National Action Plan for Health Security

Objectives

The National Action Plan for Health Security (NAPHS) 2019–2023 is Uganda’s five-year, whole-of-government framework for meeting International Health Regulations (IHR) (2005) requirements, strengthening health security and community resilience, and supporting healthy, wealthy and resilient communities by 2040.[1][2][3]It seeks to protect Uganda’s population, visitors, tourists and travellers from infectious diseases, biological, chemical and radiation hazards, and other public health threats before they escalate into international emergencies.[4][5]

• Strengthen national capacity to prevent, detect and respond to public health threats and emergencies.[2][3][6]
• Integrate human, animal and environmental health through multisectoral and One Health collaboration, coordination, collective responsibility, partnerships, information sharing, transparency and accountability.[4][6]
• Build and sustain core capacities for preparedness, detection and response through a roadmap covering 19 technical areas.[2][7][8]
• Prioritise action on national legislation, policy and financing; IHR coordination; antimicrobial resistance; zoonotic diseases; food safety; biosafety and biosecurity; immunisation; laboratories; surveillance; reporting; workforce development; preparedness; emergency response; public health and security links; medical countermeasures; risk communication; points of entry; chemical events; and radiation emergencies.[9][10]
• Establish a functional national antimicrobial resistance response across human, animal, crop, food-safety and environmental sectors, covering detection, resistant-infection surveillance, healthcare-associated infection prevention and control, antimicrobial stewardship and e-Health.[11]
• Map and align domestic and external financing, including financing for IHR capacities and timely emergency response.[3][12][8]

Implementation

Implementation uses a multisectoral, multi-pronged and One Health model coordinated by the Office of the Prime Minister, with operational support from the Ministry of Health and participation by government bodies, districts and municipalities, academia, civil society, United Nations agencies, development and implementing partners, international organisations and private-sector actors.[5][2][6][12]The approach aligns NAPHS implementation with Uganda Vision 2040, the Third National Development Plan, sector strategies, technical guidelines and relevant policies.[12]

• Provide oversight through the Office of the Prime Minister and a national steering committee, chaired by the technical working group chair, working with the National One Health Platform and technical-area focal points.[2][13]
• Maintain roles for the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, Ministry of Water and Environment and Uganda Wildlife Authority in policymaking, guideline development, training, capacity building, resource mobilisation, health-response monitoring and partner coordination.[2]
• Build on Integrated Disease Surveillance and Response, Rapid Response Teams, the Public Health Emergency Operations Centre and the National One Health Platform.[5]
• Support decentralised implementation in districts, municipalities and city authorities through guidance from line ministries and relevant authorities.[2][7]
• Track delivery electronically through technical leads from all 19 technical areas and sector representatives, and convene the expanded multisectoral health-security platform twice yearly to review progress, share learning and identify subsequent priorities.[7]
• Conduct progress checks every six months until the next Joint External Evaluation, report through Joint Sector Reviews, and use mid-year and annual reviews to identify challenges, good practice and priority actions.[12][14]
• Use the IHR Monitoring and Evaluation Framework, World Health Organization benchmarks, the IHR Self-Assessment Annual Reporting Tool, After Action Reports and simulation-exercise data for monitoring and annual prioritisation.[13][14]
• Report progress through monthly reports, quarterly newsletters, publications, conferences and ministry quarterly review meetings; notify the IHR National Focal Point and relevant animal-health authorities of progress and major human or animal health events.[14][15][12]
• Strengthen antimicrobial resistance delivery by finalising sector implementation and monitoring plans, procuring laboratory supplies, improving sample referral and laboratory information systems, training personnel, and establishing quality-assurance systems.[16][17]

The estimated 2019–2023 implementation cost is 160 billion Ugandan shillings, equivalent to USD 43 million; principal cost drivers are surveillance, antimicrobial resistance, medical countermeasures, personnel deployment and national laboratory systems.[5][2]Financing is to be integrated into sector budgets and the Third National Development Plan, alongside additional government and partner resource mobilisation.[5][12]

Monitoring & Evaluation

Monitoring and evaluation combine periodic implementation review, International Health Regulations (IHR) assessments, surveillance systems and structured reporting. Progress is to be coordinated nationally by the Office of the Prime Minister, working with the IHR National Focal Point and the technical working group chair.[13]

• Conduct National Action Plan for Health Security progress checks and identify priority activities every six months until the next Joint External Evaluation.[12]
• Track implementation electronically through technical-area leads and sector representatives, and convene the expanded multisectoral health-security platform twice yearly to review progress, share lessons and set priorities.[7]
• Use mid-year and annual review meetings involving government, implementing partners and development partners to identify progress, challenges, good practice and subsequent priorities.[14]
• Report progress through Joint Sector Reviews coordinated by the Office of the Prime Minister.[12]
• Use stakeholder self-reporting and regular technical review meetings to examine funding updates, progress, successes, bottlenecks, implementation gaps and areas for improvement.[13]
• Apply the global IHR Monitoring and Evaluation Framework, World Health Organization Benchmarks, the IHR Self-Assessment Annual Reporting Tool, After Action Reports and simulation-exercise data.[13]
• Use annual reviews of benchmark, self-assessment, simulation-exercise and After Action Report findings to prioritise activities for the following year.[14]
• Produce monthly progress reports for ministries, the Prime Minister, Uganda-based organisations and development partners; issue quarterly newsletters; contribute to publications and conferences; and participate in ministry quarterly review meetings.[14][15]

The 2017 Joint External Evaluation assessed 50 indicators across 19 technical areas: 10 indicators showed demonstrated capacity, 20 developed capacity, 15 limited capacity and five no capacity; none achieved sustainable capacity.[3]The assessment informed the situation analysis and plan priorities.[3]

• Monitor national health-security capacities through technical indicators scored from 1 to 4 across prevention, detection and response, including legislation and financing, coordination, antimicrobial resistance, zoonotic disease, food safety, biosafety, immunisation, laboratories and real-time surveillance.[9]
• Strengthen detection and response through Integrated Disease Surveillance and Response, national laboratory capacity, Rapid Response Teams and the Public Health Emergency Operations Centre.[5]
• Provide regular reports to the World Health Organization and the World Organisation for Animal Health, and notify the Ministry of Health IHR National Focal Point and the Ministry of Agriculture, Animal Industry and Fisheries delegate of progress towards IHR competencies and major human or animal health events.[12]
• Develop national and sector-specific antimicrobial resistance monitoring and evaluation plans, including indicators across all five strategic areas and reporting from facilities to national and global levels.[16][17]
• Optimise antimicrobial resistance surveillance, sentinel-site reporting, sample referral and national systems for collecting, collating, reviewing and reporting data; maintain a biorepository of isolates and establish laboratory quality-assurance programmes.[17]

Although the plan sets review cycles, assessment tools and reporting channels, it does not specify a single consolidated indicator framework, quantified performance targets, reporting templates, a complete evaluation methodology or accountability sanctions.[12][13]

Costing & Financing

The National Action Plan for Health Security implementation estimate for 2019–2023 is 160 billion Ugandan shillings, also presented as USD 43 million.[5][2]Financing is intended to combine integration within sector budgets and the Third National Development Plan with additional government and health-partner resource mobilisation.[5][12]

• Map and align existing and potential domestic and external financing for implementation.[3]
• Incorporate the plan into the Third National Development Plan and seek further funding from health partners.[5]
• Integrate health-security resources into sector budgets and use links with national strategic and operational plans to support domestic financing.[12]
• Prioritise financing for IHR core capacities and timely response to public health emergencies.[8]
• Focus expenditure on surveillance, antimicrobial resistance, medical countermeasures, personnel deployment and national laboratory systems, which are identified as the principal cost drivers.[2]

Action tables also provide separate antimicrobial-resistance budget lines for laboratory strengthening, surveillance, information systems, training, sample referral and quality assurance.[16][17]The monitoring tool is intended to capture funding updates during implementation.[13]

Resources needed to contain major public health emergencies may exceed national budget limits.[4]The cited sections do not specify annual allocations, detailed activity-level financing for the overall plan, confirmed financing commitments, an overall funding-gap estimate, or economic assumptions beyond the implementation estimate and listed antimicrobial-resistance activity budgets.[2][8][16][17]