National Action Plan For Health Security (NAPHS)

Objectives

Namibia’s National Action Plan for Health Security (NAPHS) provides a five-year, government-owned roadmap to strengthen the capacities required under the International Health Regulations (IHR) (2005), using a unified One Health system spanning human, animal, wildlife and environmental health. Its vision is a well-prepared system that prevents, promptly detects and effectively responds to public health threats, while its mission is to develop and maintain a comprehensive, multisectoral and collaborative national action plan for health security and emergency response.[1][2]The plan is presented principally for 2021–2025, although some source material labels it 2020–2025.[3][4]

• Strengthen prevention, early detection, reporting, preparedness, response, recovery and national resilience against outbreaks, zoonoses, climate-related events, chemical, radiological and other public-health hazards.[5][6][7]
• Address gaps identified through the 2016 Joint External Evaluation (JEE), which found demonstrated or sustainable capacity in 8 of 48 indicators, limited or developed capacity in 24, and no capacity in 16.[8][9]
• Improve core capacities across 19 technical areas, including legislation and financing, IHR coordination, antimicrobial resistance, zoonotic disease, food safety, biosafety and biosecurity, immunisation, laboratories, surveillance, reporting, workforce development, emergency operations, points of entry, chemical events and radiation emergencies.[10][9][11]
• Align health security with universal health coverage, resilient health systems, the Sustainable Development Goals, disaster-risk management and wider national development priorities.[12][8][10]
• Apply resilience, country ownership, leadership, community engagement, evidence-led planning, risk management, cross-border cooperation and intersectoral collaboration as guiding principles.[8][2]

Implementation

Implementation uses a multisectoral One Health and Sector Wide Approach, with government stewardship, technical leadership from the Ministry of Health and Social Services, and coordination through the Multi-Agency Committee, or One Health Platform. The platform is the highest decision-making body for policy formulation and coordination oversight, reports health-security concerns to Cabinet and the Presidency, and operates before, during and after public-health events.[13][14][15]The IHR National Focal Point, located within the Ministry of Health and Social Services, acts as the implementation reference point, manages day-to-day IHR communication and coordination, and is intended to operate continuously.[15][16][17]

• Coordinate national preparedness, resource mobilisation, risk mapping, joint assessments, contingency planning, asset inventories and technical working groups through the One Health Platform.[18][19]
• Deliver activities through national, regional, district and local structures, with District Health Management Teams, Public Health Emergency Management Committees and District Disaster Management Committees supporting implementation until national coordination arrangements are fully operational.[17]
• Engage the Office of the Prime Minister, ministries responsible for health, agriculture, environment, finance, defence, security, planning and transport, alongside universities, laboratories, civil society, communities, the Namibia Red Cross Society, private-sector actors and development partners.[10][20][21]
• Strengthen surveillance through Integrated Disease Surveillance and Response, event-based and syndromic surveillance, interoperable human and animal reporting, laboratory networks, electronic systems and formal information sharing across sectors.[22][23][24]
• Build operational readiness through a public health emergency operations centre, rapid response teams, multi-hazard risk assessment, simulation exercises, after-action and intra-action reviews, emergency plans, standard operating procedures, medical countermeasure arrangements and risk-communication systems.[25][26][27][28]
• Monitor implementation through a logical framework, JEE-linked indicators, annual coordination reviews, routine quarterly supervision, State Party Self-Assessment Annual Reporting, simulation exercises and internal evaluations after year one, mid-implementation and at the end of the plan period.[29][26][30]
• Finance implementation through domestic government resources, partner contributions and further donor engagement. The estimated five-year requirement is Namibia dollars 576,323,486, equivalent to US dollars 38,421,565, with Detect accounting for approximately 47% of the total cost.[31][32]
• Prioritise expenditure on workforce development, antimicrobial resistance and points of entry, the three largest technical-area cost drivers.[33][34]

Monitoring & Evaluation

Namibia’s National Action Plan for Health Security (NAPHS) uses the International Health Regulations Monitoring and Evaluation Framework and the 2016 Joint External Evaluation (JEE) as its principal baseline for strengthening prevention, detection and response capacities. The JEE assessed 48 indicators: 8 (16.6%) showed demonstrated or sustainable capacity, 24 (50%) limited or developed capacity, and 16 (33.3%) no capacity.[8][9]

• Monitor implementation through logical frameworks, SMART indicators, baselines, milestones, targets and implementation schedules across 19 technical areas.[29][26][11]
• Report International Health Regulations core-capacity status annually to the World Health Organization through the International Health Regulations National Focal Point and the State Party Self-Assessment Annual Reporting Tool.[16][17][30]
• Strengthen surveillance through Integrated Disease Surveillance and Response, indicator-based, syndromic and event-based surveillance, interoperable human and animal health systems, laboratory networks and electronic reporting.[22][35][23][24]
• Review progress through quarterly supervision, annual coordination-committee reviews, annual health-sector reviews, veterinary-services and environmental assessments, simulations, intra-action reviews and after-action reviews.[26][30][18]
• Conduct internal evaluations at the end of the first implementation year, midway through implementation and at the end of the plan period, using Multi-Agency Committee participation, site visits and internal and external stakeholders.[30]
• Assign monitoring responsibilities to the Ministry of Health and Social Services for the overall plan, the Ministry of Agriculture, Water and Land Reform for animal-health components, the Office of the Prime Minister for annual, mid-term and final reviews, and the Ministry of Finance for audits and assessment of resource utilisation.[21][36]
• Support transparency and accountability through the World Health Organization Strategic Planning Portal, civil-society scrutiny, media engagement, public debate and citizen feedback.[13][15]

Indicators cover legislation and policy, coordination, workforce, immunisation, laboratory quality and specimen transport, surveillance timeliness and completeness, reporting, emergency operations, risk communication and points of entry. Selected targets include 100% timely and complete surveillance reporting, 100% timely reporting of potentially significant public-health events, annual risk-profile updates, annual simulations, and implementation targets extending to 2025.[37][25][11][38]The supplied material does not provide a single consolidated indicator matrix, independent accountability mechanism or sanctions for non-performance.[11][38]

Costing & Financing

The estimated five-year cost of implementing all NAPHS activities during 2021–2025 is NAD 576,323,486, equivalent to USD 38,421,565.[10][31][34]This is approximately NAD 115,264,697 per year, or about USD 8 million annually.[5]

• Allocate the largest thematic-area amount to Detect at NAD 269,104,169, followed by Prevent at NAD 203,067,640, other International Health Regulations-related hazards and points of entry at NAD 63,255,243, and Respond at NAD 40,896,434.[33]
• Prioritise workforce development, antimicrobial resistance and points of entry as the three largest cost drivers.[33][32][34]
• Plan government allocation of approximately NAD 144,080,871, equivalent to USD 9 million, annually through human-resource costs, direct priority-intervention allocations and other sectoral operational expenditure.[31]
• Mobilise domestic funding, partner contributions and additional donor support, while using resource mapping to identify investments and gaps.[39][26]
• Establish a government budget line for NAPHS activities, with targets rising from a zero baseline to 5% in 2021, 7% in 2022, 10% in 2023, 12% in 2024 and 15% in 2025.[40]
• Manage financial risks through advocacy for increased domestic funding, donor coordination, financial accountability and transparency in fund management.[39]

The plan frames preparedness expenditure as an investment intended to reduce the larger health and economic consequences of epidemics and pandemics.[5]Activities are phased across year 1, year 2 and years 3–5 according to anticipated resources and the financial outlook, with technical areas expected to identify potential domestic and external funding.[41]Although many action matrices contain activity-level costs, the supplied material often does not specify currency, financing source, funding gap, disbursement schedule or economic assumptions for individual items.[42][43]