Malawi Emergency Preparedness And Response Roadmap 2023-2025

Objectives

Malawi’s Emergency Preparedness and Response Roadmap 2023–2025 is a two-year national health-security framework that seeks to strengthen the capacity to anticipate, prepare for, detect, respond to and recover from outbreaks, disasters and other public health emergencies, while maintaining essential health services and building resilience to recurrent climatic, environmental and epidemic shocks.[1][2][3][4]It operationalises the Emergency Preparedness and Response flagship initiative through Promoting Resilience of Systems for Emergencies, Transforming African Surveillance Systems and Strengthening and Utilizing Response Groups for Emergencies.[2][5]

• Strengthen One Health coordination across human, animal and environmental sectors, including cross-border collaboration, joint planning and resource mobilisation.[2][6][7]
• Finalise public health and disaster legislation, policies, plans, guidelines and the National Action Plan for Health Security, including an annual operational plan and a cholera-control strategy to 2030.[2][6][8]
• Assess multi-hazard risks, mitigation measures and preparedness capacity through Joint External Evaluation preparation, risk assessments, contingency planning and simulation exercises.[8][7]
• Scale up Integrated Disease Surveillance and Response to district, facility and community levels, strengthen event-based surveillance, outbreak analytics, emergency information management, environmental surveillance and interoperability of data systems.[7][9][10]
• Strengthen laboratory capacity for priority pathogen diagnosis, sequencing, antimicrobial resistance, sample referral, quality management, biosafety and biosecurity under a One Health framework.[6][10][11]
• Develop a trained and deployable emergency workforce, including 200 multisectoral and transdisciplinary surge experts across five health zones, strengthened pre-service curricula, standard operating procedures and pocket guidance for public and private facilities.[12][13][11]
• Improve readiness through functional national and district Public Health Emergency Operations Centres, strengthened case management, infection prevention and control, water, sanitation and hygiene, emergency logistics, warehousing and pre-positioned supplies.[14][15][16]
• Enhance preparedness at Points of Entry and district level through International Health Regulations core-capacity training, risk assessments, contingency plans, cross-border simulations and supervision.[17][18]
• Strengthen risk communication and community engagement through a multi-hazard strategy, technical working groups, feedback and rumours-tracking mechanisms, and sustainable resource mobilisation.[19][16]

Implementation

Implementation uses a government-led, whole-of-government and multisectoral model that combines national leadership with district delivery, partner support and community participation.[2][20][4]Malawi Government technical teams are to work with the Ministry of Health, the Public Health Institute of Malawi, the Department of Disaster Management Affairs, district councils, other ministries, civil society, private-sector actors, academia, United Nations agencies, donors and the World Health Organization.[20][5][4]The roadmap applies the resilience, surveillance and surge-workforce pillars concurrently, using assessments to identify gaps, prioritise immediate actions and mobilise resources.[2][5]

• Coordinate implementation through multisectoral technical teams, the cluster system, national and sub-national emergency structures, public health emergency operations centres, rapid response teams and One Health mechanisms.[6][4][14]
• Deliver local action through district councils, village development committees, area development committees, community volunteers, facility focal points and district risk communication and community engagement subcommittees.[4][9][15]
• Conduct operational assessments, field visits, bilateral consultations, resource mapping, gap analysis and priority setting to guide implementation and develop budgeted activities.[5][2]
• Train surveillance officers, health workers, community leaders, laboratory staff, logisticians, emergency responders and academic staff through pre-service, in-service, training-of-trainers and simulation-based approaches.[9][10][13][15]
• Strengthen routine delivery through guideline dissemination, integrated district supervision and mentorship, quarterly One Health surveillance reviews, epidemic analytics, data-system integration and cross-border information-sharing protocols.[9][10]
• Invest in operational readiness through laboratory equipment and supplies, sample transport including drones, reporting devices and data bundles, communication-equipped vehicles, emergency stocks and expanded warehouses in Blantyre, Lilongwe and Mzuzu.[10][15][16]
• Mobilise financing by establishing a contingency fund, mapping domestic and external resources, engaging donors and partners, and using an inter-ministerial task force to identify funding sources and prepare a resource-mobilisation plan.[2][17][13]
• Monitor implementation through the International Health Regulations Monitoring and Evaluation Framework, State Parties Annual Reports, Joint External Evaluations, After Action Reviews, simulation exercises, quarterly reviews and roadmap performance indices.[8][19]Targets include 90% for the Points of Entry Emergency Preparedness Index, 80% for surveillance scale-up, five district Public Health Emergency Operations Centres achieving 80% functionality, 70% for emergency logistics readiness and 90% for risk communication and community engagement effectiveness.[18][16][21]

Monitoring & Evaluation

The roadmap combines International Health Regulations (2005) monitoring processes, surveillance strengthening, implementation reviews, simulation exercises and composite readiness indices. It specifies several targets, but does not provide one consolidated accountability or reporting framework across all priority areas.[8][19][18][16]

• Apply the International Health Regulations Monitoring and Evaluation Framework, including State Parties Annual Reports, Joint External Evaluations, After Action Reviews and Simulation Exercises; plan a Joint External Evaluation in 2024 and a technical session for State Parties Annual Report compilation.[8]
• Strengthen integrated disease surveillance and response, indicator-based and event-based surveillance, interoperable data systems, epidemic analytics, supportive supervision and cross-border information sharing.[7][9][10]
• Conduct quarterly One Health surveillance review meetings, quarterly reviews of ministerial actions, Points of Entry risk assessments, supervision and audits to assess implementation and identify gaps.[17][22][10]
• Track implementation quarterly against roadmap timelines using six strategic key performance indicators, although the full indicator set, data sources and reporting lines are not specified.[19]
• Measure the Legislation and Guidance Documents Implementation Index, including adoption and dissemination of plans, policies and legislation, guideline review, ethics guidance and integration into Health Sector Strategic Plan III; target 80%.[19]
• Measure Points of Entry preparedness through implementation of capacity-building, risk-assessment, contingency-planning and cross-border activities; target 90%.[18]
• Measure surveillance scale-up through completed sub-national activities, training quality, supervision, mentorship and quarterly reviews; target 80% for the Scaling Up Index.[18]
• Assess laboratory strengthening through implementation progress, adherence to ISO 15189:2022, quality-management mentorship, and biosafety and biosecurity risk-assessment effects.[11]
• Track trained and deployable surge experts against the target of 200, including simulation participation, skill retention and deployment readiness.[12][11]
• Assess district Public Health Emergency Operations Centre progress through completed priority activities; target five district centres reaching 80% of full functionality requirements.[16]
• Measure emergency logistics readiness using response time, stock availability and stakeholder feedback; target 70% for the Emergency Logistics Readiness Index.[16]
• Measure Risk Communication and Community Engagement effectiveness through implementation progress, effectiveness assessment and stakeholder feedback; target 90%.[16][21]

Costing & Financing

The roadmap contains costed priority areas and programme budgets, while also calling for domestic resource mobilisation, contingency financing and donor engagement. Several extracts identify resource needs or limited funding, but do not specify committed financing, funding gaps or economic assumptions.[17][7][13][19]

• Budget the two-year priority package at 1,932,501.02, with the currency not specified in the supplied text; its largest allocations are risk assessment and mitigation capacity, Points of Entry preparedness, and capacity building.[7]
• Allocate USD 7,751,927 to Transforming African Surveillance Systems, principally for scaling up Integrated Disease Surveillance and Response, laboratory strengthening and digitising data-management systems.[10]
• Allocate USD 1,594,170 to workforce development and USD 10,228,180 to response readiness and coordination, including case management, Public Health Emergency Operations Centres, infection prevention and control, and water, sanitation and hygiene.[13][14]
• Allocate USD 1,686,755.52 to Operations Support and Logistics, including USD 880,756 for pre-positioning emergency stocks and related stock management.[15]
• Establish a national emergency contingency fund, map resources and sustainable financing mechanisms, and focus One Health resource mobilisation on domestic funding.[6][17][7]
• Mobilise initial seed funding for priority interventions with World Health Organization support, and use an inter-ministerial task force to map funding sources, prepare a resource-mobilisation plan and engage donors.[6][13]
• Address identified constraints, including underestimated preparedness resource requirements and limited funding for risk communication and community engagement; no quantified funding gap is provided.[20][19]
• Develop a costed National Action Plan for Health Security after the 2024 Joint External Evaluation and a transitional costed annual operational plan; no monetary values are provided for either plan.[8]