National Pandemic Preparedness and Response Plan

Objectives

The Pandemic Preparedness and Response Plan provides a whole-of-government and whole-of-society framework within the National Health Emergency Operations Plan and National Emergency Operations Framework. It updates earlier influenza-pandemic preparedness arrangements and aims to minimise deaths, serious illness, disruption to community life and economic harm, while enabling essential societal functions to continue as far as possible during a pandemic.[1][2][3][4][5]The framework applies to novel acute respiratory infections with pandemic potential, including influenza, severe acute respiratory syndrome and other acute respiratory pathogens, and incorporates lessons from influenza outbreaks and the COVID-19 response.[1][2]

• Organise preparedness and response through phased escalation covering standby preparedness, prevention of entry, containment of spread, surge response, post-peak easing and recovery, with actions adapted to national risk assessments, transmission patterns and World Health Organization phase assessments.[6][7][8][9]
• Maintain emergency structures, timely alerts, risk assessment, disease surveillance and International Health Regulations core capacities during the standby phase.[9][10]
• Prevent or delay viral entry through border health measures, traveller management, notification systems, quarantine and isolation capacity, and timely public risk information.[11][12][13][14]
• Contain detected cases, clusters and island-level outbreaks through case investigation, contact tracing, testing, infection prevention and control, clinical management and rapid mobilisation of additional personnel.[15][16][17][18]
• Reduce mortality and morbidity during community transmission by expanding health-system, laboratory, medical-supply and hospital surge capacity while maintaining essential services, including vaccination, maternity, mental health, emergency and home-based care.[19][20][21]
• Protect vulnerable populations, including persons with disabilities, migrant workers, children, older people and women, through equitable access to healthcare, scarce resources, accessible communication, relief, social protection and psychosocial support.[8][22][23]
• Safeguard societal functioning by maintaining essential goods, services, supply chains, critical infrastructure and agency business continuity arrangements throughout response phases.[24][10][25][26]
• Support recovery by progressively easing measures, restoring routine services, mobilising resources, reviewing response arrangements, strengthening resilience and retaining readiness for resurgence.[27][28][29][30][31]

Implementation

Implementation relies on coordinated national and local action led by the Ministry of Health, with the Health Protection Agency serving as the lead national agency for public health emergencies and surveillance.[32]The plan combines strategic oversight, incident management, multisectoral workstreams, operational standard operating procedures, exercised contingency plans and evidence-led decisions.[3][33][10]It requires agencies, local councils, healthcare providers, civil society, private-sector organisations, international partners and affected communities to contribute within an all-of-government and all-of-society response model.[1][32][34]

• Activate Health Emergency Operations Plan structures in alert phases 3 and 4, and activate National Emergency Operations Centre structures from phase 5 through the pandemic phase where required by risk assessment and national decisions.[32]
• Coordinate strategic and operational action through the Health Emergency Coordination Committee, Disaster Management Steering Committee when national emergency structures are activated, Technical Advisory Committee, National Task Force, incident command and Emergency Operations Centre workstreams.[24][33][11]
• Assign workstreams for planning, surveillance, contact tracing, rapid response, laboratories, border health, information management, logistics, finance, human resources, medical care, quarantine, mental health, social support, compliance and risk communication.[33][9]
• Maintain planning functions to analyse developments, forecast needs, identify resource requirements, mobilise domestic and international support, develop policy options, maintain disaggregated information and support business continuity.[33]
• Train key personnel, orient contingency staff, conduct inter-agency exercises and drills, and maintain a workforce with pandemic-response competencies.[3][10][11]
• Use surveillance, epidemiological, clinical and virological data, national and subnational risk assessments, World Health Organization alerts and international monitoring to determine phase changes and adjust interventions.[3][7][32][9]
• Maintain annual monitoring and evaluation arrangements, including minimum datasets for each phase, annual implementation reporting, published reports, International Health Regulations capacity assessment and corrective action from exercises.[35][36][37]
• Apply time-bound operational targets for activation, risk assessment, notification, contact tracing, quarantine, border controls, facility readiness and committee coordination, including activation of specified emergency coordination structures within 24 hours of relevant decisions.[13][25][38][39]
• Communicate through multilingual, accessible public messaging, websites, dashboards, press briefings, call centres, social-media monitoring and coordination with the World Health Organization, United Nations Maldives and other international partners.[40][41][23][42]
• Mobilise financial, material and human resources through national mechanisms and international support, including a public health emergency contingency budget following National Task Force decision-making; the plan does not specify monetary budget amounts, allocations or funding gaps.[24][11][13]

Monitoring & Evaluation

The plan establishes a phased monitoring, evaluation and accountability system linking risk assessment, surveillance, operational readiness and recovery. It combines routine preparedness monitoring with intensified reporting, epidemiological analysis and time-bound operational targets as pandemic risk escalates.[35][38][27][30]

• Maintain integrated surveillance through human, animal and community reporting; monitor overseas disease trends; analyse virological, epidemiological and clinical evidence; and use these findings to determine pandemic phases and national alert levels.[32][35][17]
• Define minimum annual datasets for each phase, covering operational, health-system, epidemiological and surveillance indicators, and incorporate updates into annual monitoring reports published on the Ministry of Health website.[35]
• Conduct outcome, output and process evaluation, monitor implementation annually, exercise surveillance, notification, infection prevention and control, border response and cluster-control systems annually, and share findings for corrective action.[35][36][37]
• Conduct at least one pandemic exercise or drill annually for each phase, make exercise reports available, and use drills to test inter-agency integration, staff readiness and adjustments to the plan.[3][10]
• Maintain preparedness evidence through published International Health Regulations core-capacity reports, agency business-continuity plans, pandemic strategies, sector guidelines, standard operating procedures and gazetted regulations.[10]
• Monitor key preparedness capacities, including current response-workforce and critical-stock records, annual animal-health surveillance, timely international-threat risk assessments, and influenza vaccine uptake among high-risk groups, for which an 80% target is specified.[34][43][44]
• Use phase-specific triggers and targets to assess escalation and de-escalation, including transmission patterns, case clusters, community spread, vaccination coverage, health-system capacity and epidemiological parameters.[8][9][45][46]
• Issue regular operational reporting, including daily situation updates and dashboards during active response, weekly situation and response reports to national coordination bodies, and weekly or monthly epidemiological analyses, forecasts and health-system capacity reports.[38][41][45][17]
• Track response timeliness through targets such as activation of emergency coordination structures within 24 hours of relevant decisions, risk assessments within 48 hours of relevant World Health Organization alerts, case investigation and contact tracing within 24 hours, and quarantine or isolation of suspected cases within 48 hours of notification.[13][47][48][16]
• Monitor response delivery through operational indicators, including stock levels and usage, laboratory supplies, essential commodities, health-facility readiness, telecommunications and outbreak-system downtime, public-information outputs, helpline performance, border procedures and compliance with public health measures.[26][49][50][51]
• Require daily review of the situation during active response, with actual and anticipated impacts and response actions reported at least weekly, or more frequently as determined, to the Health Emergency Coordination Committee and Disaster Management Steering Committee.[25]
• Support accountability through documented coordination meetings, resource and procurement records, published reports, agency websites, dashboards, notification systems and clear responsibilities for the Ministry of Health, Health Protection Agency and emergency coordination structures.[11][41][52]
• Maintain recovery monitoring by reviewing surveillance for resurgence, monitoring vaccine coverage and effectiveness, analysing mortality and disease patterns, documenting lessons learned, updating protocols and presenting indicators to coordination committees.[27][28][46][30]

Costing & Financing

The plan identifies resource mobilisation, finance management and contingency funding as essential implementation functions, but does not provide a costed plan, total budget, monetary allocation, funding-gap estimate or economic assumptions.[33][9][25][30]

• Mobilise and dedicate financial, material and human resources as pandemic risk escalates, including through central national coordination and post-peak transition arrangements.[8][24]
• Activate a public health emergency contingency budget following a National Task Force decision, with the Ministry of Health, National Task Force and Ministry of Finance responsible for the mechanism.[13]
• Maintain planning functions for developing resource requirements, sourcing and managing finance, procuring and managing stocks, mobilising personnel and infrastructure, and coordinating domestic and international resources.[33][9]
• Seek technical, humanitarian and financial support from international partners for gaps in the government response, including engagement through the Health Emergency Operations Centre and United Nations partners.[24]
• Map available and committed resources and develop proposals for external aid and fund mobilisation within 10 days of detecting the first national case.[15]
• Maintain weekly records of human, material and financial resources, alongside procurement documentation and established procedures for resource release.[52][53][54]
• Prepare financial and legal arrangements for pandemic vaccine procurement within 24 hours of the relevant decision, and involve the Ministry of Finance in planning medical-supply orders and national stockpile requirements.[26][45]
• Mobilise funds and resources during recovery, estimate standby resources for resurgence, and review and replenish essential national supply reserves where required.[27][29][30]
• Resource operational needs including medical and laboratory supplies, vaccine cold-chain and logistics, testing, quarantine and isolation capacity, oxygen, transport, communications, staffing, relief, social protection, psychosocial support and temporary medical facilities, without assigning monetary values.[34][49][45][21]