National Emergency Preparedness And Response Plan

Objectives

Liberia’s 2023 National Emergency Preparedness and Response Plan provides an all-hazards, risk-based framework for preparing for, detecting, managing and recovering from natural or human-made public health emergencies before, during and after an event. It seeks a coordinated, effective and functional mechanism at every level of the health system to address outbreaks and other threats, building on lessons from Ebola virus disease and COVID-19 and aligning with Integrated Disease Surveillance and Response guidance, the National Action Plan for Health Security and International Health Regulations capacities.[1][2][3][4]

• Establish clear roles, responsibilities, procedures and coordination arrangements for government bodies, partners and other actors involved in preparedness, response and return to routine activities.[2][3]
• Apply risk assessment to identify hazards, population vulnerabilities, likely consequences, threat levels, mitigation options and capacity gaps, then prioritise measures that reduce harm and strengthen coping capacity.[5][6]
• Strengthen surveillance, reporting, alert notification, verification, field investigation, contact tracing, laboratory diagnosis, genomic surveillance and rapid response for immediately notifiable diseases, unusual events and health threats.[1][3][7][8]
• Protect health workers and communities through infection prevention and control, clinical care, isolation capacity, laboratory quality systems, mental health and psychosocial support, and reliable supplies of medicines, vaccines and personal protective equipment.[9][10][11]
• Maintain essential health services, including maternal and child health, chronic-condition care, critical inpatient therapies and emergency care, while advancing universal health coverage during crises.[12]
• Strengthen risk communication and community engagement through evidence-based, people-centred and community-led approaches that address misinformation, build trust and support public participation in prevention and response.[13][7]
• Build and test preparedness through contingency and business-continuity plans, workforce training, simulation exercises, surge arrangements, emergency stockpiles, vaccination readiness, research and innovation.[14][4][15]

Implementation

Implementation is county-led and nationally supported, using shared responsibility across health, disaster management, agriculture, environment, security, finance, civil society, private-sector, academic and international partners. The National Public Health Institute of Liberia leads implementation in consultation with the Ministry of Health, while a flexible Incident Management System and Public Health Emergency Operations Centres coordinate scalable operations at national, county and district levels.[1][2][16][17][18]

• Govern preparedness through the National Emergency Preparedness and Response Committee, Public Health Emergency Management Committees, the National Incident Management System, the Public Health Emergency Operations Centre, the Emergency Preparedness and Response Unit and national, county and district Rapid Response Teams.[19][20][18]
• Use multisectoral coordination structures that link the Ministry of Health, National Public Health Institute of Liberia, National Disaster Management Agency, Ministry of Agriculture, environmental and security institutions, local authorities, communities and technical and development partners.[16][4][19]
• Activate operations proportionately through watch, alert and response modes and three Incident Management System levels, based on epidemic thresholds, severity, geographical spread, concurrent events, resource needs and county capacity.[17][21][22]
• Deploy a bottom-up response model in which district teams seek county support and counties request national assistance when their capacity is exceeded, multiple counties are affected, an event crosses borders or action thresholds are reached.[23][24]
• Organise response through adaptable technical pillars for planning and financing, coordination, risk communication and community engagement, surveillance and outbreak investigation, points of entry, laboratories, infection prevention and control, case management, logistics, essential services, vaccination, and research and innovation.[19][25][26]
• Maintain operational readiness through trained and rostered personnel, pre-positioned stocks, referral arrangements, isolation and treatment capacity, laboratory surge plans, resource directories, mutual-aid arrangements and updated standard operating procedures.[27][14][11]
• Engage communities, health workers, media, traditional and civil-society actors, and local and international partners in communication, surveillance, case finding, contact follow-up, resource mobilisation and delivery support.[19][7][28]
• Monitor preparedness and response through surveillance data, weekly epidemiological bulletin review, situation and spot reports, resource and expenditure tracking, stock monitoring, periodic reviews, simulations, intra-action reviews and after-action reviews. County and national plans are reviewed twice yearly or after events, while a comprehensive annual plan review is envisaged.[19][20][29][30][25][3]
• Mobilise national and external financial, technical, human and material resources, supported by finance planning, rapid fund-release arrangements, expenditure oversight and a budget template covering each response pillar. The supplied text provides no quantified budget, allocations, funding gaps or financing commitments.[6][20][12][26]

Monitoring & Evaluation

The plan establishes a multi-level monitoring, surveillance and learning system for preparedness, response, recovery and plan revision. It combines routine and event-based surveillance, threshold-based escalation, operational reporting, review processes and resource tracking, although a single comprehensive indicator framework is not specified.[3][20][30]

• Monitor immediately notifiable diseases, unusual clusters, animal-health signals, health-worker exposures, severe admissions, travel-associated illness, school absenteeism and unusual medicine sales through the Integrated Disease Surveillance and Response system.[3]
• Maintain surveillance, alert notification, verification, field investigation and response procedures, with community health workers and community-based focal persons supporting early detection and prompt reporting.[1][4][20]
• Apply watch, alert and response modes, using disease-specific alert and action thresholds, event magnitude, geographic spread, population impact, concurrent outbreaks and available county capacity to guide escalation and activation.[17][21][22]
• Require county rapid response teams to investigate reported outbreaks within 6 to 12 hours, verify rumours, analyse epidemiological information, assess control measures and prepare investigation reports.[31]
• Use real-time data, sentinel surveillance, laboratory confirmation, epidemiological analysis, modelling and geographic information system analysis to guide priorities, transmission assessment and proportionate public-health and social measures.[9][7][32][33]
• Monitor response performance through indicators and operational information including disease trends, attack rate, case fatality rate, incidence, programme coverage, resource and supply availability, stock consumption, community acceptability, food security and ambulance coordination.[30]
• Produce periodic situation reports for affected communities and facilities, covering activities, locations and dates, epidemiological curves, spot maps, case analyses, line lists, operational gaps, response effectiveness and recommended improvements.[30]
• Review the national epidemiological and surveillance bulletin weekly through the National Emergency Preparedness and Response Committee, which monitors reported events, identifies trend-based actions and considers intervention mechanisms.[19]
• Track laboratory performance through standardised daily line lists, urgent reporting of priority specimens, specimen-transport updates, external quality assurance, inter-laboratory quality schemes and documentation of sequencing activities.[10]
• Monitor implementation and compliance with public-health measures at points of entry, including cross-border data sharing and evaluation of measures under the International Health Regulations (2005).[8]
• Track availability, access barriers, service use, community outcomes and disruptions to essential health services, alongside vaccine storage, deployment, impact and specified vaccine-related adverse events.[12][15]
• Conduct annual comprehensive plan reviews and event-triggered updates; review national and county plans twice yearly or after events; use simulation exercises, intra-action reviews, post-emergency evaluations and After-Action Reviews to identify lessons and corrective actions.[3][25][29][30]
• Maintain accountability through defined institutional roles, reporting lines, Incident Management System coordination, documentation of lessons, resource-use tracking and administrative and financial oversight of response expenditure.[27][20][25]

The source does not specify a consolidated indicator matrix, universal reporting timetable, independent accountability mechanism or detailed evaluation methodology. Reporting frequencies explicitly identified include weekly epidemiological bulletin review, quarterly stock and supply status reports by the National Rapid Response Team, annual plan review, and twice-yearly or event-triggered plan review.[19][23][3][25]

Costing & Financing

The financing framework emphasises rapid access to emergency funds, resource mobilisation, stockpiling and expenditure oversight. It provides a budget-template structure for response pillars but does not give monetary allocations, total costs, funding gaps or economic assumptions in the supplied material.[6][20][26]

• Prepare a finance plan that identifies funding sources, sets conditions for fund release and enables rapid access to funds during a public health emergency.[6]
• Cover both continuing preparedness expenditure, including surveillance and risk analysis, and emergency expenditure for control measures and response operations.[6]
• Maintain an accessible emergency preparedness and response budget line, adequate operational funds, transport, logistics, equipment, communications and critical material stocks.[9]
• Mobilise national and external financial and technical resources through government and partners, including support for emergency prevention, control, Public Health Emergency Operations Centre development and sustainability.[3][20]
• Map human, logistical and financial resources; maintain and update emergency stockpiles; and monitor resource use before, during and after emergencies.[20]
• Estimate, track and approve response-related expenditure, coordinate funding from all sources, and maintain cash-flow oversight and expenditure tracking within the Incident Management System.[20][18]
• Review available county resources during an event, seek local partner support and release outbreak-response funds under the plan before requesting national assistance when local supplies are unavailable.[21][22]
• Develop compensation policy arrangements for epidemic-prone and zoonotic diseases, potentially including payments for emergency responders and compensation for destroyed animals or property, with defined levels, payment methods and timing.[6][14]
• Use procurement and partnership mechanisms, including pooled procurement such as COVAX, research and manufacturing partnerships, and access to quality-assured vaccines through a vaccine bank or other sources.[9][34]
• Use a budget template that records total costs in United States dollars for coordination and monitoring, surveillance, risk communication, points of entry, laboratories, infection prevention and control, case management, logistics and supply chains, essential health services, vaccination, and research and innovation.[26]
• Develop a costed risk communication and community engagement response plan, while recognising that stringent public-health and social measures may create substantial social and economic costs requiring proportionate and regularly reviewed implementation.[7][32]

No quantified budget, pillar allocation, unit cost, financing commitment, funding gap, currency amount or economic assumption is available in the supplied source text.[26][35]