National Action Plan For Health Security (NAPHS) 2018-2022

Objectives

Myanmar’s National Action Plan for Health Security (NAPHS) 2018–2022 is a five-year framework for sustainable implementation of the International Health Regulations (2005), intended to prevent, detect, control and respond to public health risks and international disease spread while minimising unnecessary disruption to travel and trade.[1][2]Its vision is high levels of health and wellbeing security through universal health coverage and a resilient health system able to adapt to outbreaks, risks and emergencies; its mission is to sustain national multisectoral capacity for preventing public health emergencies.[3]

• Reduce human and animal morbidity, mortality, disability and socioeconomic disruption caused by public health threats.[4][3]
• Strengthen capacity to prevent, rapidly detect, verify, confirm, respond to and recover from outbreaks and other health emergencies.[1][4]
• Implement 19 technical areas across prevention, detection, response, other International Health Regulations-related hazards and points of entry.[1][5]
• Apply a One Health approach linking human, animal and environmental health, including coordinated surveillance and action at their interface.[1][6]
• Align health security action with the Myanmar National Health Plan, universal health coverage and sustainable health-system strengthening rather than creating parallel systems.[1][6]
• Apply country ownership, equity, gender mainstreaming, human rights, community engagement and intersectoral, multidisciplinary collaboration as guiding principles.[3]

Priority capacity gaps include antimicrobial resistance, biosafety and biosecurity, preparedness, emergency response operations, medical countermeasures, risk communication, chemical events and radiation emergencies.[7]The plan also seeks to strengthen legislation and formal procedures, food safety, zoonotic disease management, immunisation, laboratory systems, real-time surveillance, reporting, workforce development, points of entry and links between public health and security authorities.[8][9][10]

Joint External Evaluation findings provide the principal baseline for prioritisation: the 2017 assessment covered 48 indicators, of which 2 were rated green, 33 yellow and 13 red.[4][11]Immediate action was prioritised for technical areas assessed as having no capacity, including antimicrobial resistance, biosafety, preparedness, emergency operations, medical countermeasures, risk communication, chemical events and radiation emergencies.[4]

Implementation

Delivery is based on whole-of-government, multisectoral implementation led by the Ministry of Health and Sports, combining national leadership with state, regional, district and township action.[5][2]The plan uses the National Action Plan for Health Security as a coordination platform to integrate existing sectoral plans, national budgets, partner assistance and operational workplans for each technical area.[7][12]

• Provide political and technical oversight through the Minister responsible for the Ministry of Health and Sports, the National Cross Government Steering Committee and the Technical Strategy Group for Public Health Emergency Preparedness.[3]
• Coordinate implementation through the Technical Strategy Group, guided by the Cross Government Steering Committee within the Myanmar Health Sector Coordination Committee.[1][5]
• Assign lead departments, associated ministries and development partners responsibility for area-specific operational workplans, implementation, monitoring and reporting.[7]
• Synchronise overlapping activities and coordinate human, technical, financial and time resources to reduce duplication and improve value for money.[7]
• Engage communities through culturally acceptable, scientifically sound risk communication and participatory implementation that reaches all population groups.[3]
• Maintain cross-border, regional and subregional cooperation, information exchange and memoranda of understanding to support coordinated interventions.[6][8]

Core government participants include health, agriculture, livestock and veterinary, environmental, aviation, port, customs, immigration, forestry, defence, foreign affairs, police, administration, atomic energy, relief and resettlement, and city-development institutions.[4]Development and technical partners include the World Health Organization, Food and Agriculture Organization of the United Nations, World Bank, Asian Development Bank, Japan International Cooperation Agency, United States Centers for Disease Control and Prevention, United States Agency for International Development, Public Health England and other partners.[13][4]

Operational delivery includes developing legislation, guidelines, standard operating procedures and contingency plans; building laboratory, surveillance, workforce and emergency-operations capacity; conducting training, field visits, simulations and functional exercises; strengthening real-time reporting; and supporting preparedness at points of entry, for chemical events and for radiation emergencies.[14][15]The plan calls for at least one table-top exercise and one functional exercise each year, supported by a continuous-improvement programme for preparedness, Incident Management System personnel and emergency operations centre functions.[14]

Monitoring combines regular coordination, supervision and field visits with twice-yearly assessment of technical-area objectives and output indicators, annual reporting, annual activity and costing reviews, and a Joint External Evaluation every five years.[5][16]Implementation updates are to be shared through monthly and biannual meetings, with minutes, resource mapping, evaluation findings, constraints and stakeholder input informing annual revisions.[16]Activities are intended to use measurable outcome indicators, milestones and targets, although the source does not provide a complete consolidated indicator framework or reporting template.[12]

The plan’s total estimated cost for 2018–2022 is USD 158,524,934.49.[5]Prevention accounts for 56.08% of estimated costs, detection 24.35%, other International Health Regulations-related hazards 17.99% and response 1.58%.[5]Resource mobilisation is expected to combine domestic resources, mapped external support, private-sector engagement and alignment with national budgeting, while implementation risks include budget availability, human resources, government commitment and stable security and political conditions.[4][12]

Monitoring & Evaluation

Monitoring and evaluation combine routine implementation review, technical-area supervision, indicator tracking and periodic external assessment. The framework uses the 2017 Joint External Evaluation (JEE) as a baseline, which assessed 48 indicators: 2 green, 33 yellow and 13 red, identifying major capacity gaps in antimicrobial resistance, biosafety, preparedness, emergency operations, medical countermeasures, risk communication, chemical events and radiation emergencies.[4][11]

• Assess technical-area objectives and output indicators twice yearly, complete annual reporting, and undertake a JEE every five years.[5]
• Review activities, achievements, budgets, constraints and resource mapping through monthly, biannual and annual coordination and evaluation meetings; retain meeting records to inform annual plan revisions.[16][17]
• Use Activity Monitoring Tables, area-specific operational workplans and responsible focal persons to track implementation, delays, progress, gaps and reporting across technical areas.[7][18]
• Align quantitative achievements, verifiable objectives and indicators with the International Health Regulations Monitoring and Evaluation Framework, including an intended impact assessment after three and five years.[17]
• Strengthen surveillance through indicator-based and event-based reporting, notifiable-disease review, laboratory collaboration, integrated human-animal-wildlife surveillance, data-quality assessment and electronic real-time reporting systems.[8][14][19]
• Conduct at least one table-top and one functional emergency exercise annually, use after-action reviews to identify lessons, and evaluate public information messaging through feedback mechanisms.[14][20]

Technical monitoring includes output measures such as trained personnel, meetings, plans, guidelines, standard operating procedures, laboratory functionality, exercises, surveillance reports, equipment and facilities. Several extracts do not specify detailed indicator definitions, targets, reporting templates, data-verification procedures or formal sanctions for non-performance.[21][9][22]

Costing & Financing

The five-year National Action Plan for Health Security for 2018–2022 has a total estimated cost of USD 158,524,934.49. Prevention accounts for 56.08% of costs, Detect for 24.35%, other International Health Regulations-related hazards for 17.99%, and Response for 1.58%.[5]

• Prioritise investment in immunisation, the National Health Laboratory, chemical events, zoonotic diseases, biosafety and biosecurity, antimicrobial resistance, points of entry, workforce development, radiation emergencies and emergency response operations.[5]
• Map domestic and external financing annually, align area-specific workplans with national budgets, identify cost drivers and potential funding sources, and reduce duplication through activity synchronisation.[7][12]
• Mobilise resources through the National Cross Government Steering Committee, which is responsible for monitoring programme budgets and expenditure.[23]
• Use domestic resources for sustainability while seeking development-partner support, including from the World Health Organization, United States Agency for International Development, Food and Agriculture Organization of the United Nations, World Bank, Asian Development Bank, Japan International Cooperation Agency and other partners.[13][3]
• Recognise implementation risks associated with government commitment, policy support, political and security conditions, budget availability and human resources.[4][5]

Development partner support includes Gavi Health Systems Strengthening 2 funding for immunisation activities, UNICEF support for multi-hazard emergency preparedness planning, and Asian Development Bank contributions to implementation and selected points-of-entry activities.[24][25][26]Several activity tables mark existing budgets as unavailable, and many do not specify currency, financing source, allocation basis or funding gap.[21][27][28]