Under the leadership of Rwanda’s Biomedical Center of the Ministry of Health and WHO Country Office, following the Joint External Evaluation (JEE) for International Health Regulation (IHR) held in May 2018, a workshop for the development of National Action Plan for Human Security in Rwanda commenced at the Golden Tulip Nyamata, Rwanda on 9th July 2018.

The focus of the workshop is to translate the recommendations of the JEE into an actionable and time-bound plan. One of the other purposes of holding the workshop is also to bring the health security debate outside the Ministry of Health and WHO to draw some public attention. During the week, Rwandan experts from multiple sectors will identify critical activities to address priority actions identified in the JEE and other assessments, in order to strengthen health security. 

On the first day of the workshop, participants learned about the health security planning process, and worked on reviewing gaps in national legislation, policy and financing.  The group agreed there is a need to develop a public health law that will cover the IHR (2005) requirements with consideration of all existing national and regional regulations frameworks. . Given the importance of the animal-human-environmental interface in epidemic prevention, the group also focused on improving coordination through existing One Health Platforms between the animal, environmental and human health sectors at both national and decentralized levels. This will also involve improved coordinated surveillance and laboratory detection of diseases in both animal and human populations

According to RESOLVE to Save Lives NGO Representatives, a partner of the Rwandan Ministry of Health and WHO Country Office, Africa has been a leader in assessing International Health Regulations (IHR) capacities. Amongst the 76 JEEs done worldwide, half have been conducted in Africa. As a matter of fact, the first JEE conducted in the whole world was in Tanzania, putting some African states in the pilot seat regarding the development of their National Action Plan for Human Security. “Rwanda is again demonstrating its leadership in public health.  This multi-sectoral planning process has shown Rwanda’s serious commitment to protecting itself and neighbouring countries from infectious disease outbreaks and other health emergencies.  Rwanda could serve as a model for other countries on the continent” said Dr Cyrus Shahpar, Director of the Prevent Epidemics Team at RESOLVE.

This step is about the development of national action. The purpose of the external evaluation is to assess country-specific status, progress in achieving the targets under Annex 1 of the IHR, and recommend priority actions to be taken across the 19 technical areas being evaluated. External evaluations should be regarded as an integral part of a continuous process of strengthening capacities for the implementation of the IHR.

“The short time between the IHR assessment and this planning exercise demonstrates the commitment of MOH and WHO  to ensure national health security”” added Dr Andre Rusanganwa, WHO Country Office’s Disease Prevention and Control Programme Officer

Participants determined that in the course of the assessment cycles at country level and in order to consolidate the process it will be crucial to ensure sustainability and coherence in action and secure funds. It was decided that to support IHR capacity building in Rwanda and to go from a red score to a green score, to use Rwanda’s EVD preparedness plan to support International Health Regulations’ implementation.

Strong coordination between laboratories, workforce, surveillance and emergency response will be crucial in this process. As of today 97 countries in the World have not planned to conduct a Joint External Evaluation, 21 are in the pipeline to conduct one, and 76 have completed it, which is the case of Rwanda. The country will need to reinforce legislation, policy, financing, IHR coordination, communication and advocacy and set priorities regarding antimicrobial resistance (AMR). Furthermore,  the designation of laboratories and sentinel sites for AMR for antimicrobial stewardship by August 2018, food safety and immunization, creation of an Emergency Operation Center (EOC) in collaboration with WHO and , securing the point of entries are critical.

“The current globalization, freedom of movement and trade is proving that health is mutually interconnected, Your Health is connected to my Health and vice versa” said Dr. Jose Nyamusore, Division Manager Epidemic Surveillance and Response within the Rwanda Biomedical Center/Ministry of Health. This multi-sectoral planning process in Rwanda will be continued with a validation and costing workshop using WHO costing tool in mid-August 2018, and be implemented over the next five years.