Background Guide Outline of WHO

Protection and Guarantee of Vulnerable Groups in Health

Emergency
 Content
Committee Overview .................................................................................................................................... 1
Introduction ............................................................................................................................................................ 1
Governance, Structure, and membership ...................................................................................................... 2
Mandate, Functions, and Powers .................................................................................................................... 3
Recent Sessions and Current Priorities .......................................................................................................... 3
Conclusion ............................................................................................................................................................ 5
Bibliography ........................................................................................................................................................ 5
Introduction of Topic .................................................................................................................................... 6
International and Regional Framework ........................................................................................................... 8
Role of the International System .....................................................................................................................10
Bibliography ......................................................................................................................................................11
I. Protection and Guarantee in Health Emergencies ............................................................................ 12
Protection and Cooperation in Health Emergency ...................................................................................12
Case Study: Ebola Outbreak ..........................................................................................................................14
Further Research .................................................................................................................................................15
Conclusion ............................................................................................................................................................16
Bibliography ......................................................................................................................................................16
II. Strengthening Measure Towards Vulnerable Groups Protection ................................................. 18
Preparedness .........................................................................................................................................................18
Prevention .............................................................................................................................................................21
Detect and Respond ............................................................................................................................................22
Further Research .................................................................................................................................................23
Annotated Bibliography ..................................................................................................................................23
Bibliography ......................................................................................................................................................25

1
 Committee Overview
Introduction

World Health Organization (WHO), specialized agency of the United Nations (UN) established in 1948

to further international cooperation for improved public health conditions. 1 This organization inherited

specific tasks relating to epidemic control, quarantine measures, and drug standardization from the

Health Organization of the League of Nations (set up in 1923) and the International Office of Public

Health at Paris (established in 1907), also it was given a broad mandate under its constitution to promote

the attainment of “the highest possible level of health” by all peoples. The work of WHO contains a

number of health-related areas. For example, WHO has established a codified set of international sanitary

regulations designed to standardize quarantine measures without interfering unnecessarily with trade and

air travel across national boundaries. WHO also keeps member countries informed of the latest

developments in cancer research, drug development, disease prevention, control of drug addiction,

vaccine use, and health hazards of chemicals and other substances. 2

In its regular activities WHO encourages the strengthening and expansion of the public

health administrations of member nations, provides technical advice to governments in the preparation

of long-term national health plans, sends out international teams of experts to conduct field surveys and

demonstration projects, helps set up local health centers, and offers aid in the development of national

training institutions for medical and nursing personnel. 3Actually, WHO have various education support

programs, which is able to provide fellowship awards for doctors, public-health administrators, nurses,

sanitary inspectors, researchers, and laboratory technicians.

WHO defines health positively as “a state of complete physical, mental, and social well-being and not

merely the absence of disease or infirmity.” 4Each year WHO celebrates its date of establishment, April

7, 1948, as World Health Day.

1 WHO, Definition of WHO.n.d.

2 Ibid
3 Ibid
4 Ibid
2
Governance, Structure, and Membership

Governance takes place through the World Health Assembly, which is the supreme decision-making body;
and the Executive Board, which gives effect to the decisions and policies of the Health Assembly. 5The
Organization is headed by the Director-General, who is appointed by the Health Assembly on the
nomination of the Executive Board.6

From our longstanding Geneva headquarters to our 6 regional offices, 150 country offices and other
offices around the world, WHO plays an essential role improving local health systems and coordinating
the global response to health threats. 7 The World Health Assembly is the decision-making body of
WHO.8 It is attended by delegations from all WHO Member States and focuses on a specific health
agenda prepared by the Executive Board. The main functions of the World Health Assembly are to
determine the policies of the Organization, appoint the Director-General, supervise financial policies,
and review and approve the proposed programme budget. 9

The Executive Board is composed of 34 technically qualified members elected for three-year terms.
10
The annual Board meeting is held in January when the members agree upon the agenda for the World
Health Assembly and the resolutions to be considered by the Health Assembly.11

A second shorter meeting takes place in May-June, as a follow-up to the Health Assembly. 12
The main
functions of the Board are to implement the decisions and policies of the Health Assembly, and advise
and generally to facilitate its work.13

The Director-General is WHO's chief technical and administrative officer and oversees the policy for the
Organization's international health work. Dr Tedros first took office on 1 July 2017 and began his second
term on 16 August 2022.14Dr Tedros Adhanom Ghebreyesus is the Director-General of WHO, elected by
a vote of Member States at the World Health Assembly on 23 May 2017 and re-elected for a second 5-
year term on 24 May 2022. 15

This Portal brings together in one place information and reports relating to WHO’s strategic planning,
performance, budget and finance, human resources and procurement. 16The facilitation of access to this
information for Member States underscores the Secretariat’s commitment to transparency and
accountability.17

Mandate, Functions, and Powers

WHO, as the directing and coordinating authority on international health within the United Nations

5 WHO, Governance of WHO. n.d.

6 Ibid
7 WHO, Structure of World Health Organization.n.d.
8 WHO, World Health Assembly. n.d.
9 Ibid
10 WHO, Executive Board.n.d.
11 Ibid
12 Ibid
13 Ibid
14 WHO, Direct General of WHO. n.d.
15 Ibid
16 WHO, Membership of WHO. n.d.
17 Ibid

3
system, adheres to the UN values of integrity, professionalism and respect for diversity. 18
WHO is the
directing and coordinating authority for health within the United Nations system and is responsible for
providing leadership on global health matters.19 The goal of WHO is to ensure that a billion more people
have universal health coverage, to protect a billion more people from health emergencies, and provide a
further billion people with better health and well-being. 20 It performs a multitude of roles globally,
including advocating for universal healthcare, monitoring public health risks, setting health standards
and guidelines, coordinating international responses to health emergencies, fighting infectious diseases
like HIV and tuberculosis, and promoting better nutrition, housing and sanitation in the name of overall
well-being. Since its inception, the WHO has scored some notable public health successes, including
21

the reduction of TB and measles through mass vaccination programmes and the near-eradication of polio.
Its finest hour was the battle against smallpox: in 1958, when the organization launched its global
initiative, 2 million were dying of the disease every year, but by 1979 the WHO was able to announce
that smallpox had been eliminated – the first that humanity had completely overcome through its own
efforts.22

Recent Sessions and Current Priorities

As at 30 September 2022, WHO is responding to 50 emergencies, 39 of which are acute graded

emergencies and 11 of which are protracted graded emergencies. Eight acute Grade 3 emergencies were
active during the reporting period from 1 January 2022 to 30 September 2022, including emergencies in
Afghanistan, Ethiopia, Somalia, and Ukraine that were covered by United Nations Inter-Agency Standing
Committee System-Wide Scale-Up protocols. Given their scale, complexity and inherent operational
challenges, these Grade 3 emergencies required the highest level of Organization-wide support.23 In line
with WHO’s Emergency Response Framework, all graded emergencies are managed through WHO’s
incident management system. Where required, the Contingency Fund for Emergencies, which can release
funding in 24 hours, was used to fund the initial response to acute events and scale up life-saving health
operations in protracted crises in response to escalating needs. A total of US$ 72.89 million had been
released to support WHO's emergency response operations between 1 January and 30 September 2022. 24
WHO developed strategic response and operational plans with national health authorities and partners
for all graded and protracted emergencies. The Organization provided support for the efforts of national
governments to increase the quality and coverage of health services; strengthen primary, secondary and
hospital care by deploying mobile teams and reinforcing health facilities; improve surveillance and early
warning systems; conduct vaccination campaigns; distribute medicines and supplies; and train health
workers in situ and through online courses. 25 Implementing emergency response operations continues
to be a challenge, with knock-on effects caused by the COVID-19 pandemic continuing to complicate
supply chains and deployments. Other impediments to implementation include limited humanitarian
access; lack of sufficient funding to ensure the provision of sustainable and continuous life-saving health
services to crisis-affected and vulnerable populations; attacks on health care workers and facilities; and

18 WHO, Value of WHO. n.d.

19 WHO, Role and Mandate to counter the world drug problems, 2014.
20 Ibid
21 WHO, Function of WHO. n.d.
22 Ibid
23 WHO, Public health emergencies: preparedness and response WHO’s work in health emergencies, 2023.
24 Ibid P2
25 Ibid P2
4
escalating field costs.26

The Seventy-fifth World Health Assembly requested the Director-General in decision WHA75(24) in
May 2022 to consult with Member States1 and Observers2 on the implementation of the proposed ways
forward contained in the Director-General’s report on the Global Health for Peace Initiative, and to then
develop, in full consultation with Member States and Observers, and in full collaboration with other
organizations of the United Nations system and relevant non-State actors in official relations with WHO,
a road map, if any, for the Initiative, for consideration by the Seventy-sixth World Health Assembly
through the Executive Board at its 152nd session.27 Where possible, it also aims to contribute to peace,
to empower communities, and to protect the health of populations in fragile, conflict-affected and
vulnerable settings, as well as wider settings globally, by strengthening the role of the health sector and
WHO as influencers of peace.28 Whereas the COVID-19 pandemic highlighted the fact that poor social
cohesion or low levels of trust between citizens, government and health workers undermine positive
health outcomes and access to health care globally, the Global Health for Peace Initiative focuses on
fragile, conflict-affected and vulnerable settings. As such, the Initiative is also highly relevant in other
countries where social cohesion, trust or resilience needs to be built or strengthened. 29

The Seventy-fifth World Health Assembly through a decision on sustainable financing,1 adopted the
recommendations of the Member States Working Group on Sustainable Financing, contained in
Appendix 2 of the Working Group’s report to the Seventy-fifth World Health Assembly.2 As part of the
recommendations, the Secretariat was requested to “explore the feasibility of a replenishment mechanism
to broaden further the financing base, in consultation with Member States and taking into consideration
the Framework of Engagement with Non-State Actors; and to present a report that includes relevant
options for Member States to consider, to the Seventy-sixth World Health Assembly, through the 152nd
session of the Executive Board and the thirty-seventh meeting of the Programme, Budget and
Administration Committee in January 2023”.30 In response to this request, the Secretariat reviewed the
feasibility of a WHO replenishment mechanism in line with the principles set out by the Working Group
on Sustainable Financing. It consulted with Member States through the work of the Agile Member States
Task Group on strengthening WHO’s budgetary, programmatic and financing governance and
benchmarked a set of replenishment mechanisms within and beyond the global health arena. 31

Conclusion

WHO is an organization of 194 Member States. The Member States elect the Director-General, who
leads the organization in achieving its global health goals. 32 WHO works with all Member States to
support them to achieve the highest standard of health for all people. The staff of WHO working in
countries advise ministries of health and other sectors on public health issues and provide support to plan,
implement and monitor health programmes.33As the WHO’s highest level constitution, World Health
Assembly is a decision-making forum. Every year, delegates from all Member States convene at the

26 Ibid P2
27 WHO, Public health emergencies: preparedness and response Global Health for Peace Initiative, 2023.
28 Ibid P1
29 Ibid P1
30 WHO, Sustainable financing: feasibility of a replenishment mechanism, including options for consideration, 2022.
31 Ibid P1
32 WHO, Who we are. n.d.
33 Ibid
5
World Health Assembly to set priorities and chart a course for global health progress. 34 With strong
connections between offices, WHO works on the front lines in 150+ locations across 6 regions. WHO’s
Director-General outlines the vision and oversees all our international health work whilst our Regional
Directors lead the work of the 6 Regional Offices and their country offices. The Regional Directors work
closely with the Director-General to implement strategies and programmes across all levels of the
Organization.35

Bibliography

WHO(n.d.) Definition of WHO.[website] Retrieved 13 February 2023 from:

[Link]
WHO(n.d.) Governance of WHO . [website] Retrieved 13 February 2023 from:
[Link]
WHO(n.d.) Structure of World Health Organization. [website] Retrieved 13 February 2023 from:
[Link]
WHO(n.d) World Health Assembly. [website] Retrieved 13 February 2023 from :
[Link]
WHO(n.d.) Executive Board. [website] Retrieved 13 February 2023 from:
[Link]
WHO(n.d.)Direct General of WHO. [website] Retrieved 13 February 2023 from:
[Link]
WHO(n.d.)Membership of WHO.[website] Retrieved 13 February 2023 from:
[Link]
WHO(n.d.)Value of WHO. [website] Retrieved 14 February 2023 from:
[Link]
WHO(2014). Role and Mandate to counter the world drug problems. [document]. Retrieved 14
February 2023 from:
[Link]
_counter_the_worlds_drug_problems_2014.pdf
WHO(n.d.) Function of WHO. [website] Retrieved 14 February 2023 from:
[Link]
WHO(2023). Public health emergencies: preparedness and response WHO’s work in health
emergencies. [document]. Retrieved 14 2023 from:
[Link]
WHO(2023). Public health emergencies: preparedness and response Global Health for Peace
Initiative. [document]. Retrieved 14 2023 from:
[Link]
WHO(2022). Sustainable financing: feasibility of a replenishment mechanism, including options for

34 Ibid
35 Ibid
6
consideration. [document]. Retrieved 14 2023 from:
[Link]
WHO(n.d.). Who we are.[website] Retrieved 14 February 2023 from:
[Link]

Introduction of Topic
Introduction

As we enter 2023, the number of people in need of humanitarian relief has increased by almost 25%
compared with 2022.36 A record number of people – 339 million – face serious health threats, including
disease outbreaks and a lack of access to essential medical services. 37 The world faces multiple crises
and challenges, and driving these crises are the emergencies of new epidemic diseases, increased
geopolitical conflict, and climate change.38 These trends and situations are increasingly interacting in
complex ways, thus having a serious and urgent impact on people. Among those facing these serious
threats, the vulnerable groups (immunosuppressed individuals, children, pregnant women) need support
eagerly and more.39

Health emergencies are disease outbreaks, disasters and humanitarian crises with public health
consequences.40 World Health Organization (WHO) classified the health emergencies as: Ungraded,
Grade 1, Grade 2, Grade 3 and Protracted (Grade 1,2, or 3). 41 Among the types of health emergencies,
we generally focus on the Grade 3 health emergencies, which is a single country or multiple country
emergency, requiring a major/maximal WHO response. 42 According to the data as of 20 January, 2023,
there exists 6 health emergencies of Grade 3 and 5 health emergencies of Protracted 3 which is
emergencies of Grade 3 that persist for longer than 6 months and require a prolonged response from
WHO.43 The crisis of health emergency can be seen at a global scale is magnified in fragile, vulnerable
and conflict-affected settings which have higher levels of extreme poverty and they experience more than
70% of cases of epidemic-prone diseases. In these settings, the provision of even basic health services is
quite a challenge.44

While the current COVID-19 pandemic is attracting widespread attention, other public health
emergencies are also supposed to be paid attention to and addressed. Among the emergencies of new
epidemic diseases, Ebola virus is one of the problems exist chronically with various forms of change,
which poses a great challenge to human survival in specific districts such as Uganda, Democratic
Republic of the Congo and Guinea. To help with disease characterization, WHO has created a Global
Clinical Platform of patient-level anonymized clinical data. It is a secure, limited-access, password-

36 WHE, WHO's Health Emergency Appeal 2023, 2023.

37 Ibid.
38 Ibid.
39 WHO, Second meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding

the multi-country outbreak of monkeypox, 2022.

40 WHE, WHO's Health Emergency Appeal 2023, 2023.
41 Ibid.
42 Ibid.
43 Ibid.
44 Ibid.

7
protected platform hosted on REDCap.45 The objectives of the Platform are to: describe the clinical
characteristics of Ebola; assess the variations in clinical characteristics of Ebola; identify the association
of clinical characteristics of Ebola with outcomes; and describe the temporal trends in clinical
characteristics of Ebola.46 WHO has developed a clinical characterization case report form (CRF) to
standardize data collection of clinical features among hospitalized cases at baseline (admission), during
treatment, and at discharge or death. These three modules may be completed prospectively or
retrospectively.47

In the regions affected by conflicts, healthcare workers and the facilities are at great risk, the health
systems in these regions are fragile. The Ukraine conflict broke out in February 2022 has multiple attacks
on health care in surrounding region, including healthcare workers, facilities, medicine and health
supplies. It is significant to provide life-saving health supplies for people who need them and WHO is
committed to providing assistance for people in humanitarian crises and conflicts to ensure their health.
WHO has updated a response bulletin monthly since February 2022. In the latest bulletin of December
2022 shows that, WHO produced a rapid risk assessment for Ukraine, focusing on winter as a hazard.48
In the context of escalating war, high population movement and displacement, damaged infrastructure
and disrupted health systems, with winter comes the risk of excess cold-related morbidity and mortality.49
From the beginning of the response and as of 31 December, emergency medical teams (EMTs)
coordinated by WHO and Health Cluster Partner organizations have provided over 18 892 consultations
across 10 oblasts, of which 13% were trauma-related and 7% were for infectious diseases. 50 In
November 14% were trauma-related and 9% were for infectious diseases. 51 United Nations (UN)
Secretary-General Antonio Guterres appointed Denise Brown of Canada as the United Nations Resident
Coordinator in Ukraine as of 30 July. She will also serve as Humanitarian Coordinator.52

Vulnerable groups are physically, mentally, or socially disadvantaged persons who may be unable to meet
their basic needs and may therefore require specific assistance, at the same time, persons exposed to
and/or displaced by conflict or natural hazard may also be considered vulnerable.53 They may experience
a higher risk of poverty and/or social exclusion.54 The world urgently needs cooperation of supporting
access to medicines, vaccines and other healthcare products as well as facilities to form a healthier and
more stable living condition.

International and Regional Framework

The International Health Regulations (IHR) were adopted by the Health Assembly in 1969, having been
preceded by the International Sanitary Regulations adopted by the Fourth World Health Assembly in
1951.55 The IHR (2005) were adopted by the Fifty-eighth World Health Assembly on 23 May 2005, they

45 WHO, WHO Global Clinical Platform for clinical characterization and management of hospitalized patients
with suspected, probable or confirmed Ebola virus disease INFORMATION SHEET, 2023.
46 Ibid.
47 Ibid.
48 WHO, WHO RESPONSE TO THE UKRAINE CRISIS: DECEMBER 2022 BULLETIN, 2023.
49 WHO, WHO RESPONSE TO THE UKRAINE CRISIS: DECEMBER 2022 BULLETIN, 2023.
50 Ibid.
51 Ibid.
52 WHO, Emergency in Ukraine External Situation Report #19, 2022.
53 UNHCR, Master Glossary of Terms Rev.1, 2006.
54 Ibid.
55 WHO, International Health Regulations (2005) Third Edition, 2016.

8
entered into force on 15 June 2007.56 The purpose and scope of the IHR (2005) are “to prevent, protect
against, control and provide a public health response to the international spread of disease in ways that
are commensurate with and restricted to public health risks, and which avoid unnecessary interference
with international traffic and trade.” 57 The application of the IHR (2005) is not limited to specific
diseases, therefore, it can adapt to the continued evolution of diseases. 58 A State Party shall communicate
to WHO timely, sufficiently detailed public health information available to it on the notified event, where
possible including conditions affecting the spread of the disease and the health measures employed; and
report, when necessary, the difficulties faced and support needed in responding to the potential public
health emergency of international concern.59

The World Health Assembly (WHA) resolution “WHA 69.21” which states the baseline capacities of
Member States stressed WHO’s significant leading role to strengthen strategic cooperation and
partnership between and within States Parties along with regional and international partners. The
recommendations include developing a Global Strategic Plan to improve public health preparedness and
response, in conjunction with States Parties and other key stakeholders, to ensure implementation of the
IHR, especially the establishment and monitoring of core capacities. 60 The Global Strategic Plan should
include financial and technical support from WHO, development partners and the private sector, which
should be linked as incentives to the achievement of predetermined milestones in the National Action
Plans, the collaborations between development partners and States Parties to support the emerging public
health emergencies should be facilitated.61

Created in 2005, the Global Health Cluster (GHC) has promoted and supported collective action at global
and country level to ensure more effective, efficient and predictable humanitarian health action. 62 The
GHC mission is to work to minimize the health impact of humanitarian emergencies, and the platform
strengthens global capacities for emergency preparedness, response and recovery, engages in collective
action and coordinated field operations, as well as advances the evidence base and practice in preparing
for responding to and recovering from humanitarian health crises.63 The strategic priorities of the GHC
Strategy 2020-2023 includes strengthening coordination for local, national, regional and global actors to
prevent, prepare for, respond to and recover from public health and humanitarian emergencies;
strengthening inter-cluster and multi-sector collaboration to achieve better health outcomes;
strengthening health cluster advocacy at local, country, regional and global levels. 64

Certain groups are more vulnerable to the health consequences of emergencies, due to various public
health and socio-cultural factors.65 Women and girls are at special risks, particularly in settings of
conflict, and the vulnerabilities as well as special needs of other groups, such as children, older people,
the disabled and ethnic or religious minorities, all of them must be addressed in the implementation of

56 Ibid.
57 Ibid.
58 Ibid.
59 Ibid.
60 WHA, Report of the Review Committee on the Role of the International Health Regulations (2005) in the Ebola

Outbreak and Response, 2016.

61 Ibid.
62 Global Health Cluster, Global Health Cluster Interim Terms of Reference, 2015.
63 Global Health Cluster, Global Health Cluster Interim Terms of Reference, 2015.
64 Global Health Cluster, Global Health Cluster Strategy 2020-2023, 2020.
65 WHO, Emergency response framework (ERF), 2nd edition, 2017.

9
emergency operations.66 WHO has put forward a Emergency Response Framework (ERF) which is an
important contribution towards improving the predictability, timeliness and effectiveness of WHO’s
response to emergencies.67 It provides WHO staff with essential guidance on how the Organization
manages the assessment, grading and response to public health events and emergencies with health
consequences, in support of Member States and affected communities.68 The ERF also includes the
creation of the WHO’s Health Emergencies Program (WHE) in 2016 and the adoption of the Incident
Management System (IMS) as the main organizational approach to managing the response to
emergencies.69

The IASC Principals (the heads of the organizations that form the IASC) have affirmed that protection
must be at the heart of humanitarian action and that all humanitarian organizations should commit to
promoting protection and working towards collective outcomes.70 Protection entails activities that
secure the rights of the individual in accordance with relevant bodies of international law. 71 In practice,
for WHO and health partners, this means ensuring the availability of health services to prevent and
alleviate human suffering, prioritizing the safety and dignity of patients and their families, meeting the
health needs of diverse groups, and responding to the specific needs of survivors of sexual and gender-
based violence and other forms of violence.72 It also means advocating for the protection of
populations, health workers and health facilities.73 WHO’s guiding principles for emergency response
also includes Humanitarian principles; Evidence-based and knowledge-based programming; Gender,
age and vulnerability sensitivity; Partnership; Accountability; and Strengthening the humanitarian-
development nexus.

Role of international system

While disease outbreaks and other acute public health risks are often unpredictable and require a range
of responses, the IHR (2005) provide an overarching legal framework that defines countries’ rights and
obligations in handling public health events and emergencies that have the potential to cross borders. 74
The IHR require countries to designate a National IHR Focal Point for communications with WHO, to
establish and maintain core capacities for surveillance and response, including at designated points of
entry.75 Additional provisions address the areas of international travel and transport such as the health
documents required for international traffic. 76 The IHR introduce important safeguards to protect the
rights of travellers and other persons in relation to the treatment of personal data, informed consent and
non-discrimination in the application of health measures under the Regulations.77

Implementing the IHR is an obligation for WHO and States Parties to the Regulations. 78 One group of
such obligations is related to the core capacity requirement for countries to “detect, assess, notify and

66 Ibid.
67 Ibid.
68 Ibid.
69 Ibid.
70 Ibid.
71 Ibid.
72 Ibid.
73 Ibid.
74 WHO,International Health Regulations (2005) Third Edition, 2005.
75 Ibid.
76 Ibid.
77 Ibid.
78 WHO, International Health Regulations (2005) Assessment tool for core capacity requirements at designated

airports, ports and ground crossings, 2005.

10
report events in accordance with the regulations” and to “respond promptly and effectively to pubic
health risks and public health emergencies of international concern” (PHEIC); there are also obligations
concerning designated ports and airports, in relation to routine prevention and control measures and
response to events that may constitute a PHEIC.79 Born of an extraordinary global consensus, the IHR
work to strengthen the collective defenses against the multiple and varied public health risks and events
that today's globalized world is facing and which have the potential to rapidly spread through expanding
travel and trade.80 At the same time, IHR (2005) urges Member States to provide support to developing
countries and countries with economies in transition if they so request in the building, strengthening and
maintenance of the public health capacities required under the IHR (2005). 81

WHO has specific responsibilities and accountabilities for emergency operations under the IHR (2005)
and within the global humanitarian system as the Interagency Standing Committee (IASC) Global Health
Cluster Lead Agency.82 The convergence between disease risk and humanitarian need is also becoming
increasingly evident.83 Outbreaks can become humanitarian emergencies (e.g. Ebola outbreak in West
Africa) and humanitarian emergencies are often complicated by outbreaks (e.g. polio re-emergence in
Syria and Nigeria; cholera outbreaks in Somalia and South Sudan).84 The second edition of ERF includes
the creation of the WHE in 2016 and the adoption of the IMS as the main organizational approach to
managing the response to emergencies. 85 While the ERF focuses primarily on acute events and
emergencies, it also introduces WHO’s new grading process for protracted emergencies.86

Bibliography

WHO’s Health Emergencies Program. (2023). WHO's Health Emergency Appeal 2023 [Resolution].
Retrieved 12 February 2023 from: [Link]
emergency-appeal-2023

World Health Organization. (2022). Second meeting of the International Health Regulations (2005)
(IHR) Emergency Committee regarding the multi-country outbreak of monkeypox [Website]. Retrieved
12 February 2023 from: [Link]
international-health-regulations-(2005)-(ihr)-emergency-committee-regarding-the-multi-country-
outbreak-of-monkeypox

World Health Organization. (2023). WHO Global Clinical Platform for clinical characterization and
management of hospitalized patients with suspected, probable or confirmed Ebola virus disease
INFORMATION SHEET [Report]. Retrieved 13 February 2023 from:
[Link]
sheet__evd_v1.[Link]?sfvrsn=67da43e2_3&download=true

79 Ibid.
80 Ibid.
81 WHO,International Health Regulations (2005) Third Edition, 2005.
82 WHO, Emergency response framework (ERF), 2nd edition, 2017.
83 Ibid.
84 Ibid.
85 Ibid.
86 Ibid.
11
World Health Organization. (2023). WHO RESPONSE TO THE UKRAINE CRISIS: DECEMBER 2022
BULLETIN [Report]. Retrieved 13 February 2023 from:
[Link]

World Health Organization. (2022). Emergency in Ukraine External Situation Report #19 [Report].
Retrieved 13 February 2023 from: [Link]
44915-65715

World Health Assembly. (2016). Report of the Review Committee on the Role of the International
Health Regulations (2005) in the Ebola Outbreak and Response [Report]. Retrieved 12 February 2023
from: [Link]
health-regulations-(2005)-in-the-ebola-outbreak-and-response

Global Health Cluster. (2015). Global Health Cluster Interim Terms of Reference [Report]. Retrieved
13 February 2023 from: [Link]
[Link]?sfvrsn=903a40af_1&download=true

World Health Organization. (2017). Emergency response framework (ERF), 2 nd edition [Resolution].
Retrieved 12 February 2023 from: [Link]

World Health Organization. (2005). International Health Regulations (2005) Third Edition [Resolution].
Retrieved 11 February 2023 from:

[Link]

World Health Organization. (2005). International Health Regulations (2005) Assessment tool for core
capacity requirements at designated airports, ports and ground crossings [Resolution]. Retrieved 15
February 2023 from: [Link]

I. Protection and Guarantee in Health Emergencies

Protection and Cooperation in Health Emergencies

In the face of current health emergencies, the situation and impact on vulnerable groups are even more
severe, therefore, they are in need of protection urgently. As mentioned above, the vulnerable groups
include elderly, persons with disabilities, ethnic minorities, women and girls, children, refugees and
migrants, and so on. 87 The recommend strategies to protect vulnerable groups include ensuring and
maintain access to healthcare and essential services, developing shielding strategies to prevent exposure
to health emergencies, providing socio-economic support, preventing stigma and discrimination,
ensuring access to education and information, establishing training for surveillance, case management
and basic infection, prevention and control, and so on.88And also, WHO leads the logistical operations
support during health emergencies-delivering rapid, flexible and predictable access to services and
supplies to communities in need.89WHO’s Operations Support and Logistics (OSL) team plays a vital

87 WHO, Update 25-Protecting the vulnerable, 2020.

88 Ibid.
89 WHO Health Emergencies Program (WHE), WHO's Health Emergency Appeal 2023, 2023.
12
role, providing technical guidance, allocating finite resources, and coordinating purchasing across partner
operations, which will play an increasingly significant role in strengthening and sustaining resilience to
future health emergencies.90

Among the groups needed to be protected, health and care workers are also a significant group. Protecting
and safeguarding health and care workers has the dual benefit of strengthening the sustainability of the
workforce and enhancing workforce performance so that workers are supported to deliver high-quality
care.91The problems that the health and care workers face include inadequate protection and support,
health emergencies pose greater threats to their safety and security. 92Not limited to emergency settings,
between January 2020 and June 2022, there were 1667 reported(to WHO) attacks on health care,
including over 800 on health and care personnel. 93 A major concern during the Ebola outbreak and
continues in the context of COVID-19 is the inadequate access to critical resources, therefore, the
investment in decent work is essential to supporting the health of workers and particularly to the priorities
of women.94

In addition, the mental health problem in health emergencies is serious as well. Almost all people affected
by emergencies will experience psychological distress, which for most people will improve over time,
and people with severe mental disorders are especially vulnerable during emergencies and need access
to mental health care and other basic need.95The supports provided should include social considerations
in basic services and security, strengthening community and family supports, focused psychosocial
supports, and also clinical services.96Besides, psychological first aid and intervention, protecting and
promoting the rights of people with severe mental health conditions and psychological disabilities, links
and referral mechanisms’ establishment are also important for the improvement of mental health during
and after health emergencies.97With regard to the health and care workers, their mental health should be
guaranteed as well in order to let them perform more effectively. 98

To response in health emergencies, the cooperation between countries, communities and areas are in
great request. The Country Cooperation Strategy (CCS) is WHO’s strategic framework to guide work in
and with a country, it responds to that country’s national health and development agenda and identifies a
set of agreed joint priorities for WHO collaboration.99Each CCS is closely aligned with the GPW13 and
United Nations Sustainable Development Cooperation Framework and serves as the starting point for
WHO work in that country, which guides WHO and governments to deliver on health priorities and
measure impact. 100 The cooperation and using the CCS needs to conduct dialogue, and the key
stakeholders to consider in this dialogue include WHO representative and working group, MoH and other
government sectors, key health agencies and institutions, and so on, thus more accurately setting the
strategic agenda as well as collaboration and developing an agreed country impact/results framework
eventually. 101 The community collaboration is also crucial for emergency response. All health

90 Ibid.
91 WHO, Working for Health 2022-2030 Action Plan: protection and performance, 2022.
92 Ibid.
93 Ibid.
94 Ibid.
95 WHO, Mental health in emergencies, 2022.
96 WHO, BUILDING BACK BETTER: Sustainable mental health care after emergencies, 2013.
97 WHO, Mental health in emergencies, 2022.
98 WHO, Working for Health 2022-2030 Action Plan: protection and performance, 2022.
99 WHO, Country Strategy and Support, 2022.
100 Ibid.
101 WHO, Country cooperation strategy guide 2020: implementing the Thirteenth General Programme of Work for

13
emergencies begin and end in communities, and when WHO responds to a health emergency, it does so
in collaboration with affected communities, healthcare professionals, local authorities and partners to
design a response that has maximum impact and effectiveness. 102WHO’s ability to work closely with
affected communities is enhanced by its workforce, two-thirds of which is at country and regional level,
which helps build knowledge and trust, and ensures that even hard-to-reach areas and marginalized
populations are recognized and supported.103

The protection of vulnerable groups and healthcare workers as well as cooperation between countries,
communities and areas are essential in the face of health emergencies and enough importance should be
attached to them.

Case Study: Ebola Outbreak

Brief Introduction of Ebola Outbreak

Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a rare but severe, often fatal
illness in humans. The virus is transmitted to people from wild animals and spreads in the human
population through human-to-human transmission. Besides, the average EVD case fatality rate is around

50%. Case fatality rates have varied from 25% to 90% in past outbreaks. The 2014 2016 outbreak in

West Africa was the largest Ebola outbreak since the virus was first discovered in 1976. The outbreak
started in Guinea and then moved across land borders to Sierra Leone and Liberia.

Role of WHO in Response of the Outbreak of Ebola

WHO aims to prevent Ebola outbreaks by maintaining surveillance for Ebola virus disease and
supporting at-risk countries to develop preparedness plans. More specifically, When an outbreak is
detected WHO responds by supporting community engagement, disease detection, contact tracing,
vaccination, case management, laboratory services, infection control, logistics, and training and
assistance with safe and dignified burial practices. Except above perspectives, WHO released an interim
guidance, which provides a summary of infection prevention and control (IPC) measures for those
providing direct and non-direct care to Ebola patients in health-care facilities. It includes instructions and
directions for those managing the implementation of IPC activities, including the following aspects:
·Direct patient care (for suspected or confirmed patients with haemorrhagic fever)

·Environmental cleaning and management of linen

·Waste management

·Non-patient care activities: diagnostic laboratory activities, movement and burial of human
remains,post-mortem examinations, managing exposure to virus through body fluids, including
blood.

·General patient care in any health-care facility

driving impact in every country, 2020.

102 WHO Health Emergencies Program (WHE), WHO's Health Emergency Appeal 2023, 2023.
103 Ibid.

14
WHO in Emergencies

WHO in emergencies include some key functions, surveillance, operations, research, training, partners
and funding. Public health surveillance is the continuous, systematic collection, analysis and
interpretation of health-related data. Disease surveillance data serves as an early warning system for
impending outbreaks that could become public health emergencies; enables monitoring and evaluation
of the impact of an intervention, helps track progress towards specified goals; and monitors and clarifies
the epidemiology of health problems, guiding priority-setting and planning and evaluation public health
policy and strategies. An effective disease surveillance system is essential to detecting disease outbreaks
quickly before they spread, cost lives and become difficult to control. Effective surveillance can improve
disease outbreak detection in emergency settings, such as in countries in conflict or following a natural
disaster.
In the event of an emergency, public health emergency operation centres are a place for emergency
management personnel to coordinate operational information and resources. WHO’s Public Health
Emergency Operations Centre Network (EOC-NET) promotes best practices and standards for
emergency operation centres and builds Member States’ capacity to rapidly respond and detect to public
health emergencies as mandated by the International Health Regulations. WHO’s Strategic Health
Operations Centre (SHOC) is the heart of this network. SHOC monitors global public health events
around the clock and facilitates international collaboration during public health emergencies.
WHO brings the world’s scientists and global health professionals together to accelerate research and
development in emergency situations. An important part of WHO's work with global expert networks is
the Research and Development Blueprint (R&D Blueprint), a global strategy and preparedness plan that
triggers the rapid activation of research and development activities during outbreaks.
Today’s health emergencies are increasingly complex. We live in a globalized, urbanized and connected
world where people, vectors and goods are constantly on the move. Past crises have taught us that even
the most qualified personnel require continued learning to respond safely and effectively to these 21st

century threats. We need a ready, willing and able workforce a workforce for excellence that can be

called upon to help save lives, reduce disease and suffering, and minimize socio-economic loss to
affected communities and countries. That’s why the WHO Health Emergencies Programme is
prioritizing learning and training as it works to meet WHO’s ambitious target of ensuring one billion
people are better protected from health emergencies. In October 2018, the Programme established a new
Learning and Capacity Development unit and launched its first-ever Learning Strategy to guide all
training and learning activities across the country, regional and global levels. The Learning Strategy
commits to creating a coherent, coordinated and high-quality approach and standards for learning to build
WHO’s health emergency workforce and surge capacity supported by partners. It was developed by a
100-member task team and external consultants, with inputs from staff across the three levels of the
Organization.
In terms of partnership, WHO supports countries to prepare for, detect and respond to health emergencies
of all kinds, ranging from disease outbreaks to conflicts to natural disasters. No organization can do this
alone. WHO relies on partners through networks, such as the Global Health Cluster, Standby Partners,
Emergency Medical Teams and the Global Outbreak Alert and Response Network. WHO also works
closely with Member States, international partners, and local institutions to help communities prevent,
prepare for, respond to, and recover from emergencies, disasters and crises.
WHO gets its funding from two main sources: Member States paying their assessed contributions
15
(countries’ membership dues), and voluntary contributions from Member States and other partners. In
the future, WHO needs US$2.54 billion to provide life-saving assistance to millions of people around
the world facing health emergencies.

Further Research

Good outbreak control relies on applying a package of interventions, including case management,
surveillance and contact tracing, a good laboratory service, safe burials and social mobilization. In the
future study, community engagement is key to successfully controlling outbreaks. Raising awareness of
risk factors for Ebola infection and protective measures (including vaccination) that individuals can take
is an effective way to reduce human transmission. The further research should based on the above
dimensions.
If the world is serious about wanting to prepare for and respond rapidly and effectively to public health
emergencies in the future, it must increase the priority given to the International Health Regulations
(IHR), address the inequities in the global response to the disease and strengthen the role of WHO in
coordinating the implementation of the International Health Regulations (IHR).
There are some recommendations in the future research in the aspect of IHR: Implement rather than
amend the IHR; develop a Global Strategic Plan to improve public health preparedness and response;
finance IHR implementation, including to support the Global Strategic Plan; increase awareness of the
IHR, and reaffirm the lead role of WHO within the UN system in implementing the IHR; introduce and
promote external assessment of core capacities, Improve WHO’s risk assessment and risk
communication; enhance compliance with requirements for Additional Measures and temporary
recommendations; Strengthen National IHR Focal Points; prioritize support to the most vulnerable
countries; boost IHR core capacities within health systems strengthening; improve rapid sharing of public
health and scientific information and data; strengthen WHO’s capacity and partnerships to implement
the IHR and to respond to health emergencies

Conclusion

WHO plays a crucial role in combating global health emergency. As we enter 2023, the number of people
in need of humanitarian relief has increased by almost a quarter compared to 2022. Sustained
commitment and innovation are required to deal with the increasing scale and complexity of threats to
health and the ever-growing scale of humanitarian need. Through the decades, WHO has been addressing
key challenges for its mission: spearheading efforts to improve social conditions so that people are born,
grow, work, live and age with good health. WHO has also been central to the global promotion of gender
and disability inclusion. In the future, WHO aims to achieve the goal of health for all.

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17
II. Strengthening Measures Towards Vulnerable Groups Protection in health
emergency
To ensure the world is better prepared for all-hazards health emergencies and better guarantee and protect
the vulnerable is prioritized by WHO in the 13th Global Programme of Work (GPW).104 Within the GPW
framework—one of the triple billion targets: 1 billion more people better protected from health
emergencies maps out the procedure towards achieving universal health coverage (UHC)—the
improvement of capacities in Emergency preparedness, prevention, and detection & response. 105

Preparedness

COVID-19 pandemic highlights the urgent need for each country to strengthen its data and health
information systems on emergencies’ emergence, transmission, susceptibility etc. 106
A truly
interconnected global system for public health intelligence, along with in-depth contextual insights on
risk and vulnerability can revolutionise our ability to detect an emerging outbreak, communicate
information fast, and rapidly initiate an appropriate response. 107
Under the health emergency
preparedness, response, and resilience (HEPR) systems, the work of strengthening national integrated
disease, threat and vulnerability surveillance is ongoing.108 The three main pillars of the global HEPR
architecture are governance, systems and financing, which are based on three key principles: equity,
inclusive and coherence.109 The three pills above also maps out how to promote an equity and inclusive
surveillance system covering the vast majority of vulnerable populations. 110

Globally, there are established surveillance systems for specific pathogens or domains of surveillance,
such as the Global Influenza Surveillance and Response System Plus (GISRS+) and the Global Early
Warning System Plus (GLEWS+).111 Further, GISRS+ and its sentinel systems have integrated SARS-
CoV-2 and other novel respiratory viruses of pandemic potential, representing a strong foundation upon
which to build a system linking national, regional and global. 112 However, compatibility and
comparability between different data sources is an obstacle on the system strengthening. 113 The
differences of vulnerable populations between and within Member States compound the barriers and
impacts we face in the construction or strengthening of surveillance system. 114 National disease
surveillance, starting at the lowest administrative level in a health system, is the foundation of the
surveillance for vulnerable population. 115 But, many routine surveillance systems do not adequately
capture vulnerable populations.116 So a strategic plan and guidelines for developing standard protocols
for surveillance system strengthening should considering the following four key principles: first, country-
led inclusive action for better targeted detect vulnerable populations; second, Evidence-informed
decision-making; third, coordination, collaboration and partnerships, for the complexity of emergencies;

104 WHO, Roadmap for access 2019-2023 v2, 2018.

105 WHO, The Triple Billion Targets: Methods to Deliver Impact, n.d.
106 WHO, GPW 13 Results Framework: 2nd Global Technical Consultation, 2020.
107 WHO, 10 proposals to build a safer world together, 2022.
108 Ibid.
109 Ibid.
110 Ibid.
111 Ibid.
112 Ibid.
113 WHO, GPW 13 Results Framework: Global Technical Consultation Meeting Summary, 2019.
114 WHO, Considerations for COVID-19 surveillance for vulnerable populations, 2021.
115 Ibid.
116 Ibid.
18
forth, engagement and empowerment of vulnerable populations. 117 However, barriers existing, as they
are marginalized. 118 The use of innovative approaches, such as mobile phone surveys and artificial
intelligence, is pushing forward to strengthen the acuteness and timeliness of data. 119 But all those
innovative approaches should be accompanied by an assessment to ensure that innovations are not
inadvertently excluding or harming the most vulnerable groups. 120

Aside from the surveillance, legislation and financing is also one of the core capacities. 121 Member
States are urged to develop the necessary public health capacities and legal and administrative provisions
for furthering the purpose and eventual implementation of the International Health Regulations (IHR).122
Inadequate political leadership and support at the country, regional and international levels in preparing
for and responding to health crises can undermine effective and timely responses and aggravate the
ignorance of vulnerable groups.123

WHO is always committed to secure adequate financial and human resources at all levels of WHO and
provide financial and technique support to Member States upon request. 124 WHO gets its funding from
two main sources: assessed contributions (AC) (Member States ‘membership dues), and voluntary
contributions from Member States and other partners. 125 Sustainable financing—that is, funding that is
sufficient, flexible and predictable—is essential for WHO fulfil its role and mandate. 126 But a key
problem was that the level of assessed contributions – which represent truly flexible funds – had remained
largely static over the past decades.127 In 2020-2021, only 16% of WHO’s financing was from assessed
contributions that is truly predictable.128 Relying so heavily on the generosity of donors for the other 84%
was considered a threat to WHO’s independence, agility and ability to remain the world’s leading
coordinating authority in global health.129 To our relief, at the Seventy-fifth World Health Assembly,
Member States finally agreed to adopt a key recommendations in the Sustainable Financing Working
Group’s report.130 Member States target a gradual increase of their AC to represent 50% of WHO’s core
budget by the 2030–2031 budget cycle, at the latest.131

Any increase in AC needs to be accompanied by appropriate governance reforms, especially together

with the further strengthening of transparency, efficiency, accountability and compliance within the
WHO. 132 Agile Member States Task Group was established to strengthen WHO’s budgetary,
programmatic and financing governance, and to analyse challenges in governance for transparency,
efficiency, accountability and compliance, and to devise long-term improvement recommendations.133
But the solutions on how to maintain a balance between providing more strategic information while

117 Ibid.
118 WHO, GPW 13 Results Framework: Global Technical Consultation Meeting Summary, 2019.
119
Ibid.
120 Ibid.
121 WHO, The Triple Billion Targets: Methods to Deliver Impact, n.d.
122 WHO, international health regulation [Link], 2016.
123 Ibid.
124 WHO, Seventy-fifth World Health Assembly: resolutions and decisions, annexes, 2016.
125 WHO, how WHO is funded, 2016.
126 WHO, Flexible funds, 2016.
127 WHO, Working toward a sustainably financed WHO, 2016.
128 Ibid.
129 Ibid.
130 WHO, World Health Assembly agrees historic decision to sustainably finance WHO, 2022.
131 Ibid.
132 WHO, Report by Mr Bjӧrn Kümmel, Chair of the WHO Sustainable Financing Working Group, to the Seventy-

five World Health Assembly, 2022.

133 WHO, FIRST MEETING OF THE AGILE MEMBER STATES TASK GROUP Provisional agenda item 3, 2022

19
retaining the operational flexibility that this funding supports are under discussion. 134 WHO also
developed a constructive implementation plan on reform adopting the recommendations of the Working
Group on Sustainable Financing (WGSF). 135 The plan suggested a reform building on previous
strengthening and reform initiatives, for greater levels of responsiveness, relevance, effectiveness and
accountability. 136 The reform of existing programme budget portal may worth further and intensive
discussion.137

Building a more effective global health architecture that is better prepared to respond to health crises will
not only require additional financial resources, but also adequate finance allocation. 138 There are three
key areas acknowledged: Firstly, supporting the implementation of health emergencies preparation,
prevention, detection and respond core capacity requirements. 139 Least developed countries and other
vulnerable countries should receive assistance from partners in this regard. 140 Secondly, expanding the
WHO Contingency Fund, which will require a 10 % increase in the organization’s assessed funding, the
provision of adequate contingency funds for emergencies to ensure rapidly scalable financing for
response. 141 And Thirdly, at least $1 billion per annum is needed to support the research and
development fund for medical countermeasures for pathogens that pose a high risk of health crises. 142

One of the key obstacles to implementing a functioning surveillance and outbreak response system at the
community level is the lack of trained health workers.143 Today’s health emergencies are increasingly
complex.144 We live in a globalized, urbanized and connected world where people, vectors and goods
are constantly on the move. 145 These movements amplify the threats to our health from infectious
hazards, natural disasters, armed conflicts and other emergencies wherever they occur. 146 The need of a
ready, willing and able workforce –– that can be called upon to help save lives, reduce disease and
suffering, and minimize socio-economic loss to affected communities and countries is more and more
urgent.147 So the WHE Learning Strategy was published to create a coordinated, coherent and high-
quality approach and standards for learning and training across the WHO Health Emergencies
Programme (WHE) that are cost effective and competence sufficient.148 The strategy applies to all WHE
personnel, partners, contractors and volunteers at the individual, team, organizational levels (country,
regional and international levels).149 The frontline workers (community health workers, medical and
paramedical personnel), and volunteers is catalyzed as secondary audiences that will also benefit from
this learning strategy.150 And the main form of programme is online training through the online platform
like OpenWHO. 151 All these might potentially hamper the ability of vulnerable communities in

134 WHO, “Task Group” Overview of the challenges, 2022.

135 WHO, Matters emanating from the Working Group on Sustainable Financing, 2023.
136
Ibid.
137 Ibid.
138 WHO, international health regulation [Link], 2016.
139 Ibid.
140 Ibid.
141 WHO, 10 proposals to build a safer world together, 2022.
142 WHO, international health regulation [Link], 2016.
143 UN, Protecting humanity from future health crises, 2016.
144WHO, WHE Learning Strategy, 2018
145 WHO, training for emergencies, n.d.
146 Ibid.
147 Ibid.
148 WHO, WHE Learning Strategy, 2018.
149 Ibid.
150 Ibid.
151 WHO, OpenWHO learning platform, n.d.

20
preparing and responding to health emergencies.152

Prevention

The availability of effective medical countermeasures, including vaccines, therapeutics and diagnostics,
is crucial in preventing and responding to communicable disease outbreaks. 153 Having suffering from
the previous epidemic, the World Health Organization (WHO) convened a broad network of experts to
develop a Research and Development (R&D) Blueprint for Action to Prevent Epidemics. 154 To ensure
efforts under WHO’s R&D Blueprint are focused and productive, the blueprint prioritized a list of
diseases and pathogens in public health emergency contexts. 155 This list will update as needs arise, and
methodologies change.156 Based on the priority diseases, WHO then works to develop R&D roadmaps
for each one, and has successfully compress R&D timelines of Ebola. 157 Draw on the lessons from
COVID-19, future R&D efforts will adopt a viral family approach to identify representative viruses (or
prototypes) within a viral family as a pathfinder in generating science, evidence and filling knowledge
gaps that may then be applicable to other viruses of threat in the same family.158 It enables fast-track
research and encourages research efforts on entire classes of viruses thus improving the capability to
respond to unforeseen strains, zoonotic viruses (an animal virus that could jump to humans) and the
potential threat of a Disease X (a currently unknown pathogen that causes a serious international
epidemic) .159

However, the circumstances are that even where vaccines or therapeutics exist, they are often inaccessible
or unaffordable to vulnerable populations.160 As revealed by the International Office of Migration (IOM)
in 2022, only 46% of refugees had access to COVID-19 vaccines in practice, compared to 83% of
migrants in regular situations.161 WHO BioHub System was established to implement the timely and
efficient sharing of biological materials with epidemic or pandemic potential (“BMEPP”) between
laboratories and countries globally.162 And this system will enable rapid and broad sharing of pathogens
for effective surveillance and the timely development of medical response products(e.g., diagnostics,
therapeutics or vaccines) with all countries in need. 163 However, the subnational level hasn’t been
reached in this system.164

Other obstacles of vaccine deployment are customs procedures and import tariffs. 165 In low-income
countries, COVID-19 vaccine imports are mainly duty free. 166 However, tariffs applied to products
related to the storage, distribution, and the administration of vaccines (e.g., facemasks, gloves, syringes,
and needles) might have an impact on access, affordability and the actual roll-out of vaccination
campaigns, tend to be high for revenue purposes. 167 And some land-locked countries including

152
WHO, WHE Learning Strategy, 2018.
153 UN, Protecting humanity from future health crises, 2016.
154 WHO, An R&D Blueprint FOR ACTION TO PREVENT EPIDEMICS, 2017
155 Ibid.
156 WHO, WHO R&D Blueprint for Epidemics, n.d.
157 Ibid.
158 Ibid.
159 Ibid.
160 UN, Protecting humanity from future health crises, 2016.
161 WHO, ACCELERATING COVID-19 VACCINE DEPLOYMENT, 2022.
162 WHO, WHO BioHub System Biosafety and biosecurity: criteria and operational modalities, 2022.
163 WHO, WHO BioHub System SMTA 1, 2021.
164 Ibid.
165 WHO, ACCELERATING COVID-19 VACCINE DEPLOYMENT, 2022.
166 Ibid.
167 Ibid.
21
Afghanistan, have reported issues related to the lack of border coordination, burdensome documentary
requirements, insufficient human and financial resources or infrastructure deficiencies.168

Within the subnational level, current market model fails to deliver products for certain priority target
groups, thus even exacerbate the vulnerability.169 However, a public health emergency may create an
urgent need for vaccinations, treatments and emergency response sites. 170 So emergency plans should
provide for the stockpiling of essential pharmaceuticals and medical supplies, and should consider the
logistics of distributing essential supplies to areas of greatest need following an emergency event
according countries’ ability.171

As marginalized population, how to guarantee vulnerable groups’ vaccine coverage—vaccines need to

be brought to people, especially the vulnerable.172 A country-specific mixture of mass vaccination sites
in dense urban areas and flexible local capacity and mobile clinics are required to reach higher levels of
coverage and to reach underserved and underrepresented populations. 173 The promotion of mobile
outreach clinics, village health volunteers, community health workers and e-health can deliver medical
care to persons living in remote locations. 174 Mass vaccination sites and national immunization
campaigns, adapted for local and community contexts, can bring vaccinations closer to citizen. 175 But it
is notable that in some countries, private facilities have not yet been involved in service delivery, which
can be a missed opportunity to scale up vaccination more rapidly given the sizeable coverage of
populations that they have.176

Detect & Respond

Detection, notification and response are the core of emergency Detect & Respond’s capacity.177 The
local community is on the front line of any outbreak, and the State is the primary actor responsible and
accountable for issuing appropriate alerts and responding to the crisis. 178 It is at these levels that
capabilities in prevention and preparedness are needed to detect new outbreaks and to ensure a
coordinated, robust response.179 Develop and enhance community surveillance systems could ensure
vulnerable populations are captured in reporting, analysis and evaluation of the data and the timely
identification of emergencies.180 Community also plays a vital role in ensuring the notification of clear,
accurate and culturally appropriate information about health emergency and relevant precautions and
countermeasures to the needs and context of different vulnerable populations. 181 For example, the
information may must be delivered by speaking in personal to persons with disabilities. 182 As an
essential component primary health care, community should make fullest use of available resources to
guarantee the inclusive and non-discriminatory access of vulnerable populations to public health services

168
Ibid.
169 WHO, Roadmap for access 2019-2023 v2, 2018.
170 Ibid.
171 Ibid.
172 UN, Protecting Humanity from Future Health Crises, 2016.
173 WHO, ACCELERATING COVID-19 VACCINE DEPLOYMENT, 2022.
174 WHO, Roadmap for access 2019-2023 v2, 2018.
175 WHO, ACCELERATING COVID-19 VACCINE DEPLOYMENT, 2022.
176 Ibid.
177 WHO, The Triple Billion targets: Methods to Deliver Impact, n.d.
178 UN, Protecting humanity from future health crises, 2016.
179 Ibid.
180 WHO, Actions for consideration in the care and protection of vulnerable population groups for COVID-19,

2020.
181 Ibid.
182 Ibid.

22
for better response.183 And this effort has preliminary outcomes. However, it is highlighted that lacking
of adequate resources for health emergency preparedness and response, particularly at the subnational
level, still hampers the protection of vulnerable groups in health emergencies.184

Some successful implementation of the Detect & Respond system lies in meaningful participation,
collaboration and consultation with subpopulations experiencing poverty and social exclusion, frontline
workers including female healthcare workers, women-led organizations, affected communities including
women and adolescent girls, and those facing vulnerabilities, discrimination and additional barriers to
access services.185 But questions on how to promote the participation still remains.186

Further Research

Considering in-depth of the obstacle and characteristic of different vulnerable population, and further
research on specified and differentiate methods (even norm) for an inclusive surveillance system
construction or evolution.

Further reaching on how to guarantee the transparency and accountability on fund implementation, in
subnational, national and international level.

Stretching the “adequate finance allocation”, considering of the allocation of other resources related to
health emergencies, including but not limited to workforce, media force, etc.

Further research on how to bring accessible, affordable, as well as “timely” immunization closer to
vulnerable groups.

Further research on the community engagement for better protecting the vulnerable population, not only
in emergency Detect & Respond, but in the whole framwork.

Annotated Bibliography
WHO (2020) GPW 13 Results Framework: 2nd Global Technical Consultation [report]. Retrieved 7
February. 2023 from: [Link]
[Link]?sfvrsn=dc04bd0c_2
WHO’s Thirteenth General Programme of Work, 2019–2023 (GPW 13) and Programme
Budget (2020-2021) provides a strategic direction and defines how the Organization will
achieve results and make an impact on people’s health. The GPW 13, approved by Member
States in May 2017, clearly pointed the Organization towards impact at the country level,
introduced a quantitative Triple Billion Target, and based WHO’s strategy on the Sustainable
Development Goals (SDGs). The Programme Budget 2020-2021, approved by Member States
in May 2019, provides the platform to determine resources and strategic allocations. The
budget is structured by the triple billion targets and introduces 46 outcome indicators. The
results framework is accompanied by the WHO Impact Framework—a system for impact
measurement, a scorecard for output measurement and country case studies. Together, they

183 GA, Declaration of Alma-Ata, 1978.

184 WHO, Seventy-fifth World Health Assembly: Geneva, 22-28 May 2022: resolutions and decisions, annexes,
2022.
185 WHO, COVID-19 STRATEGIC PREPAREDNESS AND RESPONSE PLAN, 2021.
186 Ibid.

23
 provide a holistic view of WHO’s overall impact. The WHO impact measurement structure is
based on the SDGs and consists of the top-level healthy life expectancy indicator; the triple
billion targets and related indices; and 46 outcome indicators

WHO. (2022). 10 proposals to build a safer world together. [document]. Retrieved 12 February 2023
from: [Link]
preparedness/who_hepr_june30draftforconsult.pdf?sfvrsn=e6117d2c_4&download=true
The coronavirus disease (COVID-19) pandemic continues to highlight the need for a stronger,
inclusive, equitable and coherent health emergency preparedness, response, and resilience
(HEPR) architecture. Building on the work of numerous reviews, panels, and consultations,
this White Paper outlines the Director-General’s 10 proposals to strengthen HEPR under the
aegis of a new overarching Pandemic Accord that is currently under negotiation. The
recommendations are grouped by the three main constituents of the global pandemic
architecture.

WHO. (2021) Considerations for COVID-19 surveillance for vulnerable populations. [document].
Retrieved 17 February 2023 from: [Link]
Population groups living in vulnerable situations, or vulnerable populations, may be at
increased risk of contracting COVID-19 as a result of the structural and societal factors they
face which impact on health outcomes. It is therefore critical that vulnerable populations are
included in routine surveillance and enhanced surveillance systems to provide the necessary
information to inform strategies an actions to prevent and rapidly contain or stop COVID 19
transmission. This document outlines considerations for implementation of COVID-19
surveillance for vulnerable populations.

WHO. (2020). Actions for consideration in the care and protection of vulnerable population groups for
COVID-19. [document]. Retrieved 16 February 2023 from:
[Link]
Population groups living in vulnerable situations, or vulnerable populations, may be at
increased risk of contracting COVID-19 as a result of the structural and societal factors they
face which impact on health outcomes. It is therefore critical that vulnerable populations are
included in routine surveillance and enhanced surveillance systems to provide the necessary
information to inform strategies an actions to prevent and rapidly contain or stop COVID 19
transmission. This document outlines considerations for implementation of COVID-19
surveillance for vulnerable populations.

WHO (2022) “Task Group” Overview of the challenges [report] Retrieved 10 February. 2023 from:
[Link]
Within the Task Group, this document provides an overview of the challenges raised by
Member States during the seven meetings of the Working Group on Sustainable Financing and
other related governing bodies’ processes. This document also outlines the next steps for the
Task Group to come up with recommendations for long-term improvements in strengthening
WHO’s budgetary, programmatic and financing governance. As mandated through decision
EB151(1), the Task Group should report to the Seventy-sixth World Health Assembly, through
the Executive Board at its 152nd session and the Programme, Budget and Administration
24
 Committee of the Executive Board at its thirty-seventh meeting in January 2023.

WHO (2022) ACCELERATING COVID-19 VACCINE DEPLOYMENT [document] Retrieved 13

February. 2023 from：[Link]
[Link]?sfvrsn=2d432714_1&download=true
The first meeting of G20 Finance Ministers and Central Bank Governors under the Indonesian
Presidency was held on 17 and 18 February 2022. The communique requested WHO and the
World Bank, and implementing partners to work further with countries to report on obstacles
to, and accelerate, vaccine deployment strategies to get more COVID-19 vaccines into
arms. This report, produced to answer that request, has been prepared with the support of six
international bodies involved in work to support higher levels of COVID-19 vaccination
coverage and the leadership of the COVID-19 Vaccine Delivery Partnership (CoVDP) and
ACT-Accelerator Hub. WHO and the World Bank worked in collaboration with the IMF and
WTO as members of the Multilateral Leaders Task Force on COVID-19 as well as Gavi and
UNICEF as members of the CoVDP to co-produce this report.

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