Build Back Better: Health Emergencies & All Hazards Risk Tools & Strategies to Build Resilient & Healthy Cities in the Post-COVID-19 Era

Session three of the four-part training on Build Back Better: Harnessing South-South cooperation and risk reduction planning for resilient and healthy cities in the post-COVID-19 era, jointly organized by the United Nations Office for South-South Cooperation (UNOSSC), the United Nations Office for Disaster Risk Reduction (UNDRR) Global Education and Training Institute (GETI), and the World Health Organization (WHO)’s Health Emergencies Programme happened on 22 June, 2021. Participants and presenters took a deep dive into the various aspects and issues that impact the way cities and local governments prepare  and respond to health emergencies and all-hazards risks. The session was led by Dr. Gaya Gamhewage, Head of Learning & Capacity Development, WHO Health Emergencies Programme, who stressed that equity was a core element to building back better, as was the concept of solidarity among stakeholders across sectors and within the local, national, regional, and global levels.

In her opening remarks, Dr. Stella Chungong, WHO Director for Health Security Preparedness described the important reasons behind this novel joint inter-agency collaboration that made this course possible. She also stressed the critical importance of supporting health emergency preparedness work at the local, and specifically the city level to better protect societies across the world from future health emergencies and to strengthen our shared health security as the world builds back. Dr Chungong emphasized that cities are often at the forefront of responding to emergencies, and therefore an increased focus on urban preparedness is paramount. She noted that the importance of this has been highlighted by COVID-19, where cities globally were inadequately prepared. Responding to this challenge requires investment, political support, and a greater consideration of cities in national preparedness activities.

“The importance of local governments of cities in disaster risk management and strengthening health security is immense; the pandemic has made it clear that cities are at risk of facing the brunt of health emergencies and this will only increase with further urbanization – cities will therefore be in the forefront of preparedness and disaster risk management. As a global community, we need to be prepared to face global disasters. WHO’s work around the topic of health security preparedness centers around the International Health Regulations and the Sendai Framework for Disaster Risk Reduction. However, success at the global level will be only achieved by working at the national, subnational, and local level – where their implementation needs to happen – for greater impact. Success of these global frameworks is realized at the local level, and this training is one step towards that goal”. (Dr. Stella Chungong)

The session included four presentations by different WHO experts who shared existing useful resources from WHO, highlighting the importance and key areas of all-hazard disaster risk management in cities. It is expected that this session will become a full-fledge course, addressing more in-depth key aspects on how to prepare cities for health emergencies from all-hazards risks. This course will be available at a future date through OpenWHO.org. To obtain updates on related courses as they become available, please sign up at https://openwho.org/account/new. Below you will find a few highlights from the presentations.

Dr Nathalie Roebbel’s, WHO Urban Health Coordinator, Social Determinants of Health (pictured left), spoke on urban health, healthy cities, climate change and its effect on cities. She explained how Health is at the heart of cities (including before and after the pandemic), and therefore risk reduction is key to protecting the wellbeing of populations. Dr. Roebbel highlighted that the pandemic has shown that cities are at the forefront of the health emergency response, thus interventions at the city level are key to greater impact. Urban areas are major entry points for primary prevention and multisectoral interventions. They present unique opportunity with rapid urbanization taking place globally – it is expected that 68% of the global population will live in cities by 2050. She concluded by saying that cities are critical engines for the implementation of the Sendai Framework for Disaster Risk Reduction and the Paris Agreement.

Dr Alex Camacho, Regional Adviser, AMRO (PAHO/WHO) (pictured right), presented on Disaster Risk Management in Cities, preparedness and building back better. During his presentation, he provided an overview of the basic concepts that underpin preparing cities for health emergencies from all-hazards risks. Dr. Camacho also delved into emerging lessons currently being learned from the COVID-19 pandemic at the local level – some of these include: preparedness is what all people do to protect each other; the ​impact of a pandemic goes beyond immediate health effects; current measures of preparedness are not predictive; that the return on investments for global health security is immense; and finally that ‘no one is safe until we all are safe’. He also highlighted the importance of leadership at all levels of governance​, the need for risk-informed decision making, the importance of a whole-of-society approach​, the need to invest in knowledge and innovation, the centrality of adhering to health requirements under IHR​, the core value of community engagement; and need to build trust and manage infodemics.

Mr Ludy Suryantoro, Unit Head, Multisectoral Engagement for Health Security  (pictured left), took a deep dive into the importance of Resource Mapping and Impact Analysis on health security investment. His presentation focused on Resource Mapping and Data Visualization, a process powered by a country-owned tool developed by WHO that links national priorities for health security with available and potential resources (financial and technical).​  He explained that the outcome of this country-level exercise is the mapping of existing health security related-investments and activities in the country aims to pinpoint needs and gaps in implementing country health security plans based on the country all-hazards risk profile. Additionally, these tools allow for the ​mapping and strategic identification of potential areas of collaboration between the government and partners to facilitate joint planning and implementation of health security preparedness​.​ Additionally, Mr. Suryantoro presented the “WHO Global Strategic Preparedness Network”, a group focused on encouraging, promoting and sharing information about strategic partnerships and technical collaboration for preparedness, including those between relevant international, regional and national institutions, in particular national public health institutes, including in cities. 

Ms Kaylee Errecaborde, WHO Consultant, Human-Animal Interface (HAI), led the presentation on One health in cities and the importance of applying this approach in cities. During her presentation – alongside members of the WHO HAI Unit (pictured right) – she emphasized how cities and urban settings are faced with unique challenges arising from the human-animal-environmental interface. They also provided details on the One Health Approach and its relevance in the city context. This approach looks at the interconnection of environmental health, human health and animal health in all settings – including cities. Some of the zoonotic hazards present in urban and suburban settings that were discussed during the presentation included; zoonotic influenzas, leptospirosis, tick-borne diseases, salmonellosis and other foodborne diseases, West Nile virus and other mosquito borne diseases and rabies among others. Among their main conclusions regarding the importance of adopting a One Health Approach in cities was that each hazard requires a unique approach that addresses the specific factors to disease context and spread. The team also presented the Joint Risk Assessment Operational Tool, which follows a 10 step qualitative process that brings sectors together to develop a system for joint risk assessment, assess the likelihood and impact for priority One Health challenges and create shared communication and management options.

The last presentation for session three was lead by Dr Liviu Vedrasco, Unit Head, Country Simulation Exercises and Review (pictured left). The focus was on testing systems through emergency exercises and learning through response reviews. Dr. Vedrasco noted that the functionality of response capacities as evaluated by SimEx & Reviews are critical operational tools for continuous learning and system improvements. He highlighted that exercises have three main purposes:  Validation: to validate plans​; Training: to develop staff competencies and ensure adequete practice in carrying out their roles in the plans;​ and Testing: of well-established procedures & planning assumptions. He also described how the reviews of real emergency response operations help to Identify: best practices, gaps and les­sons learned​; and lead to Corrective measures: actions to improve and strengthen the continued response.

Dr Qudsia Huda, WHO’s Unit Head of Disaster Risk Management and Resilience Unit, gave the concluding remarks and highlighted how cities have shown the way forward. Through the active intersectoral collaboration of all actors within cities, successful coordination efforts have helped address the impact of COVID-19. A major lessons learned was that a health emergency like COVID-19 affects not only the health of populations but also their livelihoods, thus there is urgency for strategic collaboration and ongoing capacity development and learning. She highlighted how all actions needed to include an equitable and gender-sensitive approach, must include all segments of society and be in line with all pertinent international frameworks. She concluded the session by congratulating participants for taking the time to participate in this first round of learning workshops focused on developing their capacities to better prepare their cities for health emergencies from all-hazards risks.