Plan de preparación y respuesta para eventos de salud pública de importancia nacional o internacional con potencial epidémico y/o pandémico (ESPINI)

Objectives

Argentina’s 2023 national plan for preparedness and response to public-health events with epidemic or pandemic potential adapts the World Health Organization’s Preparedness and Resilience for Emerging Threats approach within a multi-hazard cycle of prevention, mitigation, preparedness, response and recovery. Its purpose is to define agreed competencies, responsibilities and functions to prevent, contain and mitigate health, social and economic impacts, including transmission, morbidity and mortality.[1]The principal objective is to strengthen national preparedness, prevention and response capacities using lessons from COVID-19 and earlier epidemics and pandemics.[1]

• Organise preparedness, response and resilience around five interconnected components, aligned with the International Health Regulations (2005) and essential public-health capacities.[2]
• Apply cross-cutting pillars of climate change, human rights, gender equity and interculturality, alongside equity, inclusion, non-discrimination, evidence-based decision-making, transparency, sustainability and continuous learning.[1][3]
• Strengthen surveillance, laboratory and information capacities for early detection, notification, assessment and response to known, unusual, emerging and re-emerging threats.[4][5]
• Protect communities and sustain essential health services while expanding emergency capacity, including clinical care, infection prevention and control, mental health and psychosocial support, and continuity of treatment for chronic conditions.[6][7][8]
• Ensure equitable access to vaccines, medicines, diagnostics, equipment and other medical countermeasures, treating equity as both an ethical requirement and a strategic condition for controlling pandemic impacts.[9][6][8]
• Integrate One Health approaches across human, animal, plant and environmental health, recognising climate-related changes in vectors, infectious diseases, zoonoses and environmental hazards.[10][11]
• Promote multidisciplinary research, innovation, technology transfer and evidence generation to inform decisions, assess measures and accelerate development of diagnostics, treatments, vaccines and other countermeasures.[12][13]

Implementation

Implementation uses a federal, decentralised and multisectoral model spanning the national government, provinces, the Autonomous City of Buenos Aires, municipalities, and public, social-security and private health subsectors.[14]It combines common all-hazards strategies with subsequent pathogen- or event-specific plans, scaling measures across inter-epidemic conditions, introduction or emergency, sustained and widespread community transmission, and stable situations.[15][16]

• Coordinate comprehensive health-risk management through the Ministry of Health’s Unit for Comprehensive Health Risk Management, known as GIRSAL, which links health-sector actors to the National System for Comprehensive Risk Management and Civil Protection.[17][18]GIRSAL coordinates planning, information management, training, research, protocol development and resource optimisation, and acts as an Emergency Operations Centre during emergencies and disasters.[19]
• Assign leadership for specific events according to their type and magnitude, establish ad hoc cross-government working groups when required, and use situation-room command arrangements to prioritise and allocate crisis tasks.[19][20]Provincial counterparts or active emergency operating committees are intended to serve as coordination nodes for health-risk management.[21]
• Maintain national and international notification arrangements through the National Focal Point in the Directorate of Epidemiology, which operates continuously as the channel for communication with World Health Organization International Health Regulations contact points.[21]
• Operate surveillance through the National Health Surveillance System 2.0 within the Argentine Integrated Health Information System, linking notification data with vaccine, establishment and professional registers.[4][5]Combine indicator-based, syndromic and event-based surveillance, including monitoring of official reports, rumours, media and administrative information.[16][22]
• Undertake systematic risk assessments using locally informed baselines and thresholds, monitoring transmissibility, severity, mortality, service use, interventions, pathogen characteristics and animal-human-environment interfaces.[5][22]
• Coordinate One Health surveillance, investigation and response with the National Service for Agri-Food Health and Quality, environmental authorities, laboratories, animal-health services and research institutions.[23][24]The laboratory system includes national reference, jurisdictional and local laboratories, with emergency expansion through additional university and research partners where necessary.[25]
• Build and mobilise a scalable health workforce using updated workforce information, emergency registers, rapid education, supervised training, accelerated recruitment and qualification recognition, occupational protection, and mental-health support.[26][27]
• Prepare facilities through bed, equipment, workforce and service mapping; temporary structures and surge capacity; hospital emergency operations centres; triage; referral and transport arrangements; and maintenance of essential services.[28][29][30]
• Engage communities, civil society, local leaders and multisectoral partners in situation analysis, prioritisation, planning and evaluation.[31]Use risk communication, community feedback, infodemic monitoring and locally adapted messages to enable informed protective decisions.[32][33]
• Deliver vaccination through authorised facilities and outreach services, record administration in the Digital National Vaccinated Population Register, and monitor adverse events following immunisation across all jurisdictions.[34][35][36]
• Support access to countermeasures through regulatory preparedness, emergency authorisation where applicable, pharmacovigilance, logistics planning, quality-managed vaccine distribution, supply-chain traceability and coordinated procurement.[37][38][39]
• Finance preparedness through annual national budget allocations distributed across responsible bodies rather than a single Ministry of Health emergency fund.[40]Potential rapid-response sources include Ministry resources, the National Emergency Fund when activated, external donations, multilateral development-bank financing, and the National Fund for Integrated Risk Management and Civil Protection.[40][41]
• Monitor and improve the plan through annual State Party Self-Assessment Annual Reporting, voluntary Joint External Evaluations, after-action reviews, simulations, tabletop exercises and drills.[42]GIRSAL conducts annual reviews, follows evaluation recommendations, recommends updates and records exercises, post-event reports and improvement actions in plan annexes.[43]

Monitoring & Evaluation

The plan establishes a continuous, multi-level monitoring and evaluation system for epidemic and pandemic preparedness, centred on surveillance, risk assessment, event notification, exercises, reviews and plan updating. It aligns assessment with the International Health Regulations (2005) and the World Health Organization’s Preparedness and Resilience for Emerging Threats approach.[44][45]

• Operate mandatory notification and surveillance through the National Health Surveillance System 2.0, integrated within the Argentine Integrated Health Information System, to register, analyse, communicate and disseminate events of public-health importance.[4][5]
• Combine indicator-based clinical and syndromic surveillance with event-based surveillance using official reports, media, administrative data and rumours, supporting early detection, risk assessment and response escalation or de-escalation.[16][22]
• Assess epidemic and pandemic risk periodically using locally informed baselines and thresholds, including transmissibility, severity, mortality, affected groups, pathogen characteristics, health-service use, intervention effectiveness and animal-human-environment interfaces.[5][22]
• Notify and consult the World Health Organization through the permanently available National Focal Point when events meet International Health Regulations criteria for a potential public health emergency of international concern.[21][46]
• Publish epidemiological analyses through the National Epidemiological Bulletin according to epidemiological dynamics and decision-making needs, while integrating surveillance components to improve interpretation of the epidemiological situation.[5]
• Conduct surveillance-system evaluations across jurisdictions, including assessment of sustainability between emergencies, capacity for rapid expansion, functional performance and use of multisource data.[5][47]
• Maintain laboratory reporting, real-time access to relevant results, specimen traceability and quality management, including proficiency testing by national reference laboratories.[25][48]
• Monitor zoonotic threats through coordinated human and animal surveillance, real-time alerts, joint investigations and notification of prioritised animal events to the National Service for Agri-Food Health and Quality.[23][24]
• Use information systems and registries to monitor capacity and operations, including records of health establishments, beds, equipment, licensed professionals, vaccine administration, supply-chain stages and health-workforce availability.[26][34][28][29][39]
• Assess health-service preparedness through rapid verification of quality, patient safety, threats, vulnerabilities, capacities, bottlenecks and critical-process interruption risks.[49][50][30][51]
• Monitor public-health measures using epidemiological data, vital statistics, excess mortality, service demand, treatment adherence, resource availability and population response; use findings to review risk and adapt measures across operational periods.[52][53]
• Record vaccine administration in the Digital National Vaccinated Population Register and conduct national surveillance of events supposedly attributable to vaccination or immunisation, supported by safety-signal analysis and technical oversight bodies.[35][36]
• Monitor infodemics and community feedback, correct misinformation, evaluate communication activities and test communication readiness through simulations.[32][33]
• Activate crisis management when surveillance or monitoring alerts meet thresholds specified in event-specific protocols; use situation rooms to follow events, prioritise tasks and allocate responsibilities.[19][20]
• Undertake annual State Party Self-Assessment Annual Reporting evaluations using mandatory quantitative measurement of functional capacities; complement these with voluntary Joint External Evaluations, after-action reviews, simulations, tabletop exercises and drills.[42]
• Review implementation annually through the Unit for Comprehensive Health Risk Management, follow evaluation recommendations, maintain an evaluation schedule and recommend plan updates to preserve validity and effectiveness.[43]
• Submit evaluation reports within 10 working days of completing an evaluation strategy, and document simulations, exercises, post-event reports, findings and improvement actions in plan annexes.[43]

Accountability is supported by mandatory-notification law, International Health Regulations procedures, procurement documentation and transparency requirements, formal coordination bodies, technical advisory mechanisms and post-event management reports.[54][55][40][56][57]The source does not provide a single consolidated indicator framework, universal reporting timetable, quantified performance targets or independent accountability mechanism for the whole plan.[43]

Costing & Financing

The plan identifies financing, resource availability and equitable access to countermeasures as essential to preparedness and response, but provides very limited monetary information. It establishes that Argentina has annual public-health emergency budget resources distributed across participating bodies, rather than a single dedicated Ministry of Health emergency fund.[40]

• Allocate annual resources through the National Budget Law for public-health emergency prevention, detection and response, with funds distributed among the responsible bodies.[40]
• Finance relevant Ministry of Health programmes and budget activities for health surveillance, community prevention, sanitary border controls and International Health Regulations capacities.[40]
• Provide adequate multi-year financing and mechanisms for rapid emergency disbursement through Ministry of Health resources, the National Emergency Fund when activated, external donations and multilateral development-bank financing.[40]
• Use the National Fund for Integrated Risk Management and Civil Protection and the National Emergency Fund as potential financing sources outside the Ministry of Health; expenditure from the latter requires approval by the Chief of the Cabinet of Ministers as President of the National Council of the National System for Comprehensive Risk Management.[41]
• Require emergency procurements to include a cost estimate, certification of budget availability, legal review and an authorised administrative act, except where an applicable rule provides otherwise.[56]
• Invest sustainably in public health, primary healthcare, health research, workforce capacity, surveillance, diagnostics, information systems, health-service resilience and emergency logistics.[6][3]
• Accelerate financing, research and development, technology transfer, production scale-up, coordinated procurement and secure supply chains for medicines, diagnostics, equipment, vaccines and other medical countermeasures.[8]
• Support national research funding and advance-purchase and technology-transfer agreements for emergency products, technologies and countermeasures.[12][13]

The plan identifies resource needs including trained personnel, laboratory networks, temporary facilities, beds, equipment, oxygen, medicines, telemedicine, transport and supply-chain systems, but does not cost these requirements.[26][58][30][7][39]No budget totals, allocations by activity, funding-gap estimates, economic assumptions, cost-effectiveness analyses or quantified resource-mobilisation targets are specified in the supplied material.[43]