National Action Plan for Health Security

Objectives

Uganda’s National Action Plan for Health Security (NAPHS) for 2019–2023 seeks to build and sustain the capacities required to prevent, detect and respond to public health threats in line with the International Health Regulations (IHR) (2005), contributing to healthy, wealthy and resilient communities by 2040.[1]It addresses biological, chemical, radiological and nuclear hazards, emerging and re-emerging infections, deliberate biological events, and risks affecting human, animal and environmental health.[2][3][4]

• Strengthen national prevention, early detection, containment, preparedness and emergency-response capacity across all 19 health-security technical areas.[3][5]
• Apply One Health, whole-of-government and multisectoral principles to link human, animal and environmental health systems and promote shared responsibility, transparency, information sharing and accountability.[5][1]
• Address priority gaps identified by the 2017 Joint External Evaluation, which found no sustained capacity across its 50 indicators and identified particularly weak capacity in national legislation, policy and financing, preparedness, and points of entry.[6][1]
• Improve core systems for surveillance, reporting, laboratory services, antimicrobial resistance, zoonotic diseases, food safety, biosafety and biosecurity, immunisation, workforce development, emergency operations, risk communication, medical countermeasures and personnel deployment.[7][5]
• Strengthen legal and financing arrangements for IHR implementation, including revised legal instruments, a funding advocacy strategy, ministry budget lines and a rapid-response fund for outbreak investigation and response.[8][9]
• Develop specialist capacity for chemical and radiation emergencies, including coordination, infrastructure, equipment, policies, standard operating procedures and trained responders for radiological and nuclear incidents.[4]

Implementation

Implementation uses a coordinated multisectoral delivery model led by the Office of the Prime Minister, with operational participation from the Ministry of Health, the Ministry of Agriculture, Animal Industry and Fisheries, the Ministry of Water and Environment, the Uganda Wildlife Authority and other relevant public authorities.[10][5]The plan combines existing health-security structures, technical-area leadership, decentralised implementation, partner engagement, routine review and resource mobilisation to translate assessment findings into prioritised activities.[3][5][11]

• Coordinate national implementation through the Office of the Prime Minister, the National One Health Platform, the One Health Technical Working Group, the National IHR Focal Point and the relevant animal-health country delegate.[12][13]
• Assign a focal person for each technical area within the relevant ministry to support ownership, continuity of reporting and national monitoring and evaluation.[11]
• Engage ministries, departments and agencies, decentralised districts and local authorities, academia, professional bodies, civil society, United Nations agencies, development partners, bilateral partners, international organisations and private-sector organisations.[10][5][14]
• Build on Integrated Disease Surveillance and Response, Rapid Response Teams, the Public Health Emergency Operations Centre, laboratory and real-time reporting systems, and the National One Health Platform.[3][6]
• Develop and validate policies, plans, guidelines and standard operating procedures through technical working groups, including for multi-hazard preparedness, medical countermeasures, personnel deployment, risk communication and deliberate chemical, biological, radiological, nuclear and explosives incidents.[12][15][16]
• Train managers, IHR focal points, frontline workers, media representatives, private-sector partners and community-level personnel in surveillance, reporting, emergency operations, infection prevention and control, risk communication and One Health practice.[17][18]
• Conduct simulation exercises, tabletop exercises, after-action reviews and hot washes to test emergency operations procedures, deployment arrangements, medical-countermeasure systems and public-health and security coordination.[19][15][16]
• Track implementation electronically through technical leads and sector representatives, conduct six-monthly multisectoral reviews, and use stakeholder self-reporting, technical review meetings, mid-year reviews and annual reviews to identify bottlenecks and reprioritise actions.[5][12][11][20]
• Align monitoring with the global IHR monitoring and evaluation framework, World Health Organization benchmarks, the IHR Self-Assessment Annual Reporting Tool, after-action reports and simulation-exercise findings.[11][20]
• Report progress monthly to ministries, the Prime Minister, Uganda-based organisations and development partners, circulate quarterly newsletters, and align accountability with joint sector reviews.[8][20]
• Integrate priority activities into annual ministry budget requests and sector budgets, while mobilising additional government and partner resources.[8][13]The overall estimated NAPHS implementation cost is 160,708,941,019 Ugandan shillings, equivalent to 42,571,905 United States dollars, with major cost drivers in real-time surveillance, antimicrobial resistance, medical countermeasures and laboratory systems.[13]

Monitoring & Evaluation

Monitoring and evaluation are structured around the International Health Regulations (IHR) monitoring and evaluation framework, with progress intended to strengthen Uganda’s capacity across 19 technical areas and support subsequent Joint External Evaluation (JEE) improvements.[11][20]The 2017 JEE assessed 50 indicators and found 10 with demonstrated capacity, 20 with developed capacity, 15 with limited capacity and five with no capacity; none had reached sustained capacity.[1]

• Monitor implementation electronically through technical leads for each technical area and representatives from participating sectors.[5]
• Assign a focal person in each relevant ministry to support ownership, continuity of reporting and national monitoring and evaluation.[11]
• Use stakeholder self-reporting, technical-area meetings, one-day mid-year reviews and two-day annual reviews to identify progress, challenges, bottlenecks, gaps and priorities for the following year.[11][20]
• Conduct multisectoral progress reviews twice yearly through the expanded health-security platform to review implementation and share lessons.[5]
• Apply World Health Organization benchmarks, the IHR Self-Assessment Annual Reporting Tool, After Action Reports and simulation-exercise results within the monitoring framework.[11][20]
• Maintain surveillance, laboratory investigation tracking, real-time reporting and Public Health Emergency Operations Centre functions to support detection, notification and response monitoring.[6]
• Track and map health personnel, review workforce requirements, assess frontline training milestones annually and maintain databases of experts, rapid-response teams and surveillance coordinators.[17][18][21]
• Use simulation exercises, tabletop exercises, hot washes and after-action reviews to validate emergency operations, medical-countermeasure procedures and coordination arrangements, incorporating findings into plans and training.[19][15][16]
• Align accountability and reporting with Joint Sector Reviews under the Office of the Prime Minister, and provide progress information to the National IHR Focal Point and the animal-health country delegate.[8][13]
• Produce monthly progress reports for ministries, the Prime Minister, Uganda-based organisations and development partners; issue quarterly newsletters; and contribute to publications, conferences and ministry quarterly reviews.[20]
• Maintain regular reporting to the World Health Organization and World Organisation for Animal Health in accordance with IHR obligations and membership requirements.[8]

Accountability is supported by Office of the Prime Minister oversight, the National One Health Platform, a national steering committee, technical working groups and multisectoral review structures.[5][13][11]The supplied material identifies indicator domains in the JEE annex, including financing, surveillance, laboratory quality, reporting, workforce, preparedness, response, points of entry and chemical or radiation emergencies, but annex score fields are unpopulated in the available text.[22][23]

Costing & Financing

The National Action Plan for Health Security (NAPHS) is costed for 2019–2023 at 160,708,941,019 Ugandan shillings, equivalent to 42,571,905 United States dollars; elsewhere, the implementation estimate is presented in rounded form as 160 billion Ugandan shillings, approximately 43 million United States dollars.[13][10]Major cost drivers are real-time surveillance, antimicrobial resistance, medical countermeasures, personnel deployment and national laboratory systems.[5][13]

• Integrate NAPHS activities into annual ministry budget requests and sector budgets, including through National Development Plan III, while mobilising additional Government and partner resources.[10][8][13]
• Map and align existing and potential domestic and external financing, which is an explicit plan objective and a consideration in activity prioritisation.[1][12]
• Establish relevant ministry budget lines, develop advocacy for increased government financing and create a rapid-response fund for outbreak investigation and response.[9]
• Finance medical countermeasures through the National Medical Stores and Office of the Prime Minister, while supporting procurement, stockpiling, emergency deployment and response planning.[15][16]
• Recognise that emergency risk-communication messaging is largely donor sponsored and that increased government financing is needed alongside partner support.[24]
• Allocate activity-level resources for workforce development, with listed actions totalling 1,464,725,845 Ugandan shillings.[17][18]
• Allocate 11,068,089,527 Ugandan shillings to listed public health-security collaboration and Chemical, Biological, Radiological, Nuclear and Explosives activities, including a deployable emergency facility.[15]
• Allocate 4,937,711,997 Ugandan shillings to radiation-emergency actions shown in the relevant table.[4]

The material provides numerous activity-level allocations but does not set out a complete annual financing timetable, confirmed sources for every allocation, a quantified plan-wide funding gap, or detailed economic assumptions.[10][5][13]Printing support was provided by the World Health Organization, although no monetary value is specified.[7]