards that cause disease systems, and includes such activities as contin- or injury, altering unhealthy or unsafe behaviours gency planning, the stockpiling of equipment and that can lead to disease or injury, and increasing supplies, the development of arrangements for resistance to disease or injury should exposure coordination, evacuation and public information, occur. Secondary prevention aims to reduce the HEALTH EDRM GLOSSARY HEALTH 30

impact of a disease or injury that has already oc- to reduce exposure and vulnerability to hazard. curred by detecting and treating disease or injury Note: Community engagement is critical in order as soon as possible to halt or slow its progress, to raise public awareness, work for social mobili- encouraging personal strategies to prevent re-in- zation, health promotion and risk communication jury or recurrence, and implementing programmes (WHO 2015a). to return people to their original health and function to prevent long-term problems. Tertiary pre- Public communication vention aims to soften the impact of an ongoing The discipline and process of providing public au- illness or injury that has lasting effects by helping diences with information that creates awareness people manage long-term, often-complex health and knowledge so that people can adjust their per- problems and injuries (e.g. chronic diseases, personal understanding of risks, and their reactions, manent impairments) in order to improve as much decisions and responses to threats and crisis sit- as possible their ability to function, their quality of uations (WHO 2015a). life and their life expectancy. ww See ‘public awareness’, ‘risk communication’.

Primary health care Public health Essential health care based on practical, scientifi- The science and art of promoting health, prevent- cally sound, and socially acceptable methods and ing disease, and prolonging life through the orga- technology made universally accessible to individ- nized efforts of society (WHO 1998). uals and families in the community through their full participation and at a cost that the community Public health emergency and country can afford to maintain at every stage ww See ‘health emergency’. of their development in the spirit of self-reliance and self-determination (WHO 2011). Public health emergency of international concern (PHEIC) Probability An extraordinary event which is determined, as Measure of the chance of occurrence expressed provided in the International Health Regulations, as a number between 0 and 1 where 0 is impossi- (i) to constitute a public health risk to other States bility and 1 is absolute certainty (ISO 22300:2018). through the international spread of disease and ww See ‘likelihood’. (ii) to potentially require a coordinated response (WHO 2016). Protracted emergency An environment in which a significant proportion Public health emergency operations centre of the population is acutely vulnerable to death, An emergency operations centre specializing in disease and disruption of livelihoods over a pro- the command, control and coordination require- longed period of time. ments of responding to emergencies involving Note: Governance in these settings is often weak, health consequences and threats to public health with limited State capacity to respond to, and (WHO 2015a). mitigate, the threats to the population, or provide adequate levels of protection (WHO 2017a). Public health event 1. Any event that may have negative conse- Public awareness quences for human health. The extent of common knowledge about disaster Note: The term includes events that have not yet risks, the factors that lead to disasters and the ac- lead to disease and/or injury in humans but have tions that can be taken individually and collectively the potential to cause disease and injury through HEALTH EDRM GLOSSARY HEALTH 31

exposure of humans to hazards or as a result of Quarantine direct or indirect consequences of other hazard- The restriction of activities and/or separation ous events (WHO 2017a). from others of suspect persons who are not ill; or 2. A manifestation of disease or an occurrence of suspect baggage, containers, conveyances or that creates a potential for disease (WHO 2016). goods in such a manner as to prevent the possible ww See ‘hazardous event’. spread of infection or contamination (WHO 2010a, WHO 2016). Public health hazard ww See ‘hazard’. Radiation emergency The term ‘radiation emergency’ is used in some Public health measure cases when an explicit distinction between nuclear A procedure applied to prevent the spread of dis- and radiological emergencies is not required (e.g. ease or contamination. national radiation emergency plan) (IAEA 2019). Note: Often refers to non-medical or non-pharma- ww See ‘nuclear emergency’ and ‘radiological ceutical actions to reduce the spread of disease. emergency’. Examples include closing schools, limiting public gatherings, issuing travel restrictions and screen- Radiological emergency ing travellers (WHO 2010a). An emergency in which there is, or is perceived to be, a hazard due to radiation exposure [not involv- Public health risk ing a nuclear chain reaction] (IAEA 2019). A likelihood of an event that may affect adversely ww See ‘nuclear emergency’ and ‘radiation emer- the health of human populations. gency’. Note: [In the context of the International Health Regulations], there is an emphasis on an event Rapid response team which may spread internationally or may present 1. A group of trained individuals that is ready to a serious and direct danger (WHO 2010a, WHO responds quickly to an event (WHO 2018a). 2016). Note: Multidisciplinary teams of experts that can be deployed on short notice by a health authority Public health surveillance to locations of public health events to augment The ongoing systematic collection, analysis, and surveillance, risk assessment and response interpretation of data relating to public health activities already being implemented, to control (WHO 2009). disease outbreaks and strengthen international public health security. Public warning 2. A group of trained individuals that is ready to Notification and alert messages disseminated as respond quickly to an event. The composition and an incident response measure to enable respond- terms of reference are determined by the country ers and people at risk to take safety measures (ISO concerned (WHO 2010a). 22300:2018). Readiness Public warning system The ability to quickly and appropriately respond Set of protocols, processes and technologies when required (UNGA 2016). based on the public warning policy to deliver Synonym: ‘operational readiness’. notification and alert messages in a developing ww See ‘preparedness’. emergency situation to people at risk and to first responders (ISO 22300:2018). HEALTH EDRM GLOSSARY HEALTH 32

Reconstruction Resilience The medium and long-term rebuilding and sus- The ability of a system, community or society ex- tainable restoration of resilient critical infrastruc- posed to hazards to resist, absorb, accommodate, tures, services, housing, facilities, and livelihoods adapt to, transform and recover from the effects of required for the full functioning of a community a hazard in a timely and efficient manner, includ- or a society affected by a disaster, aligning with ing through the preservation and restoration of its the principles of sustainable development and essential basic structures and functions through building and ‘build back better’, to avoid or reduce risk management (UNGA 2016). future disaster risk (UNGA 2016). Response Recovery 1. The provision of emergency services and pub- The restoring or improving of livelihoods and lic assistance during or immediately after a disas- health, as well as economic, physical, social, ter in order to save lives, reduce health impacts, cultural and environmental assets, systems and ensure public safety and meet the basic subsis- activities, of a disaster-affected community or tence needs of the people affected. society, aligning with the principles of sustainable Note: Disaster response is predominantly focused development and ‘build back better’, to avoid or on immediate and short-term needs and is some- reduce future disaster risk (UNGA 2016). times called disaster relief. Effective, efficient and timely response relies on disaster risk-informed Refugee preparedness measures, including the develop- A person who cannot return to his/her country of ment of the response capacities of individuals, origin owing to a well-founded fear of persecution communities, organizations, countries and the in- or serious and indiscriminate threats to life, phys- ternational community. The institutional elements ical integrity or freedom (UNHCR 2011). of response often include the provision of emergency services and public assistance by public and Rehabilitation private sectors and community sectors, as well as 1. The restoration of basic services and facilities community and volunteer participation. “Emergen- for the functioning of a community or a society cy services” are a critical set of specialized agencies affected by a disaster (UNGA 2016). that have specific responsibilities in serving and 2. The restoration of normal functioning of peo- protecting people and property in emergency and ple and communities (WHO 2009). disaster situations. They include civil protection authorities and police and fire services, among many Residual risk others. The division between the response stage The disaster risk that remains even when effective and the subsequent recovery stage is not clear- disaster risk reduction measures are in place, and cut. Some response actions, such as the supply of for which emergency response and recovery ca- temporary housing and water supplies, may extend pacities must be maintained. well into the recovery stage (UNGA 2016). Note: The presence of residual risk implies a con- 2. Any public health action triggered by the detec- tinuing need to develop and support effective cation of a public health risk (e.g. monitoring of the pacities for emergency services, preparedness, event, information of the public, triggering field in- response and recovery, together with socioeco- vestigation and/or implementation of any control nomic policies such as safety nets and risk trans- or mitigation measures). fer mechanisms, as part of a holistic approach Note: The nature of the response will have to be (UNGA 2016). adapted according to the nature of the public health risk (WHO 2014). HEALTH EDRM GLOSSARY HEALTH 33

Response plan technical characteristics of hazards, analysis of Documented collection of procedures and infor- exposures and vulnerability and evaluation of the mation that is developed, compiled and main- effectiveness or prevailing coping capacities in tained in readiness for use in an incident (ISO respect of likely risk scenarios (WHO 2015b). 22300:2018). 2. The identification of environmental health haz- ww See ‘contingency plan’, ‘preparedness plan ards, their adverse effects, target populations and (emergency)’. conditions of exposure. A combination of hazard identification, dose–response assessment, expo- Retrofitting sure assessment and risk characterization (WHO Reinforcement or upgrading of existing struc- 2009). tures to become more resistant and resilient to 3. A three-part process of: identifying, recogniz- the damaging effects of hazards. ing and describing risks; analysing identified risks Note: Retrofitting requires consideration of the to understand the nature, sources and causes to design and function of the structure, the stresses estimate the level of risk; and evaluating each level that the structure may be subject to from partic- of risk to determine whether or not it is tolerable or ular hazards or hazard scenarios and the practi- acceptable (ISO 31000:2009). cality and costs of different retrofitting options. ww See ‘disaster risk assessment’. Examples of retrofitting include adding bracing to stiffen walls, reinforcing pillars, adding steel ties Risk communication between walls and roofs, installing shutters on 1. The interactive exchange of information and windows and improving the protection of import- opinions concerning hazards, risks and risk-relat- ant facilities and equipment (UNGA 2016). ed factors (WHO 2015b). 2. Range of communication capacities required Risk through the prevention, preparedness, response 1. The potential loss of life, injury, or destroyed or and recovery phases of a serious public health damaged assets which could occur to a system, event to encourage informed decision making, society or a community in a specific period of positive behaviour change and the maintenance time, determined probabilistically as a function of trust (WHO 2018a). of hazard, exposure, vulnerability and capacity 3. The process of sharing information and per- (UNGA 2016). ceptions about risk. 2. The effect of uncertainty on objectives (ISO Note: Risk communication should be a two-way 31000:2018, ISO 22300:2018). interaction in which experts and non-experts exchange and negotiate perceptions relating Risk analysis to both scientific and community values and The process to comprehend the nature of risk and preferences (WHO 2009). to determine the level of risk (ISO 22300:2018). ww See ‘risk assessment’, ‘risk criteria’, ‘risk evalu- Risk criteria ation’, ‘risk identification’, ‘risk register’. Terms of reference against which the significance of a risk is evaluated (ISO 22300:2018). Risk assessment 1. The process of determining risks to be priori- Risk evaluation tized for risk management, by the combination of Process of comparing the results of risk analysis risk identification, risk analysis, and evaluation of with risk criteria to determine whether the risk the level of risk against predetermined standards, and/or its magnitude is acceptable or tolerable targets, risks or other criteria. (ISO 22300:2018). Note: Risk assessments include a review of the HEALTH EDRM GLOSSARY HEALTH 34

Risk factor wherein governments, insurers, multilateral banks Any attribute, characteristic or exposure of an in- and other large risk-bearing entities establish dividual that increases the likelihood of developing mechanisms to help cope with losses in major a disease or injury. events. Such mechanisms include insurance Note: Risk factors can include any element of be- and reinsurance contracts, catastrophe bonds, haviour or lifestyle, environmental exposure, or contingent credit facilities and reserve funds, genetic characteristic that is associated with par- where the costs are covered by premiums, investor ticular outcome (WHO 2019f). contributions, interest rates and past savings, respectively (UNGA 2016). Risk identification Process of finding, recognizing and describing Risk treatment risks (ISO 22300:2018). Process to modify risk (ISO 22300:2018).

Risk management, disaster Risk, acceptable ww See ‘disaster risk management’. ww See ‘acceptable risk’.

Risk management Risk, level of Coordinated activities to direct and control an or- ww See ‘level of risk’. ganization with regard to risk (ISO 31000:2018). Risk, residual Risk ratio ww See ‘residual risk’. The ratio of the incidence of a disease among exposed people to the incidence of the disease Safe hospital among unexposed people (WHO 2009). A facility whose services remain accessible and functioning at maximum capacity, and with the Risk register same infrastructure before, during and immedi- Record of information about identified risks (ISO ately after the impact of emergencies and disas- 22300:2018). ters (WHO 2015a).

Risk transfer Sanitation The process of formally or informally shifting The provision of facilities and services for the safe the financial consequences of particular risks management of human excreta from the toilet to from one party to another, whereby a household, containment and storage and treatment onsite or community, enterprise or State authority will obtain conveyance, treatment and eventual safe end use resources from the other party after a disaster or disposal (WHO 2019g). occurs, in exchange for ongoing or compensatory social or financial benefits provided to that other Scenario party. 1. An account or synopsis of a possible course of Note: Insurance is a well-known form of risk events that could occur, which forms the basis for transfer, where coverage of a risk is obtained from planning assumptions (for example, a river floods, an insurer in exchange for ongoing premiums paid covering a nearby town and wiping out the local to the insurer. Risk transfer can occur informally population’s crop). within family and community networks where Note: Scenario-building is process of developing there are reciprocal expectations of mutual aid hypothetical scenarios in the context of a contin- by means of gifts or credit, as well as formally, gency planning exercise (IASC 2011). HEALTH EDRM GLOSSARY HEALTH 35

2. Pre-planned storyline that drives an exercise, Slow-onset disaster as well as the stimuli used to achieve exercise [A disaster] that emerges gradually over time. project performance objectives. Note: Slow-onset disasters could be associated Note: The scenario is designed to stimulate ex- with, for example, drought, desertification, sea ercise participants to respond to events (WHO -level rise, epidemic disease (UNGA 2016). 2017c, ISO 22300:2018). Socionatural hazards Self-reliance ww [Hazards that] are associated with a combi- The social and economic ability of an individual, nation of natural and anthropogenic factors, a household or a community to meet their own including environmental degradation and cli- essential needs (including food, water, shelter, mate change (UNGA 2016). personal safety, health and education) in a sustainable manner and with dignity (UNHCR Stakeholder 2011). ww See ‘interested party’.

Sexual and gender-based violence (SGBV) Standard precautions Any act of violence that results in, or is likely to The basic level of infection control precautions result in, physical, sexual or psychological harm which are to be used, as a minimum, in the care or suffering to persons on the basis of their sex or of all patients. gender, including threats of such acts, coercion or Note: Standard precautions are meant to reduce arbitrary deprivation of liberty, whether occurring the risk of transmission of bloodborne and oth- in public or in private life (UNHCR 2011). er pathogens from both recognized and unrec- ww See ‘violence’. ognized sources. They include: hand hygiene, personal protective equipment, and respiratory Shelter in place hygiene and cough etiquette, waste disposal and Remain or take immediate refuge in a protected environmental cleaning (WHO 2007c). location relevant to the risk (ISO 22300:2018). Stockpile SITREP A reserve of supplies and equipment to meet ww See ‘situation report’. emergency needs. Note: For example, a medical stockpile includes Situation report (SITREP) essential medicines, vaccines, protective A routinely produced report that provides current equipment and other supplies and equipment information about an emergency response and for use in response to a health emergency (WHO immediate and future response actions, an anal- 2017b). ysis of the impact of the emergency, and related management issues (WHO 2015a). Structural measures Any physical construction to reduce or avoid pos- Situational awareness sible impacts of hazards, or the application of Being aware of and attentive to what is happening engineering techniques or technology to achieve in a given environment at a particular time, with hazard resistance and resilience in structures or particular emphasis on the effect of changes in systems. the environment; in effect, knowing how an inci- Note: Common structural measures for disaster dent or event is evolving (WHO 2015a). risk reduction include dams, flood levies, ocean wave barriers, earthquake-resistant construc- HEALTH EDRM GLOSSARY HEALTH 36

tion and evacuation shelters. Note that in civil Suspect and structural engineering, the term “structural” Those persons, baggage, cargo, containers, con- is used in a more restricted sense to mean just veyances, goods or postal parcels considered by the load-bearing structure, and other parts such a State Party as having been exposed to a public as wall cladding and interior fittings are termed health risk and that could be a possible source of ‘non-structural’ (UNGA 2016). spread of disease (WHO 2016). ww See ‘non-structural measures’. Sustainable development Sudden-onset disaster Development that meets the needs of the present [A disaster that is] triggered by a hazardous event without compromising the ability of future gener- that emerges quickly or unexpectedly. ations to meet their own needs (WHO 1998). Note: Sudden-onset disasters could be associated with, e.g. earthquake, volcanic eruption, flash Syndromic surveillance flood, chemical explosion, critical infrastructure A method of surveillance that uses health–relat- failure, transport accident (UNGA 2016). ed data based on clinical observations rather than laboratory confirmation of diagnoses (WHO 2008). Supporting agency Note: Syndromic surveillance is used in order to An agency that provides essential services, per- detect outbreaks earlier than would otherwise be sonnel, or material to support or assist a lead possible with laboratory diagnosis-based meth- agency (i.e. the supported agency). ods. Case definitions used for syndromic surveil- Note: Supporting agencies may support either by lance are based on clinical signs and symptoms, assisting (i.e. contributing their own operational rather than on specific laboratory criteria for con- resources) or cooperating (providing indirect as- firmation of the causative agent. sistance) (WHO 2015a). Tabletop exercise (TTX) Surge [A facilitated discussion] that uses a progressive Sudden demand for health services in a mass simulated scenario, together with series of script- casualty incident where additional capacities (in ed injects, to make participants consider the im- terms of the amount of personnel, equipment or pact of a potential emergency on existing plans, supplies) and/or capabilities (in terms of special- procedures and capacities. ized expertise) are required (WHO 2007). Note: A tabletop exercise simulates an emergency situation in an informal, stress-free environment. Surge capacity A tabletop exercise is a discussion around an exer- Ability of institutions [such as clinics, hospitals, or cise scenario or narrative that is guided by a facil- public health laboratories] to respond to increased itator of an emergency situation, designed to elicit demand for their services during a public health constructive discussion between participants; to emergency (WHO 2015b). identify and resolve problems; and to refine existing operational plans (WHO 2017a, WHO 2017c). Surveillance The systematic ongoing collection, collation and Technological hazards analysis of data for public health purposes and the Hazards [that] originate from technological or in- timely dissemination of public health information dustrial conditions, dangerous procedures, infra- for assessment and public health response as structure failures or specific human activities. necessary (WHO 2010a, WHO 2016). Note: Examples include industrial pollution, nuclear radiation, toxic wastes, dam failures, transport HEALTH EDRM GLOSSARY HEALTH 37

accidents, factory explosions, fires and chemical Undernutrition spills. Technological hazards also may arise di- Stunting (low height for age), wasting (low weight rectly as a result of the impacts of a natural hazard for height), underweight (low weight for age) and event (UNGA 2016). micronutrient deficiencies or insufficiencies (a lack ww See Annex 2. WHO Classification of hazards of important vitamins and minerals) (WHO 2008). ww See ‘nutrition’. Threat ww See ‘hazard’, ‘risk’. Vaccination ww See ‘immunization’. Tolerable health risk Defined level of health risk from a specific expo- Vector sure or disease that is tolerated by society, it is 1. An insect or other animal that normally trans- used to set health-based targets (WHO 2016b). ports an infectious agent that constitutes a public health risk (WHO 2010a). Tolerable risk 2. An insect or any living carrier that transports ww See ‘acceptable risk’. an infectious agent from an infected individual to a susceptible individual or its food or immediate Toxicity surroundings (OIE 2018). The capacity of a substance to cause injury to a living organism. A highly toxic substance will cause Vector-borne diseases of humans damage in small quantities, while a substance of Diseases (e.g. malaria, leishmaniasis) that can be low toxicity will need large quantities to produce transmitted from human to human via insect vec- an effect. Toxicity is also dependent on the portal tors (e.g. mosquitoes, flies) (WHO 2016b). of entry, the time frame of exposure and the latent Note: Vector control, i.e. methods to limit or erad- period (WHO 2009). icate vectors, is an important component in the prevention and control of vector-borne diseases, Underlying disaster risk drivers specifically for transmission control(WHO 2019l). Processes or conditions, often development-related, that influence the level of disaster risk by Violence increasing levels of exposure and vulnerability or An act that intentionally threatens, attempts, or reducing capacity. actually inflicts harm on another person or group Note: Underlying disaster risk drivers — also re- of others (UNHCR 2011). ferred to as underlying disaster risk factors — in- ww See ‘sexual and gender-based violence.’ clude poverty and inequality, climate change and variability, unplanned and rapid urbanization and Vulnerability the lack of disaster risk considerations in land The conditions determined by physical, social, management and environmental and natural re- economic and environmental factors or processes source management, as well as compounding which increase the susceptibility of an individual, factors such as demographic change, non-disas- a community, assets or systems to the impacts of ter risk-informed policies, the lack of regulations hazards (UNGA 2016). and incentives for private disaster risk reduction investment, complex supply chains, the limited Vulnerable group availability of technology, unsustainable uses of Individuals who share one or several character- natural resources, declining ecosystems, pan- istics that are the basis of discrimination or ad- demics and epidemics (UNGA 2016). verse social, economic, cultural, political or health HEALTH EDRM GLOSSARY HEALTH 38

circumstances and that cause them to lack the Zoonoses means to achieve their rights or otherwise enjoy 1. Diseases that are transferable from animals to equal opportunities (ISO 22300:2018). humans (WHO 2015b). 2. Any disease or infection that is naturally trans- Warning system missible from vertebrate animals to humans. ww See ‘early warning system’ and ‘multi-hazard Note: Zoonotic diseases can be spread by food, early warning systems’. water, fomites or vectors (WHO 2019h). Synonym: ‘zoonotic disease’. WASH Acronym for water, sanitation and hygiene. Zoonotic event ww See ‘sanitation’ and ‘hygiene’. A manifestation of a disease in animals that creates a potential for a disease in humans as result World Health Organization graded emergency of human exposure to the animal source (WHO An acute public health event or emergency that re- 2010a). quires an operational response by WHO. There are three WHO grades for emergencies, signifying the level of operational response by the Organization: Grade 1 (limited response); Grade 2 (moderate response); Grade 3 (major/maximal response). If a graded emergency persists for more than six months it may transition to a protracted emergency (WHO 2017a). ww See ‘level of event’. HEALTH EDRM GLOSSARY HEALTH 39 4 THESAURUS

This thesaurus lists terms in five large groups of health: health system, access to health related concepts, under a head term, e.g. “Risk”. Within services, people-centred care, primary health these large groups, terms are grouped at smaller care; critical systems (in hospitals), health conceptual levels, under a secondary head term, e.g. care facility, safe hospital; environmental “hazard”. Italicized text indicates terms drawn from the health, cluster, health cluster, public health; Report of the open-ended intergovernmental expert hygiene, sanitation; public health measure; working group on indicators and terminology relating food safety; food security, food insecurity, to disaster risk reduction, which was adopted by the mental health and psychosocial support. United Nations General Assembly (UNGA 2016). nutrition: malnutrition, undernutrition. 4.1 RISK hazard: anthropogenic hazards, biological health policy : global health security, health hazards, bioterrorism, chemical hazard, promotion, One Health. environmental hazards, geological or geophysical hazards, hydrometeorological hazards, multi- community: interested party. hazard, Natech, natural hazards, public health hazard, socionatural hazards, technological hazards, zoonoses; climate change, El Niño- 4.3 HAZARDOUS EVENT southern oscillation; mass gathering; sexual and disaster : slow-onset disaster, sudden-onset gender-based violence, violence; vector-borne disaster; emergency, complex emergency, lev- disease of humans. el of event, protracted emergency; crisis; incident; radiation emergency, nuclear emergen- disaster risk: extensive disaster risk, intensive cy, radiological emergency; chemical incident, disaster risk, risk factor; acceptable risk, chemical event; zoonotic event. residual risk; public health risk, tolerable health risk; consequence, likelihood, probability; health emergency : acute public health event, context; threat, level of risk. acute public health emergency, public health event, public health emergency of international vulnerability : exposure, fragile states, people concern; mass casualty incident. at risk, underlying disaster risk drivers, vulnerable groups. communicable disease: epidemic, outbreak, pandemic; contamination, infection, health- care associated infection, pathogens; antimi- 4.2 CAPACITY crobial resistance. resilience: capability; coping capacity, self-reliance, surge capacity; competence; impact: disaster damage, disaster impact; di- capacity assessment, capacity development; saster loss database; health outcome, disabil- critical infrastructure; point of entry; sustain- ity, disability-adjusted life years; dead; injury, able development; stockpile; national plat- morbidity, mortality; morbidity rate, risk ratio. form for disaster risk reduction. HEALTH EDRM GLOSSARY HEALTH 40

affected: directly affected, indirectly affected; cy, supporting agency; mutual aid agreement; internally-displaced person, missing person, emergency medical team, rapid response refugee case, casualty. team; health sector.

economic loss: direct economic loss, indirect prevention: mitigation; disease prevention, in- economic loss. fection prevention and control; climate change adaptation, climate change mitigation.

4.4 RISK MANAGEMENT preparedness: readiness. disaster risk management: disaster risk governance; disaster risk management plans, planning: contingency planning: action plan, disaster risk information; community-based business continuity plan, emergency response disaster risk management; health emergency plan, preparedness plan; concept of operations. and disaster risk management. exercise: exercise project; field exercise, full- risk assessment: health impact assessment; scale exercise, functional exercise, tabletop risk analysis, risk criteria, risk evaluation, risk exercise; scenario. identification, risk register. incident management system: mass casual- epidemiology : case definition, case fatality management system; chain of command; ty ratio/rate; epidemic intelligence, epidemic command, control, coordination; business threshold. continuity management.

surveillance: community surveillance, event- emergency operations centre: emergency co- based surveillance, syndromic surveillance, ordination centre, multi-agency coordination monitoring, public health surveillance; expo- centre; public health emergency operations sure route; disinsection. centre; interoperability; logistics; situation report, situational awareness; activation level. disaster risk reduction: disaster risk reduction strategies and policies; risk transfer, risk public warning: early warning system, hazard treatment; non-structural measures, structural monitoring function, multi-hazard early warn- measures. ing systems, public warning system; alert, notifiable disease, notification. public communication: public awareness, risk communication. response: disaster response; evacuation, shelter in place; surge; contact tracing, decontamination, isolation, personal protective equip- 4.5 EMERGENCY MANAGEMENT ment, quarantine. disaster management: comprehensive approach, comprehensive emergency manage- recovery : reconstruction, rehabilitation; build ment programme, all-hazards approach. back better, retrofitting.

emergency (risk) management agency or or- debrief: cold debrief, hot debrief; after-action ganization: civil protection; jurisdiction; lead report, after-action review; lessons learned. agency, assisting agency, cooperating agen- HEALTH EDRM GLOSSARY HEALTH 41

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ISO 22301: 2012 Societal security—Business continuity United Nations High Commissioner for Refugees management systems. International Organization (UNHCR) (2015). Cluster approach (IASC) (https:// for Standardization. Geneva (https://www.iso.org/ emergency.unhcr.org/entry/61190/cluster-approach- standard/50038.html, accessed 29 April 2019). iasc, accessed 29 April 2019).

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WHO, FAO & OIE (2019). Taking a Multisectoral, One World Organisation for Animal Health (OIE) (2019). Health Approach: A Tripartite Guide to Addressing Terrestrial animal health code – Glossary (https:// Zoonotic Diseases in Countries (https://apps.who.int/ www.oie.int/index.php?id=169&L=0&htmfile=glossai iris/handle/10665/325620, accessed 29 April 2019). re.htm, accessed 25 November 2019).

WHO & UN Water (2019). National systems to World Organisation for Animal Health (2019). support drinking-water, sanitation and hygiene: One health (http://www.oie.int/en/for-the-media/ global status report 2019. UN-Water global analysis onehealth/, accessed 29 April 2019). and assessment of sanitation and drinking- water (GLAAS) 2019 report. Geneva: World Health Organization (https://apps.who.int/iris/bitstream/ handle/10665/326444/9789241516297-eng.pdf, accessed 25 November 2019). HEALTH EDRM GLOSSARY HEALTH ANNEX 1. OTHER GLOSSARIES 46 The following glossaries may be referred to for further terms and definitions in specific subject areas.

SUBJECT GLOSSARY AREA

Animal World Organisation for Animal Health (OIE) (2018). Terrestrial animal health code – Glossary (http://www.oie.int/fileadmin/Home/eng/Health_standards/tahc/current/ health glossaire.pdf, accessed 29 April 2019).

Business ISO 22301: 2012. Societal security—Business continuity management systems. International Organization for Standardization. Geneva (https://www.iso.org/ continuity standard/50038.html, accessed 29 April 2019).

Chemical WHO (2009a). The public health management of chemical incidents (http://www.who. int/environmental_health_emergencies/publications/Manual_Chemical_Incidents/en/, incidents accessed 29 April 2019).

Chemical risk Programme on Chemical Safety and Organisation for Economic Co-operation and Development (IPCS) (2004). IPCS risk assessment terminology. Geneva: WHO. assessment (http://www.who.int/iris/handle/10665/42908, accessed 29 April 2019). Intergovernmental Panel on Climate Change (IPCC) (2012). Managing the risks of Climate extreme events and disasters to advance climate change adaptation. A special report change of working groups I and II of the Intergovernmental Panel on Climate Change (https:// www.ipcc.ch/pdf/special-reports/srex/SREX_Full_Report.pdf, accessed 29 April 2019).

Emergency WHO. Emergency response framework (ERF) (2017). (http://www.who.int/hac/about/ operations erf/en/, accessed 29 April 2019).

IRDR. Peril classification and hazard glossary (2014). http://www.irdrinternational.org/( Hazards wp-content/uploads/2014/04/IRDR_DATA-Project-Report-No.-1.pdf, accessed 29 April 2019).

Health and WHO. Health and environment lexicon. (http://apps.who.int/thelexicon/entry.php, the environment accessed 29 April 2019).

Health WHO (2011). Health systems strengthening: glossary (http://www.who.int/ systems healthsystems/Glossary_January2011.pdf, accessed 29 April 2019)

Incident ISO 22320:2011. Societal security—Emergency management—Requirements for incident response. International Organization for Standardization. Geneva (https://www. response iso.org/standard/53347.html, accessed 29 April 2019).

Mortality Checchi, F. and Roberts, L. (2005). Interpreting and using mortality data in humanitarian emergencies: A primer for non-epidemiologists. Humanitarian Practice Network Paper data No.52. London: Overseas Development Institute.

Nuclear safety IAEA (2019). IAEA safety glossary: 2018 edition. Vienna. (https://www.iaea.org/ and radiation protection publications/11098/iaea-safety-glossary-2018-edition, accessed 28 October 2019).

Risk ISO 31000:2018. Risk management–Principles and guidelines, International Organization for Standardization. Geneva (https://www.iso.org/standard/65694.html, management accessed 29 April 2019).

Simulation WHO (2017). Simulation exercise manual (http://www.who.int/ihr/publications/WHO- exercises WHE-CPI-2017.10/en/, accessed 29 April 2019).

WHO & UN Water (2019). National systems to support drinking-water, sanitation and Water, sanitation hygiene: global status report 2019. UN-Water global analysis and assessment of sanitation and drinking-water (GLAAS) 2019 report. Geneva: World Health Organization and hygiene (https://apps.who.int/iris/bitstream/handle/10665/326444/9789241516297-eng. pdf?ua=1). HEALTH EDRM GLOSSARY HEALTH 47 17 3. 3.1 DEGRADATION Erosion Deforestation Salinization rise level Sea Desertification loss/ Wetland degradation retreat/ Glacier melting Sand encroachment ENVIRONMENTAL ENVIRONMENTAL ENVIRONMENTAL 15,16 14 2.2 2,3 SOCIETAL non- Chemical, hyper- currency international biological, radiological, and nuclear, explosives inflation crisis Acts of violence Acts Armed conflicts: international - - unrest Civil Stampede Terrorism: - Financial crises: - - h 2. 1 8,9 12,13 8,11 11 i HUMAN-INDUCED 2.1 j 8 radiation dam/bridge water, rail, road, air, waste waste, solid [radiological, nuclear] failures space water biological, chemical,biological, radiological TECHNOLOGICAL Industrial hazards: Industrial spill chemical - leak gas - - collapse:Structural collapse building - - Occupational hazards mining - Transportation: - Explosions Fire pollution: Air haze - Infrastructure disruption: outage power - supply water - - telecommunication - Cybersecurity materials Hazardous water: soil, air, in - contamination Food 4 1.4 Impact: airburst - meteorite - weather: Space particles energetic - storms geomagnetic - shockwave - EXTRATERRESTRIAL 5 4 7 1.3 venomous animals [snakes, spiders] BIOLOGICAL Airborne diseases Waterborne diseases Vector-borne diseases Foodborne outbreaks Insect infestation: grasshopper - locust - diseases Animal diseases Plant Aeroallergens Antimicrobial resistant microorganisms Animal-human contact - 4 1.2.3 land fire [e.g. fire land brush, bush,brush, pasture] Drought fire: Wild - fire forest - lake Glacial (flood) outburst 1. CLIMATOLOGICAL 4 NATURAL 6 [e.g. 1.2 1.2.2 extratropical extratropical cyclone tropical convective winter severe storm wind, [cyclonic rain, cyclonic (storm) cyclone surge] [tornado,storm rain,wind, storm,winter blizzard, derecho, lightning, thunderstorm, sand/dusthail, storm] condition frost/ snow/ice, dzud] freeze, Storm: - - - Extreme temperature: heatwave - coldwave - - Fog METEOROLOGICAL 4 HYDRO-METEOROLOGICAL 1.2.1 avalanche avalanche (snow) HYDROLOGICAL Flood: flood riverine - flood flash - flood coastal - flood jam ice - movement Mass (hydrometeorological trigger): landslide - - mudflow - flow debris - action: Wave wave rogue - seiche - 4 1.1 WHO CLASSIFICATION OF HAZARDS CLASSIFICATION WHO ground- pyroclastic shaking flow

Earthquake: - Tsunami movement Mass (geophysical trigger): landslide - fall rock - subsidence - Liquefaction activity: Volcanic fall ash - lahar - - flow lava - GEOPHYSICAL

1 GROUPS GENERIC GROUPS -subtypes Main typesMain SUBGROUPS [sub-subtypes] HEALTH EDRM FRAMEWORK HEALTH 2. ANNEX 48

SOURCES

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