National Action Plan For Health Security

Objectives

Tanzania’s five-year National Action Plan for Health Security provides a framework for attaining and sustaining the minimum core capacities required under the International Health Regulations (2005), building national resilience to public health threats affecting people, animals and the environment.[1][2][3]Its goal is to reduce morbidity, mortality, disability and socio-economic disruption from such threats, while contributing to Sustainable Development Goal 3 on healthy lives and well-being.[4][2]

• Strengthen and sustain the capacity to prevent outbreaks and other health emergencies through a One Health, whole-of-government and whole-of-society approach.[4][2]
• Improve the prompt detection, confirmation, reporting and investigation of outbreaks, public health events and priority zoonotic risks.[4][5][6]
• Enhance effective response, recovery and mitigation of the health, social and economic effects of emergencies.[4][2]
• Cover prevention, detection and response functions, alongside International Health Regulations-related hazards, designated points of entry and cross-cutting capacities.[4][6][7]
• Align health-security actions with health-system strengthening, equity, community participation, gender and human-rights principles, evidence-led planning, transparency, shared responsibility and cross-border collaboration.[2][3]

The plan was informed by the 2016 Joint External Evaluation and complementary assessments of veterinary services, antimicrobial resistance, laboratory and surveillance systems, regulatory capacity, vulnerability and risk, integrated threat profiling and simulation exercises.[1][8][9]The Joint External Evaluation found progress but continuing gaps in prevention, detection and response capacities, with no core capacity assessed as sustainable and most assessed as limited or developed.[4][10]

Priority action spans legislation and financing, coordination, antimicrobial resistance, zoonotic diseases, food safety, biosafety and biosecurity, immunisation, laboratory systems, surveillance and reporting, workforce development, emergency preparedness and operations, risk communication, medical countermeasures, and points of entry.[6][7]The plan also addresses multi-hazard risks, including outbreaks, epidemics, natural hazards, accidents, conflict, terrorism, chemical events and radiological or nuclear emergencies.[11][7]

• Strengthen links between human, animal and environmental health services, including One Health teams and surveillance for priority zoonoses.[12][6]
• Develop laboratory staffing, specimen referral and transport, diagnostic testing and electronic priority-disease surveillance.[12][6][7]
• Build a trained workforce through Field Epidemiology and Laboratory Training Programme provision, community health-worker engagement and regional and district capacity development.[12][7]
• Establish functional emergency operations, rapid-response teams, hazard-specific plans, risk-communication arrangements and preparedness at designated points of entry.[6][7]
• Review relevant laws and regulations, amend at least half by the end of 2019, and establish International Health Regulations implementation budget lines in relevant sectors from the 2017/2018 financial year.[13][6]

Implementation

Implementation is designed as a living, multisectoral coordination platform linking sectors, existing plans and administrative levels, under the guidance of the Prime Minister’s Office.[1][12][3]It applies One Health and multi-hazard approaches across national, regional, zonal, district, local-government and community levels, with periodic review and updating in response to changing needs, policies and institutions.[10][2]

• Lead implementation through the Ministry of Health, Community Development, Gender, Elderly and Children under an inter-ministerial steering committee or high-level technical group accountable to the Prime Minister’s Office.[3][14]
• Coordinate disaster preparedness and response through the Prime Minister’s Office Disaster Management Department, including warnings, emergency information, supplies, resources and damage assessment.[14]
• Engage the President’s Office Regional Administration and Local Government, which manages regional and council administration, alongside local authorities responsible for planning, delivering and overseeing relevant services.[15][14]
• Involve ministries responsible for finance, livestock, agriculture, home affairs, education, infrastructure, foreign affairs and other sectors, as well as laboratories, research institutions, regulatory agencies, private facilities, communities, civil society and development partners.[16][2][14]
• Sequence activities across the first year, second year and years three to five, identifying responsible ministries and offices while considering domestic and external finance.[3]

Operational delivery combines service support, workforce training, equipment and transport provision, community engagement, surveillance and laboratory strengthening, point-of-entry preparedness, information sharing and redesigned supervision arrangements where required.[12][17]The plan envisages domestic government resources and development-partner support, with financing mapped across existing and potential domestic and external sources.[12][2]Its five-year implementation cost is USD 86,586,339 excluding immunisation, rising to USD 603,158,558 when animal vaccines are included.[4]

Monitoring and evaluation use a harmonised framework intended to generate data for decision-making, programme development, resource allocation and management across stakeholders and levels.[17]Progress is to be reviewed quarterly, annually, at mid-term and at end-term, drawing on human and animal health surveillance, routine reporting, supervision, facility assessments, after-action reviews, simulation exercises, Joint External Evaluations and other relevant assessments.[12][17]

• Incorporate selected health-security indicators into the Joint Annual Health Sector Review and use routine information systems to track International Health Regulations core capacities, priority diseases and public health events.[5]
• Monitor surveillance performance through reporting timeliness and completeness, outbreak investigation and response, morbidity and mortality, case-fatality rates, and data quality measures.[5]
• Conduct annual reporting to the World Health Organization using the International Health Regulations self-evaluation tool, supplemented by peer review, after-action reviews and simulation exercises.[18]
• Undertake a mixed internal and external mid-term review in 2019 and end-term review with follow-up Joint External Evaluation in 2021.[13]
• Strengthen information use, dissemination, transparency and accountability among stakeholders, supported by periodic supervisory schedules from national to local levels.[17]

Monitoring & Evaluation

Monitoring and evaluation combine routine surveillance, structured reviews, simulations and external assessment to track implementation of the National Action Plan for Health Security (NAPHS), International Health Regulations (IHR) core capacities and priority public-health threats.[17][5]The Inter-ministerial Committee or multisectoral technical group administers the plan, monitors implementation and is accountable to the Prime Minister’s Office.[1][3]

• Monitor IHR core capacities through annual reporting to the World Health Organization using the revised IHR monitoring or self-evaluation tool.[18][5]
• Collect evidence through human and animal health surveillance, integrated disease surveillance and response systems, routine health information systems, annual reviews and reporting, facility surveys, periodic supervision, after-action reviews, simulation exercises, Joint External Evaluations and veterinary-services assessments.[12][17][5][13]
• Assess surveillance performance using reporting timeliness and completeness, quarterly feedback to sub-national levels, outbreak investigation and response, morbidity, mortality and case-fatality rates, and data accuracy, representativeness and validity.[5]
• Conduct progress reviews quarterly, annually, at mid-term and at end-term, with routine quarterly supervision across national, regional and local-government levels.[12][17]
• Incorporate selected NAPHS indicators into the Joint Annual Health Sector Review and strengthen data use, dissemination, experience-sharing, transparency and accountability among stakeholders.[17][5]
• Use Joint External Evaluation as a voluntary peer-to-peer, multi-stakeholder assessment across 19 technical areas; Tanzania’s 2016 evaluation found continuing capacity gaps, with no core capacity rated sustainable.[4][10][13]
• Undertake a mixed internal and external mid-term review in 2019, followed by an end-term review and follow-up Joint External Evaluation in 2021, to inform a subsequent action plan.[13]
• Track time-bound targets, including review of relevant laws and regulations by end-2018, amendment and passage of at least 50% by end-2019, implementation of the national antimicrobial-resistance plan in 80% of regions by 2021, seven antimicrobial-resistance sentinel sites by 2021, surveillance for at least five priority zoonoses by 2020, and functional electronic priority-disease surveillance in at least 80% of districts by 2020.[13][6][7]
• Report potential public health emergencies of international concern within 24 hours through designated national and international channels, and achieve significant-event reporting by 80% of regions by 2019.[6][7]

Costing & Financing

The five-year NAPHS implementation cost is US dollars 86,586,339 excluding immunisation, increasing to US dollars 603,158,558 when animal vaccines are included.[4]Financing is expected from domestic government resources and development partners, supported by mapping and mobilisation of existing and potential domestic and external sources.[12][2]

• Allocate the largest stated component to Detect at US dollars 50,329,373, followed by Prevent at US dollars 22,054,730.[4]
• Provide US dollars 9,281,500 for other IHR-related hazards and Points of Entry, US dollars 4,850,782 for Response, and US dollars 69,955 for cross-cutting activities.[4]
• Establish annual IHR implementation budget lines across relevant sectors from financial year 2017/2018, including a budget line for medical countermeasures in each fiscal year.[13][6][7]
• Use Government procurement guidelines and authoritative reference prices where government cost data are unavailable, and classify priorities using large, intermediate or small cost drivers.[9][3]
• Assess whether higher-cost activities are included in the Government of Tanzania budget and whether development partners may finance activities outside that budget.[9][3]
• Recognise the economic rationale for preparedness: the 2014/15 Ebola epidemic was associated with estimated losses of US dollars 2.2 billion in the three most affected West African countries and US dollars 3.8 billion in global response expenditure; the 2007 Rift Valley Fever outbreak also generated livestock-trade, animal-mortality and outbreak-control losses.[19]
• Note that the supplied material does not specify committed contributions, financing shares, annual allocations, quantified funding gaps or detailed economic assumptions beyond stated costs and contextual economic indicators.[4][9][3]