Due to the unpredictability of disease outbreaks and public health risks that require a range of responses, 196 countries implemented the International Health Regulations (2005) (IHR) that outline countries’ rights and obligations for handling potential cross-border public health events and emergencies. The IHR, adopted in 2005 at the 58th World Health Assembly, aims to prevent, protect against, control, and provide 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."

The assessment of the IHR is carried out through mandatory annual reporting (States Parties Annual Reporting) and three voluntary components (after action review, simulation exercises, and external evaluation). These components assess and test the IHR’s core capacities. External evaluations include exclusive self-assessments to approaches that combine self-evaluation, peer review, and external evaluations by domestic and independent experts. The Joint External Evaluation (JEE) enables countries to identify the most urgent needs and opportunities within their health security system for enhanced emergency preparedness, detection, and response thus leading to consensus on national priorities to frame or update the National Action Plan for Health Security (NAPHS) with the requisite allocation of resources.

In collaboration with the World Health Organization (WHO), EMPHNET participated in JEE missions in Yemen, Pakistan, and Syria. Experts from the region and WHO EMRO, the IHR Office, health ministries and other stakeholders took part in these missions, which were conducted by the respective health ministries.

The first stage of the process involves a self-evaluation completed by the country with multisectoral engagement using the JEE tool and country implementation guide. This self-evaluation information covering all the 19 capacities in the tool is then given to the external JEE team consisting of international subject matter experts. A review of this self-evaluation data provides the team members with an understanding of the country’s baseline health security capabilities. The JEE team then visits the country for a facilitated in-depth review of the self-evaluation data, structured site visits and meetings organized by the host country.

During the JEE mission, experts discussed and evaluated the JEE 19 technical areas:  Immunization and linking public health with security, emergency management and health service provision, zoonoses and food safety, surveillance, risk communication and community engagement, legislation, and finance, chemical and radiation, national IHR focal points, and points of entry, IPC and AMR, National Laboratory and biosafety and biosecurity, and workforce development.

It is worth noting that EMPHNET served on the Joint External Evaluation Mission for Iraq, Jordan, Sudan, Tunisia, Lebanon, and Libya, as well as the afore mentioned countries. Its participation in such missions corresponds with its strategic goals to strengthen public health programs and respond to public health needs in the Eastern Mediterranean Region.