National Action Plan For Health Security Of Cabo Verde 2022–2026

Objectives

The National Action Plan for Health Security 2022–2026 aims to build a healthy, resilient Cabo Verde that can prevent, detect and respond rapidly and effectively to public health threats, in line with the International Health Regulations (2005) and a multisectoral One Health approach linking human, animal and environmental health.[1][2][3]Its intended outcome is to reduce morbidity, mortality and the adverse socio-economic consequences of public health emergencies.[4][3]

• Strengthen and sustain national capacities to prevent, detect, assess, notify and respond to public health events, including at points of entry and during epidemic outbreaks or natural disasters.[5][6][7]
• Address priority gaps identified through the 2019 Joint External Evaluation, national self-assessments, public health risk assessments, after-action reviews and sectoral assessments.[1][8][9]
• Organise action across the 19 Joint External Evaluation technical areas, grouped under prevention, detection, response and other International Health Regulations areas.[4][9]
• Prioritise preparedness and contingency planning for risks rated very high or high, including drought, COVID-19, violence, novel influenza, highly pathogenic avian influenza, climate-related hazards, antimicrobial resistance and selected infectious diseases.[10][11]
• Strengthen health-system resilience and contribute to Sustainable Development Goal 3 through investment in workforce capacity, infrastructure, health technologies, information systems, community engagement, health promotion and emergency preparedness.[12]
• Integrate climate-health adaptation, including risk and capacity assessment, integrated environmental and health surveillance, investigation, response, monitoring and programme management.[2]
• Prevent and control antimicrobial resistance through the National Action Plan to Combat Antimicrobial Resistance, coordinated under One Health and aligned with the World Health Organization Global Action Plan.[2][3]
• Strengthen animal-health preparedness, surveillance and response, including implementation of the National Contingency Plan for Highly Pathogenic Avian Influenza and improved control of risks such as African swine fever.[13][14]

Implementation

Implementation uses existing multisectoral coordination mechanisms and combines national leadership, technical working arrangements, local delivery, activity-based costing, domestic resource mobilisation and structured monitoring.[15][16][17]The Ministry of Health administers and manages implementation, while the National Coordination Instance provides the One Health coordination platform and the Multisectoral Technical Team for the Management of Public Health Emergencies provides technical and operational support.[16][12]

• Coordinate implementation through the Ministry of Health, the National Institute of Public Health, the National Coordination Instance and a multisectoral follow-up core supervised by the designated national coordinating body.[18][17][19]
• Engage the Office of the Prime Minister in high-level leadership, decision-making, political advocacy and oversight of institutional responsibilities.[12]
• Involve government sectors, local authorities, development partners, United Nations agencies, media, civil society, private organisations, the Cabo Verde Red Cross and institutions responsible for agriculture, environment, finance, transport, civil aviation, ports, water and sanitation.[18][17][20][21]
• Deliver activities locally through municipal health offices, city councils and other established local structures covering human, animal and environmental health.[16]
• Strengthen operational capacity by recruiting doctors, nurses and laboratory technicians, expanding virology laboratory capacity from one laboratory to four across islands, and providing field epidemiology training through the National Institute of Public Health and partners.[16][12]
• Develop and monitor integrated multi-risk and disease-specific contingency plans, with clear coordination, command and communication arrangements for very high and high risks.[11]
• Use veterinary focal points, decentralised agricultural services and the Veterinary Laboratory to collect, verify, analyse and notify epidemiological information, including to national, regional and international bodies.[13]
• Cost activities and map domestic and external funding sources through multisectoral workshops, prioritising urgent actions and actions with available financing in the early implementation period.[4][3]
• Finance implementation partly through the General State Budget and seek inclusion of the endorsed plan in national fiscal planning, while mobilising partner support and resources for human, infrastructure and equipment needs.[3][17]
• Implement a plan budget of 2,783,928,058 Cabo Verdean escudos, equivalent to 26,263,472 United States dollars; detection represents 65.9% of costs, and 52.9% of expenditure is scheduled for the first two years.[4]
• Address the funding gap, as only 17% of planned activities had funding at the time of costing.[4]
• Monitor activity-level process and result indicators through a logical model, designated focal points, defined collection frequencies and verification sources.[17][19]
• Hold biannual progress reviews and annual reviews incorporating after-action reviews, simulation exercises and State Party Self-Assessment Annual Reports; conduct at least one national simulation exercise each year.[19]
• Undertake a Joint External Evaluation and a Ministry of Health-led mid-term evaluation in 2024, supported by the designated national coordinating body and relevant partners.[19][22]
• Review and update the plan in response to changing needs or epidemiological situations.[1]

Monitoring & Evaluation

The National Action Plan for Health Security (NAPHS) establishes a structured monitoring and evaluation system to track implementation across 19 technical areas, support compliance with the International Health Regulations (2005), and strengthen prevention, detection and response capacities through a One Health approach.[17]Monitoring is overseen by the Ministry of Health and the designated national coordinating body, supported by a multisectoral follow-up core.[12][17][19]

• Use a logical model with activity-level process and result indicators, defined collection frequencies and verification sources in the NAPHS planning tool.[17][19]
• Designate focal points for each technical area to promote ownership, coordination and interoperability among stakeholders.[19]
• Document and disseminate implementation progress through periodic meetings, including biannual reviews of progress, challenges and good practice.[19]
• Hold annual reviews that consider after-action reviews, simulation-exercise findings and State Party Self-Assessment Annual Reports.[19]
• Submit annual International Health Regulations implementation reports and conduct an after-action review after each public health event.[8][19]
• Conduct at least one national simulation exercise each year to test International Health Regulations capacities.[19]
• Undertake a Joint External Evaluation and a mid-term evaluation in 2024, led by the Ministry of Health and the national coordinating body with partner support.[19][22]
• Use annual health-sector reviews, veterinary-service performance evaluations, environmental assessments and other relevant assessments to inform implementation.[22]

Baseline assessment and accountability draw on the 2019 Joint External Evaluation, public health risk assessments, State Party self-assessment reporting, after-action reviews and sectoral assessments.[1][23][8][9]The Joint External Evaluation assesses capacities including financing, legislation, surveillance, laboratories, emergency operations, risk communication, points of entry, vaccination and biosafety; it identified limited or absent capacity in many areas, partly because existing procedures had not been documented.[8][10]

Risk assessment is used to prioritise contingency planning for very high and high risks, while implementation of related contingency plans is to be monitored.[10][11]Surveillance arrangements include integrated environmental and health surveillance for climate-related risks, veterinary epidemiological reporting through decentralised focal points and central analysis, laboratory diagnosis, and notification to national, regional and international bodies after information is verified.[13][2]

Formal accountability relies on coordination at all levels, compliance with international obligations and information-sharing requirements, and clear roles for implementing parties.[16][12]The source does not provide a consolidated public accountability framework or a complete list of individual NAPHS indicators and targets.[12][19]

Costing & Financing

The NAPHS has a costed implementation plan and identifies domestic budgeting, partner support and resource mapping as central financing mechanisms, but substantial funding needs remain.[4][3][17]The estimated cost of executing planned activities is 2,783,928,058 Cabo Verdean escudos, equivalent to 26,263,472 United States dollars.[4]

• Allocate costs by Joint External Evaluation thematic group, with Detection accounting for 65.9%, Other International Health Regulations areas 15.1%, Prevention 10.8% and Response 8.2%.[4]
• Schedule 52.9% of the budget for the first two years of implementation.[4]
• Prioritise the National Laboratory System, Human Resources and Points of Entry, which account for 42.5%, 14.1% and 10.1% of costs respectively.[4]
• Address the funding gap, as only 17% of planned activities have identified funding.[4]
• Include domestic financing in the General State Budget and seek endorsement and integration of the plan within national fiscal planning.[3][17]
• Map resources with government and development partners, identify potential internal and external funding sources, and mobilise additional partner support.[18][4][3]

A separate cost-distribution extract reports one-time costs of 1,131,628,408 Cabo Verdean escudos and 10,675,740 United States dollars, recurrent costs of 1,088,599,650 Cabo Verdean escudos and 10,269,808.02 United States dollars, and capital or investment costs of 563,700,000 Cabo Verdean escudos and 5,317,925 United States dollars.[20]Capital or investment costs represent 20.2% in that extract.[20]

Financial assumptions include timely and sufficient allocations, continued government funding, identification of contributing partners and availability of adequate funds for implementation.[15]World Health Organization support for preparation of the plan included technical and financial assistance.[1][18]The document identifies resource requirements for workforce, infrastructure, technologies, information systems, community engagement, animal and environmental health, and veterinary inspection and quarantine capacity, but does not quantify most of these needs.[14][12][17]