National Action Plan For Health Security (NAPHS)

Objectives

Namibia’s National Action Plan for Health Security (NAPHS) 2021–2025 is a country-owned, five-year framework to build a unified One Health system that can prevent, promptly detect and effectively respond to epidemics, disasters and other public health threats. Its mission is to sustain a comprehensive, multisectoral and collaborative health security system that protects lives and strengthens emergency response across human, animal, wildlife and environmental health.[1][2][3][4]

• Strengthen implementation and institutionalisation of the International Health Regulations (IHR) 2005 core capacities, including national legislation, coordination, surveillance, reporting, laboratory systems, workforce development and designated points of entry.[5][3][6]
• Prevent and mitigate outbreaks, zoonoses, antimicrobial resistance, food safety incidents, biosafety and biosecurity risks, chemical events, radionuclear emergencies and climate-related or natural hazards.[3][7][8]
• Improve timely detection, risk assessment, reporting and coordinated response through integrated indicator-based, syndromic and event-based surveillance, laboratory confirmation and early-warning systems.[9][10][11]
• Build resilient health-system capacity through immunisation, infection prevention and control, workforce development, emergency preparedness, medical countermeasures, risk communication and community engagement.[9][12][13]
• Advance global health security, Universal Health Coverage and Sustainable Development Goal 3 by improving access to quality healthcare, reducing health risks and protecting populations without financial hardship.[9][14][15]
• Align health security action with Namibia’s Fifth National Development Plan, sector strategies, disaster-risk management instruments, the National Health Emergency Preparedness and Response Plan and related national programmes.[6][16]

The plan uses Joint External Evaluation findings, Performance of Veterinary Services assessments, risk assessments and institutional priorities to address gaps across 19 technical areas. It prioritises 32 of 70 Joint External Evaluation recommendations as high-priority actions and sequences activities across the first year, second year and years three to five according to impact, feasibility, resource needs and complementarity with existing plans.[9][17][6]

Implementation

Implementation relies on government leadership, national ownership and a multisectoral One Health delivery model. The Ministry of Health and Social Services provides overall technical stewardship and coordination, working with the Ministry of Agriculture, Water and Land Reform, the Ministry of Environment, Forestry and Tourism, the Office of the Prime Minister, Parliament, finance and planning authorities, technical agencies, communities, civil society, academia, the private sector and development partners.[9][18][19][20]

• Coordinate policy, preparedness, resource mobilisation and plan review through the National Multi-Agency Coordination Committee, or One Health Platform, with the International Health Regulations National Focal Point serving as secretariat and day-to-day centre for event assessment, communication and coordination.[2][21][22]
• Operate district implementation through District Health Management Teams and existing district committees until national coordination structures are fully operational, while strengthening information sharing with national ministries and agencies.[23]
• Activate the Incident Management System during public health events, conduct joint rapid event assessments within 24 hours, produce situation reports, recommend action and support response, recovery and post-event reporting.[22][24]
• Develop and update legislation, policies, memoranda of understanding, standard operating procedures and coordination mechanisms to align national systems with IHR 2005 and the One Health approach.[25][26][27]
• Strengthen operational readiness through multi-hazard planning, risk profiling and mapping, emergency operations centre procedures, trained rapid response teams, simulation exercises, medical countermeasure arrangements, personnel-deployment protocols and points-of-entry contingency plans.[28][12][29]
• Build specialist capacity through Field Epidemiology and Laboratory Training Programme support, laboratory and epidemiology recruitment, training for health, veterinary and environmental personnel, and collaboration with universities and research institutions.[10][12][13]
• Engage communities through culturally acceptable, scientifically sound risk communication, public awareness campaigns, media engagement, rumour management and participatory communication strategies.[3][30][31]

Governance includes political and technical oversight of planning, implementation, monitoring and evaluation, alongside parliamentary responsibilities for reviewing outdated laws, enacting IHR-related legislation and approving health budgets. The Office of the Prime Minister coordinates disaster risk management and emergency operations, while the Ministry of Finance mobilises and audits domestic resources.[3][19][20]

Monitoring combines annual IHR core-capacity reporting to the World Health Organization, routine quarterly supervision at national, regional and local levels, annual NAPHS reviews, and evaluations after the first implementation year, at mid-term and at completion. Supporting mechanisms include State Party Annual Reporting, Joint External Evaluations, simulation exercises, Intra-Action and After Action Reviews, veterinary-service assessments, surveillance-system reviews and indicator matrices with baselines, milestones and targets.[32][33][34][35]

The estimated five-year implementation cost is approximately 576,323,486 Namibian dollars, equivalent to 38,421,565 United States dollars. Major cumulative cost drivers are workforce development, antimicrobial resistance and points of entry. The plan seeks domestic budget lines, transparent financial management, coordinated partner support and additional donor financing, although funding sources and quantified funding gaps are not fully specified.[36][26][37][16]

Monitoring & Evaluation

The National Action Plan for Health Security (NAPHS) provides a multi-sectoral monitoring, evaluation, surveillance and accountability framework for strengthening International Health Regulations (IHR) core capacities and One Health preparedness. It combines annual indicator tracking, routine supervision, event-based and indicator-based surveillance, periodic reviews, simulation exercises, external assessments and public reporting mechanisms.[2][33][34][8][29][38]

• Monitor implementation through indicators, baselines, milestones, targets, logical frameworks and annual action-plan matrices, including 48 Joint External Evaluation indicators and annual indicators for 2021 to 2025.[2][39][5][17][8][29][38]
• Track preparedness through annual, mid-term and final NAPHS reviews led through the One Health Platform and supported by the IHR National Focal Point, with routine quarterly supervision at national, regional and local levels.[19][33][34][35]
• Assess progress through Joint External Evaluations, State Party Annual Reporting, After Action Reviews, Intra-Action Reviews, simulation exercises, Performance of Veterinary Services assessments and follow-up external expert missions.[32][33][34]
• Maintain integrated disease surveillance and response, including indicator-based, syndromic and event-based surveillance; strengthen interoperability between human and animal health systems; and support continuous IHR event assessment, communication and notification.[10][7][11][21][23]
• Report IHR core-capacity status annually to the World Health Organization and require district structures to share information and report NAPHS implementation through national coordination structures.[23]
• Use the World Health Organization Strategic Planning Portal to share monitoring and evaluation benchmark information openly and support transparency and accountability.[25]
• Audit resource mobilisation, use and efficiency through the Ministry of Finance, while the Ministry of Health and Social Services and the Ministry of Agriculture, Water and Land Reform monitor health and animal-health components respectively.[19][20]

Specific performance targets include 100% timely and complete national surveillance reporting by 2021, six influenza sentinel sites by 2025, 25 trained rapid response teams by 2025, 80% of main designated points of entry adequately equipped by 2025, and 150 people trained to respond to radio-nuclear events by 2025.[8][29][38]

Some extracts do not specify a consolidated reporting calendar, uniform evaluation methodology, accountability sanctions or a single document-wide indicator framework beyond the listed monitoring arrangements and technical-area targets.[12][40][30][33][34]

Costing & Financing

The estimated five-year cost of implementing Namibia’s NAPHS is approximately 576,323,486 Namibian dollars, equivalent to 38,421,565 United States dollars, or an estimated minimum annual investment of approximately 115,264,697 Namibian dollars and about 8 million United States dollars.[9][36]

• Prioritise workforce development, estimated at 192,679,462 Namibian dollars, as the largest cumulative cost driver.[36]
• Fund antimicrobial resistance activities at 82,283,344 Namibian dollars and points-of-entry activities at 56,768,467 Namibian dollars.[36]
• Allocate substantial resources to zoonotic disease, food safety, reporting, real-time surveillance, emergency response operations and the national laboratory system.[36]
• Concentrate implementation expenditure in the first year, followed by costs distributed almost evenly across the remaining four years.[36]
• Establish a government budget line for NAPHS activities, targeted for inclusion by December 2022, and provide identifiable allocations for participating government organisations in the multi-hazard preparedness and response plan.[26][12]
• Mobilise domestic resources and donor or partner support through the Ministry of Health and Social Services, the Ministry of Agriculture, Water and Land Reform, the Office of the Prime Minister, the Ministry of Finance and the National Planning Commission.[16][19][20][41]
• Strengthen financial accountability and transparency in managing implementation funds and audit resource use against NAPHS objectives.[16][20]

Financial constraints are assessed as high likelihood and high impact; proposed responses include increased domestic financing, additional donor and partner funding, improved coordination of donor-funded programmes and transparent external investment.[16]Partner resource mapping identifies zoonotic diseases and preparedness as the technical areas receiving the greatest partner support.[37]

Many activity-level implementation tables specify costs without identifying the currency, confirmed funding source, aggregate financing gap or broader economic assumptions.[27][42][43][44][45]Namibia’s economy grew by an average of 4.6% annually during 2012 to 2016, providing wider economic context rather than a confirmed financing assumption for the plan.[46][13]