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 plan establishes a national framework for preparing for and responding to public health events of national or international importance with epidemic or pandemic potential. It seeks to prevent, contain and mitigate health, social and economic impacts, including transmission, morbidity and mortality, through timely, effective and appropriate action.[1][2]It adapts the World Health Organization’s Preparedness and Resilience for Emerging Threats framework, aligns with the International Health Regulations (2005), and applies a multi-hazard, integrated risk-management and One Health approach.[3][4][5]

• Strengthen preparedness, prevention, response and resilience capacities by incorporating lessons from previous epidemics and pandemics, especially COVID-19.[3][2][6]
• Organise action across inter-epidemic or inter-pandemic, event-introduction, sustained-transmission, widespread-transmission and stable-situation periods.[2][7]
• Apply cross-cutting principles of equity, inclusion, gender equality, interculturality, human rights, non-discrimination, transparency, sustainability, evidence-based decision-making and continuous learning.[8]
• Address climate change, environmental degradation, zoonoses, vector-borne disease and other risks through coordination across human, animal, plant and ecosystem health.[3][9][10]
• Strengthen five interconnected capacity components aligned with International Health Regulations essential capacities to build resilient communities, multisectoral systems and effective emergency response.[5]
• Maintain continuity of essential health services, including primary care, childbirth, urgent surgery, chronic-disease treatment, mental health support, organ donation and transplantation.[11][12][13]
• Ensure equitable access to countermeasures, including medicines, diagnostics, medical equipment, personal protective equipment and vaccines, alongside research, production, procurement and secure supply chains.[14][15]

The plan is embedded in wider national and regional commitments, including the Sustainable Health Agenda for the Americas 2018-2030 and a Health in All Policies approach that considers health and equity implications across sectors.[4]It promotes sustained investment in public health, primary care, research, social protection for vulnerable populations and institutionalisation of good practice from prior emergencies.[8]

Implementation

Implementation combines federal coordination, integrated health-risk management, surveillance-led activation, event-specific protocols, multisectoral participation and scalable service delivery. The Integrated Health Risk Management Unit, known as GIRSAL, coordinates health risk management within the Ministry of Health and may operate as the Emergency Operations Centre during emergencies.[16]The Ministry’s highest authority designates response leadership according to an event’s type and scale.[5][16]

• Coordinate national, provincial, Autonomous City of Buenos Aires and municipal governments, alongside public, social-security and private health subsectors, through Argentina’s federal health structure.[17][18]
• Integrate risk management through the National System for Integrated Risk Management and Civil Protection, established by Law No. 27,287/2016, including its health, sanitation and environment functions.[17][19][20]
• Engage health, agriculture, environment, science, economy, social development, public works, defence, security, interior and tourism sectors, as well as civil society, academia, scientific societies and the private sector.[21]
• Establish provincial GIRSAL mirror arrangements or use active emergency operating committees as local reference and coordination nodes.[22]
• Activate crisis management immediately when surveillance or monitoring systems generate alerts specified in event-specific protocols, using a situation room for command, control, prioritisation and task allocation.[16][23]
• Form ad hoc response and recovery groups across government levels according to an emergency’s hazard, impact, geographical reach and scale.[23][24]
• Use the National Liaison Centre, permanently available within the Directorate of Epidemiology, as the single communication point with World Health Organization International Health Regulations contact points for notification, consultation, verification and information-sharing.[22][25]

Delivery priorities include interoperable health-information systems, epidemiological and laboratory surveillance, rapid response teams, One Health data exchange, risk communication, community participation, border health, clinical care, infection prevention and control, workforce mobilisation, procurement, logistics and research.[26][27][28]Surveillance uses the National Health Surveillance System 2.0 through the Argentine Integrated Health Information System, supported by mandatory notification, laboratory networks, event-based and indicator-based surveillance, rumour monitoring and periodic risk assessment.[29][30][31]

• Maintain laboratory, sequencing, diagnostics, quality-assurance and sample-traceability capacity, coordinated nationally by the National Administration of Laboratories and Health Institutes Dr Carlos G. Malbrán and linked with animal-health and environmental systems.[32][10]
• Develop workforce registers, rapid training, phased recruitment, role redistribution, occupational protection, psychosocial support and emergency staffing arrangements.[33][34]
• Reconfigure and expand health services, facilities, beds, equipment and referral networks while preserving essential care and applying hospital emergency command structures.[35][36]
• Implement risk communication through trained national and provincial teams, accessible multi-channel messages, community feedback, misinformation monitoring and simulations.[37][38]
• Coordinate procurement through documented technical, budgetary, legal and administrative processes, and publish emergency-acquisition data to support transparency.[39]
• Strengthen research through emergency priority-setting groups, rapid data and sample-sharing procedures, clinical trials, accelerated ethical review and publication of findings.[40][41]

Monitoring includes continuous surveillance, periodic risk assessment, annual State Party Self-Assessment Annual Reporting, Joint External Evaluations, after-action reviews, simulations and drills.[6][42]GIRSAL conducts annual reviews, follows up evaluation recommendations and recommends plan updates; evaluation reports are due within 10 working days of completing an evaluation strategy.[43]The plan provides for annual congressional budget allocations across responsible bodies, possible use of the National Emergency Fund and National Fund for Comprehensive Risk Management and Civil Protection, donations and multilateral development-bank finance, but specifies no total budget, costed activities or funding gap.[24][44]

Monitoring & Evaluation

The plan establishes a broad monitoring, evaluation and accountability architecture centred on integrated surveillance, risk assessment, information systems, notification, operational reporting, simulation exercises and continuous plan revision. It combines national and subnational mechanisms across human, animal and environmental health, consistent with the International Health Regulations (2005) and a One Health approach.[45][7][6]

• Operate the National Health Surveillance System 2.0 through the Argentine Integrated Health Information System as the federal platform for recording and communicating mandatory-notification events, linked to vaccination, health-establishment and professional registers.[29][30]
• Maintain mandatory notification of communicable diseases and other notifiable events under Law No. 15,465/1960 and Ministry of Health Resolution No. 2,827/2022.[45][29]
• Conduct continuous epidemiological surveillance using both event-based sources, including media and administrative data, and indicator-based approaches such as syndromic and rapid clinical surveillance.[7]
• Assess risks periodically using multiple data sources and indicators on transmissibility, severity and impact, with locally informed baselines and thresholds derived from historical data.[31]
• Monitor mortality, clinical severity, case-fatality, affected groups, pathogen characteristics, antimicrobial resistance, countermeasure performance, health-system access, vulnerable populations and the effects of pharmaceutical and non-pharmaceutical measures.[30][31]
• Publish systematic analysis through the National Epidemiological Bulletin and strengthen automation and real-time visualisation across surveillance and information systems.[30]
• Use the National Liaison Centre as the permanent communication point with World Health Organization International Health Regulations contact points, leading event assessment and timely notification where events may have international consequences.[22][25]
• Coordinate International Health Regulations implementation through the Commission for Implementation and Monitoring of the International Health Regulations and Core Capacities, the National Focal Point and relevant animal-health surveillance systems.[45]
• Assess surveillance capacity through coordinated evaluations and simulation exercises, including functional capacity, scalability and multisource performance during emergencies.[27]
• Maintain laboratory information and traceability through real-time reporting to the National Health Surveillance System 2.0 and the SIGMA system for recording sample receipt.[32]
• Monitor zoonotic threats through linked human and animal notification systems, real-time alerts, joint risk assessment, outbreak investigation and laboratory quality assurance.[10][46][47]
• Use operational situation rooms, event-specific alert protocols and Management Board command arrangements to follow events, activate crisis management and assign priorities.[16][23]
• Monitor emergency procurement through required technical, budgetary, legal and administrative documentation, and provide public, open access to procurement data.[39]
• Record vaccination in the Digital National Vaccinated Population Register and monitor events supposedly attributable to vaccination or immunisation through the national surveillance system and technical vaccine-safety advice.[48][49]
• Evaluate public health and social measures, including community participation, and use findings to revise epidemiological risk assessments and de-escalation decisions.[50][51][52]
• Monitor risk communication through simulations, infodemic tracking, correction of misinformation and systematic analysis of community feedback.[37][38]
• Use the Federal Register of Health Establishments for emergency bed censuses, facility suitability assessment and registration of temporary or reconfigured services.[53][35]
• Apply rapid preparedness verification, quality and patient-safety assessments, and evaluations of threats, vulnerabilities and capacities in health establishments.[54][55][36]
• Conduct annual State Party Self-Assessment Annual Reporting, voluntary Joint External Evaluations, after-action reviews, simulations and drills; Argentina has completed annual self-assessments since 2011 and its first Joint External Evaluation in 2019.[6][42]
• Submit evaluation reports within 10 working days of completing the relevant strategy, conduct annual GIRSAL reviews, follow up recommendations and record simulation, drill, post-event and plan-update information in the plan annex.[43]

The plan does not provide a single consolidated indicator framework, universal performance targets, or a fully specified independent accountability mechanism; monitoring arrangements are distributed across surveillance, legal notification, operational reporting, regulatory oversight and evaluation processes.[45][42][43]

Costing & Financing

Financing is framed as a requirement for preparedness, emergency coordination, workforce capacity, infrastructure, countermeasures, logistics, research and surveillance. The plan identifies annual public-budget financing and several potential emergency funding channels, but does not provide a total costed implementation plan, quantified funding gap or economic assumptions.[26][24][15]

• Finance prevention, detection and response through annual National Congress budget allocations distributed among the participating bodies.[24]
• Fund programme and budget activities for health surveillance, community prevention, border health protection and implementation of International Health Regulations capacities.[24]
• Recognise that the Ministry of Health has no single dedicated emergency fund.[24]
• Secure adequate multi-year financing and rapid emergency disbursement through Ministry of Health resources, the National Emergency Fund when activated, external donations and multilateral development bank financing.[24]
• Use the National Fund for Comprehensive Risk Management and Civil Protection in jurisdictions participating in the national risk-management system, and exceptionally use the National Emergency Fund for contracting and procurement after an emergency declaration and required approval.[44]
• Plan resources for workforce remuneration, insurance, incentives, occupational protection, personal protective equipment, training, digital infrastructure, psychosocial support and emergency logistics.[34]
• Invest over the long term in public health, primary care, health research, social policies and the physical, technological, human and financial resources needed for preparedness and response.[11][8]
• Plan facility resources for beds, equipment, supplies, personnel, temporary services, transport and emergency mortuary capacity.[56][35][36][57]
• Prioritise accelerated financing for research and development, technology transfer, scalable production, coordinated procurement and secure supply chains for equitable access to countermeasures.[14][15]
• Apply emergency procurement procedures requiring technical justification, specifications, delivery planning, costing, budget-availability certification, legal opinion and administrative authorisation.[39]
• Use national procurement arrangements for emergency acquisition of supplies, governed by the National Administration contracting regime and associated regulations.[58]

No explicit budget amount, line-item allocation, cost estimate, unit cost, financing envelope, quantified resource requirement, funding gap, exchange-rate assumption or wider economic assumption is specified in the supplied material.[24][33][59]