Strengthening hospital resilience in the Eastern Mediterranean Region.

"Adaptation is surviving but resilience is for thriving."In recent years, the multiple threats of COVID-19 and other disease outbreaks, intensified climate change and severe weather events, and increasing conflicts and humanitarian emergencies have highlighted the need to strengthen resilience in the different sectors, including social, economic, environment, and health. Resilience is the ability of a system, community or society exposed to hazards to resist, absorb, accommodate, adapt to, transform, and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions through risk management.

Earthquakes as triggers for public health disasters: WHO and health systems' response.

The February 2023 earthquakes in Syria and Türkiye The earthquakes that hit southeast Türkiye and northwest Syria in February 2023 have been the most devastating among several earthquakes witnessed globally in the past decades. As of 28 February 2023, it had caused the death of over 50 000 people and affected more than 18 million others. In northwest Syria alone, the earthquakes affected at least 96 communities and 35 sub-districts, damaging or destroying more than 10 000 buildings, including 48 health facilities, and leaving over 11 000 people homeless (4). More than 45 000 deaths and 85 000 injuries have been reported in Harim, Afrin and Jebel Saman districts, and at least 50 000 families displaced in Aleppo, Homs, Hama, and Latakia.

Genomic sequencing for epidemic and pandemic preparedness and response: EMRO's vision and strategic interventions.

Whole-genome sequencing (WGS) is an approach for studying and analysing the entire genomic sequence of pathogens. It provides the most comprehensive characterization of an organism's genetic make-up. In January 2020, scientists used next-generation sequencing (NGS) as one of several sequencing technologies to study severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to reveal the first genetic makeup of this new virus only 11 days after the first cluster of cases due to the COVID-19 pandemic was reported. This crucial information was vital to the subsequent rapid development of test kits, vaccines and treatment regimens to respond to the pandemic. The sequencing information, later as the pandemic evolved, became essential for informing public health policies through monitoring and characterization of SARS-CoV-2 variants.

Reaching the Sustainable Development Goals in the post-COVID-19 era - the 69th Session of the WHO Regional Committee for the Eastern Mediterranean Region.

After nearly 3 years of increasingly successful response to the COVID-19 pandemic, policymakers and other stakeholders need to broaden their focus to deal with other public health challenges too. That was the message of the 69th Session of the WHO Regional Committee for the Eastern Mediterranean Region, which took place at WHO Regional Office for the Eastern Mediterranean (WHO/EMRO) in Cairo, Egypt, from 10 to 13 October 2022. The Regional Committee is the WHO's main governing body in the Eastern Mediterranean Region (EMR). Its 2022 annual session brought together ministers of health, other representatives of Member States, WHO experts, partner organizations, civil society groups, and other stakeholders to discuss a wide range of health policy issues, review achievements and challenges, and chart a course for the region. For the first time in 3 years, Member State delegations were able to meet in person, with many other participants joining virtually.

Solidarity in response to COVID-19 outbreak in the Eastern Mediterranean Region.

The coronavirus disease 2019 (COVID-19) outbreak that began in Wuhan, Hubei Province, China in late 2019 has spread globally within a few months. The Director General of the World Health Organization (WHO) declared the COVID-19 outbreak to be a public health emergency of international concern (PHEIC) after the second meeting of the IHR (2005) Emergency Committee on 30 January 2020. On 12 March 2020, the outbreak of COVID-19 was characterized as a pandemic.

Country offices as operational base for WHO programmes: the case of Qatar.

Globalization, integration, digitization, and engagement have become commonly used terminologies reflecting the strategic and forward-looking nature of public health in the 21st Century, as public health programmes aim to make impact globally while acting locally.The World Health Organization (WHO) Constitution had laid the foundation 75 years ago in a visionary way of the important functions of the Organisation, the scope of support to countries, and the potential role country offices should play. Member States are at the centre of WHO's work across the globe, and technical assistance to them is channeled primarily through country offices, which attempt to foster decentralization of WHO's work across the globe and provide avenues to consult directly with in-country stakeholders and agree on priority health needs.

"Our planet, our health": saving lives, promoting health and attaining well-being by protecting the planet - the Eastern Mediterranean perspectives

Environmental health work in the Region focuses on supporting the leadership of the public health and environmental protection sectors in regulating and monitoring environmental health factors and nexuses with the burden of disease (including Coronavirus), promoting preventive interventions, and catalyzing adequate environmental health services and actions by relevant sectors (e.g. water, municipalities, energy, agriculture, industry, transport, etc.). Climate change, biodiversity loss, pollution, rapid urbanization, geopolitical conflict and militarization, demographic change, population displacement, poverty, and widespread inequity create risks of future crises even more severe than those experienced today" (6). During the latest conference of the Parties of the UN Framework Convention on Climate Change COP26, eleven countries from the Region committed to develop climate-resilient and sustainable health systems (7).

From working in emergency to working for peace: leveraging health to build peace in the Eastern Mediterranean Region.

The World Health Organization has noted the important synergies between health and peace since its very inception, both in its foundational document and in its work globally. The WHO Constitution remarks that the "health of all peoples is fundamental to the attainment of peace and security and is dependent on the fullest co-operation of individuals and States". In addition, peace is noted as being one of the fundamental conditions to promote health in the Ottawa Charter for Health Promotion in 1986. The Eastern Mediterranean Region (EMR) has been contending with the challenges borne of conflict and insecurity for decades. Currently, nine out of the 22 countries and territories in the Eastern Mediterranean Region are represented in the World Bank's List of Fragile and Conflict Affected States ranging from acute conflict to high institutional fragility.

Addressing the health-related SDGs in the Eastern Mediterranean Region: Regional Health Alliance strengthens collaboration towards better health.

The United Nations launched the Sustainable Development Agenda 2030 and its 17 Sustainable Development Goals (SDGs) in 2015, as a more detailed and ambitious follow-up to the Millennium Developments Goals (MDGs). Health and wellbeing of all, at all ages, is addressed by the third SDG (SDG3) and health-related targets of other SDGs. However, progress to date on the health-related SDGs in the Eastern Mediterranean Region (EMR) is not on track. Although there was progress in over half of the 50 health-related SDG targets and indicators between 2015 and 2019, there is still a long way to go. Progress is required, among others, in reducing maternal, child and neonatal mortality; increasing vaccination coverage; reducing the number of cases of malaria and HIV; and in tackling the increase in mortality rates due to noncommunicable diseases. Much progress is needed in many health-related SDGs considered as important social, economic and environmental determinants of health.

Rebuilding better and fairer in the Eastern Mediterranean Region - the 68th session of the WHO Regional Committee.

The COVID-19 pandemic remains a major concern in the Eastern Mediterranean Region. At time of writing, nearly 300 000 deaths from the disease have been reported, and that figure almost certainly understates the reality. The Region is facing another wave of infection; the Delta variant is widespread; and while some countries have achieved impressively high vaccination rates, overall coverage in the Region is far too low at around 15%. Ensuring equitable access to COVID-19 vaccine across all 22 countries and territories in the Region is an urgent priority.

Adapting to the events in Afghanistan: Call for maintaining essential public health services and supporting critical medical supplies distribution.

The unfolding events in Afghanistan have recently left us with scenes of chaos and desperation at Kabul airport where men, women and children risked their lives, and some tragically died in efforts to flee the country. However, it is important to note that even before these latest events, Afghanistan was the world's third largest humanitarian operation due to war, displacement, and, of course, the COVID-19 pandemic. Over 18 million people - more than half the population - already need humanitarian assistance to survive, and these needs are increasing daily.

Eastern Mediterranean Region Vision 2023 and expansion of WHO presence at country level: new WHO offices in Bahrain and Kuwait

[...]WHO/EMRO had always provided technical support and engaged in policy dialogues and capacity development initiatives with the three countries, through important high level advocacy meetings, innovative technical initiatives, and dedicated desk officers based in WHO Saudi Arabia country office and the Regional Office. Bahrain and Kuwait s national development visions and national health strategies are aligned with the SDGs and positioned health at the centre of their national strategies. [...]both countries expressed high-level commitment to Universal Health Coverage (UHC), signing in 2018 the landmark Salalah Declaration joining the UHC 2030 compact (5) and to have primary health care (PHC) at the centre of their health strategies. [...]focusing family medicine practice, integrating noncommunicable diseases (NCDs), immunizations targets, adopting multisectoral approaches to address the social and environmental determinants of health, and developing national action plans for health security.

Progress on the health-related Sustainable Development Goals in Eastern Mediterranean Region countries: getting back on track in the time of COVID-19

The report shows that availability of data for health-related SDG indicators varied considerably for the period, with huge gaps across indicators for cause-specific mortality, hepatitis prevalence, health financing and access to medicine indicators. There has been a decline in the reported number of new cases of HIV/AIDS and TB;improvements in routine vaccination coverage;sustained high proportion of births attended by skilled health workers;fewer malnourished children;and an increasing access to improved drinking-water and sanitation. [...]key decisions and actions are inevitable. [...]addressing gender equality and health inequities is essential if the Region is going to meet the health-related SDGs.

COVID-19 pandemic: a unique opportunity to 'build back fairer' and reduce health inequities in the Eastern Mediterranean Region.

Evidence has shown that some of the major causes of health inequities arise from the conditions in which people are born, grow, live, work and age, in addition to a wider set of forces and systems shaping individuals' and societies' health and well-being. Such conditions are known as the 'social determinants of health'. However, efforts to address these determinants have remained challenging and unsatisfactory in many parts of the world, including in the Eastern Mediterranean Region. Policies to contain the ongoing COVID-19 pandemic have further exposed and amplified the existing and even created new dimensions in social and health inequities, as we elaborate further below. Meanwhile, the pandemic offers a unique opportunity to tackle inequities and build back fairer.

Improving health and mortality data in Eastern Mediterranean Region countries: implementation of the International Classification of Diseases, 11th Revision (ICD-11).

On 25 September 2015, the United Nations (UN) General Assembly adopted and committed to a new development agenda "Transforming our world: the 2030 Agenda for Sustainable Development", which translated into 17 Sustainable Development Goals (SDGs). Global commitment to SDGs ushered in renewed calls to improve availability and accessibility of timely and quality information to monitor the progress towards achieving the health-related SDGs globally and in the Eastern Mediterranean Region (EMR). Health-related targets - under SDG 3 and also within other goals - require careful measurement and monitoring in order to track progress and success in policy implementation. SDG targets requires accurate and timely reporting of diseases, risk factors, mortality and causes of deaths (ranging from maternal mortality to death from road traffic accidents) and health care and social determinants of health.