National Action Plan for Health Security Indonesia. 2020-2024

i COLLABORATION ii FOREWORD BY THE SECRETARY GENERAL MINISTRY OF HEALTH Document : National Action Plan For Health Security International Health Regulations (IHR) 2005 represents anagreement of member states of the World Health Organization (WHO) to enhance their capacity toprevent, detect, and respond quickly to any potential public health threats that spread across countries based on national surveillance systems and legislation that have already existed in eachcountry. The emerging and re-emerginginfectiousdiseasesas well as easier and faster mobilization of the population from one country to another may result in quicker spread of the disease epidemic which recognizes noboundaries. The threats can be in the form of biological, chemical and nuclear agents that have impacts not onlyon health,butal soon economy. Thus, the effort to deal with these threats requires a multi sectoral approach, both nationally and internationally. IHR (2005) mandates each member country to have core capacities, including: the legislation and policies, coordination, surveillance, preparedness, response, risk communication, human resources and laboratories. Indonesia has fully implemented the IHR (2005) in 2014. Nevertheless, manyareas still need to beimproved. To evaluateand improve thecountry's capacity in implementing IHR (2005), in November 2017, Indonesia took the initiative to conduct the Joint External Evaluation (JEE) and has received further recommendations to enhance its capacity in implementing IHR (2005). The JEE is a voluntary, collaborative, multisectoral coordination to assess country's core capacities to prevent, detect and respond quickly to public health threats. The JEE also helps countries in identifying critical and emergency issues in the health system to determine priorities in preparedness and response. This National Action Plan for Health Security (NAPHS) was compiled as a recommendation of the JEE results,and representsan integral partofthe implementation of the Presidential Instruction Number 4 of 2019 concerning Capacity Enhancementin Preventing, Detecting and Responding to Outbreaks of Disease, Global Pandemic and Nuclear, Biological and Chemical Emergencies iii FOREWORD BY THE SECRETARY GENERAL MINISTRY OF HEALTH Document : National Action Plan For Health Security International Health Regulations (IHR) 2005 represents anagreement of member states of the World Health Organization (WHO) to enhance their capacity toprevent, detect, and respond quickly to any potential public health threats that spread across countries based on national surveillance systems and legislation that have already existed in eachcountry. The emerging and re-emerginginfectiousdiseasesas well as easier and faster mobilization of the population from one country to another may result in quicker spread of the disease epidemic which recognizes noboundaries. The threats can be in the form of biological, chemical and nuclear agents that have impacts not onlyon health,butal soon economy. Thus, the effort to deal with these threats requires a multi sectoral approach, both nationally and internationally. IHR (2005) mandates each member country to have core capacities, including: the legislation and policies, coordination, surveillance, preparedness, response, risk communication, human resources and laboratories. Indonesia has fully implemented the IHR (2005) in 2014. Nevertheless, manyareas still need to beimproved. To evaluateand improve thecountry's capacity in implementing IHR (2005), in November 2017, Indonesia took the initiative to conduct the Joint External Evaluation (JEE) and has received further recommendations to enhance its capacity in implementing IHR (2005). The JEE is a voluntary, collaborative, multisectoral coordination to assess country's core capacities to prevent, detect and respond quickly to public health threats. The JEE also helps countries in identifying critical and emergency issues in the health system to determine priorities in preparedness and response. This National Action Plan for Health Security (NAPHS) was compiled as a recommendation of the JEE results,and representsan integral partofthe implementation of the Presidential Instruction Number 4 of 2019 concerning Capacity Enhancementin Preventing, Detecting and Responding to Outbreaks of Disease, Global Pandemic and Nuclear, Biological and Chemical Emergencies iv The preparation for this National Action Plan for Health Security began in 2018, involving 22 Ministries/Institutions. This document contains guidelines for collaboration as well as synergistic programs and activities to becarried out by all related Ministries/Institutions to enhance national health resilience capacity. This document is also a living document and provides an important strategy for immediate implementation. It should serve asa reference for planning technical activities at the respective Ministries /Institutions, and for Governors, Mayors and Regents to draw up their Regional Action Plans in accordance with the Presidential Instruction Number 4 of 2019. We would like to extend our highest gratitude and appreciation to all those who have participated and supported the completion of this National Action Plan for Health Security (NAPHS). Secretary General Ministry of Health drg. Oscar Primadi, MPH FOREWORD BY THE MINISTER OF HEALTH Document: National Action Plan For HealthSecurity Climate change has led to an increasedthreat of new-emerging and re-emerging diseases that may develop into pandemic, characterized by high risk of death and extremelyrapid spread of disease. Globalization, which has resulted in the increased human and animal mobility across countries and changes in human lifestyles,hasalso contributed to accelerating the spread of disease outbreaks that pose a threat to global health. Since the outbreak of the Severe Acute Respiratory Syndrome (SARS) in the Asian region in 2003, global health threats have continued to show an increasing trend, among others, the outbreak of Avian Influenza (H5N1) in 2004. In May 2005, the 58thWorld Health Assembly (WHA) has agreed to the International Health Regulation (2005) to be enforced in all WHO memberstatesstartingJune 15, 2007. The IHR (2005) mandates countries to be able to detect the risk of public health emergencies, as well as assess, respond and inform events in the region to the community, both at the national and international levels. The World Health Organizationhas developed theJoint External Evaluation (JEE) tool, an instrument to assist countries in strengthening their IHR (2005) implementation. Indonesia assessed its capacities with this instrument in 2017, and one of the recommendations is to develop the National Action Plan for Health Security (NAPHS). This NAPHS document was prepared by the Ministry of Health in collaboration with other 21 Ministries / Institutions involved during the JEE assessment. With the enactment of Presidential Instruction number 4 of 2019 concerning Capacity Enhancement in Preventing, Detecting and Responding to Outbreaks of Disease, Global Pandemic and Nuclear, Biological and Chemical Emergencies, the Ministries and Institutionsinvolved, including Governors, Mayors and Regents, are expected to take necessary measures in a coordinated and integrated manner according to their respective duties, functions and authorities in the effort to enhance the country's capacity to prevent, detect and respond to epidemics, global pandemics, nuclear, biological and chemical emergencies, which can have national and global impacts. v membantu negara-negara mengidentifikasi hal-hal kritis dan emergency dalam sistem kesehatan untuk menentukan prioritas dalam membuat suatu kesiapsiagaan dan respon. National Action Plan for Health Security (NAPHS) ini disusun sebagai amanah rekomendasi dalam pelaksanaan JEE dan sebagai upaya dalam implementasi Instruksi Presidennomor 4 tahun 2019 tentang Peningkatan Kemampuan dalam Mencegah, Mendeteksi, dan MeresponsWabah Penyakit, Pandemi Global, dan Kedaruratan Nuklir, Biologi, dan Kimia Proses penyusunan National Action Plan for Health Security(Rencana Aksi Nasional Ketahanan Kesehatan) dimulai sejak tahun 2018 dengan melibatkan 22 Kementerian/Lembaga. Dokumen ini memuat panduan kolaborasi serta sinergi program dan kegiatan yang dilakukan seluruh K/L terkait dalam peningkatan kapasitas ketahanan kesehatan nasional. Dokumen ini juga bersifat sebagai living document dan merupakan perihal yang penting dan strategis untuk segera diimplementasikan serta menjadi acauan untuk menyusun kegiatan teknis di Kementerian/Lembaga masing-masing dan acuan bagi Gubernur dan Walikota serta Bupati untuk menyusun Rencana Aksi Daerah sesuai dengan amanah Instruksi Presidennomor 4 tahun 2019. Kepada semua pihak yang telah berpartisipasi dan membantu sampai dapat diselesaikannyaNational Action Plan for Health Security(NAPHS) ini, kamisampaikanterimakasihdan penghargaanyangsetinggi-tingginya. Sekretaris Jenderal Kementerian Kesehatan drg. Oscar Primadi, MPH v The preparation for this National Action Plan for Health Security began in 2018, involving 22 Ministries/Institutions. This document contains guidelines for collaboration as well as synergistic programs and activities to becarried out by all related Ministries/Institutions to enhance national health resilience capacity. This document is also a living document and provides an important strategy for immediate implementation. It should serve asa reference for planning technical activities at the respective Ministries /Institutions, and for Governors, Mayors and Regents to draw up their Regional Action Plans in accordance with the Presidential Instruction Number 4 of 2019. We would like to extend our highest gratitude and appreciation to all those who have participated and supported the completion of this National Action Plan for Health Security (NAPHS). Secretary General Ministry of Health drg. Oscar Primadi, MPH FOREWORD BY THE MINISTER OF HEALTH Document: National Action Plan For HealthSecurity Climate change has led to an increasedthreat of new-emerging and re-emerging diseases that may develop into pandemic, characterized by high risk of death and extremelyrapid spread of disease. Globalization, which has resulted in the increased human and animal mobility across countries and changes in human lifestyles,hasalso contributed to accelerating the spread of disease outbreaks that pose a threat to global health. Since the outbreak of the Severe Acute Respiratory Syndrome (SARS) in the Asian region in 2003, global health threats have continued to show an increasing trend, among others, the outbreak of Avian Influenza (H5N1) in 2004. In May 2005, the 58thWorld Health Assembly (WHA) has agreed to the International Health Regulation (2005) to be enforced in all WHO memberstatesstartingJune 15, 2007. The IHR (2005) mandates countries to be able to detect the risk of public health emergencies, as well as assess, respond and inform events in the region to the community, both at the national and international levels. The World Health Organizationhas developed theJoint External Evaluation (JEE) tool, an instrument to assist countries in strengthening their IHR (2005) implementation. Indonesia assessed its capacities with this instrument in 2017, and one of the recommendations is to develop the National Action Plan for Health Security (NAPHS). This NAPHS document was prepared by the Ministry of Health in collaboration with other 21 Ministries / Institutions involved during the JEE assessment. With the enactment of Presidential Instruction number 4 of 2019 concerning Capacity Enhancement in Preventing, Detecting and Responding to Outbreaks of Disease, Global Pandemic and Nuclear, Biological and Chemical Emergencies, the Ministries and Institutionsinvolved, including Governors, Mayors and Regents, are expected to take necessary measures in a coordinated and integrated manner according to their respective duties, functions and authorities in the effort to enhance the country's capacity to prevent, detect and respond to epidemics, global pandemics, nuclear, biological and chemical emergencies, which can have national and global impacts. vi We would like to extend our highest appreciation for the support of various take holders in the preparation of this document, and it is our hope that our efforts to work closely together in dealing with the global pandemic can come to fruition. Minister of Health Terawan Agus Putranto vii Dengan telah ditetapkannya Instruksi Presiden Nomor 4 Tahun 2019 tentang Peningkatan Kemampuan dalam Mencegah, Mendeteksi, dan Merespons Wabah Penyakit, Pandemi Global, dan Kedaruratan Nuklir, Biologi, dan Kimia. Kementerian dan Lembaga yang terlibat, termasuk Gubernur dan Walikota/Bupati diharapkan dapat mengambil langkah langkah secara terkoordinasi dan terintegrasi sesuai tugas, fungsi, dan kewenangan masing-masing sebagai upaya meningkatkan kemampuan negara untuk mencegah, mendeteksi, dan merespons wabah penyakit, pandemi global, dan kedaruratan nuklir, biologi, dan kimia, yang dapat berdampak nasional dan/atau global. Kami memberikan apresiasi yang setinggi – tingginya atas dukungan berbagai pihak dalam penyusunan dokumen ini, semoga upaya kita untuk bersinergi dalam rangka menghadapi pandemik dunia dapat berjalan dengan baik. 11 Desember 2019 Menteri Kesehatan, Letjen TNI (Pur.) Dr. dr. Terawan Agus Putranto, Sp.Rad (K) RI vii We would like to extend our highest appreciation for the support of various take holders in the preparation of this document, and it is our hope that our efforts to work closely together in dealing with the global pandemic can come to fruition. Minister of Health Terawan Agus Putranto TABLE OF CONTENTS FOREWORD ACKNOWLEDGEMENT I. INTRODUCTION ------------------------------------------------------------------------------------1 II. VISION, MISSION, AND OBJECTIVES ----------------------------------------------------------2 III. SITUATION ANALYSIS A. SOCIO-ECONOMIC DEVELOPMENT ------------------------------------------------------3 B. HEALTH SITUATION --------------------------------------------------------------------------3 C. HEALTH SECURITY ----------------------------------------------------------------------------6 IV. POLICY AND STRATEGY A. LEGAL FRAMEWORK ---------------------------------------------------------------------- 13 B. NAPHS STRATEGY -------------------------------------------------------------------------- 13 V. NAPHS DEVELOPMENT AND IMPLEMENTATION A. NAPHS DEVELOPMENT PROCESS ------------------------------------------------------ 14 B. NAPHS 2020 – 2024 ----------------------------------------------------------------------- 16 C. MONITORING AND EVALUATION ------------------------------------------------------ 42 VI. CONCLUSION ------------------------------------------------------------------------------------- 43 ANNEX ES ANNEX 1 : ALLOCATION OF FUND ANNEX 2 : PRIORITY ACTION PLAN BY TECHNICAL AREA viii 1 I. INTRODUCTION In November 2017, the Government of Indonesia (GOI) voluntarily underwent Joint External Evaluation (JEE) conducted by WHO external team to assess the country’s core capacities to prevent, detect and respond to public health threats under the International Health Regulations (IHR) (2005). The Indonesia National Action Plan for Health Security (NAPHS) 2020 – 2024 was developed in response to JEE results. GOI engaged all relevant ministries, agencies and institutions involved in JEE 2017 to develop the NAPHS. The NAPHS used the logic model proposed by Indonesia to the Global Health Security Agenda (GHSA). GHSA is a forum established by a number of countries to support WHO in implementing IHR (2005). This logic model harmonizes various priority activities that are considered to provide major contribution to achieving indicators and level of capacities related to those indicators for the 19 Technical Areas (TAs) in JEE tools. In addition, NAPHS also accommodated JEE external team recommendations for each Technical Area. At the same time, the World Bank is in the process of conducting the country’s financing assessment for health security. A tool called the Health Security Financing Assessments Tool (HSFAT) is being field tested in Indonesia to calculate the budget for health security that had been allocated in the previous fiscal year. This information may be regarded as an indication of the supply side, while NAPHS denotes the demand side. Comparison between information produced by HSFAT and NAPHS will provide a gap analysis, whether a positive or negative one in carrying out activities related to health security. The Presidential Instruction Number 4 of 2019 concerning “Improved Capacity in Preventing, Detecting, and Responding to Disease Outbreaks, Pandemic, and Nuclear, Biological, and Chemical Emergencies”was issued on June 17, 2019. This Presidential Instruction will be advocated among the relevant ministries, agencies and local governments to improve awareness and to be used as a reference in implementing health security. Health security contributes not only to health development but also to national development. As part of the health development, strengthening of health system is indispensable for robust health security since these two entities interacts reciprocally. Besides, health security is an important component of national resilience. GOI will monitor and evaluate NAPHS implementation in accordance with the current practice adopted for the Annual Plan. Meanwhile Presidential Instruction Number 4 of 2019 necessitates each ministry/agency/institution to determine the appropriate indicators that are part of all indicators proposed in NAPHS. It is worth noting that WHO HQ has established a web portal known as Strategic Partnership Portal (SPP). Member states that have undergone external evaluation on 19 Technical Areas are encouraged to upload their outcome. This will facilitate interested development partners to directly contact any country that they believeis worth assisting. 1 1 I. INTRODUCTION In November 2017, the Government of Indonesia (GOI) voluntarily underwent Joint External Evaluation (JEE) conducted by WHO external team to assess the country’s core capacities to prevent, detect and respond to public health threats under the International Health Regulations (IHR) (2005). The Indonesia National Action Plan for Health Security (NAPHS) 2020 – 2024 was developed in response to JEE results. GOI engaged all relevant ministries, agencies and institutions involved in JEE 2017 to develop the NAPHS. The NAPHS used the logic model proposed by Indonesia to the Global Health Security Agenda (GHSA). GHSA is a forum established by a number of countries to support WHO in implementing IHR (2005). This logic model harmonizes various priority activities that are considered to provide major contribution to achieving indicators and level of capacities related to those indicators for the 19 Technical Areas (TAs) in JEE tools. In addition, NAPHS also accommodated JEE external team recommendations for each Technical Area. At the same time, the World Bank is in the process of conducting the country’s financing assessment for health security. A tool called the Health Security Financing Assessments Tool (HSFAT) is being field tested in Indonesia to calculate the budget for health security that had been allocated in the previous fiscal year. This information may be regarded as an indication of the supply side, while NAPHS denotes the demand side. Comparison between information produced by HSFAT and NAPHS will provide a gap analysis, whether a positive or negative one in carrying out activities related to health security. The Presidential Instruction Number 4 of 2019 concerning “Improved Capacity in Preventing, Detecting, and Responding to Disease Outbreaks, Pandemic, and Nuclear, Biological, and Chemical Emergencies”was issued on June 17, 2019. This Presidential Instruction will be advocated among the relevant ministries, agencies and local governments to improve awareness and to be used as a reference in implementing health security. Health security contributes not only to health development but also to national development. As part of the health development, strengthening of health system is indispensable for robust health security since these two entities interacts reciprocally. Besides, health security is an important component of national resilience. GOI will monitor and evaluate NAPHS implementation in accordance with the current practice adopted for the Annual Plan. Meanwhile Presidential Instruction Number 4 of 2019 necessitates each ministry/agency/institution to determine the appropriate indicators that are part of all indicators proposed in NAPHS. It is worth noting that WHO HQ has established a web portal known as Strategic Partnership Portal (SPP). Member states that have undergone external evaluation on 19 Technical Areas are encouraged to upload their outcome. This will facilitate interested development partners to directly contact any country that they believeis worth assisting. 2 2 II. VISION, MISSION AND OBJECTIVES A. VISION AND MISSION Vision Contribute actively to global efforts in preventing, detecting and responding to potential pandemics attributed to biological, chemical and radio-nuclear agents. Missions 1. Strengthen national capacity in preventing, detecting and responding to public health emergency of international concern/PHEIC 2. Collaborate with international/UN agencies and civil society in dealing with PHEIC B. OBJECTIVES The objective of NAPHS 2020 – 2024 is to support the achievement of the above vision and to strengthen the implementation of the missions, by: 1. Advocating common understanding among all stakeholders in dealing with efforts to prevent, detect and respond to public health emergency 2. Developinga comprehensive National Action Plan for Health Security (NAPHS) document 3. Working closely with WHO, FAO, OIE, WB and GHSA 3 III. SITUATION ANALYSIS A. SOCIO-ECONOMIC DEVELOPMENT Indonesia is the largest archipelagic country in the world, located geographically between two continents (Asia and Australia) and two oceans (the Indian and the Pacific Ocean), with over 250 million population across an estimated total of 6,000 inhabited islands out of 17,504 islands. This diverse country is home to numerous ethnic, cultural and linguistic communities, with more than 700 local dialects. Despite being hit hard by economic and political crisis in 1998, Indonesia has emerged as an economically strong and politically stable nation. Indonesia is a republic and in accordance with the 1945 Constitution, the government consisted of three governing bodies: the executive, judicial and legislative bodies. The Government of Indonesia is led by a President and Vice-President who are elected through general elections for a five-year term. The President is both the head of state and the head of government, and in carrying out his duties is assisted by a cabinet formed by the President. In June 2019, Joko Widodo (Jokowi) won his second term for presidency. Indonesia, as the world’s fourth most populous country, isreckoned as a rising power both in the Association of Southeast Asian Nations (ASEAN) and the world. The Government of Indonesia is putting a lot of effortinto becoming a high-income country by 2036, and determined to be ranked among the world's fifth largest Gross Domestic Product (GDP) in 2045.To achieve this target, Indonesia's GDP must grow by 5.7 percent per year and be out of the Middle-Income trap in 2036, and reach USD 23,199 GDP in 2045. In addition, Indonesia also plans to achieve the 10th rank in the Ease of Doing Business (EoDB) and puts special emphasis on economic growth that is evenly distributed throughout the decile of income, such that Indonesia's poverty rate in 2045 could be reduced to zero or 0.02 percent, with extreme poverty at zero by 20401. B. HEALTH SITUATION With the increasing connectivity and interdependence between countries nowadays, people, goods, services and transportation can be easily transported between countries. Nations around the world must be able to respond, control and prevent, and effectively address threats to public health2. Indonesia's political and social landscape has been undergoing several changes, such as the transition from authoritarianism to democracy and decentralized reform. This macro transition simultaneously influences the epidemiologic transition in which non-communicable diseases (NCDs) are becoming 1Head of the National Development Planning AgencyBambangBrodjonegoro presentation: Visi Indonesia 2045, KBRI Singapura, 10 November 2018 2Strengthening global health security by embedding the International Health Regulations requirements into national health system.Hans Kluge,1 Jose Maria Martín-Moreno,2 Nedret Emiroglu,3 Guenael Rodier,4Edward Kelley,5 Melitta Vujnovic,6 GovinPermanand, 2018 3 2 II. VISION, MISSION AND OBJECTIVES A. VISION AND MISSION Vision Contribute actively to global efforts in preventing, detecting and responding to potential pandemics attributed to biological, chemical and radio-nuclear agents. Missions 1. Strengthen national capacity in preventing, detecting and responding to public health emergency of international concern/PHEIC 2. Collaborate with international/UN agencies and civil society in dealing with PHEIC B. OBJECTIVES The objective of NAPHS 2020 – 2024 is to support the achievement of the above vision and to strengthen the implementation of the missions, by: 1. Advocating common understanding among all stakeholders in dealing with efforts to prevent, detect and respond to public health emergency 2. Developinga comprehensive National Action Plan for Health Security (NAPHS) document 3. Working closely with WHO, FAO, OIE, WB and GHSA 3 III. SITUATION ANALYSIS A. SOCIO-ECONOMIC DEVELOPMENT Indonesia is the largest archipelagic country in the world, located geographically between two continents (Asia and Australia) and two oceans (the Indian and the Pacific Ocean), with over 250 million population across an estimated total of 6,000 inhabited islands out of 17,504 islands. This diverse country is home to numerous ethnic, cultural and linguistic communities, with more than 700 local dialects. Despite being hit hard by economic and political crisis in 1998, Indonesia has emerged as an economically strong and politically stable nation. Indonesia is a republic and in accordance with the 1945 Constitution, the government consisted of three governing bodies: the executive, judicial and legislative bodies. The Government of Indonesia is led by a President and Vice-President who are elected through general elections for a five-year term. The President is both the head of state and the head of government, and in carrying out his duties is assisted by a cabinet formed by the President. In June 2019, Joko Widodo (Jokowi) won his second term for presidency. Indonesia, as the world’s fourth most populous country, isreckoned as a rising power both in the Association of Southeast Asian Nations (ASEAN) and the world. The Government of Indonesia is putting a lot of effortinto becoming a high-income country by 2036, and determined to be ranked among the world's fifth largest Gross Domestic Product (GDP) in 2045.To achieve this target, Indonesia's GDP must grow by 5.7 percent per year and be out of the Middle-Income trap in 2036, and reach USD 23,199 GDP in 2045. In addition, Indonesia also plans to achieve the 10th rank in the Ease of Doing Business (EoDB) and puts special emphasis on economic growth that is evenly distributed throughout the decile of income, such that Indonesia's poverty rate in 2045 could be reduced to zero or 0.02 percent, with extreme poverty at zero by 20401. B. HEALTH SITUATION With the increasing connectivity and interdependence between countries nowadays, people, goods, services and transportation can be easily transported between countries. Nations around the world must be able to respond, control and prevent, and effectively address threats to public health2. Indonesia's political and social landscape has been undergoing several changes, such as the transition from authoritarianism to democracy and decentralized reform. This macro transition simultaneously influences the epidemiologic transition in which non-communicable diseases (NCDs) are becoming 1Head of the National Development Planning AgencyBambangBrodjonegoro presentation: Visi Indonesia 2045, KBRI Singapura, 10 November 2018 2Strengthening global health security by embedding the International Health Regulations requirements into national health system.Hans Kluge,1 Jose Maria Martín-Moreno,2 Nedret Emiroglu,3 Guenael Rodier,4Edward Kelley,5 Melitta Vujnovic,6 GovinPermanand, 2018 4 4 increasingly important, while infectious diseases remain an important part of the burden. Indonesia currently has a double burden of health problems: the unfinished agenda of infectious diseases and the emergence ofNCDs. Infectious diseases consist of new emerging and re-emerging diseases. Indonesia is one of the three countries with the highest prevalence of tuberculosis (TB) in the world. In addition, Indonesia has to overcomethe risk factors forNCDs, such as high blood pressure, high cholesterol and smoking asunhealthy life style. In 1990, 56% of the burden of the disease was caused by infectious diseases, 37% by NCDs and 7% by injuries. In 2015, there was an increasedincidence of high blood and cholesterol caused by unhealthy diets, an increase in overweight population, and tobacco use. As a result, the burden of NCDs increased to 66%, while infectious diseases declined to 27%3. The increasingly complex epidemiological pattern of diseases andvarious macro transitions pose major challenges for Indonesia’s health development as a nation. Indonesia's health status indicators have increased significantly in the past few decades. Life expectancy at birth, which is one of the key health indicators, has shown a significant improvement from 64.40 years in 1996 to 71.06 years in 2017. Total fertility decreased significantly from 5.61 in 1971 to 2.27 per womanin 2000 and remained at 2.4per woman in 20154. The aging population of 65 years and over is expected to increase sharply from 2015 and projected to reach 10% of the population by 2030. Infant and child mortality (IMR) have shown significant reductions. IMR was 68/1000 in 1991, 34/1000 in 2007 and 25.5/1000 in 2016. Under-five mortality rate has shown a steady decline from 97/1000 in 1991, to 44/1000 in 2007, and 27/1000 in 20155. However, key challenges remain, especially with regard to maternal health andmalnutrition. Maternal Mortality Rate (MMR) is still high. In 2015, MMR was305/100,000 live births6. This number is still far from the MDG target of 102/100,000 live births by the end of 2015 and the SDG target of 70/100,000 live births by 2030. In addition, Indonesia has a high prevalence of stunted children. Basic Health Research 2018 noted that the national stunting prevalence had reached 30.8% for children under five and 29.9% for children under two years of age. The Indonesian government has committed itself to prevent childhood stunting and reduce under-two stunting to 28% by 2019. Indonesia has been dealing with the rising occurrence of overweight and obesity in children and adults. Between 2007 and 2010, the prevalence of overweight increased from 12 to 14% in children under five and 19 to 22% in adults7. The "double burden of malnutrition" in the form of mal- and over-nutrition appears simultaneously in the same 3Institute of Health Metrics and Evaluation database (IHME) 2015 4 Statistics Indonesia (BPS) 5 Statistics Indonesia (BPS) 6 Statistics Indonesia (BPS) 7 Basic Health Research, 2010 5 community, whichresults ina significant increase in non-communicable diseases (NCDs) such as diabetes, stroke and heart diseases. Indonesia has 34 provinces, 514 districts/cities, and 72,000 villages with 9,825 primary health center (Puskesmas), 55.517 auxiliary Puskesmas8 and private primary health clinics. Public and private secondary/tertiary care facilities consist of 68 type A hospitals, 402 type B hospitals, 1,380 type C hospitals, 730 type D hospitals, 237 unclassified hospitals, and 582 specialty hospitals9. There are also 289,635 community-managed mother and child health (MCH) center and integrated health center (Posyandu). Indonesia has 0.45 physicians, 1.84 nurses and 1.73 midwives per 1,000 population10.To improve healthcare worker distribution, the Government of Indonesia appoints contracted physicians and midwives, deploys healthcare worker teams to remote areas (Nusantara Sehat Team), performs cross-training and task shifting, and assigns internship for fresh graduates of physicians or healthcare specialists to more remote locations (4 months at Puskesmas and 8 months at public hospitals). Although there has been a substantial increase in health expenditure at the national level, health spending as a proportion of gross domestic product (GDP) remains below the average among middle-to-low income countries. In 2009, government health expenditure amounted to IDR 2.7 trillion or 2.7% of government expenditure. This number increased to IDR 104 Trillion or 5% of government expenditure in 201711. The findings of several assessments of the capacity of global response to health crises indicate the need for integration between healthcare system, strengthening activities and healthcare security efforts for prevention, warning and prompt response. A country's ability to detect, report and respond to health threats requires strong relationships between, for example, clinical laboratories and healthcare information systems and medical technology, and between the emergency personnel and training of public healthcare personnel. In addition, emergency responses to health threats heavily involve coordination, financing, incident management systems, public awareness and community involvement supported by strong government commitments and resources. There is no special Budget Execution (Allotment) Document (DIPA) to accommodate the needs for HS resource,hence close collaboration among related stakeholders is mandatory from the planning, implementation and monitoring of HS programs. 8 Ministry of Health, 2017 9 Ministry of Health, April 2018, http://sirs.yankes.kemkes.go.id/rsonline/report/ 10 Ministry of Health, 2016 11Ministry of Finance ,2017 5 4 increasingly important, while infectious diseases remain an important part of the burden. Indonesia currently has a double burden of health problems: the unfinished agenda of infectious diseases and the emergence ofNCDs. Infectious diseases consist of new emerging and re-emerging diseases. Indonesia is one of the three countries with the highest prevalence of tuberculosis (TB) in the world. In addition, Indonesia has to overcomethe risk factors forNCDs, such as high blood pressure, high cholesterol and smoking asunhealthy life style. In 1990, 56% of the burden of the disease was caused by infectious diseases, 37% by NCDs and 7% by injuries. In 2015, there was an increasedincidence of high blood and cholesterol caused by unhealthy diets, an increase in overweight population, and tobacco use. As a result, the burden of NCDs increased to 66%, while infectious diseases declined to 27%3. The increasingly complex epidemiological pattern of diseases andvarious macro transitions pose major challenges for Indonesia’s health development as a nation. Indonesia's health status indicators have increased significantly in the past few decades. Life expectancy at birth, which is one of the key health indicators, has shown a significant improvement from 64.40 years in 1996 to 71.06 years in 2017. Total fertility decreased significantly from 5.61 in 1971 to 2.27 per womanin 2000 and remained at 2.4per woman in 20154. The aging population of 65 years and over is expected to increase sharply from 2015 and projected to reach 10% of the population by 2030. Infant and child mortality (IMR) have shown significant reductions. IMR was 68/1000 in 1991, 34/1000 in 2007 and 25.5/1000 in 2016. Under-five mortality rate has shown a steady decline from 97/1000 in 1991, to 44/1000 in 2007, and 27/1000 in 20155. However, key challenges remain, especially with regard to maternal health andmalnutrition. Maternal Mortality Rate (MMR) is still high. In 2015, MMR was305/100,000 live births6. This number is still far from the MDG target of 102/100,000 live births by the end of 2015 and the SDG target of 70/100,000 live births by 2030. In addition, Indonesia has a high prevalence of stunted children. Basic Health Research 2018 noted that the national stunting prevalence had reached 30.8% for children under five and 29.9% for children under two years of age. The Indonesian government has committed itself to prevent childhood stunting and reduce under-two stunting to 28% by 2019. Indonesia has been dealing with the rising occurrence of overweight and obesity in children and adults. Between 2007 and 2010, the prevalence of overweight increased from 12 to 14% in children under five and 19 to 22% in adults7. The "double burden of malnutrition" in the form of mal- and over-nutrition appears simultaneously in the same 3Institute of Health Metrics and Evaluation database (IHME) 2015 4 Statistics Indonesia (BPS) 5 Statistics Indonesia (BPS) 6 Statistics Indonesia (BPS) 7 Basic Health Research, 2010 5 community, whichresults ina significant increase in non-communicable diseases (NCDs) such as diabetes, stroke and heart diseases. Indonesia has 34 provinces, 514 districts/cities, and 72,000 villages with 9,825 primary health center (Puskesmas), 55.517 auxiliary Puskesmas8 and private primary health clinics. Public and private secondary/tertiary care facilities consist of 68 type A hospitals, 402 type B hospitals, 1,380 type C hospitals, 730 type D hospitals, 237 unclassified hospitals, and 582 specialty hospitals9. There are also 289,635 community-managed mother and child health (MCH) center and integrated health center (Posyandu). Indonesia has 0.45 physicians, 1.84 nurses and 1.73 midwives per 1,000 population10.To improve healthcare worker distribution, the Government of Indonesia appoints contracted physicians and midwives, deploys healthcare worker teams to remote areas (Nusantara Sehat Team), performs cross-training and task shifting, and assigns internship for fresh graduates of physicians or healthcare specialists to more remote locations (4 months at Puskesmas and 8 months at public hospitals). Although there has been a substantial increase in health expenditure at the national level, health spending as a proportion of gross domestic product (GDP) remains below the average among middle-to-low income countries. In 2009, government health expenditure amounted to IDR 2.7 trillion or 2.7% of government expenditure. This number increased to IDR 104 Trillion or 5% of government expenditure in 201711. The findings of several assessments of the capacity of global response to health crises indicate the need for integration between healthcare system, strengthening activities and healthcare security efforts for prevention, warning and prompt response. A country's ability to detect, report and respond to health threats requires strong relationships between, for example, clinical laboratories and healthcare information systems and medical technology, and between the emergency personnel and training of public healthcare personnel. In addition, emergency responses to health threats heavily involve coordination, financing, incident management systems, public awareness and community involvement supported by strong government commitments and resources. There is no special Budget Execution (Allotment) Document (DIPA) to accommodate the needs for HS resource,hence close collaboration among related stakeholders is mandatory from the planning, implementation and monitoring of HS programs. 8 Ministry of Health, 2017 9 Ministry of Health, April 2018, http://sirs.yankes.kemkes.go.id/rsonline/report/ 10 Ministry of Health, 2016 11Ministry of Finance ,2017 6 6 C. HEALTH SECURITY In the last five decades, public health emergencies have been marked by the spread of infectious diseases and/or events caused by nuclear radiation, biological pollution, chemical contamination, bioterrorism and food that pose health hazards, and have the potential to spread across regions or countries. Various emerging infectious diseases have resulted in the Public Health Emergency of International Concern (PHEIC), including Ebola (2019 and 2014), Poliomyelitis (2018),Zika Virus Disease (2016), Influenza A (H1N1)(2009), Severe Acute Respiratory Syndrome (SARS)(2002-2003), as well as the Nuclear Blast in Hiroshima which resulted in the emergence of certain diseases. Since 2005-2018, there have been 200 Avian Influenza (AI)cases with 168 deaths (CFR 84%) in Indonesia. Ever since the outbreak in 2005, Indonesia has carried out various efforts in preventing and controlling AI, including: strengthening surveillance, communication and collaboration amongst related sectors, and comprehensive pandemic influenza preparedness program (such as developing guidelines, contingency plan, and carrying out table top exercise and field simulations). In 2018, Indonesia reported 1 case of cVDPV1 and 2 contacts of positive cases of cVDPV1 that occurred in Papua. As this case originated from Papua New Guinea (PNG), in addition to implementing sub-National Immunization Weekand increasing routine immunization, Indonesia also strengthens surveillance at ground crossing and develops a Memorandum of Understanding (MOU) between the Indonesian and PNG government. MERS is one of the diseases that have the potential to cause public health emergencies in Indonesia. The cumulative number of suspected MERS cases in Indonesia from 2013 to the 30th week of 2019 are 553 cases (546 cases with negative laboratory results and 7 cases where thesample specimens could not be taken). Until now there has been no confirmedMERS case in Indonesia. Zoonoses diseases have becomeboth a national and a global concern. There is an increased threat of new infectious diseases, most of which are from zoonotic diseases. Zoonotic prevention and control must be carried out by means of communication, collaboration and cross-sectoral coordination within the framework of "One Health" which wasadoptedglobally since 2011. Someembryonic activities based on One Health approach have been implemented in Indonesia since 1972 with various cooperations and joint degrees between Ministry of Health (MOH) and Ministry of Agriculture (MOA), followed by Presidential Regulations on National Commission of Bird Flu and Pandemic Preparedness in 2006 and Zoonoses Control in 2011. The development of One Health in Indonesia has improved and become more harmonious across sectors, especially between the MOH, MOA and the Ministry of Environment and Forestry (MOEF). 7 HISTORY OF IHR IMPLEMENTATION IN INDONESIA The International Health Regulations(IHR) (2005), agreed upon by 196 WHO member countries including Indonesia, was intended to be a reference for international cooperation to achieve global health security. IHR (2005) aims to prevent, protect, control and respond to public health threats through increased surveillance, as well as reporting and information-sharing between nations. At present, IHR (2005) is an instrument that unites 196 WHO member countries. Nonetheless, compliance with the implementation of IHR (2005) at the global level remains to bechallengingand needs to be improved. IHR (2005) requires resources at designated airports, ports, and ground crossings or 'Points of Entry' (PoEs) which are able to respond to Public Health Emergency of International Concerns (PHEICs) at any time, limit the spread of public health risks at the international level, and prevent unnecessary restrictions of travel and trades. However, there is more and more evidence showing that effort for controlling the spread of PHEICs at ports and ground crossings are becoming less effective and less efficient. Containment at source by implementing real-time surveillance and strengthening health system hasproven to be more effective. Screening of incoming travelers is less important than screening of outgoing travelers. Indonesia started implementing IHR (2005) in 2007 and conducted self-assessment on its eight core capacities. The first assessment in 2007 showed that Indonesia lacked capacities and resources in Surveillance, Response, Laboratory and Infection Control, hence it needed to strengthen the capacities through multi sectoral approach, and to emphasize the importance at point of entries (PoE). In 2009, Indonesia developed the IHR strategic plan and conducted self-assessment in 2010 and 2011, whose results showed that surveillance and PoE had not met the requirements yet. To emphasizeIndonesia’s commitment to accelerate core capacities fulfillment, a National Committee representing multi sectoral agencies was established in 2011. In 2012, Indonesia conducted a self-assessment using WHO tools 2010-2012 and the result showed that capacities in surveillance, response, preparedness, coordination and point of entry were not optimal. Finally, in 2014, Indonesia conducted the last self assessment using WHO tools 2013 and the result was encouraging. The result showed that Indonesia had an optimal and functioning IHR implementation in all eight core capacities. 7 6 C. HEALTH SECURITY In the last five decades, public health emergencies have been marked by the spread of infectious diseases and/or events caused by nuclear radiation, biological pollution, chemical contamination, bioterrorism and food that pose health hazards, and have the potential to spread across regions or countries. Various emerging infectious diseases have resulted in the Public Health Emergency of International Concern (PHEIC), including Ebola (2019 and 2014), Poliomyelitis (2018),Zika Virus Disease (2016), Influenza A (H1N1)(2009), Severe Acute Respiratory Syndrome (SARS)(2002-2003), as well as the Nuclear Blast in Hiroshima which resulted in the emergence of certain diseases. Since 2005-2018, there have been 200 Avian Influenza (AI)cases with 168 deaths (CFR 84%) in Indonesia. Ever since the outbreak in 2005, Indonesia has carried out various efforts in preventing and controlling AI, including: strengthening surveillance, communication and collaboration amongst related sectors, and comprehensive pandemic influenza preparedness program (such as developing guidelines, contingency plan, and carrying out table top exercise and field simulations). In 2018, Indonesia reported 1 case of cVDPV1 and 2 contacts of positive cases of cVDPV1 that occurred in Papua. As this case originated from Papua New Guinea (PNG), in addition to implementing sub-National Immunization Weekand increasing routine immunization, Indonesia also strengthens surveillance at ground crossing and develops a Memorandum of Understanding (MOU) between the Indonesian and PNG government. MERS is one of the diseases that have the potential to cause public health emergencies in Indonesia. The cumulative number of suspected MERS cases in Indonesia from 2013 to the 30th week of 2019 are 553 cases (546 cases with negative laboratory results and 7 cases where thesample specimens could not be taken). Until now there has been no confirmedMERS case in Indonesia. Zoonoses diseases have becomeboth a national and a global concern. There is an increased threat of new infectious diseases, most of which are from zoonotic diseases. Zoonotic prevention and control must be carried out by means of communication, collaboration and cross-sectoral coordination within the framework of "One Health" which wasadoptedglobally since 2011. Someembryonic activities based on One Health approach have been implemented in Indonesia since 1972 with various cooperations and joint degrees between Ministry of Health (MOH) and Ministry of Agriculture (MOA), followed by Presidential Regulations on National Commission of Bird Flu and Pandemic Preparedness in 2006 and Zoonoses Control in 2011. The development of One Health in Indonesia has improved and become more harmonious across sectors, especially between the MOH, MOA and the Ministry of Environment and Forestry (MOEF). 7 HISTORY OF IHR IMPLEMENTATION IN INDONESIA The International Health Regulations(IHR) (2005), agreed upon by 196 WHO member countries including Indonesia, was intended to be a reference for international cooperation to achieve global health security. IHR (2005) aims to prevent, protect, control and respond to public health threats through increased surveillance, as well as reporting and information-sharing between nations. At present, IHR (2005) is an instrument that unites 196 WHO member countries. Nonetheless, compliance with the implementation of IHR (2005) at the global level remains to bechallengingand needs to be improved. IHR (2005) requires resources at designated airports, ports, and ground crossings or 'Points of Entry' (PoEs) which are able to respond to Public Health Emergency of International Concerns (PHEICs) at any time, limit the spread of public health risks at the international level, and prevent unnecessary restrictions of travel and trades. However, there is more and more evidence showing that effort for controlling the spread of PHEICs at ports and ground crossings are becoming less effective and less efficient. Containment at source by implementing real-time surveillance and strengthening health system hasproven to be more effective. Screening of incoming travelers is less important than screening of outgoing travelers. Indonesia started implementing IHR (2005) in 2007 and conducted self-assessment on its eight core capacities. The first assessment in 2007 showed that Indonesia lacked capacities and resources in Surveillance, Response, Laboratory and Infection Control, hence it needed to strengthen the capacities through multi sectoral approach, and to emphasize the importance at point of entries (PoE). In 2009, Indonesia developed the IHR strategic plan and conducted self-assessment in 2010 and 2011, whose results showed that surveillance and PoE had not met the requirements yet. To emphasizeIndonesia’s commitment to accelerate core capacities fulfillment, a National Committee representing multi sectoral agencies was established in 2011. In 2012, Indonesia conducted a self-assessment using WHO tools 2010-2012 and the result showed that capacities in surveillance, response, preparedness, coordination and point of entry were not optimal. Finally, in 2014, Indonesia conducted the last self assessment using WHO tools 2013 and the result was encouraging. The result showed that Indonesia had an optimal and functioning IHR implementation in all eight core capacities. 8 8 THE JOINT EXTERNAL EVALUATION The JointExternal Evaluation (JEE) - IHR (2005) is intended to assess the country's ability to prevent, detect, and respond quickly to public health threats independently, regardless of whether the threats occur naturally, intentionally, or accidentally. The JEE reviewed the country’s preparedness and response-readiness in facing PHEICs for 19 Technical Areas and the extent of multisectoral coordination and collaboration. The JEE tools comprise4 aspects: Prevent, Detect, Respond and Others (PoE, Chemical Events and Radiation Emergencies). Each Technical Area is associated with a target statement, one or more indicators, and a rank-ordered scoring system for each indicator. To facilitate a fair comparison between countries, the assessments are conducted using a standard template provided in the JEE tool. For the implementation of JEE, the Indonesian Ministry of Health has issued a Ministerial Decree No. HK.02.02/MENKES/273/2016 appointing the coordinators for each category of Prevent, Detect, Respond and Others as well as the responsible focal points for each technical area within the MOH to implement this internal and external evaluation in collaboration and coordination with other related ministries. The Government of Indonesia invited the Joint External Evaluation (JEE) team on November 20-24, 2017. The reports from the JEE assessments are made publicly available. Countries undergoing an assessment are urged to develop a National Action Plan for Health Security (NAPHS) for strengthening IHR (2005) core capacities based on the findings of the assessment. 9 JEE Result12 The JEE process is of particular importance to a nation facing such a complex array of challenges and provide an opportunity for Indonesia to identify strengths, address challenges and demonstrate further leadership. Indonesia’s geographically disparate territory imposes a requirement for high level national coordination and monitoring to ensure progress in national core capacities under the IHR (2005). This was demonstrated through the findings of Indonesia’s JEE self-assessment exercise and confirmed by the work of the JEE expert team and its Indonesian colleagues during the evaluation week. Belowis a summary of the JEE scores for the Republic of Indonesia: TECHNICAL AREAS INDICATORS SCORE PREVENT National legislation, policy and financing P.1.1 Legislation, laws, regulations, administrative requirements, policies or other government instruments in place are sufficient for implementation of IHR (2005) 3 P.1.2 The State can demonstrate that it has adjusted and aligned its domestic legislation, policies and administrative arrangements to enable compliance with IHR (2005) 3 IHR coordination, communication and advocacy P.2.1 A functional mechanism is established for the coordination and integration of relevant sectors in the implementation of IHR 3 Antimicrobial resistance P.3.1 Antimicrobial resistance detection 2 P.3.2 Surveillance of infections caused by antimicrobial resistant pathogens 2 P.3.3 Health care-associated infection (HCAI) prevention and control programs 3 P.3.4 Antimicrobial stewardship activities 3 Zoonotic diseases P.4.1 Surveillance systems are in place for priority zoonotic diseases/pathogens 3 P.4.2 Veterinary or animal health workforce 3 P.4.3 Mechanisms for responding to infectious and potential zoonotic diseases are established and functional 2 Food safety P.5.1 Mechanisms for multisectoral collaboration are established to ensure rapid response to food safety emergencies and outbreaks of foodborne diseases 3 Biosafety and biosecurity P.6.1 Whole-of-government biosafety and biosecurity system is in place for human, animal and agriculture facilities 3 12Joint external evaluation of the Republic of Indonesia report, November 20-24, 2017 9 8 THE JOINT EXTERNAL EVALUATION The JointExternal Evaluation (JEE) - IHR (2005) is intended to assess the country's ability to prevent, detect, and respond quickly to public health threats independently, regardless of whether the threats occur naturally, intentionally, or accidentally. The JEE reviewed the country’s preparedness and response-readiness in facing PHEICs for 19 Technical Areas and the extent of multisectoral coordination and collaboration. The JEE tools comprise4 aspects: Prevent, Detect, Respond and Others (PoE, Chemical Events and Radiation Emergencies). Each Technical Area is associated with a target statement, one or more indicators, and a rank-ordered scoring system for each indicator. To facilitate a fair comparison between countries, the assessments are conducted using a standard template provided in the JEE tool. For the implementation of JEE, the Indonesian Ministry of Health has issued a Ministerial Decree No. HK.02.02/MENKES/273/2016 appointing the coordinators for each category of Prevent, Detect, Respond and Others as well as the responsible focal points for each technical area within the MOH to implement this internal and external evaluation in collaboration and coordination with other related ministries. The Government of Indonesia invited the Joint External Evaluation (JEE) team on November 20-24, 2017. The reports from the JEE assessments are made publicly available. Countries undergoing an assessment are urged to develop a National Action Plan for Health Security (NAPHS) for strengthening IHR (2005) core capacities based on the findings of the assessment. 9 JEE Result12 The JEE process is of particular importance to a nation facing such a complex array of challenges and provide an opportunity for Indonesia to identify strengths, address challenges and demonstrate further leadership. Indonesia’s geographically disparate territory imposes a requirement for high level national coordination and monitoring to ensure progress in national core capacities under the IHR (2005). This was demonstrated through the findings of Indonesia’s JEE self-assessment exercise and confirmed by the work of the JEE expert team and its Indonesian colleagues during the evaluation week. Belowis a summary of the JEE scores for the Republic of Indonesia: TECHNICAL AREAS INDICATORS SCORE PREVENT National legislation, policy and financing P.1.1 Legislation, laws, regulations, administrative requirements, policies or other government instruments in place are sufficient for implementation of IHR (2005) 3 P.1.2 The State can demonstrate that it has adjusted and aligned its domestic legislation, policies and administrative arrangements to enable compliance with IHR (2005) 3 IHR coordination, communication and advocacy P.2.1 A functional mechanism is established for the coordination and integration of relevant sectors in the implementation of IHR 3 Antimicrobial resistance P.3.1 Antimicrobial resistance detection 2 P.3.2 Surveillance of infections caused by antimicrobial resistant pathogens 2 P.3.3 Health care-associated infection (HCAI) prevention and control programs 3 P.3.4 Antimicrobial stewardship activities 3 Zoonotic diseases P.4.1 Surveillance systems are in place for priority zoonotic diseases/pathogens 3 P.4.2 Veterinary or animal health workforce 3 P.4.3 Mechanisms for responding to infectious and potential zoonotic diseases are established and functional 2 Food safety P.5.1 Mechanisms for multisectoral collaboration are established to ensure rapid response to food safety emergencies and outbreaks of foodborne diseases 3 Biosafety and biosecurity P.6.1 Whole-of-government biosafety and biosecurity system is in place for human, animal and agriculture facilities 3 12Joint external evaluation of the Republic of Indonesia report, November 20-24, 2017 10 10 TECHNICAL AREAS INDICATORS SCORE P.6.2 Biosafety and biosecurity training and practices 3 Immunization P.7.1 Vaccine coverage (measles) as part of national programme 4 P.7.2 National vaccine access and delivery 4 DETECT National laboratory system D.1.1 Laboratory testing for detection of priority diseases 4 D.1.2 Specimen referral and transport system 4 D.1.3 Effective modern point-of-care and laboratory-based diagnostics 3 D.1.4 Laboratory quality system 3 Real-time surveillance D.2.1 Indicator- and event-based surveillance systems 3 D.2.2 Interoperable, interconnected, electronic real-time reporting system 3 D.2.3 Integration and analysis of surveillance data 2 D.2.4 Syndromic surveillance systems 4 Reporting D.3.1 System for efficient reporting to FAO, OIE and WHO 3 D.3.2 Reporting network and protocols in country 3 Workforce development D.4.1 Human resources available to implement IHR core capacity requirements 3 D.4.2 FETP13 or other applied epidemiology training programme in place 4 D.4.3 Workforce strategy 3 RESPONSE Preparedness R.1.1 National multi-hazard public health emergency preparedness and response plan is developed and implemented 3 R.1.2 Priority public health risks and resources are mapped and utilized 2 Emergency response operations R.2.1 Capacity to activate emergency operations 3 R.2.2 EOC operating procedures and plans 2 R.2.3 Emergency operations programme 3 R.2.4 Case management procedures implemented for IHR relevant hazards. 3 Linking public health and security authorities R.3.1 Public health and security authorities (e.g. law enforcement, border control, customs) are linked during a suspect or confirmed biological event 4 Medical countermeasures R.4.1 System in place for sending and receiving medical countermeasures during a public health emergency 4 13FETP: Field epidemiology training programme 11 TECHNICAL AREAS INDICATORS SCORE and personnel deployment R.4.2 System in place for sending and receiving health personnel during a public health emergency 4 Risk communication R.5.1 Risk communication systems (plans, mechanisms, etc.) 3 R.5.2 Internal and partner communication and coordination 3 R.5.3 Public communication 4 R.5.4 Communication engagement with affected communities 4 R.5.5 Dynamic listening and rumour management 4 OTHER IHR HAZARDS AND POE Points of entry PoE.1 Routine capacities established at points of entry 4 PoE.2 Effective public health response at points of entry 4 Chemical events CE.1 Mechanisms established and functioning for detecting and responding to chemical events or emergencies 2 CE.2 Enabling environment in place for management of chemical events 3 Radiation emergencies RE.1 Mechanisms established and functioning for detecting and responding to radiological and nuclear emergencies 3 RE.2 Enabling environment in place for management of radiation emergencies 3 Indonesia JEE Final Result Final Score: 63% INDICATOR STATUS 0 RED (˂40%) 34 YELLOW (40-70%) 14 GREEN (˃70%) 11 10 TECHNICAL AREAS INDICATORS SCORE P.6.2 Biosafety and biosecurity training and practices 3 Immunization P.7.1 Vaccine coverage (measles) as part of national programme 4 P.7.2 National vaccine access and delivery 4 DETECT National laboratory system D.1.1 Laboratory testing for detection of priority diseases 4 D.1.2 Specimen referral and transport system 4 D.1.3 Effective modern point-of-care and laboratory-based diagnostics 3 D.1.4 Laboratory quality system 3 Real-time surveillance D.2.1 Indicator- and event-based surveillance systems 3 D.2.2 Interoperable, interconnected, electronic real-time reporting system 3 D.2.3 Integration and analysis of surveillance data 2 D.2.4 Syndromic surveillance systems 4 Reporting D.3.1 System for efficient reporting to FAO, OIE and WHO 3 D.3.2 Reporting network and protocols in country 3 Workforce development D.4.1 Human resources available to implement IHR core capacity requirements 3 D.4.2 FETP13 or other applied epidemiology training programme in place 4 D.4.3 Workforce strategy 3 RESPONSE Preparedness R.1.1 National multi-hazard public health emergency preparedness and response plan is developed and implemented 3 R.1.2 Priority public health risks and resources are mapped and utilized 2 Emergency response operations R.2.1 Capacity to activate emergency operations 3 R.2.2 EOC operating procedures and plans 2 R.2.3 Emergency operations programme 3 R.2.4 Case management procedures implemented for IHR relevant hazards. 3 Linking public health and security authorities R.3.1 Public health and security authorities (e.g. law enforcement, border control, customs) are linked during a suspect or confirmed biological event 4 Medical countermeasures R.4.1 System in place for sending and receiving medical countermeasures during a public health emergency 4 13FETP: Field epidemiology training programme 11 TECHNICAL AREAS INDICATORS SCORE and personnel deployment R.4.2 System in place for sending and receiving health personnel during a public health emergency 4 Risk communication R.5.1 Risk communication systems (plans, mechanisms, etc.) 3 R.5.2 Internal and partner communication and coordination 3 R.5.3 Public communication 4 R.5.4 Communication engagement with affected communities 4 R.5.5 Dynamic listening and rumour management 4 OTHER IHR HAZARDS AND POE Points of entry PoE.1 Routine capacities established at points of entry 4 PoE.2 Effective public health response at points of entry 4 Chemical events CE.1 Mechanisms established and functioning for detecting and responding to chemical events or emergencies 2 CE.2 Enabling environment in place for management of chemical events 3 Radiation emergencies RE.1 Mechanisms established and functioning for detecting and responding to radiological and nuclear emergencies 3 RE.2 Enabling environment in place for management of radiation emergencies 3 Indonesia JEE Final Result Final Score: 63% INDICATOR STATUS 0 RED (˂40%) 34 YELLOW (40-70%) 14 GREEN (˃70%) 12 12 JEE Recommendations Three overarching recommendations emerged from the evaluation week, which are intended to address challenges affecting Indonesia’s capacities in a number of technical areas, as follows: 1. Develop and implement a fully integrated, multisectoral National Action Plan for IHR implementation, facilitated by a legal decree at the highest level. 2. Establish a mechanism to coordinate the IHR and global health security work of all relevant ministries, agencies and institutions. 3. Evaluate and improve decision making structures and delegation of authority and responsibility to act, not only between the national and sub-national levels, but also at the national level. 13 IV. POLICY AND STRATEGY A. LEGAL FRAMEWORK In strengthening health security, the Minister of Health has issued Ministerial Decree no. Hk.02.02 / Menkes / 273/2016 on“the Global Health Resilience Working Group in the Ministry of Health”to coordinate various aspects from detect, prevent, and respond in the health sector. Presidential Instruction Number 4 of 2019 concerning “Improved Capacity in Preventing, Detecting, and Responding to Disease Outbreaks, Pandemic, and Nuclear, Biological, and Chemical Emergencies” came into force on June 17, 2019. This Presidential Instruction mandates the duties and responsibilities of each relevant ministry / institution in the technical and management aspects for the prevention and control of public health emergencies, outbreaks and epidemic. Various laws and regulations refer to Law No. 4 of 1984 on“Communicable Diseases Epidemic”for the prevention and control of outbreaks / epidemic. The Law No. 4/ 1984 is currently under revision to adjust to the development of national and global situations. In addition, Law No. 6/ 2018 on“Health Quarantine” has just been issued, which regulates various aspects of health quarantine and covers aspects of detect, prevent, and respond from various diseases and health problems related to biological, chemical and nuclear agents that have the potential to cause public health emergencies. B. STRATEGY FOR NAPHS IMPLEMENTATION Implementation strategyfor NAPHS are: 1. To mobilize road shows to advocate NAPHS among related ministries/bodies/agencies 2. To work closely with the World Bank (WB) team in finalizing the HSFAT/Health Security Financing Assessment Tool and its implementation 3. To strengthen the role of local governments in the implementation of IHR and NAPHS 4. To monitor and evaluate NAPHS regularly 13 12 JEE Recommendations Three overarching recommendations emerged from the evaluation week, which are intended to address challenges affecting Indonesia’s capacities in a number of technical areas, as follows: 1. Develop and implement a fully integrated, multisectoral National Action Plan for IHR implementation, facilitated by a legal decree at the highest level. 2. Establish a mechanism to coordinate the IHR and global health security work of all relevant ministries, agencies and institutions. 3. Evaluate and improve decision making structures and delegation of authority and responsibility to act, not only between the national and sub-national levels, but also at the national level. 13 IV. POLICY AND STRATEGY A. LEGAL FRAMEWORK In strengthening health security, the Minister of Health has issued Ministerial Decree no. Hk.02.02 / Menkes / 273/2016 on“the Global Health Resilience Working Group in the Ministry of Health”to coordinate various aspects from detect, prevent, and respond in the health sector. Presidential Instruction Number 4 of 2019 concerning “Improved Capacity in Preventing, Detecting, and Responding to Disease Outbreaks, Pandemic, and Nuclear, Biological, and Chemical Emergencies” came into force on June 17, 2019. This Presidential Instruction mandates the duties and responsibilities of each relevant ministry / institution in the technical and management aspects for the prevention and control of public health emergencies, outbreaks and epidemic. Various laws and regulations refer to Law No. 4 of 1984 on“Communicable Diseases Epidemic”for the prevention and control of outbreaks / epidemic. The Law No. 4/ 1984 is currently under revision to adjust to the development of national and global situations. In addition, Law No. 6/ 2018 on“Health Quarantine” has just been issued, which regulates various aspects of health quarantine and covers aspects of detect, prevent, and respond from various diseases and health problems related to biological, chemical and nuclear agents that have the potential to cause public health emergencies. B. STRATEGY FOR NAPHS IMPLEMENTATION Implementation strategyfor NAPHS are: 1. To mobilize road shows to advocate NAPHS among related ministries/bodies/agencies 2. To work closely with the World Bank (WB) team in finalizing the HSFAT/Health Security Financing Assessment Tool and its implementation 3. To strengthen the role of local governments in the implementation of IHR and NAPHS 4. To monitor and evaluate NAPHS regularly 14 14 V. NAPHS DEVELOPMENT AND IMPLEMENTATION A. NAPHS DEVELOPMENT PROCESS In accordance with the recommendations of the IHR Committee at the 68th WHA, evaluation of progress and capacity building of IHR (2005) should begin with exclusive self-evaluation, followed by approaches that combine self-evaluation, peer assessment and voluntary external evaluation involving a combination of domestic and independent experts. Indonesia has implemented Joint External Evaluation (JEE) in November 2017 using the same approach. NAPHS Methodology 1. Engage stakeholders’ commitment and participation in implementing activities and achieving higher core capacity level in 19 TAs to meet IHR (2005) capacities by facilitating legal decree from the Coordinating Ministry and regular meetings 2. Use Indonesia’s Logic Model to plan the NAPHS. Indonesia’s logic model harmonized key milestones planned in GHSA Action Package Roadmap with Indicators described in JEE tool for each Technical Area, while statement for Level of Capacity for each indicator in JEE tools is used for short, medium and long term in GHSA Outcomes. Indonesia’s Logic Model The WHO General Guidelines to develop NAPHS have been used in the process together with the Logic Model that Indonesia has proposed to GHSA Steering Committee which harmonizes GHSA template and JEE tool. WHO guideline on developing NAPHS can be modified to accommodate the use of Indonesia’s proposed logic model. As the Indicators and level of capabilities in the JEE tools is standard, this harmonization will easily and quickly allow national and international partners/donors/agencies to understand the current and target level of capabilities, activities planned, and opportunities to fund certain activities in Indonesia for Health Security initiatives. (see example of Indonesia’s Logic Model below) Indonesia has conducted many initiatives to implement IHR (2005), therefore the development of NAPHS were focused on priority activities only. Moreover, the priority activities were harmonized with existing national work plan. This harmonization ensures that the priority activities are implemented. Gaps were identified by comparing the existing activities with JEE recommendations and capacity level, while source of funding was identified for filling the gaps. To facilitate the development of NAPHS, Ministry of Health of Indonesia has continued its efforts to actively engage all relevant ministries, agencies and institutions which were involved during the JEE process in November 2017 and hence same technical working groups for respective 19 TAs have worked on the development of the National Action 15 Plan for Health Security by translating priorities identified during the JEE and other assessments into actionable activities using the planning matrix provided by WHO. World Bank has initiated the development of Health Security Financing Assessments Tool (HSFAT) in 2016. HSFAT will assess the expenditure related to health security. Hence, it expresses the supply of funds from all ministries, partners/ donors, agencies and institutions for health security in the last one year. Meanwhile, NAPHS measures the needs or demand for executing national health security. Matching the supplies and demands for health security will provide an estimate of the gaps in financing. Unfortunately, there are some delays in conducting the assessment through surveys using the said tools. After priority activities were determined, calculation of the costing using Indonesia’s standard cost - based on Ministry of Finance Regulation – are done for each technical area. Several activities were organized to submit these costing into WHO Costing Tools, as follows: 1. Planning and costing workshop, Jakarta, 24 – 27 July 2018 The Ministry of Health convened a multi-sector workshop to review the NAPHS draft by all sectors involved. It allowed technical activities proposed by each relevant TA within the MOH to be introduced to relevant sectors through this multi sectoral workshop to explore additional valued inputs and activities from other sectors and experts. As a result of the workshop, 12 out of 19 TAs completed drafting activities and costing them using WHO costing tool. 2. NAPHS finalization meeting, Jakarta, 25-26 October 2018 The finalization meeting with multi sectoral participation including partners ensures the mapping out of all planned and budgeted activities for all 19 TAs for health security and IHR implementation. This meeting yielded an overview of fund allocation and priority action plan for five years. The result is shown in Annex 1 and Annex 2 as illustration on NAPHS priority activities development and budgeting. 3. Technical Meeting for Finalization of NAPHS Document Indonesia , Jakarta, 16-17 July 2019 In this meeting, all 19 TAs update their priority action plan that has been developed in 2018 and finalize them in the form of logic model. 15 14 V. NAPHS DEVELOPMENT AND IMPLEMENTATION A. NAPHS DEVELOPMENT PROCESS In accordance with the recommendations of the IHR Committee at the 68th WHA, evaluation of progress and capacity building of IHR (2005) should begin with exclusive self-evaluation, followed by approaches that combine self-evaluation, peer assessment and voluntary external evaluation involving a combination of domestic and independent experts. Indonesia has implemented Joint External Evaluation (JEE) in November 2017 using the same approach. NAPHS Methodology 1. Engage stakeholders’ commitment and participation in implementing activities and achieving higher core capacity level in 19 TAs to meet IHR (2005) capacities by facilitating legal decree from the Coordinating Ministry and regular meetings 2. Use Indonesia’s Logic Model to plan the NAPHS. Indonesia’s logic model harmonized key milestones planned in GHSA Action Package Roadmap with Indicators described in JEE tool for each Technical Area, while statement for Level of Capacity for each indicator in JEE tools is used for short, medium and long term in GHSA Outcomes. Indonesia’s Logic Model The WHO General Guidelines to develop NAPHS have been used in the process together with the Logic Model that Indonesia has proposed to GHSA Steering Committee which harmonizes GHSA template and JEE tool. WHO guideline on developing NAPHS can be modified to accommodate the use of Indonesia’s proposed logic model. As the Indicators and level of capabilities in the JEE tools is standard, this harmonization will easily and quickly allow national and international partners/donors/agencies to understand the current and target level of capabilities, activities planned, and opportunities to fund certain activities in Indonesia for Health Security initiatives. (see example of Indonesia’s Logic Model below) Indonesia has conducted many initiatives to implement IHR (2005), therefore the development of NAPHS were focused on priority activities only. Moreover, the priority activities were harmonized with existing national work plan. This harmonization ensures that the priority activities are implemented. Gaps were identified by comparing the existing activities with JEE recommendations and capacity level, while source of funding was identified for filling the gaps. To facilitate the development of NAPHS, Ministry of Health of Indonesia has continued its efforts to actively engage all relevant ministries, agencies and institutions which were involved during the JEE process in November 2017 and hence same technical working groups for respective 19 TAs have worked on the development of the National Action 15 Plan for Health Security by translating priorities identified during the JEE and other assessments into actionable activities using the planning matrix provided by WHO. World Bank has initiated the development of Health Security Financing Assessments Tool (HSFAT) in 2016. HSFAT will assess the expenditure related to health security. Hence, it expresses the supply of funds from all ministries, partners/ donors, agencies and institutions for health security in the last one year. Meanwhile, NAPHS measures the needs or demand for executing national health security. Matching the supplies and demands for health security will provide an estimate of the gaps in financing. Unfortunately, there are some delays in conducting the assessment through surveys using the said tools. After priority activities were determined, calculation of the costing using Indonesia’s standard cost - based on Ministry of Finance Regulation – are done for each technical area. Several activities were organized to submit these costing into WHO Costing Tools, as follows: 1. Planning and costing workshop, Jakarta, 24 – 27 July 2018 The Ministry of Health convened a multi-sector workshop to review the NAPHS draft by all sectors involved. It allowed technical activities proposed by each relevant TA within the MOH to be introduced to relevant sectors through this multi sectoral workshop to explore additional valued inputs and activities from other sectors and experts. As a result of the workshop, 12 out of 19 TAs completed drafting activities and costing them using WHO costing tool. 2. NAPHS finalization meeting, Jakarta, 25-26 October 2018 The finalization meeting with multi sectoral participation including partners ensures the mapping out of all planned and budgeted activities for all 19 TAs for health security and IHR implementation. This meeting yielded an overview of fund allocation and priority action plan for five years. The result is shown in Annex 1 and Annex 2 as illustration on NAPHS priority activities development and budgeting. 3. Technical Meeting for Finalization of NAPHS Document Indonesia , Jakarta, 16-17 July 2019 In this meeting, all 19 TAs update their priority action plan that has been developed in 2018 and finalize them in the form of logic model. 16 16 B. NAPHS 2020 – 2024 Indonesia has responded comprehensively on JEE overarching recommendations, as follow: JEE Recommendation Activity 1 Develop and implement a fully integrated, multisectoral National Action Plan for IHR implementation, facilitated by a legal decree at the highest level. NAPHS developed and finalized in December 2018 2 Establish a mechanism to coordinate the IHR and global health security work of all relevant ministries, agencies and institutions. Presidential Instruction Number 4 of 2019concerning “Improved Capacity in Preventing, Detecting, and Responding to Disease Outbreaks, Pandemic, and Nuclear, Biological, and Chemical Emergencies” 3 Evaluate and improve decision making structures and delegation of authority and responsibility to act, not only between the national and sub-national levels, but also at the national level. All 19 TAs also plan priority activities in each indicator to achieve higher level of capacity as shown in the logic model below: 17 TA N AT IO N AL L EG IS LA TI O N , P O LI CY A N D FI N AN CI N G Le ve l 4 : Th e co un tr y ca n de m on st ra te th e ex is te nc e an d us e of re le va nt la w s an d po lic ie s in th e va rio us s ec to rs in vo lv ed in th e im pl em en ta tio n of th e IH R Ad vo ca te th e im pl em en ta tio n of P re si de nt In st ru ct io n N um be r 4 /2 01 9 1. D is se m in at io n 2. G ui de lin e de ve lo pm en ts fo r D is tr ic t H ea d 3. C oo rd in at io n m ee tin g fo r p re pa re A dv oc at io n St ra te gi c. 4. A dv oc at e re la te d in st itu tio ns to d ev el op M in is te r A ct c on si st o f t he c oo rd in at io n in im pl em en tin g th e Pr es id en t I ns tr uc tio n w ith in in te rn al m in is tr y/ in st itu tio n. n an d Re sp on se fo r P ub lic H ea lth E m er ge nc y Co nt ai nm en t T ra in in g in P O E fo r P or t H ea lth O ff ic er . 2. F lig ht S ur ge on a nd F lig ht N ur se T ra in in g fo r P or t H ea lth O ff ic er 3. T ra in in g fo r H ea lth Q ua ra nt in e Ca pa ci ty In pu ts Le ve l 4 : Po lic ie s to fa ci lit at e IH R N FP co re a nd ex pa nd ed fu nc tio ns a nd to st re ng th en c or e ca pa ci tie s M an M on ey M et ho d Pa rt ne r Le ve l 4 : Po lic ie s to fa ci lit at e IH R N FP c or e an d ex pa nd ed fu nc tio ns a nd to s tr en gt he n co re ca pa ci tie s M on ito rin g a nd E va lu at io n 1. P re pa ra tio n M ee tin g fo r M on ito rin g an d Ev al ua tio n In st ru m en ts 2. M on ito rin g 3. M id te rm E va lu at io n 4. E nd te rm E va lu at io n 5. E nd T er m E va lu at io n Le gi sl at io n, la w s, re gu la tio ns , a dm in is tr at iv e re qu ire m en ts , p ol ic ie s or o th er g ov er nm en t in st ru m en ts in p la ce a re s uf fic ie nt fo r i m pl em en ta tio ns o f I H R Th e St at e ca n D em on st ra te th at it h as a dj us te d an d al ig ne d its d om es tic le gi sl at io n, p ol ic ie s, a nd a dm in is tr at iv e to e na bl e co m pl ia nc e w ith IH R (2 00 5) D is se m in at io n of P ro vi nc ia l & D is tr ic t A ct io n Pl an H ea lth S ec ur ity (r eg io na l) 1. C oo rd in at io n M ee tin g Te ch ni ca l A ss is ta nc e fo r t he P re pa ra tio n of P ro vi nc ia l & D is tr ic t A ct io n Pl an H ea lth S ec ur ity – 3 4 Pr ov in ce s. 1. M od ul e D ev el op m en t 2. T ra in in g of T ra in er (n at io na l) 3. T ra in in g of T ra in er (p ro vi nc e) 4. T ec hn ic al A ss ita nc e (p ro vi nc e) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) H ar m on iz at io n of re gi on al p ol ic ie s w ith th e In do ne si a N at io na l A ct io n Pl an fo r H ea lth S ec ur ity . 1. C oo rd in at io n m ee tin g to id en tif y lo ca l p ol ic y an d N AP H S (2 02 0) 2. T ec hn ic al A ss is st an ce in a dj us tm en t o f l oc al p ol ic y (2 02 1) 3. P re pa ra tio n M ee tin g fo r m on ito rin g an d Ev al ua tio n in st ru m en ts o f t he im pl em en ta tio n in lo ca l p ol ic ie s (2 02 2) 4. M on ito rin g Le ve l 5 : Po lic ie s to fa ci lit at e IH R N FP c or e an d ex pa nd ed fu nc tio ns a nd to s tr en gt he n co re c ap ac iti es in co rp or at ed w ith in th e na tio na l h ea lth se ct or p la n (N H SP ) Le ve l 5 : Th e co un tr y en su re s co or di na ti on o f t he le ga l a nd re gu la to ry fr am ew or k s be tw ee n se ct or s H ar m on iz at io n an d Sy nc hr on iz at io n of S tr at eg ic P ol ic y ac cr os s TA (p ol ic y ga ps , c on fli ct , n ee ds ) 1. C oo rd in at io n M ee tin g 2. D ev el op m en t o f L oc al a nd n at io na l a ct io n pl an (2 02 2) 1. C oo rd in at io n m ee tin g (n at io na l a ct io n pl an ) 2. C oo rd in at io n m ee tin g (lo ca l a ct io n pl an ) H ea lth S ec ur ity F in an ci ng M ap pi ng o f a ll re le va nt s ec to rs 1. C oo rd in at io n M ee tin g Le ve l 4 : Th e co un tr y ca n de m on st ra te th e ex is te nc e an d us e of re le va nt la w s an d po lic ie s in th e va rio us s ec to rs in vo lv ed in th e im pl em en ta tio n of th e IH R 17 16 B. NAPHS 2020 – 2024 Indonesia has responded comprehensively on JEE overarching recommendations, as follow: JEE Recommendation Activity 1 Develop and implement a fully integrated, multisectoral National Action Plan for IHR implementation, facilitated by a legal decree at the highest level. NAPHS developed and finalized in December 2018 2 Establish a mechanism to coordinate the IHR and global health security work of all relevant ministries, agencies and institutions. Presidential Instruction Number 4 of 2019concerning “Improved Capacity in Preventing, Detecting, and Responding to Disease Outbreaks, Pandemic, and Nuclear, Biological, and Chemical Emergencies” 3 Evaluate and improve decision making structures and delegation of authority and responsibility to act, not only between the national and sub-national levels, but also at the national level. All 19 TAs also plan priority activities in each indicator to achieve higher level of capacity as shown in the logic model below: 17 TA N AT IO N AL L EG IS LA TI O N , P O LI CY A N D FI N AN CI N G Le ve l 4 : Th e co un tr y ca n de m on st ra te th e ex is te nc e an d us e of re le va nt la w s an d po lic ie s in th e va rio us s ec to rs in vo lv ed in th e im pl em en ta tio n of th e IH R Ad vo ca te th e im pl em en ta tio n of P re si de nt In st ru ct io n N um be r 4 /2 01 9 1. D is se m in at io n 2. G ui de lin e de ve lo pm en ts fo r D is tr ic t H ea d 3. C oo rd in at io n m ee tin g fo r p re pa re A dv oc at io n St ra te gi c. 4. A dv oc at e re la te d in st itu tio ns to d ev el op M in is te r A ct c on si st o f t he c oo rd in at io n in im pl em en tin g th e Pr es id en t I ns tr uc tio n w ith in in te rn al m in is tr y/ in st itu tio n. n an d Re sp on se fo r P ub lic H ea lth E m er ge nc y Co nt ai nm en t T ra in in g in P O E fo r P or t H ea lth O ff ic er . 2. F lig ht S ur ge on a nd F lig ht N ur se T ra in in g fo r P or t H ea lth O ff ic er 3. T ra in in g fo r H ea lth Q ua ra nt in e Ca pa ci ty In pu ts Le ve l 4 : Po lic ie s to fa ci lit at e IH R N FP co re a nd ex pa nd ed fu nc tio ns a nd to st re ng th en c or e ca pa ci tie s M an M on ey M et ho d Pa rt ne r Le ve l 4 : Po lic ie s to fa ci lit at e IH R N FP c or e an d ex pa nd ed fu nc tio ns a nd to s tr en gt he n co re ca pa ci tie s M on ito rin g a nd E va lu at io n 1. P re pa ra tio n M ee tin g fo r M on ito rin g an d Ev al ua tio n In st ru m en ts 2. M on ito rin g 3. M id te rm E va lu at io n 4. E nd te rm E va lu at io n 5. E nd T er m E va lu at io n Le gi sl at io n, la w s, re gu la tio ns , a dm in is tr at iv e re qu ire m en ts , p ol ic ie s or o th er g ov er nm en t in st ru m en ts in p la ce a re s uf fic ie nt fo r i m pl em en ta tio ns o f I H R Th e St at e ca n D em on st ra te th at it h as a dj us te d an d al ig ne d its d om es tic le gi sl at io n, p ol ic ie s, a nd a dm in is tr at iv e to e na bl e co m pl ia nc e w ith IH R (2 00 5) D is se m in at io n of P ro vi nc ia l & D is tr ic t A ct io n Pl an H ea lth S ec ur ity (r eg io na l) 1. C oo rd in at io n M ee tin g Te ch ni ca l A ss is ta nc e fo r t he P re pa ra tio n of P ro vi nc ia l & D is tr ic t A ct io n Pl an H ea lth S ec ur ity – 3 4 Pr ov in ce s. 1. M od ul e D ev el op m en t 2. T ra in in g of T ra in er (n at io na l) 3. T ra in in g of T ra in er (p ro vi nc e) 4. T ec hn ic al A ss ita nc e (p ro vi nc e) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) H ar m on iz at io n of re gi on al p ol ic ie s w ith th e In do ne si a N at io na l A ct io n Pl an fo r H ea lth S ec ur ity . 1. C oo rd in at io n m ee tin g to id en tif y lo ca l p ol ic y an d N AP H S (2 02 0) 2. T ec hn ic al A ss is st an ce in a dj us tm en t o f l oc al p ol ic y (2 02 1) 3. P re pa ra tio n M ee tin g fo r m on ito rin g an d Ev al ua tio n in st ru m en ts o f t he im pl em en ta tio n in lo ca l p ol ic ie s (2 02 2) 4. M on ito rin g Le ve l 5 : Po lic ie s to fa ci lit at e IH R N FP c or e an d ex pa nd ed fu nc tio ns a nd to s tr en gt he n co re c ap ac iti es in co rp or at ed w ith in th e na tio na l h ea lth se ct or p la n (N H SP ) Le ve l 5 : Th e co un tr y en su re s co or di na ti on o f t he le ga l a nd re gu la to ry fr am ew or k s be tw ee n se ct or s H ar m on iz at io n an d Sy nc hr on iz at io n of S tr at eg ic P ol ic y ac cr os s TA (p ol ic y ga ps , c on fli ct , n ee ds ) 1. C oo rd in at io n M ee tin g 2. D ev el op m en t o f L oc al a nd n at io na l a ct io n pl an (2 02 2) 1. C oo rd in at io n m ee tin g (n at io na l a ct io n pl an ) 2. C oo rd in at io n m ee tin g (lo ca l a ct io n pl an ) H ea lth S ec ur ity F in an ci ng M ap pi ng o f a ll re le va nt s ec to rs 1. C oo rd in at io n M ee tin g Le ve l 4 : Th e co un tr y ca n de m on st ra te th e ex is te nc e an d us e of re le va nt la w s an d po lic ie s in th e va rio us s ec to rs in vo lv ed in th e im pl em en ta tio n of th e IH R 18 18 TA IH R CO O RD IN AT IO N , C O M M U N IC AT IO N A N D AD VO CA CY 3) D ev el op a ct io n pl an fo r c oo rd in at io n an d co m m un ic at io n in cl ud in g si m ul at io n/ TT X fo r r es po nd d ur in g PH EI C 4) D is se m in at io n of P re si de nt ia l I ns tr uc tio n no 4 /2 01 9 at n at io na l a nd s ub na tio na l le ve l 5) M on ev fo r N AP H S im pl em en ta tio n in 2 02 0 6) D ev el op a nn ua l r ep or t o f I H R im pl em en ta tio n an d sh ar in g to re le va nt st ak eh ol de rs In pu ts Le ve l 2 : Co or di na tio n m ec ha ni sm be tw ee n re le va nt m in is tr ie s is in p la ce sa nd N at io na l St an da rd O pe ra tin g Pr oc ed ur es (S O Ps ) or e qu iv al en t e xi st s fo r t he c oo rd in at io n be tw ee n IH R N FP an d re le va nt se ct or s M an M on ey M et ho d Pa rt ne r Le ve l 3 : A m ul tis ec to ra l, m ul tid is ci pl in ar y bo dy , c om m itt ee o r ta sk fo rc e ad dr es si ng IH R re qu ire m en ts o n su rv ei lla nc e an d re sp on se fo r p ub lic he al th e m er ge nc ie s of n at io na l a nd in te rn at io na l co nc er n is in p la ce an d pa rt ic ip at ed in la te st e ve nt P. 2. 1 A fu nc tio na l m ec ha ni sm is e st ab lis he d fo r t he c oo rd in at io n an d in te gr at io n of re le va nt se ct or s i n th e im pl em en ta tio n of IH R Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 1) En ha nc e th e ab ili ty o f t he IH R na tio na l f oc al p oi nt to c om m un ic at e he al th ri sk in fo rm at io n 2) D ev el op re po rt in g m ec ha ni sm to IH R N FP (i nt er na l M O H ) a nd to W H O , i nc lu di ng ro le a nd re sp on si bi lit ie s 19 TA A N TI M IC RO BI AL R ES IS TA N CE (A M R) (1 ) Le ve l 2 : N at io na l pl an fo r su rv ei lla nc e of in fe ct io ns ca us ed b y pr io rit y AM R pa th og en s ha s be en ap pr ov ed be tw ee n IH R N FP an d re le va nt se ct or s Le ve l 3 : D es ig na te d se nt in el s ite s ar e co nd uc tin g su rv ei lla nc e of in fe ct io ns c au se d by s om e pr io rit y AM R pa th og en s P. 3. 2. S ur ve ill an ce o f i nf ec tio ns c au se d by a nt im ic ro bi al r es is ta nt pa th og en s 1) Im pl em en ta tio n of b io se cu rit y 3 zo na a t m ed iu m s ca le p ou ltr y fa rm 2) Pr ev en tio n of fi sh d is ea se s 3) Pr ep ar at io n of F is h D ru g Re gu la tio ns 1) G lo ba l S ur ve ill an ce E SB L E Co li 2) A M R su rv ei lla nc e at s hr im p an d fis h fa rm er s 3) C oo rd in at io n m ee tin g/ w or ks ho p on P PI 4) L in k la bo ra to ry d ia gn os tic s to fi el d an im al d is ea se s ur ve ill an ce a nd c on tr ol p ro gr am m es 5) S tr en gt he n la bo ra to ry d ia gn os tic c ap ac ity fo r E ID s an d zo on os es 1) N RL a pp oi nt m en t a t t he M in is tr y of A gr ic ul tu re , M in is tr y of H ea lth , M in is tr y of M ar in e Af fa irs a nd F is he rie s 2) Re vi ew N AP A M R In do ne si a 20 17 2 01 9 to a pp oi nt N CC 3) D ev el op m en t o f N AP A M R In do ne si a th e ne xt 5 p er io d Le ve l 2 : N at io na l pl an fo r d et ec tio n an d re po rt in g of pr io rit y AM R pa th og en s ha s be en ap pr ov ed (S O Ps ) o r eq ui va le nt e xi st s fo r th e co or di na tio n be tw ee n IH R N FP an d re le va nt se ct or s Le ve l 3 : D es ig na te d la bo ra to rie s ar e co nd uc tin g de te ct io n an d re po rt in g of s om e pr io rit y AM R pa th og en s 1) Ca pa ci ty b ui ld in g fo r r ef er ra l a nd te st in g la bo ra to ry a t t he M in is tr y of M ar in e Af fa irs a nd Fi sh er ie s 2) Fa ci lit at e es ta bl is hm en t o f a n An tim ic ro bi al R es is ta nc e Co nt ro l C om m itt ee (A RC C/ KP RA ) i n M oA 3) Fa ci lit at e AR CC /K PR A st ud ie s on a nt im ic ro bi al u sa ge (A M U ) a nd A M R 4) Ra is e st ak eh ol de r’s a w ar en es s of p ru de nt a nd a pp ro pr ia te u se o f a nt im ic ro bi al s an d th e he al th ris ks o f A M R. 5) Ad vo ca te w ith s ta ke ho ld er s (G O I, pr iv at e se ct or /i nd us tr y) fo r a dh er en ce to re gu la tio ns /p ol ic ie s on A M U a nd A M R 6) Bu ild s ta ke ho ld er c ap ac ity to c on du ct m on ito rin g, s ur ve ill an ce , a nd te st in g fo r A M U a nd A M R In pu ts M an M on ey M et ho d Pa rt ne r P. 3. 1 An tim ic ro bi al re si st an ce d et ec tio n Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 19 19 TA A N TI M IC RO BI AL R ES IS TA N CE (A M R) (1 ) Le ve l 2 : N at io na l pl an fo r su rv ei lla nc e of in fe ct io ns ca us ed b y pr io rit y AM R pa th og en s ha s be en ap pr ov ed be tw ee n IH R N FP an d re le va nt se ct or s Le ve l 3 : D es ig na te d se nt in el s ite s ar e co nd uc tin g su rv ei lla nc e of in fe ct io ns c au se d by s om e pr io rit y AM R pa th og en s P. 3. 2. S ur ve ill an ce o f i nf ec tio ns c au se d by a nt im ic ro bi al r es is ta nt pa th og en s 1) Im pl em en ta tio n of b io se cu rit y 3 zo na a t m ed iu m s ca le p ou ltr y fa rm 2) Pr ev en tio n of fi sh d is ea se s 3) Pr ep ar at io n of F is h D ru g Re gu la tio ns 1) G lo ba l S ur ve ill an ce E SB L E Co li 2) A M R su rv ei lla nc e at s hr im p an d fis h fa rm er s 3) C oo rd in at io n m ee tin g/ w or ks ho p on P PI 4) L in k la bo ra to ry d ia gn os tic s to fi el d an im al d is ea se s ur ve ill an ce a nd c on tr ol p ro gr am m es 5) S tr en gt he n la bo ra to ry d ia gn os tic c ap ac ity fo r E ID s an d zo on os es 1) N RL a pp oi nt m en t a t t he M in is tr y of A gr ic ul tu re , M in is tr y of H ea lth , M in is tr y of M ar in e Af fa irs a nd F is he rie s 2) Re vi ew N AP A M R In do ne si a 20 17 2 01 9 to a pp oi nt N CC 3) D ev el op m en t o f N AP A M R In do ne si a th e ne xt 5 p er io d Le ve l 2 : N at io na l pl an fo r d et ec tio n an d re po rt in g of pr io rit y AM R pa th og en s ha s be en ap pr ov ed (S O Ps ) o r eq ui va le nt e xi st s fo r th e co or di na tio n be tw ee n IH R N FP an d re le va nt se ct or s Le ve l 3 : D es ig na te d la bo ra to rie s ar e co nd uc tin g de te ct io n an d re po rt in g of s om e pr io rit y AM R pa th og en s 1) Ca pa ci ty b ui ld in g fo r r ef er ra l a nd te st in g la bo ra to ry a t t he M in is tr y of M ar in e Af fa irs a nd Fi sh er ie s 2) Fa ci lit at e es ta bl is hm en t o f a n An tim ic ro bi al R es is ta nc e Co nt ro l C om m itt ee (A RC C/ KP RA ) i n M oA 3) Fa ci lit at e AR CC /K PR A st ud ie s on a nt im ic ro bi al u sa ge (A M U ) a nd A M R 4) Ra is e st ak eh ol de r’s a w ar en es s of p ru de nt a nd a pp ro pr ia te u se o f a nt im ic ro bi al s an d th e he al th ris ks o f A M R. 5) Ad vo ca te w ith s ta ke ho ld er s (G O I, pr iv at e se ct or /i nd us tr y) fo r a dh er en ce to re gu la tio ns /p ol ic ie s on A M U a nd A M R 6) Bu ild s ta ke ho ld er c ap ac ity to c on du ct m on ito rin g, s ur ve ill an ce , a nd te st in g fo r A M U a nd A M R In pu ts M an M on ey M et ho d Pa rt ne r P. 3. 1 An tim ic ro bi al re si st an ce d et ec tio n Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 20 20 TA A N TI M IC RO BI AL R ES IS TA N CE (A M R) (2 ) 1) Im pl em en ta tio n of th e Sm ar t S oc ie ty M ov em en t P ro gr am U si ng M ed ic in es (G em a Ce rm at ) f or P ha rm ac is ts a nd C om m un iti es 2) PO R an d G em a Ce rm at p ub lic at io n th ro ug h th e m ed ia 3) M on ito rin g an d Ev al ua tio n of th e im pl em en ta tio n of th e G em a Ce rm at 4) Pr ep ar at io n of a nt ib io tic g ui de lin es 5) In cr ea si ng C oo pe ra tio n in d is se m in at in g th e U se o f A nt ib io tic s an d An tib io tic C on tr ol in H ea lth S er vi ce s Le ve l 3 : D es ig na te d fa ci lit ie s ar e co nd uc tin g so m e H CA I pr og ra m s se ct or s M an M on ey M et ho d Pa rt ne r Le ve l 4 : D es ig na te d fa ci lit ie s ha ve co nd uc te d al l H CA I pr og ra m s fo r a t le as t o ne y ea r Le ve l 3 : D es ig na te d ce nt re s ar e co nd uc tin g so m e an tim ic ro bi al st ew ar ds hi p pr ac tic es Le ve l 4 : D es ig na te d ce nt re s ha ve co nd uc te d al l an tim ic ro bi al st ew ar ds hi p pr ac tic es fo r at le as t o ne y ea r P. 3. 3 H ea lth c ar e as so ci at ed in fe ct io n (H CA I) pr ev en tio n an d co nt ro l pr og ra m m es In pu ts P. 3. 4 An tim ic ro bi al s te w ar ds hi p ac tiv iti es 1) St ud y an d pe rf or m an ce d at a Ev al ua tio n on In di ca to rs o f R at io na l D ru g U se 1) Te ch ni ca l s up po rt to im pr ov e ac ce ss to e ss en tia l m ed ic in es a nd te ch no lo gi es , a nd G ui de lin es o f A nt im ic ro bi al U se 2) St re ng th en d is ea se s ur ve ill an ce a nd d at a an al ys is c ap ac ity to s up po rt d is ea se c on tr ol po lic y (M O A) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 1) Im pl em en ta tio n PP RA a t h os pi ta ls , F KR TL 2) D is se m in at io n of R ef er ra l H ea lth S er vi ce s (o ne o f t he m is th e PR A pr og ra m ) 3) Co nd uc t d is ea se id en tif ic at io n an d ta rg et ed s ur ve ill an ce a ct iv iti es in h ig h ris k en vi ro nm en ts a nd o n an im al s at h ig h ris k of c on tr ac tin g zo on os es a nd E ID s, in cl ud in g fa rm ed w ild lif e an d m ig ra to ry b ird s 4) D ev el op G O I c ap ac ity to im pl em en t t ar ge te d zo on os es a nd E ID p re ve nt io n an d co nt ro l pr og ra m m e 21 TA Z O O N O TI C D IS EA SE (1 ) 1. Id en tif ic at io n of p rio rit y zo on ot ic d is ea se s in cl ud e AI , R ab ie s, A nt hr ax , L ep to sp iro si s, B ru ce llo sI S In pu ts Le ve l 3 : Z oo no tic su rv ei lla nc e sy st em s in p la ce fo r 1 4 zo on os tic di se as es / pa th og en s of gr ea te st p ub lic he al th c on ce rn M an M on ey M et ho d Pa rt ne r Le ve l 4 : Zo on ot ic su rv ei lla nc e sy st em s in p la ce fo r f iv e or m or e zo on ot ic di se as es / p at ho ge ns of g re at es t p ub lic he al th c on ce rn 1. D ev el op m en t o f F ET PV Tr ai ni ng F ET PV Le ve l 3 : An im al he al th w or kf or ce ca pa ci ty w ith in th e na tio na l p ub lic he al th s ys te m a nd le ss th an h al f o f s ub na tio na l l ev el s Le ve l 4 : An im al he al th w or kf or ce ca pa ci ty w ith in th e na tio na l p ub lic he al th s ys te m a nd m or e th an h al f o f su b na tio na l l ev el s Su rv ei lla nc e sy st em s i n pl ac e fo r p rio rit y zo on ot ic l3 di se as es /p at ho ge ns → 2 01 7 An im al H ea lth a nd V et er in ar ia n W or kf or ce 2. Co nd uc t d is ea se id en tif ic at io n an d ta rg et ed s ur ve ill an ce a ct iv iti es in h ig h ris k en vi ro nm en ts a nd on a ni m al s at h ig h ris k of c on tr ac tin g zo on os es a nd E ID s, in cl ud in g fa rm ed w ild lif e an d m ig ra to ry b ird s. 3 . St re ng th en d is ea se s ur ve ill an ce a nd d at a an al ys is c ap ac ity to s up po rt d is ea se c on tr ol p ol ic y 4 . M O H re gu la tio n fo r r ab ie s co nt ro l Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 2. Es ta bl is hm en t o f M O A re gu la tio n fo r t he im pl em en ta tio n of v et er in ar y au th or iti es in th e su b na tio na l 5 . D ev el op m en t/ tr y ou t o f r is k m ap pi ng to ol s (Z oo no tic a nd E ID ) 1. 2. 6 . Su rv ei lla nc e de ve lo pm en t 3. 3 . D ev el op G O I c ap ac ity to im pl em en t t ar ge te d zo on os es a nd E ID p re ve nt io n an d co nt ro l pr og ra m m e 21 21 TA Z O O N O TI C D IS EA SE (1 ) 1. Id en tif ic at io n of p rio rit y zo on ot ic d is ea se s in cl ud e AI , R ab ie s, A nt hr ax , L ep to sp iro si s, B ru ce llo sI S In pu ts Le ve l 3 : Z oo no tic su rv ei lla nc e sy st em s in p la ce fo r 1 4 zo on os tic di se as es / pa th og en s of gr ea te st p ub lic he al th c on ce rn M an M on ey M et ho d Pa rt ne r Le ve l 4 : Zo on ot ic su rv ei lla nc e sy st em s in p la ce fo r f iv e or m or e zo on ot ic di se as es / p at ho ge ns of g re at es t p ub lic he al th c on ce rn 1. D ev el op m en t o f F ET PV Tr ai ni ng F ET PV Le ve l 3 : An im al he al th w or kf or ce ca pa ci ty w ith in th e na tio na l p ub lic he al th s ys te m a nd le ss th an h al f o f s ub na tio na l l ev el s Le ve l 4 : An im al he al th w or kf or ce ca pa ci ty w ith in th e na tio na l p ub lic he al th s ys te m a nd m or e th an h al f o f su b na tio na l l ev el s Su rv ei lla nc e sy st em s i n pl ac e fo r p rio rit y zo on ot ic l3 di se as es /p at ho ge ns → 2 01 7 An im al H ea lth a nd V et er in ar ia n W or kf or ce 2. Co nd uc t d is ea se id en tif ic at io n an d ta rg et ed s ur ve ill an ce a ct iv iti es in h ig h ris k en vi ro nm en ts a nd on a ni m al s at h ig h ris k of c on tr ac tin g zo on os es a nd E ID s, in cl ud in g fa rm ed w ild lif e an d m ig ra to ry b ird s. 3 . St re ng th en d is ea se s ur ve ill an ce a nd d at a an al ys is c ap ac ity to s up po rt d is ea se c on tr ol p ol ic y 4 . M O H re gu la tio n fo r r ab ie s co nt ro l Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 2. Es ta bl is hm en t o f M O A re gu la tio n fo r t he im pl em en ta tio n of v et er in ar y au th or iti es in th e su b na tio na l 5 . D ev el op m en t/ tr y ou t o f r is k m ap pi ng to ol s (Z oo no tic a nd E ID ) 1. 2. 6 . Su rv ei lla nc e de ve lo pm en t 3. 3 . D ev el op G O I c ap ac ity to im pl em en t t ar ge te d zo on os es a nd E ID p re ve nt io n an d co nt ro l pr og ra m m e 22 22 TA Z O O N O TI C D IS EA SE (2 ) 1. Su rv ei lla nc e an d re sp on se o f z oo no se s ou tb re ak s In pu ts Le ve l 2 : N at io na l po lic y, s tr at eg y or pl an fo r t he re sp on se to zo on ot ic e ve nt s is in pl ac e M an M on ey M et ho d Pa rt ne r Le ve l 3 : A m ec ha ni sm fo r co or di na te d re sp on se to ou tb re ak s of zo on ot ic d is ea se s by h um an , a ni m al an d w ild lif e se ct or s is e st ab lis he d M ec ha ni sm s fo r r es po nd in g to in fe ct io us zo on os es a nd p ot en tia l z oo no se s ar e es ta bl is he d an d fu nc tio na l 2. ZD AP n at io na l c oo rd in at io n 3 . Pr oc ur em en t f or zo on os is d is ea se : r ab ie s an d le pt os pi ro si s va cc in e 1. 4 . IE C m at er ia l f or z oo no se s di se as es Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 8. Id en tif y po ul tr y he al th b es t p ra ct ic es 1 0. Pr ov id e te ch ni ca l a ss is ta nc e fo r p ou ltr y fa rm er s. 9. Bu ild c ap ac ity o f t ec hn ic al s er vi ce p ro vi de rs . 1 1. Pr om ot e ce rt ifi ca tio n sy st em fo r p ou ltr y fa rm s w hi ch a re a bl e to fu lfi l a ni m al h ea lth p ra ct ic es re qu ire d by go ve rn m en t 12 . Ra is e aw ar en es s of p ou ltr y he al th b es t p ra ct ic es to fa rm er s. 13 . Co nd uc t s tu dy to s up po rt e vi de nc e ba se d po lic y m ak in g to im pr ov e th e qu al ity o f p ou ltr y m ar ke tin g pr oc es se s. 14 . Bu ild s ta ke ho ld er (G ov er nm en t, Pr iv at e) c ap ac ity to im pr ov e bi os ec ur ity a lo ng th e po ul tr y m ar ke t c ha in . 15 . Ad vo ca te fo r s ta ke ho ld er c ol la bo ra tio n on in te rv en tio ns to im pr ov e th e qu al ity o f p ou ltr y m ar ke tin g pr oc es se s. 1 6. Ra is e aw ar en es s of s ta ke ho ld er s an d co ns um er s to im pr ov e th e qu al ity o f p ou ltr y an d po ul tr y pr od uc t m ar ke tin g pr oc es se s. 1 7. Su pp or t d is ea se e m er ge nc y pr ep ar ed ne ss p la nn in g. 7 . Su pp or t e st ab lis hm en t o f a n at io na l w eb b as ed p la tf or m fo r z oo no se s a nd E ID in fo rm at io n ac ce ss a nd sh ar in g. (S IZ E) 5 . Tr ai ni ng fo r s ur ve ill an ce /e pi de m io lo gy o ff ic er in p rim ar y he al th c en te r, an im al h ea lth c en te r, an d di st ric t he al th c en te r t ha t f oc us ed o n in ve st ig at io n in fe ct io us d ise as e w ith O ne H ea lth a pp ro ac h. 2. 6 . Su pp or t z oo no se s an d EI D c om m un ic at io n ac tiv iti es ; d is se m in at e th e co m m un ic at io n st ra te gy o n O ne H ea lth ta rg et ed z oo no se s a nd E ID p re ve nt io n an d co nt ro l. 3. 23 TA F O O D S AF ET Y Le ve l 3 : O pe ra tio na l lin ks a re e st ab lis he d be tw ee n su rv ei lla nc e an d re sp on se s ta ffs , fo od sa fe ty , a ni m al he al th a nd la bo ra to rie s be tw ee n IH R N FP Le ve l 4 : S ta ff re sp on si bl e fo r su rv ei lla nc e an d re sp on se , f oo d sa fe ty , l ab or at or ie s an d ag ric ul tu re w or k to ge th er to co ns id er th e ris ks an d in te rv en tio ns 1) TO T on F oo d Sa fe ty 2) Es ta bl is hm en t N at io na l Q ui ck R es po ns e Te am (Q RT ) 3) D ev el op N at io na l g ui de lin es R is k Pr of ile a nd F oo d Ri sk C at eg or y 4) Fo od S af et y Ri sk A na ly si s st ud y 5) Fo od S af et y Im pl em en ta tio n Sy st em : A ni m al P ro du ct S af et y M on ito rin g at U PH , N KV c er tif ic at io n (v et er in ar y co nt ro l n um be r) a ni m al fa rm / U PH , U PH su pe rv is io n an d N KV A ud ito r T ra in in g an d Ve te rin ar y Pu bl ic H ea lth Su pe rv is or 6) IE C m at er ia l f or fo od s af et y In pu ts M an M on ey M et ho d Pa rt ne r P. 5. 1 M ec ha ni sm s fo r m ul tis ec to ra l c ol la bo ra tio n ar e es ta bl is he d to en su re ra pi d re sp on se to fo od s af et y em er ge nc ie s an d ou tb re ak s of fo od bo rn e di se as es Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 23 23 TA F O O D S AF ET Y Le ve l 3 : O pe ra tio na l lin ks a re e st ab lis he d be tw ee n su rv ei lla nc e an d re sp on se s ta ffs , fo od sa fe ty , a ni m al he al th a nd la bo ra to rie s be tw ee n IH R N FP Le ve l 4 : S ta ff re sp on si bl e fo r su rv ei lla nc e an d re sp on se , f oo d sa fe ty , l ab or at or ie s an d ag ric ul tu re w or k to ge th er to co ns id er th e ris ks an d in te rv en tio ns 1) TO T on F oo d Sa fe ty 2) Es ta bl is hm en t N at io na l Q ui ck R es po ns e Te am (Q RT ) 3) D ev el op N at io na l g ui de lin es R is k Pr of ile a nd F oo d Ri sk C at eg or y 4) Fo od S af et y Ri sk A na ly si s st ud y 5) Fo od S af et y Im pl em en ta tio n Sy st em : A ni m al P ro du ct S af et y M on ito rin g at U PH , N KV c er tif ic at io n (v et er in ar y co nt ro l n um be r) a ni m al fa rm / U PH , U PH su pe rv is io n an d N KV A ud ito r T ra in in g an d Ve te rin ar y Pu bl ic H ea lth Su pe rv is or 6) IE C m at er ia l f or fo od s af et y In pu ts M an M on ey M et ho d Pa rt ne r P. 5. 1 M ec ha ni sm s fo r m ul tis ec to ra l c ol la bo ra tio n ar e es ta bl is he d to en su re ra pi d re sp on se to fo od s af et y em er ge nc ie s an d ou tb re ak s of fo od bo rn e di se as es Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 24 24 TA B IO SA FE TY A N D B IO SE CU RI TY D ra ft fi na liz at io n N SP In pu ts M an M on ey M et ho d Pa rt ne r W ho le o f go ve rn m en t b io sa fe ty a nd b io se cu rit y sy st em is in pl ac e fo r h um an , a ni m al a nd a gr ic ul tu re fa ci lit ie s Bi os af et y an d bi os ec ur ity tr ai ni ng a nd p ra ct ic es Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es ( 1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) D ev el op P P Bi os af et y an d bi os ec ur ity N at io na l G ui de lin es Re fr es hm en t o f A ss es so r S M BL D ev el op S M BL C er tif ic at io n bo dy In fr as tr uc tu re a nd e qu ip m en t m ai nt en an ce D ev el op la bo ra to ry b ui ld in g st an da rd a cc or di ng to Bi os af et y an d bi os ec ur ity Co m pr eh en si ve B io m ed ic al W as te M an ag em en t s ys te m D ev el op m on ito rin g na tio na l I nv en to ry a ge nt s in s to ra ge St ak eh ol de r N et w or ki ng C ro ss s ec to r M ee tin g Ed uc at e an d de pl oy p er so nn el / te am n at io nw id e fo r m ai nt en an ce a nd c on tr ol o f l ab or at or y sa fe ty fa ci lit ie s an d eq ui pm en t D ev el op a m as te r t ra in in g an d ce rt ifi ca tio n sc he m e fo r bi os af et y an d bi or is k of fic er s in b ot h th e hu m an a nd an im al s ec to rs , a cc re di te d an d ce rt ifi ed b y re le va nt in te rn at io na l b od ie s su ch a s W H O , F AO , O IE , I FB A, N SF , et c Le ve l 3 : Co m pr eh en si ve na tio na l bi os af et y an d bi os ec ur ity sy st em is b ei ng de ve lo pe d; Le ve l 4 : Bi os af et y an d bi os ec ur ity sy st em is de ve lo pe d, b ut no t s us ta in ab le Le ve l 5 : Su st ai na bl e bi os af et y an d bi os ec ur ity sy st em is in pl ac e Le ve l 3 : C ou nt ry ha s a tr ai ni ng pr og ra m in p la ce w ith c om m on cu rr ic ul um ; h as be gu n im pl em en ta tio n Le ve l 4 : C ou nt ry ha s a tr ai ni ng pr og ra m in p la ce w ith c om m on cu rr ic ul um a nd a tr ai n th e tr ai ne rs pr og ra m Le ve l 5 : C ou nt ry h as a su st ai na bl e tr ai ni ng p ro gr am , tr ai n th e tr ai ne rs pr og ra m , an d co m m on cu rr ic ul um . S ta ff ar e te st ed a t l ea st an nu al ly a nd ex er ci se s ar e co nd uc te d on bi ol og ic al ri sk pr ot oc ol s M O N IT O R EV AL U AT E 25 TA IM M U N IZ AT IO N 1) Co m pl et e ro ut in e im m un iz at io n im pl em en ta tio n (V ac ci ne a nd m ed ic al de vi ce s pr oc ur em en t, tr ai ni ng , a dv oc ac y, IE C m at er ia l) 2) M R co ve ra ge s ur ve y ph as e I i nt eg ra te d w ith ro ut in e im m un iz at io n 3) D ev el op c M YP 2 02 0 – 20 24 4) D ef au lte r t ra ck in g D ro p O ut D PT 1 M CV 1 < 5% In pu ts Le ve l 4 : 9 0% o f t he co un tr y’ s 12 m on th ol d po pu la tio n ha s re ce iv ed a t l ea st o ne do se o f m ea sl es co nt ai ni ng v ac ci ne , a s de m on st ra te d by co ve ra ge s ur ve ys o r ad m in is tr at iv e da ta . 80 % o f a ll su bn at io na l (d is tr ic ts /p ro vi nc es ) un its c ov er ed M an M on ey M et ho d Pa rt ne r Le ve l 5 : 9 5% o f t he co un tr y’ s 12 m on th o ld po pu la tio n ha s re ce iv ed a t le as t o ne d os e of m ea sl es co nt ai ni ng v ac ci ne , a s de m on st ra te d by co ve ra ge s ur ve ys o r ad m in is tr at iv e da ta ; o r 90 % o f t he c ou nt ry ’s 1 2 m on th o ld p op ul at io n ha s re ce iv ed a t l ea st o ne d os e of m ea sl es c on ta in in g va cc in e an d th e tr aj ec to ry of p ro gr es s, p la ns a nd ca pa ci tie s ar e Le ve l 4 : V ac ci ne d el iv er y (m ai nt ai ni ng c ol d ch ai n) is av ai la bl e in 6 0 79 % o f di st ric ts w ith in th e co un tr y O R Va cc in e de liv er y (m ai nt ai ni ng c ol d ch ai n) is av ai la bl e in 6 0 79 % o f t he ta rg et p op ul at io n in th e co un tr y; fu nc tio na l v ac ci ne pr oc ur em en t a nd fo re ca st in g le ad to n o st oc k ou ts a t t he c en tr al le ve l a nd ra re s to ck o ut s at th e di st ric t l ev el c ov er ag e su rv ey s or a dm in is tr at iv e da ta . 8 0% o f a ll su b na tio na l (d is tr ic ts /p ro vi nc es ) u ni ts co ve re d Le ve l 5 : V ac ci ne d el iv er y (m ai nt ai ni ng c ol d ch ai n) is av ai la bl e in g re at er th an 8 0% of d is tr ic ts w ith in th e co un tr y O R Va cc in e de liv er y (m ai nt ai ni ng c ol d ch ai n) is av ai la bl e to m or e th an 8 0% o f th e na tio na l ta rg et p op ul at io n; s ys te m s to re ac h m ar gi na liz ed p op ul at io ns us in g cu ltu ra lly a pp ro pr ia te pr ac tic es ar e in p la ce ; v ac ci ne d el iv er y ha s be en te st ed th ro ug h a na tio nw id e va cc in e ca m pa ig n or fu nc tio na l ex er ci se ; f un ct io na l pr oc ur em en t a nd v ac ci ne fo re ca st in g re su lts in n o st oc k ou ts P. 7. 1 Va cc in e co ve ra ge (m ea sl es ) a s pa rt o f n at io na l p ro gr am m e P. 7. 2 N at io na l v ac ci ne a cc es s an d de liv er y 1) Re pl ac e an d m ai nt ai ni ng c ol d ch ai n eq ui pm en t: pr oc ur em en t b as ed o n CC EI 2) Im pl em en ta tio n of S M S st oc k va cc in e an d lo gi st ic s 3) Ef fe ct iv e va cc in e m an ag em en t a ss es sm en t ( EV M A) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 25 25 TA IM M U N IZ AT IO N 1) Co m pl et e ro ut in e im m un iz at io n im pl em en ta tio n (V ac ci ne a nd m ed ic al de vi ce s pr oc ur em en t, tr ai ni ng , a dv oc ac y, IE C m at er ia l) 2) M R co ve ra ge s ur ve y ph as e I i nt eg ra te d w ith ro ut in e im m un iz at io n 3) D ev el op c M YP 2 02 0 – 20 24 4) D ef au lte r t ra ck in g D ro p O ut D PT 1 M CV 1 < 5% In pu ts Le ve l 4 : 9 0% o f t he co un tr y’ s 12 m on th ol d po pu la tio n ha s re ce iv ed a t l ea st o ne do se o f m ea sl es co nt ai ni ng v ac ci ne , a s de m on st ra te d by co ve ra ge s ur ve ys o r ad m in is tr at iv e da ta . 80 % o f a ll su bn at io na l (d is tr ic ts /p ro vi nc es ) un its c ov er ed M an M on ey M et ho d Pa rt ne r Le ve l 5 : 9 5% o f t he co un tr y’ s 12 m on th o ld po pu la tio n ha s re ce iv ed a t le as t o ne d os e of m ea sl es co nt ai ni ng v ac ci ne , a s de m on st ra te d by co ve ra ge s ur ve ys o r ad m in is tr at iv e da ta ; o r 90 % o f t he c ou nt ry ’s 1 2 m on th o ld p op ul at io n ha s re ce iv ed a t l ea st o ne d os e of m ea sl es c on ta in in g va cc in e an d th e tr aj ec to ry of p ro gr es s, p la ns a nd ca pa ci tie s ar e Le ve l 4 : V ac ci ne d el iv er y (m ai nt ai ni ng c ol d ch ai n) is av ai la bl e in 6 0 79 % o f di st ric ts w ith in th e co un tr y O R Va cc in e de liv er y (m ai nt ai ni ng c ol d ch ai n) is av ai la bl e in 6 0 79 % o f t he ta rg et p op ul at io n in th e co un tr y; fu nc tio na l v ac ci ne pr oc ur em en t a nd fo re ca st in g le ad to n o st oc k ou ts a t t he c en tr al le ve l a nd ra re s to ck o ut s at th e di st ric t l ev el c ov er ag e su rv ey s or a dm in is tr at iv e da ta . 8 0% o f a ll su b na tio na l (d is tr ic ts /p ro vi nc es ) u ni ts co ve re d Le ve l 5 : V ac ci ne d el iv er y (m ai nt ai ni ng c ol d ch ai n) is av ai la bl e in g re at er th an 8 0% of d is tr ic ts w ith in th e co un tr y O R Va cc in e de liv er y (m ai nt ai ni ng c ol d ch ai n) is av ai la bl e to m or e th an 8 0% o f th e na tio na l ta rg et p op ul at io n; s ys te m s to re ac h m ar gi na liz ed p op ul at io ns us in g cu ltu ra lly a pp ro pr ia te pr ac tic es ar e in p la ce ; v ac ci ne d el iv er y ha s be en te st ed th ro ug h a na tio nw id e va cc in e ca m pa ig n or fu nc tio na l ex er ci se ; f un ct io na l pr oc ur em en t a nd v ac ci ne fo re ca st in g re su lts in n o st oc k ou ts P. 7. 1 Va cc in e co ve ra ge (m ea sl es ) a s pa rt o f n at io na l p ro gr am m e P. 7. 2 N at io na l v ac ci ne a cc es s an d de liv er y 1) Re pl ac e an d m ai nt ai ni ng c ol d ch ai n eq ui pm en t: pr oc ur em en t b as ed o n CC EI 2) Im pl em en ta tio n of S M S st oc k va cc in e an d lo gi st ic s 3) Ef fe ct iv e va cc in e m an ag em en t a ss es sm en t ( EV M A) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 26 26 TA N AT IO N AL L AB O RA TO RY S YS TE M (1 ) Le ve l 4 : S ys te m is in p la ce to tr an sp or t sp ec im en s to na tio na l la bo ra to rie s fr om a t l ea st 8 0% of in te rm ed ia te le ve l/ di st ric ts w ith in th e co un tr y fo r ad va nc ed di ag no st ic s Le ve l 5 : D em on st ra te d ca pa bi lit y pl us , tr an sp or t sp ec im en s to /f ro m ot he r l ab s in th e re gi on ; s pe ci m en tr an sp or t i s fu nd ed fr om h os t co un tr y bu dg et D .1 .2 S pe ci m en re fe rr al a nd tr an sp or t s ys te m 1) L ab p er so nn el o rie nt at io n in c ol le ct in g, c ul tu re , p ac ka gi ng , sh ip pi ng a nd in sp ec tin g di ph th er ia sp ec im en s cu ltu ra lly a nd el ec tr on ic al ly a t 7 B / B TK L 1) Re vi se d M O H re gu la tio n no 4 11 /2 01 0 on C lin ic al L ab or at or ie s 2) Pr ep ar e on lin e La bo ra to ry D at a Co lle ct io n 3) Re vi ew o f l ab or at or y re fe re nc e sy st em s 4) M on ev E nv iro nm en ta l s ur ve ill an ce w ith 1 0 BT KL 5) D ev el op m en t o f n ew v et er in ar y la b (M O A) In pu ts Le ve l 4 : N at io na l la bo ra to ry s ys te m is c ap ab le o f co nd uc tin g fiv e or m or e of th e te n co re te st s M an M on ey M et ho d Pa rt ne r Le ve l 5 : I n ad di tio n to a ch ie vi ng “d em on st ra te d ca pa ci ty ”, co un tr y ha s na tio na l s ys te m fo r pr oc ur em en t a nd qu al ity a ss ur an ce D .1 .1 L ab or at or y te st in g fo r d et ec tio n of p rio rit y di se as es Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 27 TA N AT IO N AL L AB O RA TO RY S YS TE M (2 ) 1) H R tr ai ni ng fo r c lin ic al la b to ol c al ib ra tio n (B PF K: Ja ka rt a, S ur ab ay a, M ed an , M ak as sa r) 2) Im pr ov e La b pe rs on ne l c ap ac ity : P CR tr ai ni ng , F in al iz in g G ui de lin es fo r w or k m et ho ds C lin ic al la b to ol c al ib ra tio n 3) In cr ea se e xa m in at io n ca pa ci ty in la bo ra to ry (M O A) In pu ts Le ve l 3 : T ie r s pe ci fic di ag no st ic te st in g st ra te gi es a re do cu m en te d, b ut n ot fu lly im pl em en te d. Co un tr y is p ro fic ie nt in cl as si ca l d ia gn os tic te ch ni qu es in cl ud in g ba ct er io lo gy , s er ol og y an d PC R in s el ec t l ab s bu t h as li m ite d re fe rr al an d co nf irm at or y pr oc es se s. C ou nt ry is u si ng p oi nt o f c ar e di ag no st ic s fo r c ou nt ry pr io rit y di se as es , a nd at le as t o ne o th er pr io rit y di se as e M an M on ey M et ho d Pa rt ne r Le ve l 4 : C ou nt ry h as ti er sp ec ifi c di ag no st ic te st in g st ra te gi es d oc um en te d an d fu lly im pl em en te d, a na tio na l s ys te m o f s am pl e re fe rr al a nd c on fir m at or y di ag no st ic s cu lm in at in g in pe rf or m an ce o f m od er n m ol ec ul ar o r s er ol og ic al te ch ni qu es a t n at io na l an d/ or re gi on al la bo ra to rie s. C ou nt ry is us in g po in t o f c ar e di ag no st ic s ac co rd in g to tie r s pe ci fic d ia gn os tic te st in g st ra te gi es fo r di ag no si s of c ou nt ry pr io rit y di se as es Le ve l 3 : A s ys te m o f lic en si ng o f h ea lth la bo ra to rie s th at in cl ud es c on fo rm ity to a n at io na l q ua lit y st an da rd e xi st s bu t i t i s vo lu nt ar y or is n ot a re qu ire m en t fo r a ll la bo ra to rie s Le ve l 4 : M an da to ry lic en si ng o f a ll he al th la bo ra to rie s is in p la ce a nd co nf or m ity to a n at io na l q ua lit y st an da rd is re qu ire d. D .1 .3 E ff ec tiv e m od er n po in t of c ar e an d la bo ra to ry b as ed d ia gn os tic s D .1 .4 L ab or at or y qu al ity s ys te m Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 1) Pu sk es m as A cc re di ta tio n Ac co rd in g to M in is tr y of H ea lth 's St ra te gi c Pl an a nd RP JM M 2) Su rv ey or tr ai ni ng 3) Re vi ew S ta nd ar d an d in st ru m en t f or P us ke sm as a cc re di ta tio n 4) Ex te rn al Q ua lit y As su ra nc e fo r L ab or at or ie s4 . I nt eg ra tio n of H ea lth Q ua ra nt in e Pr og ra m w ith re la te d m in is tr ie s an d st ak eh ol de rs 27 27 TA N AT IO N AL L AB O RA TO RY S YS TE M (2 ) 1) H R tr ai ni ng fo r c lin ic al la b to ol c al ib ra tio n (B PF K: Ja ka rt a, S ur ab ay a, M ed an , M ak as sa r) 2) Im pr ov e La b pe rs on ne l c ap ac ity : P CR tr ai ni ng , F in al iz in g G ui de lin es fo r w or k m et ho ds C lin ic al la b to ol c al ib ra tio n 3) In cr ea se e xa m in at io n ca pa ci ty in la bo ra to ry (M O A) In pu ts Le ve l 3 : T ie r s pe ci fic di ag no st ic te st in g st ra te gi es a re do cu m en te d, b ut n ot fu lly im pl em en te d. Co un tr y is p ro fic ie nt in cl as si ca l d ia gn os tic te ch ni qu es in cl ud in g ba ct er io lo gy , s er ol og y an d PC R in s el ec t l ab s bu t h as li m ite d re fe rr al an d co nf irm at or y pr oc es se s. C ou nt ry is u si ng p oi nt o f c ar e di ag no st ic s fo r c ou nt ry pr io rit y di se as es , a nd at le as t o ne o th er pr io rit y di se as e M an M on ey M et ho d Pa rt ne r Le ve l 4 : C ou nt ry h as ti er sp ec ifi c di ag no st ic te st in g st ra te gi es d oc um en te d an d fu lly im pl em en te d, a na tio na l s ys te m o f s am pl e re fe rr al a nd c on fir m at or y di ag no st ic s cu lm in at in g in pe rf or m an ce o f m od er n m ol ec ul ar o r s er ol og ic al te ch ni qu es a t n at io na l an d/ or re gi on al la bo ra to rie s. C ou nt ry is us in g po in t o f c ar e di ag no st ic s ac co rd in g to tie r s pe ci fic d ia gn os tic te st in g st ra te gi es fo r di ag no si s of c ou nt ry pr io rit y di se as es Le ve l 3 : A s ys te m o f lic en si ng o f h ea lth la bo ra to rie s th at in cl ud es c on fo rm ity to a n at io na l q ua lit y st an da rd e xi st s bu t i t i s vo lu nt ar y or is n ot a re qu ire m en t fo r a ll la bo ra to rie s Le ve l 4 : M an da to ry lic en si ng o f a ll he al th la bo ra to rie s is in p la ce a nd co nf or m ity to a n at io na l q ua lit y st an da rd is re qu ire d. D .1 .3 E ff ec tiv e m od er n po in t of c ar e an d la bo ra to ry b as ed d ia gn os tic s D .1 .4 L ab or at or y qu al ity s ys te m Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 1) Pu sk es m as A cc re di ta tio n Ac co rd in g to M in is tr y of H ea lth 's St ra te gi c Pl an a nd RP JM M 2) Su rv ey or tr ai ni ng 3) Re vi ew S ta nd ar d an d in st ru m en t f or P us ke sm as a cc re di ta tio n 4) Ex te rn al Q ua lit y As su ra nc e fo r L ab or at or ie s4 . I nt eg ra tio n of H ea lth Q ua ra nt in e Pr og ra m w ith re la te d m in is tr ie s an d st ak eh ol de rs 28 28 TA R EA L TI M E SU RV EI LL AN CE (1 ) 1) El ec tr on ic re po rt in g sy st em s fo r n ot ifi ab le d is ea se s fo r h um an h ea lth im pl em en te d (E W AR S) – u pd at e sy st em (m ai nt en an ce ) 2) El ec tr on ic re po rt in g sy st em s fo r n ot ifi ab le d is ea se s fo r a ni m al h ea lth im pl em en te d (IS IK H N AS ) – s ys te m m ai nt en an ce a nd te ch ni ca l a ss is ta nc e to s ub n at io na l ( M O A) 3) D ev el op E le ct ro ni c re po rt in g sy st em s fo r n ot ifi ab le d is ea se s fo r a ni m al h ea lth (S eh at Sa tli ) M O A 4) El ec tr on ic R ep or tin g sy st em s fo r d at a sh ar in g be tw ee n se ct or s ex is t a nd im pl em en te d (A cc es s to o th er s ec to r s ys te m ) M O A 5) El ec tr on ic R ep or tin g sy st em s fo r d at a sh ar in g be tw ee n se ct or s ex is t a nd im pl em en te d (S IZ E) In te ro pe ra bl e, in te rc on ne ct ed , e le ct ro ni c re al t im e re po rt in g sy st em Le ve l 3 : C ou nt ry h as in p la ce a n in te r op er ab le , in te rc on ne ct ed , el ec tr on ic re po rt in g sy st em , f or e ith er pu bl ic h ea lth o r ve te rin ar y su rv ei lla nc e sy st em s. T he sy st em is n ot y et ab le to s ha re da ta in re al t im e. Le ve l 4 : C ou nt ry h as in p la ce a nd in te ro pe ra bl e, in te rc on ne ct ed , el ec tr on ic re al t im e re po rt in g sy st em , fo r p ub lic h ea lth an d/ or v et er in ar y su rv ei lla nc e sy st em s. T he sy st em is n ot y et fu lly s us ta in ed b y th e ho st go ve rn m en t. M an M on ey M et ho d Pa rt ne r 1) In cr ea se c ap ac ity o f E ve nt b as ed s ur ve ill an ce s ys te m a t n at io na l a nd p ro vi nc e le ve l ( 34 p ro vi nc es ) 2) In cr ea se c ap ac ity o f I nd ic at or b as ed s ur ve ill an ce s ys te m a t n at io na l a nd s ub n at io na l l ev el (p ro vi nc e, d is tr ic t, ho sp ita l) (le ve l 4 . E W AR S & IS IK N AS , L ev el 3 . S eh at S ah li) 3) In cr ea se n um be r o f P us ke sm as s ub m itt in g co m pl et e an d on t im e w ee kl y su rv ei lla nc e re po rt to th e su b na tio na l/n at io na l l ev el (l ev el 4 . E W AR S & IS IK N AS , L ev el 3 . S eh at S ah li) 4) In cr ea se d H R Ca pa ci ty in d et ec tin g an d re po rt in g di se as es th ro ug h IS IK H N AS (n at io na l a nd s ub na tio na l) M O A 5) Ca pa ci ty b ui ld in g of h um an re so ur ce s in m an ag in g pr ov in ci al a nd re gi on al s ys te m s (M O A) 6) Im pr ov e th e ab ili ty to in te rv en e in E m er gi ng In fe ct io us D is ea se s (T G C Tr ai ni ng , a dv oc ac y et c) 7) D ev el op w ee kl y re po rt a nd ri sk a na ly si s in st ru m en t o n EI D In di ca to r a nd e ve nt b as ed s ur ve ill an ce sy st em s In pu ts Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) Le ve l 3 : I nd ic at or O R ev en t ba se d su rv ei lla nc e sy st em (s ) i n pl ac e to d et ec t p ub lic he al th th re at s an d re le va nt se ct or s Le ve l 4 : I nd ic at or an d ev en t ba se d su rv ei lla nc e sy st em (s ) i n pl ac e to d et ec t p ub lic he al th th re at s 29 TA R EA L TI M E SU RV EI LL AN CE (2 ) S ys te Sy nd ro m ic s ur ve ill an ce s ys te m s 1) In cr ea se S yn dr om ic s ur ve ill an ce in P us ke sm as / s ub n at io na l 2) D ev el op N SP K fo r E m er gi ng In fe ct io us S yn dr om e Su rv ey s an d gu id el in es fo r M en in go co cc al M en in gi tis 3) D ev el op m en t o f s en tin el s ur ve ill an ce in h os pi ta ls 4) Co nt in ui ty a nd S tr en gt he ni ng S ur ve ill an ce s en tin el IL I-S AR I In pu ts M an M on ey M et ho d Pa rt ne r Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) In te gr at io n an d an al ys is o f s ur ve ill an ce d at a 1) H R Ca pa ci ty B ui ld in g in d at a an al ys is (n at io na l a nd s ub n at io na l) 2) L ab or at or y da ta fe ed s in to th e su rv ei lla nc e sy st em s (s ys te m ) 3) F in al iz e op er at io na l p la n of p ub lic h ea lth / su rv ei lla nc e la bo ra to ry n et w or k 4) Id en tif y po lic y an d re gu la tio n ne ed ed to s up po rt fu nc tio na l p ub lic h ea lth /s ur ve ill an ce la b ne tw or k 5) R ev ie w o f e xi st in g sp ec im en re fe rr al s ys te m s fo r v er tic al d is ea se p ro gr am s an d ex is tin g re so ur ce s fo r s pe ci m en re fe rr al fo r e pi de m ic p ro ne d is ea se s. 1) E st ab lis h da ta u ni t a t n at io na l l ev el a nd e ns ur e ad eq ua te n um be r o f t ra in ed a nd c om pe te nt pe rs on ne l i n da ta m an ag em en t a t a ll le ve ls (i nc lu di ng e pi de m io lo gi st s) 2) E st ab lis h N at io na l T ec hn ic al w or ki ng g ro up fo r p ub lic h ea lth /s ur ve ill an ce la bo ra to ry ne tw or k Le ve l 4 : S yn dr om ic su rv ei lla nc e sy st em (s ) i n pl ac e to d et ec t th re e or m or e co re sy nd ro m es in di ca tiv e of p ub lic he al th Le ve l 5 : In a dd iti on to su rv ei lla nc e sy st em s in c ou nt ry , us in g ex pe rt is e to su pp or t o th er co un tr ie s in de ve lo pi ng su rv ei lla nc e sy st em s Le ve l 4 : A nn ua lly o r m on th ly re po rt in g; at tr ib ut ed fu nc tio ns to e xp er ts fo r an al ys in g, a ss es si ng an d re po rt in g da ta Le ve l 3 : R eg ul ar re po rt in g of d at a w ith s om e de la y; ad h oc te am s pu t i n pl ac e to a na ly se da ta Le ve l 2 : S po ra di c re po rt s re la te d to da ta c ol le ct io n w ith de la y (S O Ps ) o r eq ui va le nt e xi st s fo r th e co or di na tio n be tw ee n IH R N FP an d re le va nt se ct or s 29 29 TA R EA L TI M E SU RV EI LL AN CE (2 ) S ys te Sy nd ro m ic s ur ve ill an ce s ys te m s 1) In cr ea se S yn dr om ic s ur ve ill an ce in P us ke sm as / s ub n at io na l 2) D ev el op N SP K fo r E m er gi ng In fe ct io us S yn dr om e Su rv ey s an d gu id el in es fo r M en in go co cc al M en in gi tis 3) D ev el op m en t o f s en tin el s ur ve ill an ce in h os pi ta ls 4) Co nt in ui ty a nd S tr en gt he ni ng S ur ve ill an ce s en tin el IL I-S AR I In pu ts M an M on ey M et ho d Pa rt ne r Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) In te gr at io n an d an al ys is o f s ur ve ill an ce d at a 1) H R Ca pa ci ty B ui ld in g in d at a an al ys is (n at io na l a nd s ub n at io na l) 2) L ab or at or y da ta fe ed s in to th e su rv ei lla nc e sy st em s (s ys te m ) 3) F in al iz e op er at io na l p la n of p ub lic h ea lth / su rv ei lla nc e la bo ra to ry n et w or k 4) Id en tif y po lic y an d re gu la tio n ne ed ed to s up po rt fu nc tio na l p ub lic h ea lth /s ur ve ill an ce la b ne tw or k 5) R ev ie w o f e xi st in g sp ec im en re fe rr al s ys te m s fo r v er tic al d is ea se p ro gr am s an d ex is tin g re so ur ce s fo r s pe ci m en re fe rr al fo r e pi de m ic p ro ne d is ea se s. 1) E st ab lis h da ta u ni t a t n at io na l l ev el a nd e ns ur e ad eq ua te n um be r o f t ra in ed a nd c om pe te nt pe rs on ne l i n da ta m an ag em en t a t a ll le ve ls (i nc lu di ng e pi de m io lo gi st s) 2) E st ab lis h N at io na l T ec hn ic al w or ki ng g ro up fo r p ub lic h ea lth /s ur ve ill an ce la bo ra to ry ne tw or k Le ve l 4 : S yn dr om ic su rv ei lla nc e sy st em (s ) i n pl ac e to d et ec t th re e or m or e co re sy nd ro m es in di ca tiv e of p ub lic he al th Le ve l 5 : In a dd iti on to su rv ei lla nc e sy st em s in c ou nt ry , us in g ex pe rt is e to su pp or t o th er co un tr ie s in de ve lo pi ng su rv ei lla nc e sy st em s Le ve l 4 : A nn ua lly o r m on th ly re po rt in g; at tr ib ut ed fu nc tio ns to e xp er ts fo r an al ys in g, a ss es si ng an d re po rt in g da ta Le ve l 3 : R eg ul ar re po rt in g of d at a w ith s om e de la y; ad h oc te am s pu t i n pl ac e to a na ly se da ta Le ve l 2 : S po ra di c re po rt s re la te d to da ta c ol le ct io n w ith de la y (S O Ps ) o r eq ui va le nt e xi st s fo r th e co or di na tio n be tw ee n IH R N FP an d re le va nt se ct or s 30 30 TA R EP O RT IN G 1) IH R N FP tr ai ni ng a nd m ec ha ni sm (r ef er to T A IH R co or di na tio n an d co m m un ic at io n) 2) O IE N FP tr ai ni ng In pu ts Le ve l 3 : C ou nt ry h as de m on st ra te d ab ili ty to id en tif y a po te nt ia l P H EI C an d fil e a re po rt to W H O s im ila rly to th e O IE b as ed o n an ex er ci se o r r ea l ev en t. M an M on ey M et ho d Pa rt ne r Le ve l 3 : C ou nt ry h as es ta bl is he d pr ot oc ol s, p ro ce ss es , re gu la tio ns , a nd /o r le gi sl at io n go ve rn in g re po rt in g an d pr oc es se s fo r m ul tis ec to ra l co or di na tio n in re sp on se to a po te nt ia l P H EI C to W H O a nd to th e O IE fo r r el ev an t z oo no tic di se as e. Sy st em fo r e ff ic ie nt re po rt in g to W H O , F AO a nd O IE Re po rt in g ne tw or k an d pr ot oc ol s in c ou nt ry 1) Pr ep ar at io n of th e M in is te r o f H ea lth R eg ul at io n on O ne D at a Po lic y 2) Re se ar ch a nd ro ut in e da ta s yn ch ro ni za tio n to a cc om m od at e O ne D at a In te gr at io n of H ea lth In fo rm at io n Sy st em 3) M in is te r o f H ea lth R eg ul at io n on P us ke sm as In fo rm at io n Sy st em (R ev ie w o f Pu sk es m as In fo rm at io n Sy st em S ta nd ar d) 4) M in is tr y of A gr ic ul tu re re gu la tio n on A ni m al H ea lth In fo rm at io n Sy st em Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) Le ve l 4 : C ou nt ry de m on st ra te s tim el y re po rt in g of p ot en tia l PH EI C to W H O a nd to th e O IE fo r r el ev an t zo on ot ic d is ea se in al ig nm en t w ith na tio na l a nd in te rn at io na l st an da rd s in s el ec te d in te rm ed ia te le ve ls (d is tr ic ts o r r eg io ns ) ba se d on a n ex er ci se or re al e ve nt s. Le ve l 4 : C ou nt ry h as de m on st ra te d ab ili ty to id en tif y a po te nt ia l P H EI C an d fil e a re po rt to W H O w ith in 2 4 ho ur s an d si m ila r t o th e O IE fo r r el ev an t zo on ot ic d is ea se ba se d on a n ex er ci se o r r ea l ev en t 1) M ai nt en an ce o f f is h di se as e m on ito rin g sy st em (S of tw ar e fo r F is h D is ea se M on ito rin g Sy st em / S SM PI ) o n lin e as a b as is fo r r ep or tin g fis h di se as es to O IE 2) D ev el op m en t o f a fi sh d is ea se m on ito rin g sy st em (S SM PI ) o n lin e an d an In do ne si an Aq ua tic A ni m al D is ea se s Al er t S ys te m / IA AD AS a s a ba si s fo r r ep or tin g fis h di se as es to O IE (M O M AF ) 3) Ev al ua tio n of fi sh d is ea se re po rt s th ro ug h SS M PI o n lin e (3 4 Pr ov in ce s) – M O M AF 1) Pu bl ic h ea rin g of th e M in is tr y of A gr ic ul tu re 's S I A ni m al H ea lth 2) D ra ft in g of th e M in is tr y of M ar in e Af ff ai rs (M O M AF ) o n Fi sh D is ea se s 3) Ca pa ci ty b ui ld in g fo r R ef er en ce la bo ra to ry a nd fi sh d is ea se te st in g la bo ra to rie s (M O M AF ) 31 TA W O RK FO RC E D EV EL O PM EN T 1) M ap pi ng o f n at io na l H R ne ed s (d oc to rs , n ur se s, v et er in ar ia ns , b io st at is tic s, la b sc ie nc es , e pi de m io lo gi st s) In pu ts M an M on ey M et ho d Pa rt ne r D .4 .1 . H um an re so ur ce s ar e av ai la bl e to im pl em en t I H R co re c ap ac ity D .4 .2 . FE TP o r o th er a pp lie d ep id em io lo gy tr ai ni ng p ro gr am m e in p la ce 6) . Ca pa ci ty b ui ld in g fo r t he H ea d of D ep ar tm en t r eg ar di ng a pp lie d ep id em io lo gy in d ec is io n m ak in g an d tr ai ni ng c ur ric ul um fo r H ea lth O ffi ce H ea ds (t ec hn ic al s ta nd ar ds ) 7) . A pp lie d ep id em io lo gy tr ai ni ng in fr on tli ne li ke tr ai ni ng a t F KT P 8) . Ap pl ie d ep id em io lo gi ca l t ec hn ic al g ui da nc e fo r p eo pl e in p ot en tia l o ut br ea ks a re as 9) . Su pp or t O ne H ea lth c ol la bo ra tio n an d co or di na tio n be tw ee n go ve rn m en t a nd u ni ve rs iti es (M O A) 10 ). S up po rt c ur ric ul um d ev el op m en t f or p re s er vi ce a nd in s er vi ce p ou ltr y he al th c ap ac ity b ui ld in g 11 ). S up po rt th e de ve lo pm en t o f F ET PV in In do ne si a 12 ). C ap ac ity b ui ld in g fo r f ie ld e pi de m io lo gy fo r v et er in ar y of fic er s (F ET P de gr ee & n on d eg re e) 13 ). A dv oc ac y to s ta ke ho ld er s (c en tr al / re gi on al ) r eg ar di ng H R ut ili za tio n (in ce nt iv es , p la ce m en t, qu al ity s ta nd ar ds , e tc .) 14 ). T oT o n su rv ei lla nc e to S up po rt h ea lth a dv oc at io n 15 ). O ne H ea lth tr ai ni ng (o ut br ea k in ve st ig at io n) 16 ). A M TC Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 19 ). St re ng th en in g th e H R da ta ba se fo r P PS D M p la nn in g 20 ). D ev el op m en t o f a n at io na l P PS D M s tr at eg ic p la n D .4 .3 . W or kf or ce s tr at eg y 2) Fu lfi llm en t o f n at io na l H R ne ed s (d oc to rs , n ur se s, v et er in ar ia ns , b io st at is tic s, la b sc ie nc es , e pi de m io lo gi st s) 3) Le ad er sh ip tr ai ni ng fo r i nt er d is ci pl in ar y an d m ul ti co un tr ie s st ud en ts to d ev el op th e co lla bo ra tio n an d co or di na tio n to so lv e he al th is su es . ( Co or di na tio n M in is tr y fo r h um an d ev el op m en t/ C M H D ) 4) Le ad er sh ip tr ai ni ng fo r i nt er d is ci pl in ar y he al th p ro fe ss io na ls to s ol ve h ea lth p ro bl em . ( CM H D ) 5) G lo ba l H ea lth D ip lo m ac y (G H D ) T ra in in g (C M H D ) 17 ). b ui ld in g Ca pa ci ty fo r e pi de m io lo gi st to U S CD C fo r S ur ve ill an ce S ys te m 18 ). Tr ai ni ng u rb an h ea lth c ol la bo ra tio n w ith N an ya ng P ol ite ch ni c Si ng ap or e Le ve l 3 M ul tid is ci pl in ar y H R ca pa ci ty is a va ila bl e at n at io na l a nd in te rm ed ia te le ve l Le ve l 4 M ul tid is ci pl in ar y H R ca pa ci ty is a va ila bl e as re qu ire d at re le va nt le ve ls of p ub lic h ea lth s ys te m (e .g . ep id em io lo gi st a t n at io na l le ve l a nd in te rm ed ia te le ve l a nd a ss is ta nc e (o r sh or t c ou rs e tr ai ne d ep id em io lo gi st ) a t l oc al le ve l a va ila bl e Le ve l 4 : T w o le ve ls o f FE TP (B as ic , In te rm ed ia te a nd /o r Ad va nc ed ) o r co m pa ra bl e ap pl ie d ep id em io lo gy tr ai ni ng p ro gr am (s ) i n pl ac e in th e co un tr y or in a no th er c ou nt ry th ro ug h an e xi st in g ag re em en t Le ve l 4 : A p ub lic h ea lth w or kf or ce s tr at eg y ha s be en d ra ft ed a nd im pl em en te d co ns is te nt ly ; st ra te gy is re vi ew ed , tr ac ke d an d re po rt ed o n an nu al ly Le ve l 5 : T hr ee le ve ls o f FE TP (B as ic , I nt er m ed ia te an d Ad va nc ed ) o r c om pa ra bl e ap pl ie d ep id em io lo gy tr ai ni ng p ro gr am (s ) i n pl ac e in th e co un tr y or in an ot he r c ou nt ry th ro ug h an e xi st in g ag re em en t, w ith s us ta in ab le n at io na l fu nd in g 31 31 TA W O RK FO RC E D EV EL O PM EN T 1) M ap pi ng o f n at io na l H R ne ed s (d oc to rs , n ur se s, v et er in ar ia ns , b io st at is tic s, la b sc ie nc es , e pi de m io lo gi st s) In pu ts M an M on ey M et ho d Pa rt ne r D .4 .1 . H um an re so ur ce s ar e av ai la bl e to im pl em en t I H R co re c ap ac ity D .4 .2 . FE TP o r o th er a pp lie d ep id em io lo gy tr ai ni ng p ro gr am m e in p la ce 6) . Ca pa ci ty b ui ld in g fo r t he H ea d of D ep ar tm en t r eg ar di ng a pp lie d ep id em io lo gy in d ec is io n m ak in g an d tr ai ni ng c ur ric ul um fo r H ea lth O ffi ce H ea ds (t ec hn ic al s ta nd ar ds ) 7) . A pp lie d ep id em io lo gy tr ai ni ng in fr on tli ne li ke tr ai ni ng a t F KT P 8) . Ap pl ie d ep id em io lo gi ca l t ec hn ic al g ui da nc e fo r p eo pl e in p ot en tia l o ut br ea ks a re as 9) . Su pp or t O ne H ea lth c ol la bo ra tio n an d co or di na tio n be tw ee n go ve rn m en t a nd u ni ve rs iti es (M O A) 10 ). S up po rt c ur ric ul um d ev el op m en t f or p re s er vi ce a nd in s er vi ce p ou ltr y he al th c ap ac ity b ui ld in g 11 ). S up po rt th e de ve lo pm en t o f F ET PV in In do ne si a 12 ). C ap ac ity b ui ld in g fo r f ie ld e pi de m io lo gy fo r v et er in ar y of fic er s (F ET P de gr ee & n on d eg re e) 13 ). A dv oc ac y to s ta ke ho ld er s (c en tr al / re gi on al ) r eg ar di ng H R ut ili za tio n (in ce nt iv es , p la ce m en t, qu al ity s ta nd ar ds , e tc .) 14 ). T oT o n su rv ei lla nc e to S up po rt h ea lth a dv oc at io n 15 ). O ne H ea lth tr ai ni ng (o ut br ea k in ve st ig at io n) 16 ). A M TC Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 19 ). St re ng th en in g th e H R da ta ba se fo r P PS D M p la nn in g 20 ). D ev el op m en t o f a n at io na l P PS D M s tr at eg ic p la n D .4 .3 . W or kf or ce s tr at eg y 2) Fu lfi llm en t o f n at io na l H R ne ed s (d oc to rs , n ur se s, v et er in ar ia ns , b io st at is tic s, la b sc ie nc es , e pi de m io lo gi st s) 3) Le ad er sh ip tr ai ni ng fo r i nt er d is ci pl in ar y an d m ul ti co un tr ie s st ud en ts to d ev el op th e co lla bo ra tio n an d co or di na tio n to so lv e he al th is su es . ( Co or di na tio n M in is tr y fo r h um an d ev el op m en t/ C M H D ) 4) Le ad er sh ip tr ai ni ng fo r i nt er d is ci pl in ar y he al th p ro fe ss io na ls to s ol ve h ea lth p ro bl em . ( CM H D ) 5) G lo ba l H ea lth D ip lo m ac y (G H D ) T ra in in g (C M H D ) 17 ). b ui ld in g Ca pa ci ty fo r e pi de m io lo gi st to U S CD C fo r S ur ve ill an ce S ys te m 18 ). Tr ai ni ng u rb an h ea lth c ol la bo ra tio n w ith N an ya ng P ol ite ch ni c Si ng ap or e Le ve l 3 M ul tid is ci pl in ar y H R ca pa ci ty is a va ila bl e at n at io na l a nd in te rm ed ia te le ve l Le ve l 4 M ul tid is ci pl in ar y H R ca pa ci ty is a va ila bl e as re qu ire d at re le va nt le ve ls of p ub lic h ea lth s ys te m (e .g . ep id em io lo gi st a t n at io na l le ve l a nd in te rm ed ia te le ve l a nd a ss is ta nc e (o r sh or t c ou rs e tr ai ne d ep id em io lo gi st ) a t l oc al le ve l a va ila bl e Le ve l 4 : T w o le ve ls o f FE TP (B as ic , In te rm ed ia te a nd /o r Ad va nc ed ) o r co m pa ra bl e ap pl ie d ep id em io lo gy tr ai ni ng p ro gr am (s ) i n pl ac e in th e co un tr y or in a no th er c ou nt ry th ro ug h an e xi st in g ag re em en t Le ve l 4 : A p ub lic h ea lth w or kf or ce s tr at eg y ha s be en d ra ft ed a nd im pl em en te d co ns is te nt ly ; st ra te gy is re vi ew ed , tr ac ke d an d re po rt ed o n an nu al ly Le ve l 5 : T hr ee le ve ls o f FE TP (B as ic , I nt er m ed ia te an d Ad va nc ed ) o r c om pa ra bl e ap pl ie d ep id em io lo gy tr ai ni ng p ro gr am (s ) i n pl ac e in th e co un tr y or in an ot he r c ou nt ry th ro ug h an e xi st in g ag re em en t, w ith s us ta in ab le n at io na l fu nd in g 32 32 TA P RE PA RE D N ES S 1) Re vi ew th e N at io na l C on tin ge nc y Pl an 2) Ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s ac co rd in g to th e di st ric t/ c ity h az ar d ris k m an ag em en t r es ul t 3) Th e si m ul at io n of n at io na l c on tin ge nc y pl an s be co m es a n op er at io na l p la n ac co rd in g to th e re su lts o f r is k ha za rd m an ag em en t i n st ag es / t ie re d. 5) Pr ep ar ed ne ss tr ai ni ng o n bi ol og ic al , n uc le ar a nd c he m ic al th re at s th at h av e th e po te nt ia l f or pu bl ic h ea lth e m er ge nc y 6) Re vi ew th e N at io na l C on tin ge nc y Pl an fo r z oo no si s an d EI D 7) Ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s on z oo no si s an d EI D in d is tr ic t/ c ity 8) EI D a nd P an de m ic P re pa re dn es s W or ks ho p as p ar t o f H os pi ta l E m er ge nc y Pl an (H os pi ta l D is as te r P re pa re dn es s Pl an ) 10 ) M ap pi ng a nd re vi ew S O P pl an fo r d is tr ib ut io n of d ru gs a nd P PE . In pu ts Le ve l 3 : N at io na l pu bl ic h ea lth em er ge nc y re sp on se pl an (s ) i nc or po ra te s IH R re la te d ha za rd s an d Po in ts o f E nt ry AN D Su rg e ca pa ci ty to re sp on d to p ub lic he al th e m er ge nc ie s of n at io na l a nd in te rn at io na l c on ce rn is a va ila bl e M an M on ey M et ho d Pa rt ne r Le ve l 4 : P ro ce du re s, pl an s or s tr at eg y in pl ac e to re al lo ca te o r m ob ili ze re so ur ce s fr om n at io na l a nd in te rm ed ia te le ve ls to su pp or t a ct io n at lo ca l r es po ns e le ve l (in cl ud in g ca pa ci ty to sc al in g up th e le ve l o f re sp on se ) Le ve l 2 : A n at io na l ris k as se ss m en t h as be en c on du ct ed to id en tif y po te nt ia l ‘u rg en t p ub lic he al th e ve nt s’ a nd re so ur ce m ap pi ng ha s be en d on e Le ve l 3 : N at io na l re so ur ce s ha ve be en m ap pe d (lo gi st ic s, e xp er ts , fin an ce e tc ..) fo r IH R re le va nt ha za rd s an d pr io rit y ris ks a nd p la n fo r m an ag em en t a nd di st rib ut io n of na tio na l s to ck pi le s is in p la ce R. 1. 1 N at io na l m ul ti ha za rd p ub lic h ea lth e m er ge nc y pr ep ar ed ne ss a nd re sp on se p la n is d ev el op ed a nd im pl em en te d R. 1. 2 Pr io rit y pu bl ic h ea lth ri sk s an d re so ur ce s ar e m ap pe d an d ut ili ze d Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 1) Tr ai ni ng / W or ks ho p to u se JR A to ol s fo r z oo no tic d is ea se s 2) O ne H ea lth T ra in in g / W or ks ho p fo r h ig h ris k ar ea s fo r e ac h se ct or fo llo w ed b y jo in t t ra in in g 3) As se ss m en t o n in fr as tr uc tu re , s er vi ce s an d H R at n at io na l a nd re gi on al h os pi ta l f or P H EI C 4) EI D ri sk m ap pi ng 1) Co nt in ge nc y pl an fo r d is tr ic t w ith d ire ct a cc es s to in te rn at io na l P O E 2) Ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s ac co rd in g to th e di st ric t/ c ity h az ar d ris k m an ag em en t r es ul t ( BN PB ) 33 TA E M ER G EN CY R ES PO N SE O PE RA TI O N S (1 ) Le ve l 2 : E O C pl an s/ pr oc ed ur es de sc rib in g in ci de nt m an ag em en t st ru ct ur e (IM S) o r eq ui va le nt st ru ct ur e ar e in p la ce ; pl an d es cr ib es k ey st ru ct ur al a nd op er at io na l e le m en ts fo r ba si c ro le s (in cl ud in g In ci de nt m an ag em en t or c om m an d, O pe ra tio ns , P la nn in g, Lo gi st ic s an d Fi na nc e) H ea lth C lu st er C oo rd in at io n M ee tin g In pu ts Le ve l 3 : E O C st af f te am is tr ai ne d in em er ge nc y m an ag em en t a nd PH EO C st an da rd op er at in g pr oc ed ur es a nd is av ai la bl e fo r re sp on se w he n ne ce ss ar y M an M on ey M et ho d Pa rt ne r Le ve l 4 : I n ad di tio n to a ct iv iti es fo r “d ev el op ed ca pa ci ty ”, th er e is de di ca te d EO C st af f th at h as re ce iv ed tr ai ni ng a nd c an ac tiv at e a re sp on se w ith in tw o ho ur s Pr ep ar at io n of a jo in t E O C be tw ee n th e PK K, S KK D ire ct or at e an d N CC Le ve l 3 : I n ad di tio n to m ee tin g re qu ire m en ts of “l im ite d ca pa ci ty ”, EO C pl an s ar e in p la ce fo r f un ct io ns in cl ud in g pu bl ic h ea lth sc ie nc e (e pi de m io lo gy , m ed ic al a nd o th er su bj ec t m at te r ex pe rt is e) , p ub lic co m m un ic at io ns , pa rt ne r l ia is on Ca pa ci ty to a ct iv at e em er ge nc y op er at io ns EO C op er at in g pr oc ed ur es a nd p la ns Im pl em en ta tio n of M O H & B N PB c oo pe ra tio n ba se d on th e 20 14 M oU o n D is as te r R is k Re du ct io n in h ea lth d is as te r m an ag em en t Th e im pl em en ta tio n of M O H & B M KG c oo pe ra tio n ba se d on th e 20 14 M oU Co lla bo ra tio n w ith th e 3 U ni ve rs iti es o n th e Im pl em en ta tio n of H ea lth C ris is R is k M an ag em en t b as ed o n th e M CC th at w as a rr an ge d in 2 01 7 (U I, U G M a nd U ni br aw ) a nd th e Co op er at io n Ag re em en t w hi ch is ta rg et ed to b e si gn ed in 2 01 9 w ith 3 o th er U ni ve rs iti es (p la nn ed w ith U nh as , U ns yi ah K ua la a nd IT B) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) Pr ep ar at io n of T ec hn ic al G ui de lin es fo r P ro vi nc ia l M in im um S er vi ce S ta nd ar ds in H ea lth cr is is m an ag em en t ( Pe rm en da gr i) R ev is ed M in is te r o f H ea lth R eg ul at io n N o. 6 4/ 20 13 o n H ea lth C ris is M an ag em en t Pr ep ar at io n of H ea lth C lu st er G ui de lin es D ev el op a N at io na l H ea lth R is k Co m m un ic at io n G ui de lin e (r ef er to R is k Co m m ) 33 33 TA E M ER G EN CY R ES PO N SE O PE RA TI O N S (1 ) Le ve l 2 : E O C pl an s/ pr oc ed ur es de sc rib in g in ci de nt m an ag em en t st ru ct ur e (IM S) o r eq ui va le nt st ru ct ur e ar e in p la ce ; pl an d es cr ib es k ey st ru ct ur al a nd op er at io na l e le m en ts fo r ba si c ro le s (in cl ud in g In ci de nt m an ag em en t or c om m an d, O pe ra tio ns , P la nn in g, Lo gi st ic s an d Fi na nc e) H ea lth C lu st er C oo rd in at io n M ee tin g In pu ts Le ve l 3 : E O C st af f te am is tr ai ne d in em er ge nc y m an ag em en t a nd PH EO C st an da rd op er at in g pr oc ed ur es a nd is av ai la bl e fo r re sp on se w he n ne ce ss ar y M an M on ey M et ho d Pa rt ne r Le ve l 4 : I n ad di tio n to a ct iv iti es fo r “d ev el op ed ca pa ci ty ”, th er e is de di ca te d EO C st af f th at h as re ce iv ed tr ai ni ng a nd c an ac tiv at e a re sp on se w ith in tw o ho ur s Pr ep ar at io n of a jo in t E O C be tw ee n th e PK K, S KK D ire ct or at e an d N CC Le ve l 3 : I n ad di tio n to m ee tin g re qu ire m en ts of “l im ite d ca pa ci ty ”, EO C pl an s ar e in p la ce fo r f un ct io ns in cl ud in g pu bl ic h ea lth sc ie nc e (e pi de m io lo gy , m ed ic al a nd o th er su bj ec t m at te r ex pe rt is e) , p ub lic co m m un ic at io ns , pa rt ne r l ia is on Ca pa ci ty to a ct iv at e em er ge nc y op er at io ns EO C op er at in g pr oc ed ur es a nd p la ns Im pl em en ta tio n of M O H & B N PB c oo pe ra tio n ba se d on th e 20 14 M oU o n D is as te r R is k Re du ct io n in h ea lth d is as te r m an ag em en t Th e im pl em en ta tio n of M O H & B M KG c oo pe ra tio n ba se d on th e 20 14 M oU Co lla bo ra tio n w ith th e 3 U ni ve rs iti es o n th e Im pl em en ta tio n of H ea lth C ris is R is k M an ag em en t b as ed o n th e M CC th at w as a rr an ge d in 2 01 7 (U I, U G M a nd U ni br aw ) a nd th e Co op er at io n Ag re em en t w hi ch is ta rg et ed to b e si gn ed in 2 01 9 w ith 3 o th er U ni ve rs iti es (p la nn ed w ith U nh as , U ns yi ah K ua la a nd IT B) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) Pr ep ar at io n of T ec hn ic al G ui de lin es fo r P ro vi nc ia l M in im um S er vi ce S ta nd ar ds in H ea lth cr is is m an ag em en t ( Pe rm en da gr i) R ev is ed M in is te r o f H ea lth R eg ul at io n N o. 6 4/ 20 13 o n H ea lth C ris is M an ag em en t Pr ep ar at io n of H ea lth C lu st er G ui de lin es D ev el op a N at io na l H ea lth R is k Co m m un ic at io n G ui de lin e (r ef er to R is k Co m m ) 34 34 TA E M ER G EN CY R ES PO N SE O PE RA TI O N S (2 ) Le ve l 3 : C as e m an ag em en t gu id el in es fo r o th er IH R re le va nt h az ar ds ar e av ai la bl e at re le va nt h ea lth sy st em le ve ls a nd SO Ps a re a va ila bl e fo r th e m an ag em en t an d tr an sp or t o f po te nt ia lly in fe ct io us pa tie nt s in th e co m m un ity a nd a t P oE M ec ha ni sm fo r e m er gi ng /r e em er gi ng p at ie nt c la im s an d vi ct im s of te rr or is m A ss es sm en t o f d is tr ic ts a nd p ro vi nc es h az ar d, v ul ne ra bi lit y an d ca pa ci ty In pu ts Le ve l 3 : F un ct io na l ex er ci se h as b ee n co m pl et ed to te st op er at io ns c ap ab ili tie s bu t E O C ha s no t y et be en a ct iv at ed fo r a re sp on se . Sy st em is n ot y et ca pa bl e of a ct iv at in g a co or di na te d em er ge nc y re sp on se w ith in 12 0 m in ut es o f t he id en tif ic at io n of a pu bl ic h ea lth em er ge nc y M an M on ey M et ho d Pa rt ne r Le ve l 4 : E O C ac tiv at ed a co or di na te d em er ge nc y re sp on se o r ex er ci se w ith in 1 20 m in ut es o f t he id en tif ic at io n of a pu bl ic h ea lth em er ge nc y; re sp on se u til iz ed op er at io ns , l og is tic an d pl an ni ng fu nc tio ns Le ve l 4 : C as e m an ag em en t, pa tie nt re fe rr al an d tr an sp or ta tio n, an d m an ag em en t an d tr an sp or t o f po te nt ia lly in fe ct io us pa tie nt s ar e im pl em en te d ac co rd in g to gu id el in es a nd /o r SO Ps Em er ge nc y op er at io ns p ro gr am m e Ca se m an ag em en t p ro ce du re s im pl em en te d fo r I H R re le va nt h az ar ds Ca pa ci ty b ui ld in g of d is tr ic ts a nd p ro vi nc es fo r r es po ns e m ap s, H os pi ta l p re pa re dn es s in d is as te rs , SI PK K, C on tin ge nc y Pl an s, T ab le T op E xe rc is e & S im ul at io n Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) Pr ep er at io n of H ea lth Q ua ra nt in e Re gi on al G ui de lin es Tr ai ni ng o f D et ec tio n an d Re sp on se K KM fo r K KP o ffi ce rs Re vi se d: P P N o. 4 0 Ta hu n 19 91 a bo ut e pi de m ic m an ag em en t, Pe rm en ke s 15 01 a bo ut d es ea se po te ns ia l o ut br ea ks d es ea se , P D 3I G ui de lin es PM K D is se m in at io n Ab ou t A m bu la nc e Se rv ic es 35 TA L IN KI N G P U BL IC H EA LT H A N D S EC U RI TY A U TH O RI TI ES Re vi si on o f t he S ea a nd A ir Q ua ra nt in e La w t o La w o n H ea lth Q ua ra nt in e In pu ts Le ve l 4 : A t l ea st 1 pu bl ic h ea lth em er ge nc y re sp on se o r ex er ci se w ith in th e pr ev io us ye ar th at in cl ud ed in fo rm at io n sh ar in g w ith Se cu rit y Au th or iti es us in g th e fo rm al M O U o r o th er ag re em en t ( i.e ., pr ot oc ol ) M an M on ey M et ho d Pa rt ne r Le ve l 5 : P ub lic h ea lth an d se cu rit y au th or iti es e xc ha ng e re po rt s an d in fo rm at io n on ev en ts o f j oi nt co nc er n at n at io na l, in te rm ed ia te a nd lo ca l l ev el s us in g th e fo rm al M O U o r ot he r a gr ee m en t (i. e. , p ro to co l) pu bl ic he al th a nd s ec ur ity au th or iti es e ng ag e in a jo in t t ra in in g pr og ra m to o rie nt , ex er ci se , a nd in st itu tio na liz e kn ow le dg e of M O U or o th er a gr ee m en ts In cr ea si ng N um be r o f P ro vi nc es / D is tr ic ts / Ci tie s th at R ec ei ve T ra in in g on T er ro ris m / Em er ge nc y N uc le ar B io lo gi ca l C he m ic al (N U BI KA ) B N PT Pu bl ic h ea lth a nd s ec ur ity a ut ho rit ie s (e .g . l aw e nf or ce m en t, bo rd er c on tr ol , c us to m s) ar e lin ke d du rin g a su sp ec t o r c on fir m ed b io lo gi ca l e ve nt Re vi si on o n In fe ct io us d is ea se L aw Fi na liz at io n of th e Pr es id en tia l I ns tr uc tio n on E nh an ci ng A bi lit y to P re ve nt , D et ec t a nd Re sp on d to D is ea se O ut br ea ks , G lo ba l P an de m ic a nd N uc le ar E m er ge nc y, B io lo gi ca l a nd Ch em ic al Co m pl et in g M O U s an d SO Ps o n th e de ve lo pm en t a nd im pl em en ta tio n of in fo rm at io n sy st em s fo r e m er gi ng z oo no tic a nd in fe ct io us d is ea se s co nn ec te d be tw ee n hu m an a nd an im al h ea lth d at ab as es / Z oo no tic In fo rm at io n Sy st em s an d Em er gi ng In fe ct io us D is ea se s (S IZ E) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) EV AL U AT E M O N IT O R 35 35 TA L IN KI N G P U BL IC H EA LT H A N D S EC U RI TY A U TH O RI TI ES Re vi si on o f t he S ea a nd A ir Q ua ra nt in e La w t o La w o n H ea lth Q ua ra nt in e In pu ts Le ve l 4 : A t l ea st 1 pu bl ic h ea lth em er ge nc y re sp on se o r ex er ci se w ith in th e pr ev io us ye ar th at in cl ud ed in fo rm at io n sh ar in g w ith Se cu rit y Au th or iti es us in g th e fo rm al M O U o r o th er ag re em en t ( i.e ., pr ot oc ol ) M an M on ey M et ho d Pa rt ne r Le ve l 5 : P ub lic h ea lth an d se cu rit y au th or iti es e xc ha ng e re po rt s an d in fo rm at io n on ev en ts o f j oi nt co nc er n at n at io na l, in te rm ed ia te a nd lo ca l l ev el s us in g th e fo rm al M O U o r ot he r a gr ee m en t (i. e. , p ro to co l) pu bl ic he al th a nd s ec ur ity au th or iti es e ng ag e in a jo in t t ra in in g pr og ra m to o rie nt , ex er ci se , a nd in st itu tio na liz e kn ow le dg e of M O U or o th er a gr ee m en ts In cr ea si ng N um be r o f P ro vi nc es / D is tr ic ts / Ci tie s th at R ec ei ve T ra in in g on T er ro ris m / Em er ge nc y N uc le ar B io lo gi ca l C he m ic al (N U BI KA ) B N PT Pu bl ic h ea lth a nd s ec ur ity a ut ho rit ie s (e .g . l aw e nf or ce m en t, bo rd er c on tr ol , c us to m s) ar e lin ke d du rin g a su sp ec t o r c on fir m ed b io lo gi ca l e ve nt Re vi si on o n In fe ct io us d is ea se L aw Fi na liz at io n of th e Pr es id en tia l I ns tr uc tio n on E nh an ci ng A bi lit y to P re ve nt , D et ec t a nd Re sp on d to D is ea se O ut br ea ks , G lo ba l P an de m ic a nd N uc le ar E m er ge nc y, B io lo gi ca l a nd Ch em ic al Co m pl et in g M O U s an d SO Ps o n th e de ve lo pm en t a nd im pl em en ta tio n of in fo rm at io n sy st em s fo r e m er gi ng z oo no tic a nd in fe ct io us d is ea se s co nn ec te d be tw ee n hu m an a nd an im al h ea lth d at ab as es / Z oo no tic In fo rm at io n Sy st em s an d Em er gi ng In fe ct io us D is ea se s (S IZ E) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) EV AL U AT E M O N IT O R 36 36 TA M ED IC AL C O U N TE RM EA SU RE S AN D P ER SO N N EL D EP LO YM EN T R. 4. 2 Sy st em in p la ce fo r s en di ng a nd re ce iv in g he al th p er so nn el du rin g a pu bl ic h ea lth e m er ge nc y 1) Ad vo ca cy a nd d is se m in at io n of th e ro le o f t he M O H in th e m ec ha ni sm o f h ea lth p er so nn el co un te rm ea su re s to c ro ss p ro gr am s / s ec to rs 2) Re gu la tio ns / g ui de lin es fo r i nt er na tio na l d ep lo ym en t o f h ea lth p er so nn el a cc or di ng to in te rn at io na l s ta nd ar ds 3) Re gu la tio n/ p ol ic y fo r E m er ge nc y M ed ic al T ea m (E M T) re fe rr in g to g lo ba l s ta nd ar d an d In do ne si a co nd iti on (c lu st er in g) , i nc lu di ng : • Pe rs on ne l r eg is tr at io n • Pe rs on ne l c er tif ic at io n • P er so nn el d ep lo ym en t 4) D at ab as e of H ea lth p er so nn el (H ea lth w or ke r d at ab as e w ho c an b e m ob ili ze d fo r e m er ge nc y an d ou tb re ak ) 5) D at ab as e/ M ap pi ng o f h ea lth c ar e fa ci lit ie s (in cl ud in g th os e ru n by N G O s, g ov er nm en t, an d ot he r a ct or s) c ap ab le o f i nt eg ra tin g fo re ig n pe rs on ne l d ur in g em er ge nc ie s 6) M on ito rin g an d ev al ua tio n of in te rn at io na l m ed ic al / p er so nn el c ou nt er m ea su re s 7) M ob ili za tio n fo r h ea lth p er so nn el (b ud ge t) 1) Ad vo ca cy a nd d is se m in at io n of th e ro le o f t he M O H in th e m ec ha ni sm o f m ed ic al c ou nt er m ea su re s to c ro ss p ro gr am s / s ec to rs 2) M ob ili za tio n fo r l og is tic / m ed ic in e 3) Su st ai n ca pa ci ty fo r d ep lo ym en t o r r ec ei pt o f m ed ic al / pe rs on ne l c ou nt er m ea su re s th ro ug h ex er ci se (T TX o r s im ul at io n) re fe r t o EO C In pu ts Le ve l 4 : A t l ea st o ne re sp on se O R a fo rm al e xe rc is e or si m ul at io n w ith in th e pr ev io us y ea r in w hi ch m ed ic al co un te rm ea su re s w er e se nt o r re ce iv ed b y th e co un tr y M an M on ey M et ho d Pa rt ne r Le ve l 5 : C ou nt ry pa rt ic ip at es in a re gi on al / in te rn at io na l p ar tn er sh ip or h as fo rm al a gr ee m en t w ith a no th er c ou nt ry o r in te rn at io na l o rg an iz at io n th at o ut lin es c rit er ia a nd pr oc ed ur es fo r s en di ng an d re ce iv in g m ed ic al co un te rm ea su re s AN D h as pa rt ic ip at ed in a n ex er ci se or re sp on se w ith in th e pa st y ea r t o pr ac tic e de pl oy m en t o r r ec ei pt o f m ed ic al c ou nt er m ea su re s Le ve l 4 : A t l ea st o ne re sp on se O R fo rm al ex er ci se o r si m ul at io n w ith in th e pr ev io us y ea r i n w hi ch h ea lth pe rs on ne l w er e se nt o r r ec ei ve d by th e co un tr y Le ve l 5 : C ou nt ry pa rt ic ip at es in a re gi on al / in te rn at io na l p ar tn er sh ip or h as fo rm al a gr ee m en t w ith a no th er c ou nt ry o r in te rn at io na l o rg an iz at io n th at o ut lin es c rit er ia a nd pr oc ed ur es fo r s en di ng an d re ce iv in g he al th pe rs on ne l A N D h as pa rt ic ip at ed in a n ex er ci se or re sp on se w ith in th e pa st y ea r t o pr ac tic e de pl oy m en t o r r ec ei pt o f he al th p er so nn el R. 4. 1 Sy st em in p la ce fo r s en di ng a nd re ce iv in g m ed ic al co un te rm ea su re s du rin g a pu bl ic h ea lth e m er ge nc y Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 4) Co un tr y pa rt ic ip at es / h as fo rm al a gr ee m en t i n re gi on al / in te rn at io na l p ar tn er sh ip s (i. e. AA D M ER , W H O G O AR N e tc ) 37 TA R IS K CO M M U N IC AT IO N (1 ) 1. To d ev el op n at io na l h ea lth ri sk c om m un ic at io n gu id el in e 2. Te ch ni ca l a ss is ta nc e by c on su lta nt to d ra ft th e he al th ri sk c om m un ic at io n gu id el in e 3. To c on du ct th e he al th ri sk c om m un ic at io n tr ai ni ng (C D C At la nt a) 4. To c on du ct th e he al th ri sk c om m un ic at io n tr ai ni ng a t a ll le ve l 5. To d ev el op n at io na l c on tin ge nc y pl an , i nc lu di ng ri sk c om m un ic at io n (r ef er to T A Pr ep ar ed ne ss ) 6. D is as te r m an ag em en t i n he al th c lu st er , i nc lu di ng ri sk c om m un ic at io n (r ef er to E O C) 7. Tr ai ne d pe rs on ne l f or h ea lth c ris is /p ub lic h ea lth e m er ge nc ie s, in cl ud in g ris k co m m un ic at io n (r ef er to E O C) 8. G ui de lin es o f C ro ss S ec to r C oo rd in at io n F ac in g Ex tr ao rd in ar y Ev en ts /O ut br ea ks o f Z oo no se s an d Em er gi ng In fe ct io us D is ea se s (E ID ) ( re fe r t o ot he r T A) 9. Av ai la bi lit y of e ar ly w ar ni ng s ys te m a pp lic at io n fo r n at ur al d is as te r ( IN A Ri sk , e st ab lis he d in 20 14 ) In pu ts Le ve l 3 : F or m al go ve rn m en t ar ra ng em en ts a nd sy st em s in p la ce w ith st an da rd o pe ra tin g pr oc ed ur es a nd ca pa ci ty w ith m ul tis ec to ra l a nd m ul tis ta ke ho ld er in vo lv em en t, bu t in su ff ic ie nt a llo ca tio n an d al ig nm en t o f hu m an a nd fi na nc ia l re so ur ce s M an M on ey M et ho d Pa rt ne r Le ve l 4 : F ul ly op er at io na l n at io na l sy st em e st ab lis he d m ee tin g cr ite ria o f a ll pr ev io us le ve ls , w ith re as on ab le s ki lle d an d/ or tr ai ne d pe rs on ne l a nd vo lu nt ee rs , a nd fin an ci al re so ur ce s an d ar ra ng em en ts fo r sc al e up a s ev id en ce d by a s im ul at io n ex er ci se or te st ed b y a re al he al th e m er ge nc y Le ve l 3 : Co m m un ic at io n co or di na tio n ex is ts bu t w ith li m ite d pa rt ne r a nd st ak eh ol de r en ga ge m en t in cl ud in g he al th c ar e w or ke rs , c iv il so ci et y or ga ni za tio ns , pr iv at e se ct or a nd ot he r n on s ta te ac to rs re po rt s Le ve l 4 : E ff ec tiv e, re gu la r co m m un ic at io n co or di na tio n w ith al l p ar tn er s re qu ire d by a ll pr ec ed in g le ve ls , a nd th ei r co or di na tio n te st ed by a s im ul at io n ex er ci se o r t es te d by a re al h ea lth em er ge nc y Ri sk C om m un ic at io n Sy st em s (p la ns , m ec ha ni sm s, e tc .) In te rn al a nd P ar tn er C om m un ic at io n an d Co or di na tio n Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 1. An nu al m ee tin g w ith m ul ti se ct or al a nd m ul ti st ak eh ol de r f or c om m un ic at io n (F or um fo r B oa rd of P ub lic R el at io ns C oo rd in at in g Bo ar d (B ak oh um as ) N at io na l & R eg io na l) 2. N at io na l H ea lth c lu st er c oo rd in at io n (r ef er to E O C, M ed ic al C ou nt er m ea su re s) 3. M ee tin g of P ro gr am P re pa ra tio n Co or di na tio n an d Pr ob le m Id en tif ic at io n E ve nt s fr om M in is tr ie s/ Ag en ci es (r ef er to o th er T A) 4. Sy nc hr on iz at io n Co or di na tio n M ee tin g fo r D is ea se C on tr ol P ol ic y Pr og ra m (r ef er to o th er T A) 5. In te ra ct iv e Ta lk sh ow 37 37 TA R IS K CO M M U N IC AT IO N (1 ) 1. To d ev el op n at io na l h ea lth ri sk c om m un ic at io n gu id el in e 2. Te ch ni ca l a ss is ta nc e by c on su lta nt to d ra ft th e he al th ri sk c om m un ic at io n gu id el in e 3. To c on du ct th e he al th ri sk c om m un ic at io n tr ai ni ng (C D C At la nt a) 4. To c on du ct th e he al th ri sk c om m un ic at io n tr ai ni ng a t a ll le ve l 5. To d ev el op n at io na l c on tin ge nc y pl an , i nc lu di ng ri sk c om m un ic at io n (r ef er to T A Pr ep ar ed ne ss ) 6. D is as te r m an ag em en t i n he al th c lu st er , i nc lu di ng ri sk c om m un ic at io n (r ef er to E O C) 7. Tr ai ne d pe rs on ne l f or h ea lth c ris is /p ub lic h ea lth e m er ge nc ie s, in cl ud in g ris k co m m un ic at io n (r ef er to E O C) 8. G ui de lin es o f C ro ss S ec to r C oo rd in at io n F ac in g Ex tr ao rd in ar y Ev en ts /O ut br ea ks o f Z oo no se s an d Em er gi ng In fe ct io us D is ea se s (E ID ) ( re fe r t o ot he r T A) 9. Av ai la bi lit y of e ar ly w ar ni ng s ys te m a pp lic at io n fo r n at ur al d is as te r ( IN A Ri sk , e st ab lis he d in 20 14 ) In pu ts Le ve l 3 : F or m al go ve rn m en t ar ra ng em en ts a nd sy st em s in p la ce w ith st an da rd o pe ra tin g pr oc ed ur es a nd ca pa ci ty w ith m ul tis ec to ra l a nd m ul tis ta ke ho ld er in vo lv em en t, bu t in su ff ic ie nt a llo ca tio n an d al ig nm en t o f hu m an a nd fi na nc ia l re so ur ce s M an M on ey M et ho d Pa rt ne r Le ve l 4 : F ul ly op er at io na l n at io na l sy st em e st ab lis he d m ee tin g cr ite ria o f a ll pr ev io us le ve ls , w ith re as on ab le s ki lle d an d/ or tr ai ne d pe rs on ne l a nd vo lu nt ee rs , a nd fin an ci al re so ur ce s an d ar ra ng em en ts fo r sc al e up a s ev id en ce d by a s im ul at io n ex er ci se or te st ed b y a re al he al th e m er ge nc y Le ve l 3 : Co m m un ic at io n co or di na tio n ex is ts bu t w ith li m ite d pa rt ne r a nd st ak eh ol de r en ga ge m en t in cl ud in g he al th c ar e w or ke rs , c iv il so ci et y or ga ni za tio ns , pr iv at e se ct or a nd ot he r n on s ta te ac to rs re po rt s Le ve l 4 : E ff ec tiv e, re gu la r co m m un ic at io n co or di na tio n w ith al l p ar tn er s re qu ire d by a ll pr ec ed in g le ve ls , a nd th ei r co or di na tio n te st ed by a s im ul at io n ex er ci se o r t es te d by a re al h ea lth em er ge nc y Ri sk C om m un ic at io n Sy st em s (p la ns , m ec ha ni sm s, e tc .) In te rn al a nd P ar tn er C om m un ic at io n an d Co or di na tio n Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 1. An nu al m ee tin g w ith m ul ti se ct or al a nd m ul ti st ak eh ol de r f or c om m un ic at io n (F or um fo r B oa rd of P ub lic R el at io ns C oo rd in at in g Bo ar d (B ak oh um as ) N at io na l & R eg io na l) 2. N at io na l H ea lth c lu st er c oo rd in at io n (r ef er to E O C, M ed ic al C ou nt er m ea su re s) 3. M ee tin g of P ro gr am P re pa ra tio n Co or di na tio n an d Pr ob le m Id en tif ic at io n E ve nt s fr om M in is tr ie s/ Ag en ci es (r ef er to o th er T A) 4. Sy nc hr on iz at io n Co or di na tio n M ee tin g fo r D is ea se C on tr ol P ol ic y Pr og ra m (r ef er to o th er T A) 5. In te ra ct iv e Ta lk sh ow 38 38 TA R IS K CO M M U N IC AT IO N (2 ) 1. Av ai la bi lit y of M O H c om m un ic at io n pl an o r r is k co m m un ic at io n pl an 2. Ap po in te d an d tr ai ne d go ve rn m en t s po ke sp er so n in e ve ry g ov er nm en t m in is tr y an d ag en cy 3. En ga ge m en t w ith M as s M ed ia a nd S oc ia l M ed ia Le ve l 4 : T he re is p la nn ed c om m un ic at io n w ith co nt in uo us e ng ag em en t a nd p ro ac tiv e m ed ia o ut re ac h (in cl ud in g re gu la r m ed ia b rie fin gs ) g ui de d by ri sk co m m un ic at io n be st p ra ct ic es a nd a ch ie ve s co m pr eh en si ve g eo gr ap hi ca l c ov er ag e, e vi de nc ed b y re gu la r c ov er ag e of h ea lth is su es a nd ri sk s in r el ev an t la ng ua ge s; a s w el l a s by m ed ia a nd s oc ia l m ed ia a ct iv ity du rin g an e m er ge nc y. M an M on ey M et ho d Pa rt ne r Le ve l 4 : R eg ul ar b rie fin g, tr ai ni ng a nd e ng ag em en t o f s oc ia l m ob ili za tio n an d co m m un ity e ng ag em en t t ea m s in cl ud in g vo lu nt ee rs . M ec ha ni sm s to h ar ne ss s ca le u p ca pa ci ty e xi st an d ar e op er at io na l. Fe ed ba ck lo op fr om li st en in g (D om ai n 5) in to c om m un ity e ng ag em en t i s op er at io na l. Pu bl ic C om m un ic at io n Co m m un ic at io n En ga ge m en t w ith A ff ec te d Co m m un iti es 1. Re gu la r b rie fin g, tr ai ni ng a nd e ng ag em en t o f s oc ia l m ob ili za tio n an d co m m un ity e ng ag em en t te am s in cl ud in g vo lu nt ee rs : a. so ci al h ar m on y vi lla ge , s tr en gt he ni ng lo ca l w is do m , a nd tr ai ni ng o f p sy ch os oc ia l s up po rt se rv ic e te am s b. D is as te r A le rt V ill ag es (K am pu ng S ia ga B en ca na ), D is as te r A le rt C ad et s Tr ai ni ng (T ag an a) , an d Ta ga na c om ra de tr ai ni ng fo r j ou rn al is ts , I nd on es ia n fil m a rt is t a ss oc ia tio ns (P ar fi) , C SO s, ar tis ts c. Re si lie nt D is as te r V ill ag e, In de pe nd en t R es ili en t V ill ag e d. N et w or ki ng w ith C SO s & c om pa ni es e. Ca dr es c oa ch in g 2. Co m m un ity o ut re ac he s (H ot lin e Co nt ac t C en te r a nd th e in fo rm at io n sy st em S IA P/ Sa lu ra n In fo rm as i, As pi ra si , d an P en ga du an C ha nn el fo r I nf or m at io n, A sp ira tio n, a nd C om pl ai nt ) D yn am ic L is te ni ng a nd R um ou r M an ag em en t Le ve l 4 : S tr on g sy st em fo r l is te ni ng a nd ru m ou r m an ag em en t on a p er m an en t b as is w hi ch is in te gr at ed in to th e de ci si on m ak in g a nd re sp on se a ct io ns fo r p ub lic c om m un ic at io ns (D om ai n 3) , c om m un ic at io n en ga ge m en t w ith a ff ec te d co m m un iti es (D om ai n 4) , a s w el l a s fo r i nt er na l a nd p ar tn er s co m m un ic at io ns (D om ai n 2) 1. Co m m un ity c on su lta tio n m ec ha ni sm s ar e in p la ce : a. Th e in te gr at ed in fo rm at io n sy st em S IA P (S al ur an In fo rm as i, As pi ra si , d an P en ga du an / Ch an ne l f or In fo rm at io n, A sp ira tio n, a nd C om pl ai nt ) w ith M O H H os pi ta ls b. Co nt en t c om pl ai nt s (c om m un ity re po rt in g sy st em fo r h oa xe s) a nd ru m ou rs s ur ve ill an ce . Ex am pl e: A du an ko nt en C on te nt c om pl ai nt s (c om m un ity re po rt in g sy st em fo r h oa xe s) a nd ru m ou rs s ur ve ill an ce . E xa m pl e: A du an ko nt en In pu ts Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 39 TA P O IN TS O F EN TR Y Ad eq ua te ly tr ai ne d he al th p er so nn el : 1. D et ec tio n an d Re sp on se fo r P ub lic H ea lth E m er ge nc y Co nt ai nm en t T ra in in g in P O E fo r P or t H ea lth O ff ic er . 2. F lig ht S ur ge on a nd F lig ht N ur se T ra in in g fo r P or t H ea lth O ff ic er 3. T ra in in g fo r H ea lth Q ua ra nt in e Ca pa ci ty In pu ts Le ve l 4 : I ns pe ct io n pr og ra m to e ns ur e sa fe e nv iro nm en t a t Po E fa ci lit ie s fu nc tio ni ng . A fu nc tio ni ng pr og ra m m e fo r t he co nt ro l o f v ec to rs an d re se rv oi rs in an d ne ar P oE e xi st s (A nn ex 1 b, A rt . 1 e) M an M on ey M et ho d Pa rt ne r Le ve l 5 : T ra in ed pe rs on ne l f or th e in sp ec tio n of co nv ey an ce s ar e av ai la bl e at de si gn at ed Po E (A nn ex 1 b, A rt . 1c ) Im pr ov e ca pa ci tie s on p re pa re dn es s at P O E Ro ut in e ca pa ci tie s es ta bl is he d at p oi nt s of e nt ry Ef fe ct iv e pu bl ic h ea lth re sp on se a t p oi nt s of e nt ry Av ai la bi lit y of n at io na l p ol ic y on in fo rm at io n sh ar in g an d si m ul ta ne ou s co m m un ic at io n of p ub lic he al th e ve nt s: 1. A dv oc ac y an d di ss em in at io n of H ea lth Q ua ra nt in e La w 2. D ev el op D ra ft G ui de lin es o f H ea lth Q ua ra nt in e M ai nt ai n ad eq ua te ly e qu ip pe d PO Es (I nf ra st ru ct ur e, re fe rr al , e qu ip m en t, et c) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) Le ve l 4 : R ef er ra l sy st em a nd tr an sp or t f or th e sa fe tr an sf er o f i ll tr av el le rs to ap pr op ria te m ed ic al fa ci lit ie s in pl ac e w ith re gu la r up da tin g an d te st in g of n at io na l p ub lic he al th e m er ge nc y co nt in ge nc y pl an w ith p ub lis he d re po rt s Le ve l 5 : E va lu at io n an d pu bl ic at io n of ef fe ct iv en es s in re sp on di ng to P H Ev en ts a t P oE Im pr ov e in fo rm at io n sh ar in g an d co m m un ic at io n w ith re la te d st ak eh ol de rs : 1. H ea lth Q ua ra nt in e Im pl em en ta tio n in G ro un d Cr os si ng 2. S ha rin g in fo rm at io n sy st em w ith re la te d st ak eh ol de rs (i m m ig ra tio n, fi na nc e, h om e af fa irs , m ar iti m e) 3. D ev el op M O U w ith ri sk c ou nt rie s (i. e. A fr ic an c ou nt rie s) o n va cc in at io n re qu ire m en ts a nd ce rt ifi ca te 4. In te gr at io n of H ea lth Q ua ra nt in e Pr og ra m w ith re la te d m in is tr ie s an d st ak eh ol de rs 39 39 TA P O IN TS O F EN TR Y Ad eq ua te ly tr ai ne d he al th p er so nn el : 1. D et ec tio n an d Re sp on se fo r P ub lic H ea lth E m er ge nc y Co nt ai nm en t T ra in in g in P O E fo r P or t H ea lth O ff ic er . 2. F lig ht S ur ge on a nd F lig ht N ur se T ra in in g fo r P or t H ea lth O ff ic er 3. T ra in in g fo r H ea lth Q ua ra nt in e Ca pa ci ty In pu ts Le ve l 4 : I ns pe ct io n pr og ra m to e ns ur e sa fe e nv iro nm en t a t Po E fa ci lit ie s fu nc tio ni ng . A fu nc tio ni ng pr og ra m m e fo r t he co nt ro l o f v ec to rs an d re se rv oi rs in an d ne ar P oE e xi st s (A nn ex 1 b, A rt . 1 e) M an M on ey M et ho d Pa rt ne r Le ve l 5 : T ra in ed pe rs on ne l f or th e in sp ec tio n of co nv ey an ce s ar e av ai la bl e at de si gn at ed Po E (A nn ex 1 b, A rt . 1c ) Im pr ov e ca pa ci tie s on p re pa re dn es s at P O E Ro ut in e ca pa ci tie s es ta bl is he d at p oi nt s of e nt ry Ef fe ct iv e pu bl ic h ea lth re sp on se a t p oi nt s of e nt ry Av ai la bi lit y of n at io na l p ol ic y on in fo rm at io n sh ar in g an d si m ul ta ne ou s co m m un ic at io n of p ub lic he al th e ve nt s: 1. A dv oc ac y an d di ss em in at io n of H ea lth Q ua ra nt in e La w 2. D ev el op D ra ft G ui de lin es o f H ea lth Q ua ra nt in e M ai nt ai n ad eq ua te ly e qu ip pe d PO Es (I nf ra st ru ct ur e, re fe rr al , e qu ip m en t, et c) Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) Le ve l 4 : R ef er ra l sy st em a nd tr an sp or t f or th e sa fe tr an sf er o f i ll tr av el le rs to ap pr op ria te m ed ic al fa ci lit ie s in pl ac e w ith re gu la r up da tin g an d te st in g of n at io na l p ub lic he al th e m er ge nc y co nt in ge nc y pl an w ith p ub lis he d re po rt s Le ve l 5 : E va lu at io n an d pu bl ic at io n of ef fe ct iv en es s in re sp on di ng to P H Ev en ts a t P oE Im pr ov e in fo rm at io n sh ar in g an d co m m un ic at io n w ith re la te d st ak eh ol de rs : 1. H ea lth Q ua ra nt in e Im pl em en ta tio n in G ro un d Cr os si ng 2. S ha rin g in fo rm at io n sy st em w ith re la te d st ak eh ol de rs (i m m ig ra tio n, fi na nc e, h om e af fa irs , m ar iti m e) 3. D ev el op M O U w ith ri sk c ou nt rie s (i. e. A fr ic an c ou nt rie s) o n va cc in at io n re qu ire m en ts a nd ce rt ifi ca te 4. In te gr at io n of H ea lth Q ua ra nt in e Pr og ra m w ith re la te d m in is tr ie s an d st ak eh ol de rs 40 40 TA C H EM IC AL E VE N TS En ab lin g en vi ro nm en t i s i n pl ac e fo r m an ag em en t o f c he m ic al E ve nt s Re vi ta liz at io n of N at io na l M er cu ry R es ea rc h Ce nt er (M oE F) Tr ai ne d O ff ic er s : Co lla bo ra tio n w ith U N EP fo r C ap ac ity B ui ld in g on C he m ic al s Av ai la bi lit y of R eg ul at io n an d G ui de lin es : 1) G ui de lin e Pr ep ar at io n fo r P ar tic ip at or y Ap pr oa ch fo r C om m un iti es in S m al l-S ca le G ol d M in in g Ar ea s (P ES K) 2) Re vi si on o f G ov er nm en t R eg ul at io n N o. 7 4/ 20 01 o n M an ag em en t o f H az ar do us a nd T ox ic M at er ia ls 3) Pr es id en tia l D ec re e N o. 2 1/ 20 19 o n N at io na l A ct io n Pl an o n Re du ci ng a nd E lim in at in g M er cu ry 4) G ui de lin e of B io m ar ke r 5) M in is tr ia l D ec re e on E m er ge nc y Re sp on se o f H az ar do us a nd T ox ic S ub st an ce s an d W as te (M oE F) 6) Pr ep ar at io n of M in is tr y of In du st ry re gu la tio n on c he m ic al s th at a re p ro hi bi te d an d re gu la te d fo r w ea po ns a nd fo r p re cu rs or s. 7) Re vi si on o f M in is tr y of In du st ry re gu la tio n N o. 2 3/ 20 13 o n La be lin g ba se d on G H S 8) M in is tr y of M an po w er re gu la tio n N o. 5 / 20 18 o n th e Sa fe ty a nd H ea lth o f t he W or k En vi ro nm en t (la un ch in g Ju ly 1 8, 2 01 8) 9) Pr ep ar at io n of M in is te r o f I nd us tr y Re gu la tio n on li st c he m ic al s an d or ga ni c ch em ic al s 10 ) Tr ai ni ng M od ul e Pr ep ar at io n fo r t he Im pl em en ta tio n of P ar tic ip at or y Ap pr oa ch fo r C om m un iti es in P ES K In pu ts M an M on ey M et ho d Pa rt ne r M ec ha ni sm s ar e es ta bl is he d an d fu nc tio ni ng fo r d et ec tin g an d re sp on di ng to c he m ic al e ve nt s o r e m er ge nc ie s Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3y ea rs ) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea rs ) 1) D ev el op p ol ic y an d le gi sl at io n on c he m ic al e ve nt s ur ve ill an ce , a le rt p ro ce ss es a nd re sp on se b as ed o n th e si tu at io n as se ss m en t 2) Ad vo ca te fo r p ol iti ca l w ill a nd p ub lic a w ar en es s on c he m ic al e ve nt ri sk a nd m an ag em en t 3) Pr ep ar at io n on C on ce pt a nd R oa dm ap o n Po llu ta nt R el ea se a nd T ra ns fe r R eg is te r ( PR TR ) a nd Ch em ic al S ub st an ce s & C on tr ol L aw (C SC L) 4) Re vi ew a nd U pd at e on N at io na l I m pl em en ta tio n Pl an o n Pe rs is te nt O rg an ic P ol lu ta nt s Le ve l 2 : G ui de lin es or m an ua ls o n th e su rv ei lla nc e, as se ss m en t a nd m an ag em en t o f ch em ic al ev en ts , i nt ox ic at io n an d po is on in g ar e av ai la bl e (S O Ps ) o r eq ui va le nt e xi st s fo r th e co or di na tio n be tw ee n IH R N FP an d re le va nt se ct or s Le ve l 3 : S ur ve ill an ce is in p la ce fo r ch em ic al e ve nt s, in to xi ca tio n, a nd po is on in gs w ith la bo ra to ry c ap ac ity or a cc es s to la bo ra to ry c ap ac ity to c on fir m p rio rit y ch em ic al e ve nt s Le ve l 3 : An em er ge nc y re sp on se p la n th at de fin es th e ro le s an d re sp on si bi lit ie s of re le va nt Le ve l 4 : F un ct io na l m ec ha ni sm s fo r m ul tis ec to ra l co lla bo ra tio ns fo r ch em ic al e ve nt s ar e in pl ac e in cl ud in g in vo lv em en t i n in te rn at io na l ch em ic al /t ox ic ol og ic al ne tw or ks . E .g . I N TO X 41 TA R AD IA TI O N E M ER G EN CI ES G H SA – P O IN T O F EN TR Y W O RK IN G D RA FT C O U N TR Y –L EV EL L O G IC M O DE L • M in is te r o f H ea lth 's R eg ul at io n on th e Es ta bl is hm en t o f t he N at io na l Re fe rr al H os pi ta l f or N uc le ar D is as te r • D oc um en ts fo r t he c on tin ge nc y pl an o f t he B an du ng N uc le ar a re a • D oc um en ts fo r t he c on tin ge nc y pl an o f t he Y og ya ka rt a N uc le ar a re a • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Se rp on g nu cl ea r a re a • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e D IY n uc le ar a re a • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Ba nd un g nu cl ea r a re a • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Pa sa r J um at n uc le ar a re a • Ri sk A ss em en t a nd M on ev ra di o nu cl ea r i n In do ne si a • In cr ea se N uc le ar L ab or at or y Ca pa ci ty • H um an re so ur ce s pr oc ur em en t f or n uc le ar e m er ge nc y te am • In ve nt or y of fa ci lit ie s fo r t he re fe ra l h os pi ta l n uc le ar e m er ge nc y • To a rr an ge S O P fo r R ad ia tio n em er ge nc y re sp on s • N uc le ar e m er ge nc y re sp on se In pu ts Le ve l 4 : S ys te m at ic in fo rm at io n ex ch an ge b et w ee n ra di ol og ic al co m pe te nt a ut ho rit ie s an d hu m an h ea lth s ur ve ill an ce u ni ts ab ou t u rg en t r ad io lo gi ca l e ve nt s an d po te nt ia l r is ks th at m ay co ns tit ut e a pu bl ic h ea lth em er ge nc y of h ea lth e m er ge nc y of in te rn at io na l c on ce rn M an M on ey M et ho d Pa rt ne r Le ve l 5 : A m ec ha ni sm is in p la ce to a cc es s1 2 he al th fa ci lit ie s w ith ca pa ci ty to m an ag e pa tie nt s of ra di at io n em er ge nc ie s Le ve l 4 : F un ct io na l co or di na tio n1 3 a nd co m m un ic at io n m ec ha ni sm 14 be tw ee n re le va nt n at io na l co m pe te nt a ut ho rit ie s re sp on si bl e fo r n uc le ar re gu la to ry c on tr ol / sa fe ty , a nd re le va nt s ec to rs 15 . re po rt s Le ve l 5 : R ad ia tio n em er ge nc y re sp on se dr ill s ca rr ie d ou t re gu la rly , i nc lu di ng th e re qu es tin g of in te rn at io na l as si st an ce (a s ne ed ed ) a nd in te rn at io na l no tif ic at io n RE .1 . M ec ha ni sm s ar e es ta bl is he d an d fu nc tio ni ng fo r d et ec tin g an d re sp on di ng to ra di ol og ic al a nd n uc le ar e m er ge nc ie s. RE .2 E na bl in g en vi ro nm en t i s i n pl ac e fo r m an ag em en t o f R ad ia tio n Em er ge nc ie s • G ui de lin es fo r S af eg ua rd in g th e Im pa ct o f R ad ia tio n on H ea lth • Pr es id en tia l R eg ul at io n on N at io na l N uc le ar a nd R ad ia tio n Sa fe ty P ol ic ie s an d St ra te gi es • M in is te r o f H ea lth re gu la tio n on G ui de lin es fo r M ed ic al M an ag em en t fo r N uc le ar E m er ge nc y an d Ra di ol og y • Re vi si on o f t he P as ar Ju m at n uc le ar a re a' s em er ge nc y pr ep ar ed ne ss a nd re sp on se p ro gr am d oc um en t • Re vi si on o f t he S er po ng n uc le ar a re a' s em er ge nc y pr ep ar ed ne ss a nd re sp on se p ro gr am d oc um en t • Re vi si on o f t he Y og ya ka rt a n uc le ar a re a' s em er ge nc y pr ep ar ed ne ss a nd re sp on se p ro gr am d oc um en t • N uc le ar e m er ge nc y pr ep ar ed ne ss a nd re sp on se tr ai ni ng a t t he B an du ng n uc le ar a re a • N uc le ar e m er ge nc y pr ep ar ed ne ss a nd re sp on se tr ai ni ng a t t he P as ar Ju m at n uc le ar a re a • Ra di at io n em er ge nc y m ed ic al tr an in g • O pe ra tio n of O TD N N ( O rg an is as i T an gg ap D ar ur at N uk lir N as io na l/ N at io na l N uc le ar E m er ge nc y Re sp on se O rg an iz at io n ) • Ra di at io n Em er ge nc y, N at io na l Ev al ua tio n Au di t • M ed ic al e m er ge nc y pr ep ar ed ne ss fo r R ad ia tio n em er ge nc y • Pl an o f r ad io ak tif m at er ia l t ra ns po rt at io n • W as te o f r ad io ac tiv e m an ag em en t f or h os pi ta l a nd in du st rie s • Th e pr ep ar at io n of th e IE C M ed ia fo r t he C om m un ity a ro un d th e Ar ea Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea r s) EV AL U AT E M O N IT O R 41 41 TA R AD IA TI O N E M ER G EN CI ES G H SA – P O IN T O F EN TR Y W O RK IN G D RA FT C O U N TR Y –L EV EL L O G IC M O DE L • M in is te r o f H ea lth 's R eg ul at io n on th e Es ta bl is hm en t o f t he N at io na l Re fe rr al H os pi ta l f or N uc le ar D is as te r • D oc um en ts fo r t he c on tin ge nc y pl an o f t he B an du ng N uc le ar a re a • D oc um en ts fo r t he c on tin ge nc y pl an o f t he Y og ya ka rt a N uc le ar a re a • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Se rp on g nu cl ea r a re a • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e D IY n uc le ar a re a • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Ba nd un g nu cl ea r a re a • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Pa sa r J um at n uc le ar a re a • Ri sk A ss em en t a nd M on ev ra di o nu cl ea r i n In do ne si a • In cr ea se N uc le ar L ab or at or y Ca pa ci ty • H um an re so ur ce s pr oc ur em en t f or n uc le ar e m er ge nc y te am • In ve nt or y of fa ci lit ie s fo r t he re fe ra l h os pi ta l n uc le ar e m er ge nc y • To a rr an ge S O P fo r R ad ia tio n em er ge nc y re sp on s • N uc le ar e m er ge nc y re sp on se In pu ts Le ve l 4 : S ys te m at ic in fo rm at io n ex ch an ge b et w ee n ra di ol og ic al co m pe te nt a ut ho rit ie s an d hu m an h ea lth s ur ve ill an ce u ni ts ab ou t u rg en t r ad io lo gi ca l e ve nt s an d po te nt ia l r is ks th at m ay co ns tit ut e a pu bl ic h ea lth em er ge nc y of h ea lth e m er ge nc y of in te rn at io na l c on ce rn M an M on ey M et ho d Pa rt ne r Le ve l 5 : A m ec ha ni sm is in p la ce to a cc es s1 2 he al th fa ci lit ie s w ith ca pa ci ty to m an ag e pa tie nt s of ra di at io n em er ge nc ie s Le ve l 4 : F un ct io na l co or di na tio n1 3 a nd co m m un ic at io n m ec ha ni sm 14 be tw ee n re le va nt n at io na l co m pe te nt a ut ho rit ie s re sp on si bl e fo r n uc le ar re gu la to ry c on tr ol / sa fe ty , a nd re le va nt s ec to rs 15 . re po rt s Le ve l 5 : R ad ia tio n em er ge nc y re sp on se dr ill s ca rr ie d ou t re gu la rly , i nc lu di ng th e re qu es tin g of in te rn at io na l as si st an ce (a s ne ed ed ) a nd in te rn at io na l no tif ic at io n RE .1 . M ec ha ni sm s ar e es ta bl is he d an d fu nc tio ni ng fo r d et ec tin g an d re sp on di ng to ra di ol og ic al a nd n uc le ar e m er ge nc ie s. RE .2 E na bl in g en vi ro nm en t i s i n pl ac e fo r m an ag em en t o f R ad ia tio n Em er ge nc ie s • G ui de lin es fo r S af eg ua rd in g th e Im pa ct o f R ad ia tio n on H ea lth • Pr es id en tia l R eg ul at io n on N at io na l N uc le ar a nd R ad ia tio n Sa fe ty P ol ic ie s an d St ra te gi es • M in is te r o f H ea lth re gu la tio n on G ui de lin es fo r M ed ic al M an ag em en t fo r N uc le ar E m er ge nc y an d Ra di ol og y • Re vi si on o f t he P as ar Ju m at n uc le ar a re a' s em er ge nc y pr ep ar ed ne ss a nd re sp on se p ro gr am d oc um en t • Re vi si on o f t he S er po ng n uc le ar a re a' s em er ge nc y pr ep ar ed ne ss a nd re sp on se p ro gr am d oc um en t • Re vi si on o f t he Y og ya ka rt a n uc le ar a re a' s em er ge nc y pr ep ar ed ne ss a nd re sp on se p ro gr am d oc um en t • N uc le ar e m er ge nc y pr ep ar ed ne ss a nd re sp on se tr ai ni ng a t t he B an du ng n uc le ar a re a • N uc le ar e m er ge nc y pr ep ar ed ne ss a nd re sp on se tr ai ni ng a t t he P as ar Ju m at n uc le ar a re a • Ra di at io n em er ge nc y m ed ic al tr an in g • O pe ra tio n of O TD N N ( O rg an is as i T an gg ap D ar ur at N uk lir N as io na l/ N at io na l N uc le ar E m er ge nc y Re sp on se O rg an iz at io n ) • Ra di at io n Em er ge nc y, N at io na l Ev al ua tio n Au di t • M ed ic al e m er ge nc y pr ep ar ed ne ss fo r R ad ia tio n em er ge nc y • Pl an o f r ad io ak tif m at er ia l t ra ns po rt at io n • W as te o f r ad io ac tiv e m an ag em en t f or h os pi ta l a nd in du st rie s • Th e pr ep ar at io n of th e IE C M ed ia fo r t he C om m un ity a ro un d th e Ar ea Pr io rit y Ac tiv iti es / M ile st on e Ac tiv iti es a nd O ut pu ts * Sh or t te rm O ut co m es (1 3 ye ar s) In te rm ed ia te O ut co m es (4 5 ye ar s) Lo ng t er m O ut co m es (5 +y ea r s) EV AL U AT E M O N IT O R 42 42 C. MONITORING AND EVALUATION Each Ministry/ Agency/ Institution will conduct their own monitoring and evaluation on NAPHS implementation based on area: Prevent, Detect and Respond as described in Presidential Instruction Number 4 of 2019. Every year 19 TAs will also conduct self assessment on its IHR core capacities using WHO tools. Local Government can use Minimum Service Standards monitoring tools to monitor activities that have the highest efficiency in health security. In addition, Secretariat of the Cabinet will also monitor and evaluate Presidential Instruction Number 4 of 2019 implementation based on reports from: 1) Coordinating Ministry for Human Development and Cultural Affairs on public health emergency and/ or natural disaster and 2) Coordinating Ministry for Political, Legal and Security Affairs on public health emergency and/ or natural disaster that have security aspect. The results of these monitoring and evaluation activities will be reported directly to the President. 43 VI. CONCLUSION This NAPHS document is very important. Relevantministries/ agencies/ institutions are expected to improve the capacity to prevent, detect and respond to outbreaks, pandemic and public health emergency that require coordination across ministries/ agencies/ institutions. It is expected that this NAPHS document can serve as guidelines in the planning, implementation and monitoring and evaluation of the relevantministries/ agencies/ institutions for health security. REFERENCES: 1. Indonesia Health Financing System Assessment: Spend More, Right and Better. World Bank Group. 2016. 2. The Republic of Indonesia, Health system review. Health systems in Transitions, vol 7 no 1, 2017. World Health Organization 2017 (on behalf of the Asia Pacific Observatory on Health Systems and Policies) 3. http://www.id.undp.org/content/indonesia/en/home/countryinfo.html 4. Joint external evaluation of the Republic of Indonesia report, November 20-24, 2017 5. Kluge H, Martín-Moreno JM, Emiroglu N, et al. Strengthening global health security by embedding the International Health Regulations requirements into national health systems. BMJ Glob Health 2018;3:e000656. doi:10.1136/ bmjgh-2017-000656 6. Australia Indonesia Partnership for Health System Strengthening: Health financing and Universal Health Coverage: a compilation of policy notes, 2015 7. Keynote Speech at International Conference “Working together for Health Security” Chiang Mai. 10-12 April 2012WORKING TOGETHER for HEALTH SECURITYAGENDA for the NEXT DECADE, DrSamleePlianbangchang, Regional Director WHO South-East Asia Region 43 42 C. MONITORING AND EVALUATION Each Ministry/ Agency/ Institution will conduct their own monitoring and evaluation on NAPHS implementation based on area: Prevent, Detect and Respond as described in Presidential Instruction Number 4 of 2019. Every year 19 TAs will also conduct self assessment on its IHR core capacities using WHO tools. Local Government can use Minimum Service Standards monitoring tools to monitor activities that have the highest efficiency in health security. In addition, Secretariat of the Cabinet will also monitor and evaluate Presidential Instruction Number 4 of 2019 implementation based on reports from: 1) Coordinating Ministry for Human Development and Cultural Affairs on public health emergency and/ or natural disaster and 2) Coordinating Ministry for Political, Legal and Security Affairs on public health emergency and/ or natural disaster that have security aspect. The results of these monitoring and evaluation activities will be reported directly to the President. 43 VI. CONCLUSION This NAPHS document is very important. Relevantministries/ agencies/ institutions are expected to improve the capacity to prevent, detect and respond to outbreaks, pandemic and public health emergency that require coordination across ministries/ agencies/ institutions. It is expected that this NAPHS document can serve as guidelines in the planning, implementation and monitoring and evaluation of the relevantministries/ agencies/ institutions for health security. REFERENCES: 1. Indonesia Health Financing System Assessment: Spend More, Right and Better. World Bank Group. 2016. 2. The Republic of Indonesia, Health system review. Health systems in Transitions, vol 7 no 1, 2017. World Health Organization 2017 (on behalf of the Asia Pacific Observatory on Health Systems and Policies) 3. http://www.id.undp.org/content/indonesia/en/home/countryinfo.html 4. Joint external evaluation of the Republic of Indonesia report, November 20-24, 2017 5. Kluge H, Martín-Moreno JM, Emiroglu N, et al. Strengthening global health security by embedding the International Health Regulations requirements into national health systems. BMJ Glob Health 2018;3:e000656. doi:10.1136/ bmjgh-2017-000656 6. Australia Indonesia Partnership for Health System Strengthening: Health financing and Universal Health Coverage: a compilation of policy notes, 2015 7. Keynote Speech at International Conference “Working together for Health Security” Chiang Mai. 10-12 April 2012WORKING TOGETHER for HEALTH SECURITYAGENDA for the NEXT DECADE, DrSamleePlianbangchang, Regional Director WHO South-East Asia Region 44 44 ANNEXES ANNEX 1 :ALLOCATION OF FUNDS (IDR)* Overall, in 5 Years period (2018 – 2022), of the estimated USD 308,462,389 for the implementation of the National Action Plan for the Health Security, Indonesia will allocate 95.2% (IDR 261,046,352/274,134,122) for the implementation of all the programs. The graphic above indicate that Indonesia allocate a considerable amount of fund for immunization as a preventive effort in health security. *) This fund allocation is an exercise for NAPHS budget 2018 - 2022 1,000,000,000,000 2,000,000,000,000 3,000,000,000,000 Prevent Detect Respond Other IHR Hazard Technical Areas Groups Prevent Detect Respond Other IHR Hazard 1,000,000,000,000 2,000,000,000,000 Immunization National Laboratory System Human Resources Risk Communication Zoonotic Events Biosafety and Biosecurity Real Time Surveillance AMR Points of Entry (PoE) Health Service Provision National Legislation National Health Emergency Response Medical Countermeasures and Personnel Deployment Food Safety Chemical Events Radiation Emergencies Reporting Linking Public Health and Security Authorities IHR Coordination Other technical area Technical Areas 45 AN N EX 2 : E XE RC IS E O F PR IO RI TY A CT IO N P LA N B Y TE CH N IC AL A RE A (2 01 8 – 20 22 ) TA N AT IO N AL L EG IS LA TI O N , P O LI CY A N D F IN AN CI N G Ta rg et s: S ta te s Pa rt ie s sh ou ld h av e an a de qu at e le ga l f ra m ew or k to s up po rt a nd e na bl e th e im pl em en ta tio n of a ll of t he ir ob lig at io ns a nd rig ht s to c om pl y w ith a nd im pl em en t th e IH R (2 00 5) . I n so m e St at es P ar tie s, im pl em en ta tio n of t he IH R (2 00 5) m ay r eq ui re n ew o r m od ifi ed le gi sl at io n. E ve n w he re n ew o r re vi se d le gi sl at io n m ay n ot b e sp ec ifi ca lly r eq ui re d un de r t he S ta te P ar ty ’s le ga l s ys te m , S ta te s m ay s til l c ho os e to r ev is e so m e le gi sl at io n, r eg ul at io ns o r ot he r in st ru m en ts in o rd er t o fa ci lit at e th ei rim pl em en ta tio n an d m ai nt en an ce in a m or e ef fic ie nt , ef fe ct iv e or b en ef ic ia l m an ne r. S ta te p ar tie s sh ou ld e ns ur e pr ov is io n of a de qu at e fu nd in g fo r IH R im pl em en ta tio nt hr ou gh n at io na l b ud ge t or ot he r m ec ha ni sm . JE E Re co m m en da tio ns : • Co ns id er a n ac co rd a cr os s Co or di na tin g M in is tr ie s to f or m al iz e co or di na tio n be tw ee n fo ca l po in ts , an d in cl ud e al l re le va nt I H R st ak eh ol de rs . • Co nd uc t a po lic y an al ys is t o id en tif y an d ev al ua te t he n ee d fo r ne w p ol ic ie s; r ev ie w e xi st in g po lic ie s fo r ga ps a nd p ot en tia l c on fli ct s; a nd ha rm on iz e an d de ve lo p st ra te gi es fo r p ol ic y im pl em en ta tio n ac ro ss li ne m in is tr ie s an d ad m in is tr at iv e le ve ls . • W or ki ng w ith k ey li ne m in is tr ie s an d st ak eh ol de rs , de ve lo p an d im pl em en t an a dv oc ac y pl an f or la w s an d re gu la tio ns o n gl ob al h ea lth se cu rit y un de r t he IH R (2 00 5) • D oc um en t a nd p ub lis h ad m in is tr at iv e ar ra ng em en ts a nd p ol ic ie s fr om v ar io us s ec to rs , i n or de r t o en co ur ag e cr os s se ct or al c ol la bo ra tio n. 45 44 ANNEXES ANNEX 1 :ALLOCATION OF FUNDS (IDR)* Overall, in 5 Years period (2018 – 2022), of the estimated USD 308,462,389 for the implementation of the National Action Plan for the Health Security, Indonesia will allocate 95.2% (IDR 261,046,352/274,134,122) for the implementation of all the programs. The graphic above indicate that Indonesia allocate a considerable amount of fund for immunization as a preventive effort in health security. *) This fund allocation is an exercise for NAPHS budget 2018 - 2022 1,000,000,000,000 2,000,000,000,000 3,000,000,000,000 Prevent Detect Respond Other IHR Hazard Technical Areas Groups Prevent Detect Respond Other IHR Hazard 1,000,000,000,000 2,000,000,000,000 Immunization National Laboratory System Human Resources Risk Communication Zoonotic Events Biosafety and Biosecurity Real Time Surveillance AMR Points of Entry (PoE) Health Service Provision National Legislation National Health Emergency Response Medical Countermeasures and Personnel Deployment Food Safety Chemical Events Radiation Emergencies Reporting Linking Public Health and Security Authorities IHR Coordination Other technical area Technical Areas 45 AN N EX 2 : E XE RC IS E O F PR IO RI TY A CT IO N P LA N B Y TE CH N IC AL A RE A (2 01 8 – 20 22 ) TA N AT IO N AL L EG IS LA TI O N , P O LI CY A N D F IN AN CI N G Ta rg et s: S ta te s Pa rt ie s sh ou ld h av e an a de qu at e le ga l f ra m ew or k to s up po rt a nd e na bl e th e im pl em en ta tio n of a ll of t he ir ob lig at io ns a nd rig ht s to c om pl y w ith a nd im pl em en t th e IH R (2 00 5) . I n so m e St at es P ar tie s, im pl em en ta tio n of t he IH R (2 00 5) m ay r eq ui re n ew o r m od ifi ed le gi sl at io n. E ve n w he re n ew o r re vi se d le gi sl at io n m ay n ot b e sp ec ifi ca lly r eq ui re d un de r t he S ta te P ar ty ’s le ga l s ys te m , S ta te s m ay s til l c ho os e to r ev is e so m e le gi sl at io n, r eg ul at io ns o r ot he r in st ru m en ts in o rd er t o fa ci lit at e th ei rim pl em en ta tio n an d m ai nt en an ce in a m or e ef fic ie nt , ef fe ct iv e or b en ef ic ia l m an ne r. S ta te p ar tie s sh ou ld e ns ur e pr ov is io n of a de qu at e fu nd in g fo r IH R im pl em en ta tio nt hr ou gh n at io na l b ud ge t or ot he r m ec ha ni sm . JE E Re co m m en da tio ns : • Co ns id er a n ac co rd a cr os s Co or di na tin g M in is tr ie s to f or m al iz e co or di na tio n be tw ee n fo ca l po in ts , an d in cl ud e al l re le va nt I H R st ak eh ol de rs . • Co nd uc t a po lic y an al ys is t o id en tif y an d ev al ua te t he n ee d fo r ne w p ol ic ie s; r ev ie w e xi st in g po lic ie s fo r ga ps a nd p ot en tia l c on fli ct s; a nd ha rm on iz e an d de ve lo p st ra te gi es fo r p ol ic y im pl em en ta tio n ac ro ss li ne m in is tr ie s an d ad m in is tr at iv e le ve ls . • W or ki ng w ith k ey li ne m in is tr ie s an d st ak eh ol de rs , de ve lo p an d im pl em en t an a dv oc ac y pl an f or la w s an d re gu la tio ns o n gl ob al h ea lth se cu rit y un de r t he IH R (2 00 5) • D oc um en t a nd p ub lis h ad m in is tr at iv e ar ra ng em en ts a nd p ol ic ie s fr om v ar io us s ec to rs , i n or de r t o en co ur ag e cr os s se ct or al c ol la bo ra tio n. 46 46 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .1 .1 L eg is la tio n, la w s, re gu la tio ns , a dm in is tr at iv e re qu ire m en ts , p ol ic ie s or o th er g ov er nm en t i ns tr um en ts in p la ce a re s uf fic ie nt fo r i m pl em en ta tio n of IH R (2 00 5) → 2 01 7 Ca pa ci ty le ve l 3 • Ad vo ca te th e im pl em en ta tio n of P re si de nt ia l In st ru ct io nc on ce rn in g Im pr ov ed C ap ac ity in P re ve nt in g, D et ec tin g, a nd R es po nd in g to D is ea se O ut br ea ks , P an de m ic , an d N uc le ar , B io lo gi ca l, an d Ch em ic al E m er ge nc ie s Ca bi ne t S ec re ta ria t, PM K, PO LH U KA M , M O H PA D K x x • D is se m in at io n of P ro vi nc ia l & D is tr ic t A ct io n Pl an H ea lth Se cu rit y – re gi on al PM K (C oo rd in at io n M in is tr y of H um an D ev el op m en t a nd C ul tu re ) PA D K x • H ar m on iz at io n an d Sy nc hr on iz at io n of S tr at eg ic P ol ic ie s ac ro ss TA (p ol ic y ga ps , p ol ic y co nf lic ts , p ol ic y ne ed s) PO LH U KA M (C oo rd in at io n M in is tr y of P ol iti ca l, Le ga l a nd S ec ur ity Af fa irs ) PA D K x x x x • Te ch ni ca l a ss is ta nc e fo r t he p re pa ra tio n of P ro vi nc ia l & D is tr ic t A ct io n Pl an H ea lth S ec ur ity – 3 4 Pr ov in ce s M O H PA D K x • M on ito rin g an d Ev al ua tio n M O H PA D K x • D ev el op m en t o f n at io na l a nd lo ca l a ct io n pl an (2 02 2) M O H PA D K x • H ea lth S ec ur ity F in an ci ng M ap pi ng o f a ll re le va nt s ec to rs M O H PA D K In di ca to r P .1 .2 T he S ta te c an d em on st ra te th at it h as a dj us te d an d al ig ne d its d om es tic le gi sl at io n, p ol ic ie s an d ad m in is tr at iv e ar ra ng em en ts to e na bl e co m pl ia nc e w ith IH R (2 00 5) → 2 01 7 Ca pa ci ty le ve l 3 • H ar m on iz at io n of R eg io na l P ol ic ie s w ith th e In do ne si an N at io na l A ct io n Pl an fo r H ea lth S ec ur ity PM K, P O LH U KA M , M O H PA D K x x x 47 TA IH R CO O RD IN AT IO N , C O M M U N IC AT IO N A N D A D VO CA CY Ta rg et s: T he e ff ec tiv e im pl em en ta tio n of th e IH R (2 00 5) r eq ui re s m ul tis ec to ra l/ m ul tid is ci pl in ar y ap pr oa ch es th ro ug h na tio na l p ar tn er sh ip s fo r ef fe ct iv e al er t a nd re sp on se s ys te m s. C oo rd in at io n of n at io nw id e re so ur ce s, in cl ud in g th e su st ai na bl e fu nc tio ni ng o f a N at io na l I H R Fo ca l P oi nt (N FP ), w hi ch is a n at io na l c en te r fo r I H R (2 00 5) c om m un ic at io ns , i s a ke y re qu is ite fo r I H R (2 00 5) im pl em en ta tio n. T he N FP s ho ul d be a cc es si bl e at a ll tim es t o co m m un ic at e w ith t he W H O IH R Re gi on al C on ta ct P oi nt s an d w ith a ll re le va nt s ec to rs a nd o th er s ta ke ho ld er s in t he c ou nt ry . St at es P ar tie s sh ou ld p ro vi de W H O w ith c on ta ct d et ai ls o f N FP s, c on tin uo us ly u pd at e an d an nu al ly c on fir m th em . JE E Re co m m en da tio ns : • In cr ea se a nd in te ns ify c om m un ic at io n an d cl os e co or di na tio n am on g st ak eh ol de rs ( na tio na l, pr ov in ci al , a nd a t ci ty le ve l) to a dd re ss t he st re ng th en in g an d m ai nt en an ce o f I H R co re c ap ac iti es , a nd th e re le va nt n ec es sa ry a ct io ns • In cr ea se t he n um be r of t ra in in g op po rt un iti es f or p ro vi nc ia l a nd n at io na l o ff ic ia ls t o su pp or t co m m un ic at io n of c as es /e ve nt s be tw ee n al l th re e le ve ls • En ha nc e th e ab ili ty o f th e IH R na tio na l fo ca l po in t to c om m un ic at e he al th r is k in fo rm at io n th ro ug h na tio na l an d pr ov in ci al n et w or ks , en su rin g th at a bi lit y is s up po rt ed w ith th e ne ce ss ar y in fo rm at io n te ch no lo gy . AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .2 .1 A fu nc tio na l m ec ha ni sm is e st ab lis he d fo r t he c oo rd in at io n an d in te gr at io n of re le va nt s ec to rs in th e im pl em en ta tio n of IH R → 20 17 C ap ac ity le ve l 3 • O rie nt at io n of IH R na tio na l f oc al p oi nt (N at io na l) M O H KA RK ES x • O rie nt at io n fo r I H R N at io na l F oc al P oi nt (I nt er na tio na l) W H O x x x x • D ev el op R ep or tin g m ec ha ni sm to IH R N FP (i nt er na l M O H ) a nd to W H O , i nc lu di ng ro le an d re sp on si bi lit ie s M O H KA RK ES x • D ev el op A ct io n pl an fo r c oo rd in at io n an d co m m un ic at io n M O H KA RK ES x x • D ev el op A nn ua l r ep or t o f I H R im pl em en ta tio n an d sh ar in g to re le va nt s ta ke ho ld er s M O H KA RK ES x x 47 47 TA IH R CO O RD IN AT IO N , C O M M U N IC AT IO N A N D A D VO CA CY Ta rg et s: T he e ff ec tiv e im pl em en ta tio n of th e IH R (2 00 5) r eq ui re s m ul tis ec to ra l/ m ul tid is ci pl in ar y ap pr oa ch es th ro ug h na tio na l p ar tn er sh ip s fo r ef fe ct iv e al er t a nd re sp on se s ys te m s. C oo rd in at io n of n at io nw id e re so ur ce s, in cl ud in g th e su st ai na bl e fu nc tio ni ng o f a N at io na l I H R Fo ca l P oi nt (N FP ), w hi ch is a n at io na l c en te r fo r I H R (2 00 5) c om m un ic at io ns , i s a ke y re qu is ite fo r I H R (2 00 5) im pl em en ta tio n. T he N FP s ho ul d be a cc es si bl e at a ll tim es t o co m m un ic at e w ith t he W H O IH R Re gi on al C on ta ct P oi nt s an d w ith a ll re le va nt s ec to rs a nd o th er s ta ke ho ld er s in t he c ou nt ry . St at es P ar tie s sh ou ld p ro vi de W H O w ith c on ta ct d et ai ls o f N FP s, c on tin uo us ly u pd at e an d an nu al ly c on fir m th em . JE E Re co m m en da tio ns : • In cr ea se a nd in te ns ify c om m un ic at io n an d cl os e co or di na tio n am on g st ak eh ol de rs ( na tio na l, pr ov in ci al , a nd a t ci ty le ve l) to a dd re ss t he st re ng th en in g an d m ai nt en an ce o f I H R co re c ap ac iti es , a nd th e re le va nt n ec es sa ry a ct io ns • In cr ea se t he n um be r of t ra in in g op po rt un iti es f or p ro vi nc ia l a nd n at io na l o ff ic ia ls t o su pp or t co m m un ic at io n of c as es /e ve nt s be tw ee n al l th re e le ve ls • En ha nc e th e ab ili ty o f th e IH R na tio na l fo ca l po in t to c om m un ic at e he al th r is k in fo rm at io n th ro ug h na tio na l an d pr ov in ci al n et w or ks , en su rin g th at a bi lit y is s up po rt ed w ith th e ne ce ss ar y in fo rm at io n te ch no lo gy . AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .2 .1 A fu nc tio na l m ec ha ni sm is e st ab lis he d fo r t he c oo rd in at io n an d in te gr at io n of re le va nt s ec to rs in th e im pl em en ta tio n of IH R → 20 17 C ap ac ity le ve l 3 • O rie nt at io n of IH R na tio na l f oc al p oi nt (N at io na l) M O H KA RK ES x • O rie nt at io n fo r I H R N at io na l F oc al P oi nt (I nt er na tio na l) W H O x x x x • D ev el op R ep or tin g m ec ha ni sm to IH R N FP (i nt er na l M O H ) a nd to W H O , i nc lu di ng ro le an d re sp on si bi lit ie s M O H KA RK ES x • D ev el op A ct io n pl an fo r c oo rd in at io n an d co m m un ic at io n M O H KA RK ES x x • D ev el op A nn ua l r ep or t o f I H R im pl em en ta tio n an d sh ar in g to re le va nt s ta ke ho ld er s M O H KA RK ES x x 48 48 TA AN TI M IC RO BI AL R ES IS TA N CE (A M R) Ta rg et : S up po rt w or k be in g co or di na te d by W H O , F AO , a nd O IE t o de ve lo p an in te gr at ed g lo ba l p ac ka ge o f a ct iv iti es t o co m ba t an tim ic ro bi al re si st an ce , s pa nn in g hu m an , a ni m al , a gr ic ul tu ra l, fo od a nd e nv iro nm en ta l a sp ec ts (i .e . a o ne h ea lth a pp ro ac h) , i nc lu di ng : a ) E ac h co un tr y ha s its o w n na tio na l c om pr eh en si ve p la n to c om ba t a nt im ic ro bi al re si st an ce ; b ) S tr en gt he n su rv ei lla nc e an d la bo ra to ry c ap ac ity a t th e na tio na l a nd in te rn at io na l le ve l fo llo w in g ag re ed i nt er na tio na l st an da rd s de ve lo pe d in t he f ra m ew or k of t he G lo ba l Ac tio n pl an , co ns id er in g ex is tin g st an da rd s an d; c ) I m pr ov ed c on se rv at io n of e xi st in g tr ea tm en ts a nd c ol la bo ra tio n to s up po rt th e su st ai na bl e de ve lo pm en t of n ew a nt ib io tic s, a lte rn at iv e tr ea tm en ts , pr ev en tiv e m ea su re s an d ra pi d, p oi nt o f ca re d ia gn os tic s, i nc lu di ng s ys te m s to pr es er ve n ew a nt ib io tic s. JE E re co m m en da tio ns : • Es ta bl is h an In te r M in is te ria l C om m itt ee o n th e im pl em en ta tio n of th e In do ne si a N AP o n AM R, to e ns ur e a sy st em at ic a nd c om pr eh en si ve “O ne H ea lth ” ap pr oa ch . Th is s ho ul d co m pr is e: t he C oo rd in at in g M in is tr y of H um an D ev el op m en t an d Cu ltu ra l A ff ai rs ; th e Co or di na tin g M in is tr y fo r Po lit ic al , Le ga l an d Se cu rit y Af fa irs ; th e M in is tr y of H ea lth ; th e M in is tr y of A gr ic ul tu re ; th e M in is tr y of M ar in e Af fa irs a nd Fi sh er y; th e M in is tr y of E nv iro nm en t an d Fo re st ry ; t he M in is tr y of D ef en ce ; t he N at io na l A ge nc y of D ru g an d Fo od C on tr ol ; t he M in is tr y of Re se ar ch , T ec hn ol og y an d H ig he r Ed uc at io n; t he M in is tr y of F in an ce ; t he M in is tr y of C om m un ic at io n an d In fo rm at ic s; a nd t he M in is tr y of Fo re ig n Af fa irs . • Fo rm al ly a pp oi nt d es ig na te d la bo ra to ry s ur ve ill an ce o n AM R in th e hu m an , a ni m al , a qu ac ul tu re , a nd e nv iro nm en t s ec to rs • Fo rm al ly a pp oi nt d es ig na te d se nt in el s ite s on A M R in th e hu m an , a ni m al , a qu ac ul tu re , a nd e nv iro nm en t s ec to rs • Im pl em en t t he W H O G lo ba l A nt im ic ro bi al S ur ve ill an ce S ys te m (G LA SS ) o n su rv ei lla nc e of A M R, u si ng a O ne H ea lth a pp ro ac h • Pr om ot e pu bl ic a w ar en es s an d co m m un ity e m po w er m en t o n AM R th ro ug h hu m an a nd a ni m al h ea lth ca re p ro vi de rs a t l oc al 49 AC TI VI TI ES A N D T IM EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .3 .1 A nt im ic ro bi al re si st an ce (A M R) d et ec tio n → 20 17 C ap ac ity le ve l 2 • N RL a pp oi nt m en t M O M AF x • Ca pa ci ty b ui ld in g fo r r ef er ra l a nd te st in g la bo ra to ry , i nc l t es t m at er ia l M O M AF x • N RL a pp oi nt m en t M O A • Fa ci lit at e es ta bl is hm en t o f a n An tim ic ro bi al R es is ta nc e Co nt ro l C om m itt ee (A RC C/ KP RA ) M O A x • Fa ci lit at e AR CC /K PR A st ud ie s on a nt im ic ro bi al u sa ge (A M U ) a nd A M R M O A x • Bu ild s ta ke ho ld er c ap ac ity to c on du ct m on ito rin g, s ur ve ill an ce a nd te st in g fo r A M U an d AM R. M O A x • Ra is e st ak eh ol de r’s a w ar en es s of p ru de nt a nd a pp ro pr ia te u se o f a nt im ic ro bi al s an d th e he al th ri sk s of A M R. M O A x • Ad vo ca te s ta ke ho ld er s (G O I, pr iv at e se ct or /i nd us tr y) fo r a dh er en ce to re gu la tio ns / po lic ie s on A M U a nd A M R. M O A x • N RL a pp oi nt m en t M O H • Re vi ew N AP A M R In do ne si a 20 17 2 01 9 to a pp oi nt N CC M O H • D ev el op m en t o f N AP A M R In do ne si a th e ne xt 5 p er io d M O H In di ca to r P .3 .2 S ur ve ill an ce o f I nf ec tio ns c au se d by A M R pa th og en s → 2 01 7 Ca pa ci ty le ve l 2 • G lo ba l S ur ve ill an ce E SB L E Co li M O H x • D ev el op m en t o f i nt eg ra te d su rv ei lla nc e gu id el in e M O H x • Co or di na tio n m ee tin g PP I w or ki ng g ro up , M O H , c ro ss s ec to rs / un it M O H x x x x x • W or ks ho p/ D is se m in at io n PP I P ro gr am P PI a t r ef er ra l h os pi ta ls (1 8 re gi on al h os pi ta ls ) M O H x • W or ks ho p/ D is se m in at io n PP I P ro gr am P PI a t r ef er ra l h os pi ta ls (2 0 re fe rr al h os pi ta ls ) M O H x • W or ks ho p PP I M O H x x x x • Te ch ni ca l a ss is ta nc e at h os pi ta l M O H x x x x x 49 49 AC TI VI TI ES A N D T IM EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .3 .1 A nt im ic ro bi al re si st an ce (A M R) d et ec tio n → 20 17 C ap ac ity le ve l 2 • N RL a pp oi nt m en t M O M AF x • Ca pa ci ty b ui ld in g fo r r ef er ra l a nd te st in g la bo ra to ry , i nc l t es t m at er ia l M O M AF x • N RL a pp oi nt m en t M O A • Fa ci lit at e es ta bl is hm en t o f a n An tim ic ro bi al R es is ta nc e Co nt ro l C om m itt ee (A RC C/ KP RA ) M O A x • Fa ci lit at e AR CC /K PR A st ud ie s on a nt im ic ro bi al u sa ge (A M U ) a nd A M R M O A x • Bu ild s ta ke ho ld er c ap ac ity to c on du ct m on ito rin g, s ur ve ill an ce a nd te st in g fo r A M U an d AM R. M O A x • Ra is e st ak eh ol de r’s a w ar en es s of p ru de nt a nd a pp ro pr ia te u se o f a nt im ic ro bi al s an d th e he al th ri sk s of A M R. M O A x • Ad vo ca te s ta ke ho ld er s (G O I, pr iv at e se ct or /i nd us tr y) fo r a dh er en ce to re gu la tio ns / po lic ie s on A M U a nd A M R. M O A x • N RL a pp oi nt m en t M O H • Re vi ew N AP A M R In do ne si a 20 17 2 01 9 to a pp oi nt N CC M O H • D ev el op m en t o f N AP A M R In do ne si a th e ne xt 5 p er io d M O H In di ca to r P .3 .2 S ur ve ill an ce o f I nf ec tio ns c au se d by A M R pa th og en s → 2 01 7 Ca pa ci ty le ve l 2 • G lo ba l S ur ve ill an ce E SB L E Co li M O H x • D ev el op m en t o f i nt eg ra te d su rv ei lla nc e gu id el in e M O H x • Co or di na tio n m ee tin g PP I w or ki ng g ro up , M O H , c ro ss s ec to rs / un it M O H x x x x x • W or ks ho p/ D is se m in at io n PP I P ro gr am P PI a t r ef er ra l h os pi ta ls (1 8 re gi on al h os pi ta ls ) M O H x • W or ks ho p/ D is se m in at io n PP I P ro gr am P PI a t r ef er ra l h os pi ta ls (2 0 re fe rr al h os pi ta ls ) M O H x • W or ks ho p PP I M O H x x x x • Te ch ni ca l a ss is ta nc e at h os pi ta l M O H x x x x x 50 50 • St ud iu m G en er al e M O H • W AA W M O H • AM R su rv ei lla nc e at s hr im p an d fis h fa rm er s de ve lo pe d M O M AF x x • Pr ev en tio n of fi sh d is ea se s M O M AF x x • AM U S ur ve ill an ce in s hr im p an d fis h fa rm er s M O M AF • Pr ep ar at io n of F is h D ru g Re gu la tio ns M O M AF x • Im pl em en ta tio n of b io se cu rit y 3 zo na a t m ed iu m s ca le p ou ltr y fa rm M O A • AM U S ur ve ill an ce a t p ou ltr y fa rm M O A • Li nk la bo ra to ry d ia gn os tic s t o fie ld a ni m al d is ea se s ur ve ill an ce a nd c on tr ol pr og ra m m es M O A x • St re ng th en la bo ra to ry d ia gn os tic c ap ac ity fo r E ID s an d zo on os es M O A x In di ca to r P .3 .3 H ea lth ca re a ss oc ia te d in fe ct io n (H CA I) pr ev en tio n an d co nt ro l p ro gr am s → 2 01 7 Ca pa ci ty le ve l 3 • Im pl em en ta tio n of th e Sm ar t S oc ie ty M ov em en t P ro gr am U si ng M ed ic in es (G em aC er m at ) f or P ha rm ac is ts a nd C om m un iti es M O H x x x x x • O pt im iz at io n of th e ro le o f p ha rm ac is ts a s ag en ts o f c ha ng e M O H x x x x x • Pr ep ar at io n of a nt ib io tic g ui de lin es M O H x • PO R an d G em aC er m at p ub lic at io n th ro ug h th e m ed ia M O H x x x x • In cr ea si ng C oo pe ra tio n in d is se m in at in g th e U se o f A nt ib io tic s an d An tib io tic C on tr ol in H ea lth S er vi ce s M O H x x x x • Cr os s se ct or c oo rd in at io n m ee tin g in A M R co nt ro l f or re le va nt s ta ke ho ld er s M O H x x x x • M on ito rin g an d Ev al ua tio n of th e im pl em en ta tio n of th e G em aC er m at M O H x x x x • St ud y an d pe rf or m an ce d at a Ev al ua tio n on In di ca to rs o f R at io na l D ru g U se M O H x x x x In di ca to r P .3 .4 A nt im ic ro bi al s te w ar ds hi p ac tiv iti es → 2 01 7 Ca pa ci ty le ve l 3 • W or ks ho p Im pl em en ta tio n PP RA a t h os pi ta ls M O H x • W or ks ho p PR A at F KR TL M O H x x x x • Te ch ni ca l a ss is ta nc e PR A at h os pi ta ls M O H x x x x x 51 • Su pe rv is io n PP RA M O H x x x x • D is se m in at io n of R ef er ra l H ea lth S er vi ce s (o ne o f t he m is th e PR A pr og ra m ) M O H x x x x x • Co or di na tio n m ee tin g KP RA M O H x • Co or di na tio n m ee tin g KP RA M O H x x x x • St re ng th en in g H ea lth S ys te m M O H x x x • Su pp or t A M R Ac tiv ity M O H x x x • St re ng th en d is ea se s ur ve ill an ce a nd d at a an al ys is c ap ac ity to s up po rt d is ea se c on tr ol po lic y M O A x • Co nd uc t d is ea se id en tif ic at io n an d ta rg et ed s ur ve ill an ce a ct iv iti es in h ig h ris k en vi ro nm en ts a nd o n an im al s at h ig h ris k of c on tr ac tin g zo on os es a nd E ID s, in cl ud in g fa rm ed w ild lif e an d m ig ra to ry b ird s M O A x • D ev el op G O I c ap ac ity to im pl em en t t ar ge te d zo on os es a nd E ID p re ve nt io n an d co nt ro l pr og ra m m e M O A x 51 51 • Su pe rv is io n PP RA M O H x x x x • D is se m in at io n of R ef er ra l H ea lth S er vi ce s (o ne o f t he m is th e PR A pr og ra m ) M O H x x x x x • Co or di na tio n m ee tin g KP RA M O H x • Co or di na tio n m ee tin g KP RA M O H x x x x • St re ng th en in g H ea lth S ys te m M O H x x x • Su pp or t A M R Ac tiv ity M O H x x x • St re ng th en d is ea se s ur ve ill an ce a nd d at a an al ys is c ap ac ity to s up po rt d is ea se c on tr ol po lic y M O A x • Co nd uc t d is ea se id en tif ic at io n an d ta rg et ed s ur ve ill an ce a ct iv iti es in h ig h ris k en vi ro nm en ts a nd o n an im al s at h ig h ris k of c on tr ac tin g zo on os es a nd E ID s, in cl ud in g fa rm ed w ild lif e an d m ig ra to ry b ird s M O A x • D ev el op G O I c ap ac ity to im pl em en t t ar ge te d zo on os es a nd E ID p re ve nt io n an d co nt ro l pr og ra m m e M O A x 52 52 TA Z O O N O TI C D IS EA SE Ta rg et : A do pt ed m ea su re d be ha vi or s, p ol ic ie s an d/ or p ra ct ic es t ha t m in im iz e th e tr an sm is si on o f z oo no tic d is ea se s fr om a ni m al s in to h um an po pu la tio ns . JE E Re co m m en da tio ns : • Su rv ei lla nc e of w ild lif e he al th s ho ul d be in cl ud ed in th e SI ZE in fo rm at io n sy st em • In cr ea se b ud ge ta ry a nd h um an r es ou rc es a llo ca tio n to O ne H ea lth R es po ns e te am s, a nd t o th e pr ev en tio n an d de te ct io n of z oo no ti c di se as es a t s ub n at io na l l ev el • Th e in te gr at ed S IZ E O ne H ea lth s ur ve ill an ce s ys te m s ho ul d be im pl em en te d at d is tr ic t l ev el th ro ug ho ut th e Re pu bl ic o f I nd on es ia • As se ss t he e xe cu tiv e le ve ls o f r es po ns ib le O ne H ea lth e xe cu tiv e of fic er s in t he v ar io us r el ev an t m in is tr ie s, t o st re am lin e in te rs ec to ra l O ne H ea lth p ro gr es s th ro ug h co lla bo ra tio n be tw ee n pa rt ic ip an ts o f e qu iv al en t h ie ra rc hi ca l l ev el s. 53 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .4 .1 S ur ve ill an ce s ys te m s in p la ce fo r p rio rit y zo on ot ic d is ea se s/ pa th og en s → 2 01 7 Ca pa ci ty le ve l 3 • Id en tif ic at io n of p rio rit y zo on ot ic d is ea se s in cl ud e AI , R ab ie s, A nt hr ax M O A x x • Co nd uc t d is ea se id en tif ic at io n an d ta rg et ed s ur ve ill an ce a ct iv iti es in hi gh r is k en vi ro nm en ts a nd o n an im al s at h ig h ris k of c on tr ac tin g zo on os es a nd E ID s, in cl ud in g fa rm ed w ild lif e an d m ig ra to ry b ird s. M O A x • St re ng th en d is ea se s ur ve ill an ce a nd d at a an al ys is c ap ac ity to s up po rt di se as e co nt ro l p ol ic y. M O A x • M O H re gu la tio n fo r r ab ie s co nt ro l M O H ZO O N O SE S x x x • Su rv ei lla nc e de ve lo pm en t M O H ZO O N O SE S x x • D ev el op m en t/ tr y ou t o f r is k m ap pi ng to ol s (Z oo no tic a nd E ID ) M O H /W H O ZO O N O SE S x x x x x • Su rv ei lla nc e de ve lo pm en t M in is tr y of E nv iro nm en t an d Fo re st ry (M O EF ) x x In di ca to r P .4 .2 . A ni m al H ea lth a nd V et er in ar ia n W or kf or ce → 2 01 7 Ca pa ci ty le ve l 3 • D ev el op m en t o f F ET PV Tr ai ni ng F ET PV M O A x x x x x • Es ta bl is hm en t o f M O A re gu la tio n fo r t he im pl em en ta tio n of ve te rin ar y au th or iti es in th e su b na tio na l M O A x x x x x • D ev el op G O I c ap ac ity to im pl em en t t ar ge te d zo on os es a nd E ID pr ev en tio n an d co nt ro l p ro gr am m e M O A x In di ca to r P .4 .3 M ec ha ni sm s fo r r es po nd in g to in fe ct io us z oo no se s an d po te nt ia l z oo no se s ar e es ta bl is he d an d fu nc tio na l → 2 01 7 Ca pa ci ty le ve l 2 • Su rv ei lla nc e an d re sp on se o f z oo no se s ou tb re ak s M O H ZO O N O SE S x x x x x • Zd ap n at io na l c oo rd in at io n M O H ZO O N O SE S x • Pr oc ur em en t f or z oo no si s d is ea se : r ab ie s n le pt o va cc in e M O H ZO O N O SE S x x x x x 53 53 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .4 .1 S ur ve ill an ce s ys te m s in p la ce fo r p rio rit y zo on ot ic d is ea se s/ pa th og en s → 2 01 7 Ca pa ci ty le ve l 3 • Id en tif ic at io n of p rio rit y zo on ot ic d is ea se s in cl ud e AI , R ab ie s, A nt hr ax M O A x x • Co nd uc t d is ea se id en tif ic at io n an d ta rg et ed s ur ve ill an ce a ct iv iti es in hi gh r is k en vi ro nm en ts a nd o n an im al s at h ig h ris k of c on tr ac tin g zo on os es a nd E ID s, in cl ud in g fa rm ed w ild lif e an d m ig ra to ry b ird s. M O A x • St re ng th en d is ea se s ur ve ill an ce a nd d at a an al ys is c ap ac ity to s up po rt di se as e co nt ro l p ol ic y. M O A x • M O H re gu la tio n fo r r ab ie s co nt ro l M O H ZO O N O SE S x x x • Su rv ei lla nc e de ve lo pm en t M O H ZO O N O SE S x x • D ev el op m en t/ tr y ou t o f r is k m ap pi ng to ol s (Z oo no tic a nd E ID ) M O H /W H O ZO O N O SE S x x x x x • Su rv ei lla nc e de ve lo pm en t M in is tr y of E nv iro nm en t an d Fo re st ry (M O EF ) x x In di ca to r P .4 .2 . A ni m al H ea lth a nd V et er in ar ia n W or kf or ce → 2 01 7 Ca pa ci ty le ve l 3 • D ev el op m en t o f F ET PV Tr ai ni ng F ET PV M O A x x x x x • Es ta bl is hm en t o f M O A re gu la tio n fo r t he im pl em en ta tio n of ve te rin ar y au th or iti es in th e su b na tio na l M O A x x x x x • D ev el op G O I c ap ac ity to im pl em en t t ar ge te d zo on os es a nd E ID pr ev en tio n an d co nt ro l p ro gr am m e M O A x In di ca to r P .4 .3 M ec ha ni sm s fo r r es po nd in g to in fe ct io us z oo no se s an d po te nt ia l z oo no se s ar e es ta bl is he d an d fu nc tio na l → 2 01 7 Ca pa ci ty le ve l 2 • Su rv ei lla nc e an d re sp on se o f z oo no se s ou tb re ak s M O H ZO O N O SE S x x x x x • Zd ap n at io na l c oo rd in at io n M O H ZO O N O SE S x • Pr oc ur em en t f or z oo no si s d is ea se : r ab ie s n le pt o va cc in e M O H ZO O N O SE S x x x x x 54 54 • IE C m at er ia l f or z oo no se s di se as es M O H ZO O N O SE S x x x x x • Tr ai ni ng fo r s ur ve ill an ce /e pi de m io lo gy o ff ic er in p rim ar y he al th ce nt er , a ni m al h ea lth c en te r, an d di st ric t h ea lth c en te r t ha t f oc us ed on in ve st ig at io n in fe ct io us d is ea se w ith O ne H ea lth a pp ro ac h. PM K x x • Su pp or t z oo no se s an d EI D c om m un ic at io n ac tiv iti es ; d is se m in at e th e co m m un ic at io n st ra te gy o n O ne H ea lth ta rg et ed z oo no se s an d EI D pr ev en tio n an d co nt ro l. M O A x x • Su pp or t e st ab lis hm en t o f a n at io na l w eb b as ed p la tf or m fo r zo on os es a nd E ID in fo rm at io n ac ce ss a nd s ha rin g. M O A x x • Id en tif y po ul tr y he al th b es t p ra ct ic es M O A x x • Bu ild c ap ac ity o f t ec hn ic al s er vi ce p ro vi de rs . M O A x x • Pr ov id e te ch ni ca l a ss is ta nc e fo r p ou ltr y fa rm er s. M O A x • Pr om ot e ce rt ifi ca tio n sy st em fo r p ou ltr y fa rm s w hi ch a re a bl e to fu lfi l a ni m al h ea lth p ra ct ic es re qu ire d by g ov er nm en t. M O A x • Ra is e aw ar en es s of p ou ltr y he al th b es t p ra ct ic es to fa rm er s. M O A x • Co nd uc t s tu dy to s up po rt e vi de nc e ba se d po lic y m ak in g to im pr ov e th e qu al ity o f p ou ltr y m ar ke tin g pr oc es se s. M O A x • Bu ild s ta ke ho ld er (G ov er nm en t, Pr iv at e) c ap ac ity to im pr ov e bi os ec ur ity a lo ng th e po ul tr y m ar ke t c ha in . M O A x • Ad vo ca te fo r s ta ke ho ld er c ol la bo ra tio n on in te rv en tio ns to im pr ov e th e qu al ity o f p ou ltr y m ar ke tin g pr oc es se s. M O A x • Ra is e aw ar en es s of s ta ke ho ld er s an d co ns um er s to im pr ov e th e qu al ity o f p ou ltr y an d po ul tr y pr od uc t m ar ke tin g pr oc es se s. M O A x • Su pp or t d is ea se e m er ge nc y pr ep ar ed ne ss p la nn in g. M O A x 55 TA F O O D S AF ET Y Ta rg et : St at es P ar tie s sh ou ld h av e su rv ei lla nc e an d re sp on se c ap ac ity f or f oo d an d w at er b or ne d is ea se r is k or e ve nt s. It r eq ui re s ef fe ct iv e co m m un ic at io n an d co lla bo ra tio n am on g th e se ct or s re sp on si bl e fo r f oo d sa fe ty a nd s af e w at er a nd s an ita tio n JE E Re co m m en da tio ns : • Pr ov id e a ‘tr ai n th e tr ai ne rs ’ p ro gr am m e fo r i ns pe ct or s on o ff ic ia l c on tr ol s to e ns ur e fo od o pe ra to rs ’ c om pl ia nc e w ith le gi sl at io n • En su re th e im pl em en ta tio n of F oo d Sa fe ty M an ag em en t S ys te m s in p ro ce ss in g pl an ts o f f oo d of a ni m al o rig in • Fo llo w in g fo od s af et y ris k an al ys is , s tr en gt he n re se ar ch in fo od bo rn e di se as e ep id em io lo gy a nd o ut br ea k in ve st ig at io ns AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .5 .1 M ec ha ni sm s ar e es ta bl is he d an d fu nc tio ni ng fo r d et ec tin g an d re sp on di ng to fo od bo rn e di se as e an d fo od c on ta m in at io n → 20 17 C ap ac ity le ve l 3 • TO T on F oo d Sa fe ty M O H a nd N at io na l F oo d & D ru g Co nt ro l ( N FD C) x x x x x • St re ng th en o f F oo d sa fe ty ri sk a na ly si s, re se ar ch in fo od bo rn e di se as e ep id em io lo gy an d ou tb re ak in ve st ig at io ns M O H KE SL IN G x x • IE C m at er ia l f or fo od s af et y M O H x x x x x • Fo od S af et y Im pl em en ta tio n Sy st em : a. An im al P ro du ct S af et y M on ito rin g at U PH (T ar ge t 1 9, 00 0 sa m pl es M O A x x x x x b. N KV c er tif ic at io n (v et er in ar y co nt ro l n um be r) a ni m al fa rm / U PH (T ar ge t 1 23 U PH ) x x x x x c. U PH S up er vi si on (T ar ge t 5 0 U PH ) x x x x x d. N KV A ud ito r T ra in in g an d Ve te rin ar y Pu bl ic H ea lth S up er vi so r x x x x x 55 55 TA F O O D S AF ET Y Ta rg et : St at es P ar tie s sh ou ld h av e su rv ei lla nc e an d re sp on se c ap ac ity f or f oo d an d w at er b or ne d is ea se r is k or e ve nt s. It r eq ui re s ef fe ct iv e co m m un ic at io n an d co lla bo ra tio n am on g th e se ct or s re sp on si bl e fo r f oo d sa fe ty a nd s af e w at er a nd s an ita tio n JE E Re co m m en da tio ns : • Pr ov id e a ‘tr ai n th e tr ai ne rs ’ p ro gr am m e fo r i ns pe ct or s on o ff ic ia l c on tr ol s to e ns ur e fo od o pe ra to rs ’ c om pl ia nc e w ith le gi sl at io n • En su re th e im pl em en ta tio n of F oo d Sa fe ty M an ag em en t S ys te m s in p ro ce ss in g pl an ts o f f oo d of a ni m al o rig in • Fo llo w in g fo od s af et y ris k an al ys is , s tr en gt he n re se ar ch in fo od bo rn e di se as e ep id em io lo gy a nd o ut br ea k in ve st ig at io ns AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .5 .1 M ec ha ni sm s ar e es ta bl is he d an d fu nc tio ni ng fo r d et ec tin g an d re sp on di ng to fo od bo rn e di se as e an d fo od c on ta m in at io n → 20 17 C ap ac ity le ve l 3 • TO T on F oo d Sa fe ty M O H a nd N at io na l F oo d & D ru g Co nt ro l ( N FD C) x x x x x • St re ng th en o f F oo d sa fe ty ri sk a na ly si s, re se ar ch in fo od bo rn e di se as e ep id em io lo gy an d ou tb re ak in ve st ig at io ns M O H KE SL IN G x x • IE C m at er ia l f or fo od s af et y M O H x x x x x • Fo od S af et y Im pl em en ta tio n Sy st em : a. An im al P ro du ct S af et y M on ito rin g at U PH (T ar ge t 1 9, 00 0 sa m pl es M O A x x x x x b. N KV c er tif ic at io n (v et er in ar y co nt ro l n um be r) a ni m al fa rm / U PH (T ar ge t 1 23 U PH ) x x x x x c. U PH S up er vi si on (T ar ge t 5 0 U PH ) x x x x x d. N KV A ud ito r T ra in in g an d Ve te rin ar y Pu bl ic H ea lth S up er vi so r x x x x x 56 56 TA B IO SA FE TY A N D B IO SE CU RI TY Ta rg et : A w ho le o f go ve rn m en t na tio na l bi os af et y an d bi os ec ur ity s ys te m i s in p la ce , en su rin g th at e sp ec ia lly d an ge ro us p at ho ge ns a re id en tif ie d, h el d, s ec ur ed a nd m on ito re d in a m in im al n um be r of fa ci lit ie s ac co rd in g to b es t pr ac tic es ; b io lo gi ca l r is k m an ag em en t tr ai ni ng a nd ed uc at io na l o ut re ac h ar e co nd uc te d to p ro m ot e a sh ar ed c ul tu re o f r es po ns ib ili ty , r ed uc e du al u se r is ks , m iti ga te b io lo gi ca l p ro lif er at io n an d de lib er at e us e th re at s, a nd e ns ur e sa fe t ra ns fe r of b io lo gi ca l ag en ts ; an d co un tr y sp ec ifi c bi os af et y an d bi os ec ur ity l eg is la tio n, l ab or at or y lic en si ng , a nd p at ho ge n co nt ro l m ea su re s ar e in p la ce a s ap pr op ria te . JE E Re co m m en da tio ns : • Co m pl et e on go in g w or k to f in al iz e a br oa de r N at io na l S tr at eg ic P la n fo r bi os af et y an d bi os ec ur ity in la bo ra to rie s in I nd on es ia , b rin gi ng to ge th er la bo ra to ry f un ct io ns in d iff er en t m in is tr ie s to a dd re ss IH R (2 00 5) t ec hn ic al a re as s uc h as z oo no tic d is ea se , l ab or at or y sy st em s, w or kf or ce d ev el op m en t, fo od s af et y, re al ti m e su rv ei lla nc e an d AM R in a s in gl e ov er ar ch in g pl an • D ev el op a c on tin uo us ly u pd at ed a nd m on ito re d na tio nw id e in ve nt or y of h ig h co ns eq ue nc e ag en ts in s to ra ge • Ed uc at e an d de pl oy a n at io nw id e fu nc tio n fo r m ai nt en an ce a nd c on tr ol o f l ab or at or y sa fe ty fa ci lit ie s an d eq ui pm en t • D ev el op a m as te r t ra in in g an d ce rt ifi ca tio n sc he m e fo r bi os af et y an d bi or is k of fic er s in b ot h th e hu m an a nd a ni m al s ec to rs , a cc re di te d an d ce rt ifi ed b y re le va nt in te rn at io na l b od ie s su ch a s W H O , F AO , O IE , I FB A, N SF , e tc . 57 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .6 .1 . W ho le o f go ve rn m en t b io sa fe ty a nd b io se cu rit y sy st em is in p la ce fo r h um an , a ni m al , a nd a gr ic ul tu re fa ci lit ie s → 2 01 7 Ca pa ci ty le ve l 3 • D ra ft fi na liz at io n N SP fo r b io sa fe ty a nd b io se cu rit y M O H x x • D ev el op P P Bi os af et y an d bi os ec ur ity N at io na l G ui de lin es M O H x • Re fr es hm en t o f A ss es so r S M BL M O H x • D ev el op S M BL C er tif ic at io n bo dy M O H x • La bo ra to ry b ui ld in g st an da rd a cc or di ng to B io sa fe ty a nd b io se cu rit y M O H x x • Co m pr eh en si ve B io m ed ic al W as te M an ag em en t s ys te m M O H x x • In do ne si a Bi ol og ic al w ea po n ac t M O H x x • D ev el op m on ito rin g na tio na l I nv en to ry o f h ig h co ns eq ue nc e ag en ts in s to ra ge x • St ak eh ol de r N et w or ki ng C ro ss s ec tio na l M ee tin g x x • In fr as tr uc tu re a nd e qu ip m en t M O H & M O A x x x x x P. 6. 2. B io sa fe ty a nd b io se cu rit y tr ai ni ng a nd p ra ct ic es → 2 01 7 Ca pa ci ty le ve l 3 • Ed uc at e an d de pl oy a n at io n w id e fu nc tio n fo r m ai nt en an ce a nd c on tr ol o f la bo ra to ry s af et y fa ci lit ie s an d eq ui pm en t: a. tr ai ni ng x x x b. As si st an ce x x c. Ce rt ifi ca tio n x x • D ev el op a m as te r t ra in in g an d ce rt ifi ca tio n sc he m e fo r b io sa fe ty a nd b io ris k of fic er s in b ot h th e hu m an a nd a ni m al s ec to rs , a cc re di te d an d ce rt ifi ed b y re le va nt in te rn at io na l b od ie s su ch a s W H O , F AO , O IE , I FB A, N SF , e tc : a. Tr ai ni ng x x x x x • O H LN 6 . I n Se rv ic e La bo ra to ry T ra in in g PM K x x 57 57 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .6 .1 . W ho le o f go ve rn m en t b io sa fe ty a nd b io se cu rit y sy st em is in p la ce fo r h um an , a ni m al , a nd a gr ic ul tu re fa ci lit ie s → 2 01 7 Ca pa ci ty le ve l 3 • D ra ft fi na liz at io n N SP fo r b io sa fe ty a nd b io se cu rit y M O H x x • D ev el op P P Bi os af et y an d bi os ec ur ity N at io na l G ui de lin es M O H x • Re fr es hm en t o f A ss es so r S M BL M O H x • D ev el op S M BL C er tif ic at io n bo dy M O H x • La bo ra to ry b ui ld in g st an da rd a cc or di ng to B io sa fe ty a nd b io se cu rit y M O H x x • Co m pr eh en si ve B io m ed ic al W as te M an ag em en t s ys te m M O H x x • In do ne si a Bi ol og ic al w ea po n ac t M O H x x • D ev el op m on ito rin g na tio na l I nv en to ry o f h ig h co ns eq ue nc e ag en ts in s to ra ge x • St ak eh ol de r N et w or ki ng C ro ss s ec tio na l M ee tin g x x • In fr as tr uc tu re a nd e qu ip m en t M O H & M O A x x x x x P. 6. 2. B io sa fe ty a nd b io se cu rit y tr ai ni ng a nd p ra ct ic es → 2 01 7 Ca pa ci ty le ve l 3 • Ed uc at e an d de pl oy a n at io n w id e fu nc tio n fo r m ai nt en an ce a nd c on tr ol o f la bo ra to ry s af et y fa ci lit ie s an d eq ui pm en t: a. tr ai ni ng x x x b. As si st an ce x x c. Ce rt ifi ca tio n x x • D ev el op a m as te r t ra in in g an d ce rt ifi ca tio n sc he m e fo r b io sa fe ty a nd b io ris k of fic er s in b ot h th e hu m an a nd a ni m al s ec to rs , a cc re di te d an d ce rt ifi ed b y re le va nt in te rn at io na l b od ie s su ch a s W H O , F AO , O IE , I FB A, N SF , e tc : a. Tr ai ni ng x x x x x • O H LN 6 . I n Se rv ic e La bo ra to ry T ra in in g PM K x x 58 58 TA IM M U N IZ AT IO N Ta rg et : A fu nc tio ni ng n at io na l v ac ci ne d el iv er y sy st em — w ith n at io nw id e re ac h, e ff ec tiv e di st rib ut io ns , ac ce ss f or m ar gi na liz ed p op ul at io ns , ad eq ua te c ol d ch ai n, a n on go in g qu al ity c on tr ol — th at is a bl e to re sp on d to n ew d is ea se th re at s JE E Re co m m en da tio ns : • D ev el op a n at io na l c ov er ag e im pr ov em en t pl an fo cu se d on e qu ity , w hi ch a dd re ss es d ro po ut s an d in te ns ifi es c om m un ity a w ar en es s of t he be ne fit s of v ac ci na tio n • Co nd uc t a n EP I c ov er ag e su rv ey to v al id at e th e re po rt ed a dm in is tr at iv e da ta • St re ng th en E PI d at a qu al ity . S pe ci fic al ly , i nt eg ra te p riv at e se ct or E PI c ov er ag e re po rt in g, a nd s tr en gt he n w eb b as ed re po rt in g an d re co rd in g m ec ha ni sm s • O pt im iz e th e us e of th e St oc k M an ag em en t S ys te m (S M S) to ol to e ns ur e th e av ai la bi lit y of v ac ci ne s in b ot h pu bl ic a nd p riv at e se ct or s • Co nd uc t t he v ac ci ne in ve st m en t c as e st ud y fo r H ea lth C ar e Se cu rit y (B PJ S) . 59 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .7 .1 .M ea sl es V ac ci ne a s pa rt o f n at io na l i m m un iz at io n pr og ra m → 2 01 7 Ca pa ci ty le ve l 4 • M R ca m pa ig n fa se 2 in 2 8 pr ov in ce s: a. Va cc in e an d m ed ic al d ev ic es p ro cu re m en t M O H Im m un iz at io n x x x x x b. Ad vo ca cy a nd S oc ia liz at io n m ee tin g n at io na l l ev el x x x x x a. Tr ai ni ng fo r h ea lth w or ke rs na tio na l l ev el x x x x x b. IE C (P SA , p rin tin g an d di st rib ut io n m at er ia l) x x c. M on ito rin g an d ev al ua tio n x x x x x d. M R co ve ra ge s ur ve y in te gr at ed w ith ro ut in e im m un iz at io n Co nt ra ct w ith in de pe nd en t o rg an iz at io n x • D ev el op c M YP 2 02 0 2 02 4 M O H Im m un iz at io n x • D ef au lte r t ra ck in g D ro p O ut D PT 1 M CV 1 > 10 % M O H Im m un iz at io n x x In di ca to r P .7 .2 . N at io na l A cc es s Va cc in e D el iv er y → 2 01 7 Ca pa ci ty le ve l 4 • Re pl ac e an d m ai nt ai ni ng c ol d ch ai n eq ui pm en t M O H Im m un iz at io n x • Im pl em en ta tio n of S M S st oc k va cc in e an d lo gi st ic s M O H Im m un iz at io n x x x 59 59 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P .7 .1 .M ea sl es V ac ci ne a s pa rt o f n at io na l i m m un iz at io n pr og ra m → 2 01 7 Ca pa ci ty le ve l 4 • M R ca m pa ig n fa se 2 in 2 8 pr ov in ce s: a. Va cc in e an d m ed ic al d ev ic es p ro cu re m en t M O H Im m un iz at io n x x x x x b. Ad vo ca cy a nd S oc ia liz at io n m ee tin g n at io na l l ev el x x x x x a. Tr ai ni ng fo r h ea lth w or ke rs na tio na l l ev el x x x x x b. IE C (P SA , p rin tin g an d di st rib ut io n m at er ia l) x x c. M on ito rin g an d ev al ua tio n x x x x x d. M R co ve ra ge s ur ve y in te gr at ed w ith ro ut in e im m un iz at io n Co nt ra ct w ith in de pe nd en t o rg an iz at io n x • D ev el op c M YP 2 02 0 2 02 4 M O H Im m un iz at io n x • D ef au lte r t ra ck in g D ro p O ut D PT 1 M CV 1 > 10 % M O H Im m un iz at io n x x In di ca to r P .7 .2 . N at io na l A cc es s Va cc in e D el iv er y → 2 01 7 Ca pa ci ty le ve l 4 • Re pl ac e an d m ai nt ai ni ng c ol d ch ai n eq ui pm en t M O H Im m un iz at io n x • Im pl em en ta tio n of S M S st oc k va cc in e an d lo gi st ic s M O H Im m un iz at io n x x x 60 60 TA N AT IO N AL L AB O RA TO RY S YS TE M Ta rg et : R ea l-t im e bi os ur ve ill an ce w ith a n at io na l l ab or at or y sy st em a nd e ff ec tiv e m od er n po in t of c ar e an d la bo ra to ry b as ed d ia gn os tic s JE E Re co m m en da tio ns : • Al l p us ke sm as s ho ul d be a cc re di te d ac co rd in g to p la n, a nd h av e po in t o f c ar e TB d ia gn os tic s in p la ce b y 20 20 • In cr ea se th e nu m be r o f a cc re di te d he al th la bo ra to rie s ev er y ye ar to re ac h 10 0% c ov er ag e • In cr ea se t he n um be r of n at io na l re fe re nc e la bo ra to rie s fo r M ed ic al D ev ic e Ev al ua tio n IE C 60 60 1, s ta bi lit y te st in g an d pe rf or m an ce ev al ua tio n • St re ng th en th e av ai la bi lit y of p er ip he ra l a ni m al re fe rr al la bs a nd th ei r a cc re di ta tio n to IS O 9 00 1 • In cr ea se th e nu m be r of a ge nt s th at c an b e te st ed a t p oi nt o f c ar e, a t p rim ar y he al th c ar e ce nt re s fo r hu m an s an d at a ni m al h ea lth c en tr es fo r a ni m al s • W or k on d ec re as in g th e tim e of tu rn ov er fr om re fe rr al to re su lt, a s th is m ay a ff ec t t re at m en t. 61 AC TI VI TI ES A N D TI M EL IN E P RI O RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r D .1 .1 L ab or at or y te st in g fo r d et ec tio n of p rio rit y di se as es → 2 01 7 Ca pa ci ty le ve l 4 • Re vi se d M O H re gu la tio n no 4 11 /2 01 0 on C lin ic al L ab or at or ie s M O H Ya nk es Ru ju ka n x x • O nl in e La bo ra to ry D at a Co lle ct io n M O H x x x x • Re vi ew o f l ab or at or y re fe re nc e sy st em s M O H x x x x • M on ev E nv iro nm en ta l s ur ve ill an ce w ith 1 0 BT KL M O H Su rv ei lla nc e x x x x x • D ev el op m en t o f V et er in ar y Ce nt er (B al ai ) i n Pa pu a M O A x In di ca to r D .1 .2 S pe ci m en re fe rr al a nd tr an sp or t s ys te m → 2 01 7 Ca pa ci ty le ve l 4 • La b pe rs on ne l o rie nt at io n in c ol le ct in g, c ul tu re , p ac ka gi ng , s hi pp in g an d in sp ec tin g di ph th er ia s pe ci m en s cu ltu ra lly a nd e le ct ro ni ca lly a t 7 B / B TK L M O H Su rv ei lla nc e x x x In di ca to r D .1 .3 E ff ec tiv e m od er n po in t o f c ar e an d la bo ra to ry b as ed d ia gn os tic s → 2 01 7 Ca pa ci ty le ve l 3 • H R tr ai ni ng fo r c lin ic al la b to ol c al ib ra tio n (B PF K: Ja ka rt a, S ur ab ay a, M ed an , M ak as sa r) M O H Ya nk es x • G ui de lin es fo r w or ki ng m et ho ds C lin ic al la b to ol c al ib ra tio n M O H Ya nk es x • Im pr ov e H R at L ab or at or y (B BT KL ) M O H Su rv ei lla nc e x x x x x • Im pr ov e ex am in at io n ca pa ci ty a t t he la b M O A x x x x x In di ca to r D .1 .4 L ab or at or y Q ua lit y Sy st em → 2 01 7 Ca pa ci ty le ve l 3 • Ac cr ed ita tio n of P us ke sm as in a cc or da nc e w ith M in is tr y of H ea lth 's St ra te gi c Pl an a nd R PJ M M M O H M U TU ? x x • Su rv ey or tr ai ni ng x x x x x • Ex te rn al Q ua lit y As su ra nc e fo r L ab or at or iu m M O H Su rv ei lla nc e x x x x x 61 61 AC TI VI TI ES A N D TI M EL IN E P RI O RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r D .1 .1 L ab or at or y te st in g fo r d et ec tio n of p rio rit y di se as es → 2 01 7 Ca pa ci ty le ve l 4 • Re vi se d M O H re gu la tio n no 4 11 /2 01 0 on C lin ic al L ab or at or ie s M O H Ya nk es Ru ju ka n x x • O nl in e La bo ra to ry D at a Co lle ct io n M O H x x x x • Re vi ew o f l ab or at or y re fe re nc e sy st em s M O H x x x x • M on ev E nv iro nm en ta l s ur ve ill an ce w ith 1 0 BT KL M O H Su rv ei lla nc e x x x x x • D ev el op m en t o f V et er in ar y Ce nt er (B al ai ) i n Pa pu a M O A x In di ca to r D .1 .2 S pe ci m en re fe rr al a nd tr an sp or t s ys te m → 2 01 7 Ca pa ci ty le ve l 4 • La b pe rs on ne l o rie nt at io n in c ol le ct in g, c ul tu re , p ac ka gi ng , s hi pp in g an d in sp ec tin g di ph th er ia s pe ci m en s cu ltu ra lly a nd e le ct ro ni ca lly a t 7 B / B TK L M O H Su rv ei lla nc e x x x In di ca to r D .1 .3 E ff ec tiv e m od er n po in t o f c ar e an d la bo ra to ry b as ed d ia gn os tic s → 2 01 7 Ca pa ci ty le ve l 3 • H R tr ai ni ng fo r c lin ic al la b to ol c al ib ra tio n (B PF K: Ja ka rt a, S ur ab ay a, M ed an , M ak as sa r) M O H Ya nk es x • G ui de lin es fo r w or ki ng m et ho ds C lin ic al la b to ol c al ib ra tio n M O H Ya nk es x • Im pr ov e H R at L ab or at or y (B BT KL ) M O H Su rv ei lla nc e x x x x x • Im pr ov e ex am in at io n ca pa ci ty a t t he la b M O A x x x x x In di ca to r D .1 .4 L ab or at or y Q ua lit y Sy st em → 2 01 7 Ca pa ci ty le ve l 3 • Ac cr ed ita tio n of P us ke sm as in a cc or da nc e w ith M in is tr y of H ea lth 's St ra te gi c Pl an a nd R PJ M M M O H M U TU ? x x • Su rv ey or tr ai ni ng x x x x x • Ex te rn al Q ua lit y As su ra nc e fo r L ab or at or iu m M O H Su rv ei lla nc e x x x x x 62 62 TA R EA L TI M E SU RV EI LL AN CE Ta rg et : St re ng th en ed f ou nd at io na l i nd ic at or an d ev en t ba se d su rv ei lla nc e sy st em s th at a re a bl e to d et ec t ev en ts o f si gn ifi ca nc e fo r pu bl ic he al th , an im al h ea lth a nd h ea lth s ec ur ity ; im pr ov ed c om m un ic at io n an d co lla bo ra tio n ac ro ss s ec to rs a nd b et w ee n su b na tio na l (lo ca l an d in te rm ed ia te ), na tio na l a nd in te rn at io na l l ev el s of a ut ho rit y re ga rd in g su rv ei lla nc e of e ve nt s of p ub lic h ea lth s ig ni fic an ce ; im pr ov ed c ou nt ry an d in te rm ed ia te le ve l/ re gi on al c ap ac ity t o an al ys e an d lin k da ta f ro m a nd b et w ee n st re ng th en ed , r ea l-t im e su rv ei lla nc e sy st em s, in cl ud in g in te ro pe ra bl e, in te rc on ne ct ed e le ct ro ni c re po rt in g sy st em s. T hi s ca n in cl ud e ep id em io lo gi c, c lin ic al , l ab or at or y, e nv iro nm en ta l t es tin g, p ro du ct sa fe ty a nd q ua lit y, a nd b io in fo rm at ic s da ta ; a nd a dv an ce m en t in f ul fil lin g th e co re c ap ac ity r eq ui re m en ts f or s ur ve ill an ce in a cc or da nc e w ith th e IH R an d th e O IE s ta nd ar ds JE E Re co m m en da tio ns : • Ad vo ca te a nd e nc ou ra ge lo ca l g ov er nm en t un its t o ho no ur e xi st in g co m m itm en ts t o su st ai na bl e im pl em en ta tio n an d ad eq ua te fu nd in g of su rv ei lla nc e pr og ra m m es • Tr ai n he al th s ta ff a t pr ov in ci al a nd d is tr ic t le ve ls ( in cl ud in g tr ai ni ng o f tr ai ne rs ), an d pr ov id e re fr es he r tr ai ni ng c ou rs es , to s tr en gt he n su rv ei lla nc e in a re as w ith e xi st in g su rv ei lla nc e sy st em s, a nd to e st ab lis h th em in th os e w ith ou t s ys te m s ye t( es pe ci al ly fo r t he w ild lif e se ct or ) • Es ta bl is h a m ec ha ni sm fo r sh ar in g su rv ei lla nc e da ta b et w ee n th e hu m an a nd a ni m al s ec to rs a t n at io na l l ev el . T hi s m ec ha ni sm c an t he n be ad op te d at p ro vi nc ia l a nd d is tr ic t l ev el s. 63 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r D .2 .1 . I nd ic at or a nd E ve nt B as ed S ur ve ill an ce S ys te m s → 2 01 7 Ca pa ci ty le ve l 3 • In cr ea se a nd im pr ov e ca pa ci ty fo r E W AR S an d Ev en t b as ed s ur ve ill an ce a t pr ov in ce le ve l ( 34 p ro vi nc es ) M O H Su rv ei lla nc e x x x x x • Im pr ov e ca pa ci ty fo r E W AR S at la bo ra to ry a nd h os pi ta l x x • TO T Ra pi d Re sp on se T ea m a t N at io na l L ev el M O H Su rv ei lla nc e x x • Re vi si ng P M K no 9 49 fo r E W AR S im pl em en ta tio n M O H Su rv ei lla nc e x • Ad vo ca cy to p ol ic y m ak er a t p ro vi nc e M O H Su rv ei lla nc e x x x x • Tr ai ni ng to im pr ov e th e ab ili ty to in te rv en e in E m er gi ng In fe ct io us D is ea se s M O H IN FE M x x • EI D E xp er t T ea m M ee tin g M O H IN FE M x x • N et w or k M ee tin g M O H IN FE M x x • D ev el op m en t o f R RT T ra in in g M od ul e fo r E ID M O H IN FE M x • Ad vo ca cy a ct iv ity o n EI D p ol ic ie s at S ub N at io na l l ev el M O H IN FE M x • Ad vo ca cy a ct iv ity o n EI D p ol ic ie s at S ub N at io na l l ev el M O H IN FE M x • St ak eh ol de r m ee tin g fo r E ID M O H IN FE M x • D ev el op m en t o f w ee kl y re po rt a nd ri sk a na ly si s in st ru m en t o n EI D M O H IN FE M x • In cr ea se d H R Ca pa ci ty in d et ec t a nd re po rt th ro ug h IS IK H N AS in th e pr ov in ce M O A P2 H x x x x x • In cr ea se d H R Ca pa ci ty in d et ec t a nd re po rt di se as es th ro ug h IS IK H N AS in th e di st ric t/ m un ic ip al ity M O A P2 H x x x x x • Ca pa ci ty b ui ld in g of h um an re so ur ce s in m an ag in g pr ov in ci al a nd re gi on al M O A P2 H x x x x x In di ca to r D .2 .2 . I nt er o pe ra bl e, in te rc on ne ct ed , e le ct ro ni c re al t im e re po rt in g sy st em → 2 01 7 Ca pa ci ty le ve l 3 • El ec tr on ic re po rt in g sy st em s fo r n ot ifi ab le d is ea se s fo r h um an h ea lth im pl em en te d (E W AR S) M O H Su rv ei lla nc e x x x x x • El ec tr on ic R ep or tin g sy st em s fo r d at a sh ar in g be tw ee n se ct or s ex is t a nd im pl em en te d (S IZ E) PM K x 63 63 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r D .2 .1 . I nd ic at or a nd E ve nt B as ed S ur ve ill an ce S ys te m s → 2 01 7 Ca pa ci ty le ve l 3 • In cr ea se a nd im pr ov e ca pa ci ty fo r E W AR S an d Ev en t b as ed s ur ve ill an ce a t pr ov in ce le ve l ( 34 p ro vi nc es ) M O H Su rv ei lla nc e x x x x x • Im pr ov e ca pa ci ty fo r E W AR S at la bo ra to ry a nd h os pi ta l x x • TO T Ra pi d Re sp on se T ea m a t N at io na l L ev el M O H Su rv ei lla nc e x x • Re vi si ng P M K no 9 49 fo r E W AR S im pl em en ta tio n M O H Su rv ei lla nc e x • Ad vo ca cy to p ol ic y m ak er a t p ro vi nc e M O H Su rv ei lla nc e x x x x • Tr ai ni ng to im pr ov e th e ab ili ty to in te rv en e in E m er gi ng In fe ct io us D is ea se s M O H IN FE M x x • EI D E xp er t T ea m M ee tin g M O H IN FE M x x • N et w or k M ee tin g M O H IN FE M x x • D ev el op m en t o f R RT T ra in in g M od ul e fo r E ID M O H IN FE M x • Ad vo ca cy a ct iv ity o n EI D p ol ic ie s at S ub N at io na l l ev el M O H IN FE M x • Ad vo ca cy a ct iv ity o n EI D p ol ic ie s at S ub N at io na l l ev el M O H IN FE M x • St ak eh ol de r m ee tin g fo r E ID M O H IN FE M x • D ev el op m en t o f w ee kl y re po rt a nd ri sk a na ly si s in st ru m en t o n EI D M O H IN FE M x • In cr ea se d H R Ca pa ci ty in d et ec t a nd re po rt th ro ug h IS IK H N AS in th e pr ov in ce M O A P2 H x x x x x • In cr ea se d H R Ca pa ci ty in d et ec t a nd re po rt di se as es th ro ug h IS IK H N AS in th e di st ric t/ m un ic ip al ity M O A P2 H x x x x x • Ca pa ci ty b ui ld in g of h um an re so ur ce s in m an ag in g pr ov in ci al a nd re gi on al M O A P2 H x x x x x In di ca to r D .2 .2 . I nt er o pe ra bl e, in te rc on ne ct ed , e le ct ro ni c re al t im e re po rt in g sy st em → 2 01 7 Ca pa ci ty le ve l 3 • El ec tr on ic re po rt in g sy st em s fo r n ot ifi ab le d is ea se s fo r h um an h ea lth im pl em en te d (E W AR S) M O H Su rv ei lla nc e x x x x x • El ec tr on ic R ep or tin g sy st em s fo r d at a sh ar in g be tw ee n se ct or s ex is t a nd im pl em en te d (S IZ E) PM K x 64 64 • El ec tr on ic re po rt in g sy st em s fo r n ot ifi ab le d is ea se s fo r a ni m al h ea lth im pl em en te d (IS IK H N AS ) M O A x x x x x In di ca to r D .2 .3 . A na ly si s of s ur ve ill an ce d at a → 2 01 7 Ca pa ci ty le ve l 2 • La bo ra to ry d at a fe ed s in to th e su rv ei lla nc e sy st em s (s ys te m ) M O H Su rv ei lla nc e x x x x x • Im pr ov e da ta a na ly si s M O H Su rv ei lla nc e x x x x x • Tr ia l E ID ri sk a ss es sm en t M O H IN FE M • Im pr ov e pu bl ic h ea lth / su rv ei lla nc e la bo ra to ry c ap ac ity M O H Su rv ei lla nc e In di ca to r D .2 .4 . S yn dr om ic s ur ve ill an ce s ys te m s→ 2 01 7 Ca pa ci ty le ve l 4 • Sy nd ro m ic s ur ve ill an ce P us ke sm as / su b na tio na l f or E ID M O H IN FE M x x • Co nt in ui ty a nd S tr en gt he ni ng S ur ve ill an ce s en tin el IL I-S AR I M O H IS PA x x x x x 65 TA R EP O RT IN G Ta rg et : T im el y an d ac cu ra te d is ea se re po rt in g ac co rd in g to W H O re qu ire m en ts a nd c on si st en t c oo rd in at io n w ith F AO a nd O IE . JE E Re co m m en da tio ns : • In cr ea se t he r ea ch o f th e w ild lif e in fo rm at io n sy st em ( SE H AT SA TL I) to a ll pr ov in ce s in I nd on es ia ; st re ng th en i nt er op er ab ili ty b et w ee n in fo rm at io n sy st em s fo r da ta s ha rin g be tw ee n an im al a nd h um an h ea lth a t na tio na l l ev el ; th en a do pt t he se s ys te m s at p ro vi nc ia l an d di st ric t l ev el s • Ac tiv at e an d en co ur ag e lo ca l g ov er nm en t an d co m m un iti es , i n lin e w ith t he “ O ne D at a” p ol ic y, t o en ha nc e th ei r co m m itm en t to p ro vi de an d sh ar e PH EI C in fo rm at io n an d da ta , i nc lu di ng th ro ug h tim el y ac kn ow le dg em en t o f o ut br ea ks a nd e m er ge nc ie s • St re ng th en t he in fo rm at io n in fr as tr uc tu re f or P H EI C m an ag em en t at a ll le ve ls , e sp ec ia lly in t he 1 12 p rio rit y di st ric ts ( Pr es id en tia l D ec re e N o. 1 31 /2 01 5) — in cl ud in g th ro ug h re tr ai ni ng t he IH R N FP a nd O IE fo ca l p oi nt , a nd p ro vi di ng c on tin uo us c ap ac ity b ui ld in g/ tr ai ni ng fo r st af f at p ro vi nc e an d di st ric t l ev el s • St re ng th en ri sk a ss es sm en t c ap ac ity a t n at io na l l ev el to fa ci lit at e re po rt in g to W H O , O IE a nd F AO . 65 65 TA R EP O RT IN G Ta rg et : T im el y an d ac cu ra te d is ea se re po rt in g ac co rd in g to W H O re qu ire m en ts a nd c on si st en t c oo rd in at io n w ith F AO a nd O IE . JE E Re co m m en da tio ns : • In cr ea se t he r ea ch o f th e w ild lif e in fo rm at io n sy st em ( SE H AT SA TL I) to a ll pr ov in ce s in I nd on es ia ; st re ng th en i nt er op er ab ili ty b et w ee n in fo rm at io n sy st em s fo r da ta s ha rin g be tw ee n an im al a nd h um an h ea lth a t na tio na l l ev el ; th en a do pt t he se s ys te m s at p ro vi nc ia l an d di st ric t l ev el s • Ac tiv at e an d en co ur ag e lo ca l g ov er nm en t an d co m m un iti es , i n lin e w ith t he “ O ne D at a” p ol ic y, t o en ha nc e th ei r co m m itm en t to p ro vi de an d sh ar e PH EI C in fo rm at io n an d da ta , i nc lu di ng th ro ug h tim el y ac kn ow le dg em en t o f o ut br ea ks a nd e m er ge nc ie s • St re ng th en t he in fo rm at io n in fr as tr uc tu re f or P H EI C m an ag em en t at a ll le ve ls , e sp ec ia lly in t he 1 12 p rio rit y di st ric ts ( Pr es id en tia l D ec re e N o. 1 31 /2 01 5) — in cl ud in g th ro ug h re tr ai ni ng t he IH R N FP a nd O IE fo ca l p oi nt , a nd p ro vi di ng c on tin uo us c ap ac ity b ui ld in g/ tr ai ni ng fo r st af f at p ro vi nc e an d di st ric t l ev el s • St re ng th en ri sk a ss es sm en t c ap ac ity a t n at io na l l ev el to fa ci lit at e re po rt in g to W H O , O IE a nd F AO . 66 66 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r D .3 .1 S ys te m fo r e ff ic ie nt re po rt in g to W H O , F AO a nd O IE → 2 01 7 Ca pa ci ty le ve l 3 • O IE N FP tr ai ni ng M O A x x x x x • M ai nt en an ce o f f is h di se as e m on ito rin g sy st em (S of tw ar e fo r F is h D is ea se M on ito rin g Sy st em / S SM PI ) o n lin e as a b as is fo r r ep or tin g fis h di se as es to O IE M O M AF x • D ev el op m en t o f a fi sh d is ea se m on ito rin g sy st em (S SM PI ) o n lin e an d an In do ne si an A qu at ic A ni m al D is ea se s Al er t S ys te m / IA AD AS a s a ba si s fo r re po rt in g fis h di se as es to O IE M O M AF x • Ev al ua tio n of fi sh d is ea se re po rt s th ro ug h SS M PI o n lin e (3 4 Pr ov in ce s) M O M AF x x In di ca to r D .3 .2 R ep or tin g ne tw or k an d pr ot oc ol s in c ou nt ry → 2 01 7 Ca pa ci ty le ve l 3 • Pr ep ar at io n of th e M in is te r o f H ea lth R eg ul at io n on O ne D at a Po lic y M O H PU SD AT IN x • Re se ar ch a nd ro ut in e da ta s yn ch ro ni za tio n to a cc om m od at e O ne D at a x • In te gr at io n of H ea lth In fo rm at io n Sy st em x • M in is te r o f H ea lth R eg ul at io n on P us ke sm as In fo rm at io n Sy st em (R ev ie w o f Pu sk es m as In fo rm at io n Sy st em S ta nd ar d) x x • M in is tr y of A gr ic ul tu re r eg ul at io n on A ni m al H ea lth In fo rm at io n Sy st em M O A x • Pu bl ic h ea rin g of th e M in is tr y of A gr ic ul tu re 's SI A ni m al H ea lth x • D ra ft in g of th e M in is tr y of M ar in e Af ff ai rs (M O M AF ) o n Fi sh D is ea se s M O M AF x • Ca pa ci ty b ui ld in g fo r R ef er en ce la bo ra to ry a nd fi sh d is ea se te st in g la bo ra to rie s x 67 TA W O RK FO RC E D EV EL O PM EN T Ta rg et : St at e pa rt ie s sh ou ld h av e sk ill ed a nd c om pe te nt h ea lth p er so nn el f or s us ta in ab le a nd f un ct io na l pu bl ic h ea lth s ur ve ill an ce a nd re sp on se a t al l l ev el s of th e he al th s ys te m a nd th e ef fe ct iv e im pl em en ta tio n of th e IH R (2 00 5) . A w or kf or ce in cl ud es p hy si ci an s, a ni m al h ea lth or ve te rin ar ia ns , bi os ta tis tic ia ns , la bo ra to ry sc ie nt is ts , fa rm in g/ liv es to ck pr of es si on al s, w ith an op tim al ta rg et o f on e tr ai ne d fie ld ep id em io lo gi st (o r e qu iv al en t) p er 2 00 ,0 00 p op ul at io n, w ho c an s ys te m at ic al ly c oo pe ra te to m ee t r el ev an t I H R an d PV S co re c om pe te nc ie s JE E Re co m m en da tio ns : • En su re th at fu nc tio na l p os iti on s ar e fil le d w ith q ua lif ie d pe rs on ne l w ho h av e be en a pp ro pr ia te ly tr ai ne d • En su re t ha t th e ve te rin ar y w or kf or ce a t fie ld le ve l is s uf fic ie nt t o pe rf or m a nt e a nd p os t m or te m i ns pe ct io ns a t sl au gh te rh ou se s, a nd an im al h ea lth s ur ve ill an ce a nd c on tr ol a ct iv iti es , i n lin e w ith in te rn at io na l s ta nd ar ds • Pr ov id e ap pr op ria te in ce nt iv es fo r h um an a nd a ni m al h ea lth w or ke rs to b e as si gn ed to lo ca l l ev el p os ts a nd to re m ot e ar ea s • St re ng th en li nk ag es w ith a ca de m ia a nd in te rn at io na l p ar tn er s, in o rd er t o en su re t ha t th e qu al ity o f ap pl ie d ep id em io lo gy t ra in in g m ee ts gl ob al s ta nd ar ds . 67 67 TA W O RK FO RC E D EV EL O PM EN T Ta rg et : St at e pa rt ie s sh ou ld h av e sk ill ed a nd c om pe te nt h ea lth p er so nn el f or s us ta in ab le a nd f un ct io na l pu bl ic h ea lth s ur ve ill an ce a nd re sp on se a t al l l ev el s of th e he al th s ys te m a nd th e ef fe ct iv e im pl em en ta tio n of th e IH R (2 00 5) . A w or kf or ce in cl ud es p hy si ci an s, a ni m al h ea lth or ve te rin ar ia ns , bi os ta tis tic ia ns , la bo ra to ry sc ie nt is ts , fa rm in g/ liv es to ck pr of es si on al s, w ith an op tim al ta rg et o f on e tr ai ne d fie ld ep id em io lo gi st (o r e qu iv al en t) p er 2 00 ,0 00 p op ul at io n, w ho c an s ys te m at ic al ly c oo pe ra te to m ee t r el ev an t I H R an d PV S co re c om pe te nc ie s JE E Re co m m en da tio ns : • En su re th at fu nc tio na l p os iti on s ar e fil le d w ith q ua lif ie d pe rs on ne l w ho h av e be en a pp ro pr ia te ly tr ai ne d • En su re t ha t th e ve te rin ar y w or kf or ce a t fie ld le ve l is s uf fic ie nt t o pe rf or m a nt e a nd p os t m or te m i ns pe ct io ns a t sl au gh te rh ou se s, a nd an im al h ea lth s ur ve ill an ce a nd c on tr ol a ct iv iti es , i n lin e w ith in te rn at io na l s ta nd ar ds • Pr ov id e ap pr op ria te in ce nt iv es fo r h um an a nd a ni m al h ea lth w or ke rs to b e as si gn ed to lo ca l l ev el p os ts a nd to re m ot e ar ea s • St re ng th en li nk ag es w ith a ca de m ia a nd in te rn at io na l p ar tn er s, in o rd er t o en su re t ha t th e qu al ity o f ap pl ie d ep id em io lo gy t ra in in g m ee ts gl ob al s ta nd ar ds . 68 68 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r D .4 .1 . H um an re so ur ce s ar e av ai la bl e to im pl em en t I H R co re c ap ac ity → 2 01 7 Ca pa ci ty le ve l 3 • M ap pi ng o f n at io na l H R ne ed s (d oc to rs , n ur se s, v et er in ar ia ns , b io st at is tic s, la b sc ie nc es , e pi de m io lo gi st s) M O H PP SD M x x x x x • Fu lfi llm en t o f H ea lth H um an R es ou rc es th ro ug h th e N us an ta ra S eh at p ro gr am M O H x x x x • Fu lfi llm en t o f H ea lth H um an R es ou rc es th ro ug h sp ec ia l d ut y pr og ra m s (t uk su s) M O H x x x x • Co m pe te nc y im pr ov em en t o f h ea lth h um an re so ur ce s M O H x x x x • In cr ea se d co m pe te nc e of A ni m al Q ua ra nt in e hu m an re so ur ce s (v et er in ar y an d ve te rin ar y pa ra m ed ic s) M O A x x x x x • D ev el op m en t o f a ni m al h ea lth w or kf or ce n et w or k an d w or k co or di na tio n M O A x x x x x • Q ua lit y as su ra nc e / st an da rd s / co m pe te nc ie s of h um an h ea lth M O H x x x x • Q ua lit y as su ra nc e / st an da rd s / co m pe te nc ie s of A ni m al h ea lth M O A x x x x • M ap pi ng tr ai ni ng n ee ds re la te d to D et ec t 4 (h um an h ea lth w or kf or ce d ev el op m en t) M O H x x x x • M ap pi ng tr ai ni ng n ee ds re la te d to D et ec t 4 (a ni m al h ea lth w or kf or ce d ev el op m en t) M O A x x x x • Le ad er sh ip tr ai ni ng fo r i nt er d is ci pl in ar y an d m ul ti co un tr ie s st ud en ts . T he p ur po se is to d ev el op th e co lla bo ra tio n an d co or di na tio n to s ol ve h ea lth is su es . PM K x x • Le ad er sh ip tr ai ni ng fo r i nt er d is ci pl in ar y he al th p ro fe ss io na l t o so lv e he al th pr ob le m . T hi s tr ai ni ng in cl ud in g in c la ss tr ai ni ng a nd fi el d vi si t i n Ci ta ru m riv er . PM K x x • G lo ba l H ea lth D ip lo m ac y (G H D ) T ra in in g is a th re e to fi ve d ay in te ns iv e pr og ra m th at c om bi ne 4 0 pe rc en t t he or y an d 60 p er ce nt p ra ct ic e. PM K x x In di ca to r D .4 .2 . A pp lie d ep id em io lo gy tr ai ni ng p ro gr am in p la ce s uc h as F ET P → 2 01 7 Ca pa ci ty le ve l 4 • Ca pa ci ty b ui ld in g fo r t he H ea d of D ep ar tm en t r eg ar di ng a pp lie d ep id em io lo gy in de ci si on m ak in g an d tr ai ni ng c ur ric ul um fo r H ea lth O ffi ce H ea ds (t ec hn ic al st an da rd s) M O H x x x x x • Ap pl ie d ep id em io lo gy tr ai ni ng in fr on tli ne li ke tr ai ni ng a t F KT P M O H x x x x 69 • Ap pl ie d ep id em io lo gi ca l t ec hn ic al g ui da nc e fo r p eo pl e in p ot en tia l o ut br ea ks a re as M O H x x x x • Ad vo ca cy to s ta ke ho ld er s (c en tr al / re gi on al ) r eg ar di ng H R ut ili za tio n (in ce nt iv es , pl ac em en t, qu al ity s ta nd ar ds , e tc .) M O H x x x x • U pd at in g of c ur ric ul um a nd m od ul es o fT oT s ur ve ill an ce to s up po rt h ea lth a dv oc ac y M O H x • To T on s ur ve ill an ce to S up po rt h ea lth a dv oc ac y M O H x • Ca pa ci ty b ui ld in g fo r e pi de m io lo gi st to U S CD C fo r S ur ve ill an ce S ys te m M O H x • O ne H ea lth tr ai ni ng (o ut br ea k in ve st ig at io n) M O H x x x x x • AM TC M O H x x x x x • Su pp or t O ne H ea lth c ol la bo ra tio n an d co or di na tio n be tw ee n go ve rn m en t a nd un iv er si tie s M O A x • Su pp or t c ur ric ul um d ev el op m en t f or p re s er vi ce a nd in s er vi ce p ou ltr y he al th ca pa ci ty b ui ld in g M O A x • Su pp or t t he d ev el op m en t o f F ET PV in In do ne si a M O A x • Ca pa ci ty b ui ld in g fo r f ie ld e pi de m io lo gy fo r v et er in ar y of fic er s (F ET P de gr ee & n on de gr ee ) M O A x x x x x • Ad vo ca cy to s ta ke ho ld er s (c en tr al / re gi on al ) r eg ar di ng H R ut ili za tio n (in ce nt iv es , pl ac em en t, qu al ity s ta nd ar ds , e tc .) M O A In di ca to r D .4 .3 . W or kf or ce s tr at eg y → 2 01 7 Ca pa ci ty le ve l 3 • St re ng th en in g th e H R da ta ba se fo r P PS D M p la nn in g M O H x x x x • D ev el op m en t o f a n at io na l P PS D M s tr at eg ic p la n x x x x 69 69 • Ap pl ie d ep id em io lo gi ca l t ec hn ic al g ui da nc e fo r p eo pl e in p ot en tia l o ut br ea ks a re as M O H x x x x • Ad vo ca cy to s ta ke ho ld er s (c en tr al / re gi on al ) r eg ar di ng H R ut ili za tio n (in ce nt iv es , pl ac em en t, qu al ity s ta nd ar ds , e tc .) M O H x x x x • U pd at in g of c ur ric ul um a nd m od ul es o fT oT s ur ve ill an ce to s up po rt h ea lth a dv oc ac y M O H x • To T on s ur ve ill an ce to S up po rt h ea lth a dv oc ac y M O H x • Ca pa ci ty b ui ld in g fo r e pi de m io lo gi st to U S CD C fo r S ur ve ill an ce S ys te m M O H x • O ne H ea lth tr ai ni ng (o ut br ea k in ve st ig at io n) M O H x x x x x • AM TC M O H x x x x x • Su pp or t O ne H ea lth c ol la bo ra tio n an d co or di na tio n be tw ee n go ve rn m en t a nd un iv er si tie s M O A x • Su pp or t c ur ric ul um d ev el op m en t f or p re s er vi ce a nd in s er vi ce p ou ltr y he al th ca pa ci ty b ui ld in g M O A x • Su pp or t t he d ev el op m en t o f F ET PV in In do ne si a M O A x • Ca pa ci ty b ui ld in g fo r f ie ld e pi de m io lo gy fo r v et er in ar y of fic er s (F ET P de gr ee & n on de gr ee ) M O A x x x x x • Ad vo ca cy to s ta ke ho ld er s (c en tr al / re gi on al ) r eg ar di ng H R ut ili za tio n (in ce nt iv es , pl ac em en t, qu al ity s ta nd ar ds , e tc .) M O A In di ca to r D .4 .3 . W or kf or ce s tr at eg y → 2 01 7 Ca pa ci ty le ve l 3 • St re ng th en in g th e H R da ta ba se fo r P PS D M p la nn in g M O H x x x x • D ev el op m en t o f a n at io na l P PS D M s tr at eg ic p la n x x x x 70 70 TA P RE PA RE D N ES S Ta rg et s: P re pa re dn es s in cl ud es t he d ev el op m en t a nd m ai nt en an ce o f n at io na l, in te rm ed ia te a nd lo ca l o r pr im ar y re sp on se le ve l p ub lic h ea lth em er ge nc y re sp on se p la ns f or r el ev an t bi ol og ic al , ch em ic al , ra di ol og ic al a nd n uc le ar h az ar ds . Th is c ov er s m ap pi ng o f po te nt ia l ha za rd s, id en tif ic at io n an d m ai nt en an ce o f a va ila bl e re so ur ce s, in cl ud in g na tio na l s to ck pi le s an d th e ca pa ci ty to s up po rt o pe ra tio ns a t t he in te rm ed ia te an d lo ca l o r p rim ar y re sp on se le ve ls d ur in g a pu bl ic h ea lth e m er ge nc y JE E Re co m m en da tio ns : • Re vi ew a nd u pd at e na tio na l di sa st er p la ns , pa rt ic ul ar ly w ith r eg ar d to C BR N h az ar ds , su rg e ca pa ci ty , re so ur ce m ob ili za tio n (in cl ud in g tr ea tm en t f ac ili tie s an d la bo ra to rie s) , a nd s to ck pi le s • In cr ea se u nd er st an di ng a nd c ap ac ity t o pr ev en t, ve rif y an d re sp on d to m ul tip le h az ar ds a m on g re le va nt s ta ke ho ld er s (e .g . p oi nt s of e nt ry , la bo ra to rie s, lo ca l g ov er nm en t, et c. ). In cl ud e re gu la r s ta ke ho ld er p la nn in g m ee tin gs a nd s im ul at io n ex er ci se s • In cr ea se lo ca l d is as te r p la nn in g, in cl ud in g by e xp an di ng c on tin ge nc y pl an s fo r m ul tip le h az ar ds fr om 3 00 d is tr ic ts /m un ic ip al iti es to a fu rt he r 17 4 di st ric ts b y 20 20 , a nd b y in cr ea si ng lo ca l g ov er nm en t p la nn in g an d bu dg et a llo ca tio ns fo r d is as te rs • Re vi ew n at io na l d is as te r ris k as se ss m en ts (i nc lu di ng r is k in de xe s) in t he c on te xt o f a ll IH R re la te d ha za rd s, a nd c om pi le in to a n at io na l r is k pr of ile 71 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R .1 .1 M ul ti ha za rd n at io na l p ub lic h ea lth e m er ge nc y pr ep ar ed ne ss a nd re sp on se p la n is d ev el op ed a nd im pl em en te d → 2 01 7 Ca pa ci ty le ve l 3 • Re vi ew th e N at io na l C on tin ge nc y Pl an M O H IS PA x x • ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s ac co rd in g to th e di st ric t/ c ity h az ar d ris k m an ag em en t r es ul t M O H IS PA x x x x • pr ep ar ed ne ss tr ai ni ng o n bi ol og ic al , n uc le ar a nd c he m ic al th re at s th at h av e th e po te nt ia l f or p ub lic h ea lth e m er ge nc y M O H IS PA x x x x • Re vi ew th e N at io na l C on tin ge nc y Pl an fo r z oo no si s an d EI D M O H IS PA x x • ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s on z oo no si s & E ID in d is tr ic t/ c ity M O H PI E x x x x • ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s on z oo no si s an d EI D in p ro vi nc e M O H PI E x x x x • Co nt in ge nc y pl an fo r d is tr ic t w ith d ire ct a cc es s to in te rn at io na l P O E M O H KA RK ES x x • EI D a nd P an de m ic P re pa re dn es s W or ks ho p as p ar t o f H os pi ta l E m er ge nc y Pl an (H os pi ta l D is as te r P re pa re dn es s Pl an ) M O H PI E x • W or ks ho p on p an de m ic a nd E ID p re pa re dn es s pl an s in th e ho sp ita l M O H PI E x • M ap pi ng a nd re vi ew S O P pl an fo r d is tr ib ut io n of d ru gs a nd P PE . M O H IS PA x x x x x • ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s ac co rd in g to th e pr ov in ce h az ar d ris k m an ag em en t r es ul t BN PB (N at io na l D is as te r M an ag em en t Ag en cy ) x x x x x • Th e si m ul at io n of n at io na l c on tin ge nc y pl an s be co m es a n op er at io na l p la n ac co rd in g to th e re su lts o f r is k ha za rd m an ag em en t i n st ag es / tie re d. BN PB x x In di ca to r R .1 .2 P rio rit y pu bl ic h ea lth ri sk s an d re so ur ce s ar e m ap pe d an d ut ili ze d → 2 01 7 Ca pa ci ty le ve l 2 • Tr ai ni ng / W or ks ho p to u se JR A to ol s fo r z oo no tic d is ea se s M O H Zo on os es x x • O ne H ea lth T ra in in g / W or ks ho p fo r h ig h ris k ar ea s fo r e ac h se ct or fo llo w ed b y jo in t tr ai ni ng M O H Zo on os es x x x x x • As se ss m en t o f i nf ra st ru ct ur e, fa ci lit ie s an d H R in N at io na l a nd R eg io na l H os pi ta l M O H IS PA x • EI D ri sk m ap pi ng M O H PI E x x x x x 71 71 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R .1 .1 M ul ti ha za rd n at io na l p ub lic h ea lth e m er ge nc y pr ep ar ed ne ss a nd re sp on se p la n is d ev el op ed a nd im pl em en te d → 2 01 7 Ca pa ci ty le ve l 3 • Re vi ew th e N at io na l C on tin ge nc y Pl an M O H IS PA x x • ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s ac co rd in g to th e di st ric t/ c ity h az ar d ris k m an ag em en t r es ul t M O H IS PA x x x x • pr ep ar ed ne ss tr ai ni ng o n bi ol og ic al , n uc le ar a nd c he m ic al th re at s th at h av e th e po te nt ia l f or p ub lic h ea lth e m er ge nc y M O H IS PA x x x x • Re vi ew th e N at io na l C on tin ge nc y Pl an fo r z oo no si s an d EI D M O H IS PA x x • ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s on z oo no si s & E ID in d is tr ic t/ c ity M O H PI E x x x x • ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s on z oo no si s an d EI D in p ro vi nc e M O H PI E x x x x • Co nt in ge nc y pl an fo r d is tr ic t w ith d ire ct a cc es s to in te rn at io na l P O E M O H KA RK ES x x • EI D a nd P an de m ic P re pa re dn es s W or ks ho p as p ar t o f H os pi ta l E m er ge nc y Pl an (H os pi ta l D is as te r P re pa re dn es s Pl an ) M O H PI E x • W or ks ho p on p an de m ic a nd E ID p re pa re dn es s pl an s in th e ho sp ita l M O H PI E x • M ap pi ng a nd re vi ew S O P pl an fo r d is tr ib ut io n of d ru gs a nd P PE . M O H IS PA x x x x x • ta bl e to p ex er ci se o f n at io na l c on tin ge nc y pl an s ac co rd in g to th e pr ov in ce h az ar d ris k m an ag em en t r es ul t BN PB (N at io na l D is as te r M an ag em en t Ag en cy ) x x x x x • Th e si m ul at io n of n at io na l c on tin ge nc y pl an s be co m es a n op er at io na l p la n ac co rd in g to th e re su lts o f r is k ha za rd m an ag em en t i n st ag es / tie re d. BN PB x x In di ca to r R .1 .2 P rio rit y pu bl ic h ea lth ri sk s an d re so ur ce s ar e m ap pe d an d ut ili ze d → 2 01 7 Ca pa ci ty le ve l 2 • Tr ai ni ng / W or ks ho p to u se JR A to ol s fo r z oo no tic d is ea se s M O H Zo on os es x x • O ne H ea lth T ra in in g / W or ks ho p fo r h ig h ris k ar ea s fo r e ac h se ct or fo llo w ed b y jo in t tr ai ni ng M O H Zo on os es x x x x x • As se ss m en t o f i nf ra st ru ct ur e, fa ci lit ie s an d H R in N at io na l a nd R eg io na l H os pi ta l M O H IS PA x • EI D ri sk m ap pi ng M O H PI E x x x x x 72 72 TA E M ER G EN CY R ES PO N SE O PE RA TI O N S Ta rg et : Co un tr ie s w ill h av e a pu bl ic h ea lth e m er ge nc y op er at io n ce nt re ( EO C) f un ct io ni ng a cc or di ng t o m in im um c om m on s ta nd ar ds ; m ai nt ai ni ng t ra in ed , fu nc tio ni ng , m ul ti se ct or al r ap id r es po ns e te am s an d “r ea l-t im e” b io su rv ei lla nc e la bo ra to ry n et w or ks a nd in fo rm at io n sy st em s; a nd t ra in ed E O C st af f ca pa bl e of a ct iv at in g a co or di na te d em er ge nc y re sp on se w ith in 1 20 m in ut es o f th e id en tif ic at io n of a p ub lic he al th e m er ge nc y JE E Re co m m en da tio ns : • Im pl em en t co m pr eh en si ve t ra in in g in c as e m an ag em en t an d in fe ct io n pr ev en tio n an d co nt ro l f or a ll he al th p er so nn el b as ed o n an a ll ha za rd s ap pr oa ch , a nd in cl ud in g th e IH R (2 00 5) • D ev el op a n at io na l he al th s ec to r co nt in ge nc y pl an f or I H R re le va nt h az ar ds a nd i nt eg ra te i t w ith t he N at io na l D is as te r M an ag em en t Au th or ity c on tin ge nc y pl an • Im pr ov e pu bl ic h ea lth e m er ge nc y m an ag em en t ca pa ci tie s— sp ec ifi ca lly o n IH R (2 00 5) — fo r de si gn at ed r ef er ra l h os pi ta ls , i nc lu di ng t hr ou gh tr ai ni ng , i nf ra st ru ct ur e de ve lo pm en t, an d st an da rd o pe ra tin g pr oc ed ur es (S O Ps ) • Im pr ov e co or di na tio n an d co lla bo ra tio n fo r em er ge nc y re sp on se b et w ee n th e op er at io ns c en tr es w ith in t he M in is tr y of H ea lth a nd be tw ee n th e M O H a nd o th er re la te d se ct or s • St re ng th en in fo rm at io n ex ch an ge s ys te m s be tw ee n th e M in is tr y of H ea lth a nd o th er a ge nc ie s by h ol di ng re gu la r m ee tin gs , c on du ct in g jo in t ex er ci se s, a nd e st ab lis hi ng m em or an da o f u nd er st an di ng (M O U ) w ith o th er o pe ra tio ns c en tr es . 73 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R .2 .1 C ap ac ity to A ct iv at e Em er ge nc y O pe ra tio ns → 2 01 7 Ca pa ci ty le ve l 3 • H ea lth C lu st er C oo rd in at io n M ee tin g M O H PK K x x • Im pl em en ta tio n of M O H & B N PB c oo pe ra tio n ba se d on th e 20 14 M oU o n D is as te r R is k Re du ct io n in h ea lth d is as te r m an ag em en t M O H PK K x x x x x • Th e im pl em en ta tio n of M O H & B M KG c oo pe ra tio n ba se d on th e 20 14 M oU M O H PK K x x x x x • Co lla bo ra tio n w ith th e 3 U ni ve rs iti es o n th e Im pl em en ta tio n of H ea lth C ris is R is k M an ag em en t b as ed o n th e M CC th at w as a rr an ge d in 2 01 7 (U I, U G M a nd U ni br aw ) an d th e Co op er at io n Ag re em en t w hi ch is ta rg et ed to b e si gn ed in 2 01 9 w ith 3 o th er U ni ve rs iti es (p la nn ed w ith U nh as , U ns ya h Ku al a an d U np ad ) M O H PK K x In di ca to r R .2 .2 E m er ge nc y O pe ra tio ns C en tr e O pe ra tin g Pr oc ed ur es a nd P la ns → 2 01 7 Ca pa ci ty le ve l 2 • Pr ep ar at io n of a jo in t E O C be tw ee n th e PK K, S KK D ire ct or at e an d N CC • Re vi se d M in is te r o f H ea lth R eg ul at io n N o. 6 4/ 20 13 o n H ea lth C ris is M an ag em en t M O H PK K x • Pr ep ar at io n of T ec hn ic al G ui de lin es fo r P ro vi nc ia l M in im um S er vi ce S ta nd ar ds in H ea lth c ris is m an ag em en t ( Pe rm en da gr i) M O H PK K x • Pr ep ar at io n of H ea lth C lu st er G ui de lin es M O H PK K x In di ca to r R .2 .3 E m er ge nc y O pe ra tio ns P ro gr am → 2 01 7 Ca pa ci ty le ve l 3 • Ca pa ci ty b ui ld in g of d is tr ic ts a nd p ro vi nc es fo r c on tin ge nc y pl an s (3 y ea r p ro gr am s) , na m el y: A ss is ta nc e, tr ai ni ng : r es po ns e m ap s, H os pi ta l p re pa re dn es s in d is as te rs , SI PK K, C on tin ge nc y Pl an s, T TX & S im ul at io n) M O H PK K x x x x x In di ca to r R .2 .4 C as e m an ag em en t p ro ce du re s ar e im pl em en te d fo r I H R re le va nt h az ar ds → 2 01 7 Ca pa ci ty le ve l 3 • PM K D is se m in at io n Ab ou t A m bu la nc e Se rv ic es 73 73 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R .2 .1 C ap ac ity to A ct iv at e Em er ge nc y O pe ra tio ns → 2 01 7 Ca pa ci ty le ve l 3 • H ea lth C lu st er C oo rd in at io n M ee tin g M O H PK K x x • Im pl em en ta tio n of M O H & B N PB c oo pe ra tio n ba se d on th e 20 14 M oU o n D is as te r R is k Re du ct io n in h ea lth d is as te r m an ag em en t M O H PK K x x x x x • Th e im pl em en ta tio n of M O H & B M KG c oo pe ra tio n ba se d on th e 20 14 M oU M O H PK K x x x x x • Co lla bo ra tio n w ith th e 3 U ni ve rs iti es o n th e Im pl em en ta tio n of H ea lth C ris is R is k M an ag em en t b as ed o n th e M CC th at w as a rr an ge d in 2 01 7 (U I, U G M a nd U ni br aw ) an d th e Co op er at io n Ag re em en t w hi ch is ta rg et ed to b e si gn ed in 2 01 9 w ith 3 o th er U ni ve rs iti es (p la nn ed w ith U nh as , U ns ya h Ku al a an d U np ad ) M O H PK K x In di ca to r R .2 .2 E m er ge nc y O pe ra tio ns C en tr e O pe ra tin g Pr oc ed ur es a nd P la ns → 2 01 7 Ca pa ci ty le ve l 2 • Pr ep ar at io n of a jo in t E O C be tw ee n th e PK K, S KK D ire ct or at e an d N CC • Re vi se d M in is te r o f H ea lth R eg ul at io n N o. 6 4/ 20 13 o n H ea lth C ris is M an ag em en t M O H PK K x • Pr ep ar at io n of T ec hn ic al G ui de lin es fo r P ro vi nc ia l M in im um S er vi ce S ta nd ar ds in H ea lth c ris is m an ag em en t ( Pe rm en da gr i) M O H PK K x • Pr ep ar at io n of H ea lth C lu st er G ui de lin es M O H PK K x In di ca to r R .2 .3 E m er ge nc y O pe ra tio ns P ro gr am → 2 01 7 Ca pa ci ty le ve l 3 • Ca pa ci ty b ui ld in g of d is tr ic ts a nd p ro vi nc es fo r c on tin ge nc y pl an s (3 y ea r p ro gr am s) , na m el y: A ss is ta nc e, tr ai ni ng : r es po ns e m ap s, H os pi ta l p re pa re dn es s in d is as te rs , SI PK K, C on tin ge nc y Pl an s, T TX & S im ul at io n) M O H PK K x x x x x In di ca to r R .2 .4 C as e m an ag em en t p ro ce du re s ar e im pl em en te d fo r I H R re le va nt h az ar ds → 2 01 7 Ca pa ci ty le ve l 3 • PM K D is se m in at io n Ab ou t A m bu la nc e Se rv ic es 74 74 TA L IN KI N G P U BL IC H EA LT H A N D S EC U RI TY A U TH O RI TI ES Ta rg et : I n th e ev en t of a b io lo gi ca l e ve nt o f s us pe ct ed o r co nf irm ed d el ib er at e or ig in , a c ou nt ry w ill b e ab le t o co nd uc t a ra pi d, m ul tis ec to ra l re sp on se , i nc lu di ng t he c ap ac ity t o lin k pu bl ic h ea lth a nd la w e nf or ce m en t, an d to p ro vi de a nd /o r re qu es t ef fe ct iv e an d tim el y in te rn at io na l as si st an ce , i nc lu di ng to in ve st ig at e al le ge d us e ev en ts JE E Re co m m en da tio ns : • Co m pl et el y re vi se in fe ct io us d is ea se o ut br ea k an d he al th q ua ra nt in e la w s to e ns ur e th e in cl us io n of la nd q ua ra nt in e m ea su re s an d cl ea r m an da te s fo r c ol la bo ra tio n • Re vi ew M O U s w ith v et er in ar y au th or iti es . Id en tif y po in ts o f co nt ac t an d th e tr ig ge rs f or n ot ifi ca tio n an d in fo rm at io n sh ar in g be tw ee n re le va nt a ut ho rit ie s • Re vi ew re gu la tio ns to s tr en gt he n IH R ca pa ci ty in cl ud in g co un te r t er ro ris m m ea su re s, in cl ud in g at p oi nt s of e nt ry • Fi na liz e th e M O U a nd S O Ps o n de ve lo pi ng a nd im pl em en tin g an e le ct ro ni c zo on os is a nd e m er gi ng in fe ct io us d is ea se in fo rm at io n sy st em th at is li nk ed t o ot he r hu m an a nd a ni m al h ea lth d at ab as es . T he M O U a nd S O Ps s ho ul d be e ff ec tiv e be tw ee n th e Co or di na tin g M in is tr y fo r H um an D ev el op m en t a nd C ul tu ra l A ff ai rs ; t he M in is tr y of H ea lth ; t he M in is tr y of A gr ic ul tu re ; t he M in is tr y of E nv iro nm en t a nd F or es tr y; a nd th e N at io na l D is as te r M an ag em en t A ut ho rit y • In cr ea se t he n um be r of p ro vi nc es t ha t ha ve r ec ei ve d tr ai ni ng o n bi ol og ic al d ef en se a nd p ub lic h ea lth e m er ge nc y of in te rn at io na l c on ce rn (P H EI C) c ou nt er m ea su re s fr om 1 1 to a ll pr ov in ce s. 75 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R .3 .1 P ub lic H ea lth a nd S ec ur ity A ut ho rit ie s, (e .g . L aw E nf or ce m en t, Bo rd er C on tr ol , C us to m s) a re li nk ed d ur in g a su sp ec t o r c on fir m ed b io lo gi ca l ev en t → 2 01 7 Ca pa ci ty le ve l 4 • Re vi si on o f t he S ea a nd A ir Q ua ra nt in e La w t o La w o n H ea lth Q ua ra nt in e) M O H H U KO R x • Re vi si on o n In fe ct io us d is ea se L aw x x • Fi na liz at io n of th e • In st ru ct io n on E nh an ci ng A bi lit y to P re ve nt , D et ec t a nd R es po nd to D is ea se O ut br ea ks , G lo ba l P an de m ic a nd N uc le ar E m er ge nc y, B io lo gi ca l a nd C he m ic al x • Co m pl et in g M O U s an d SO Ps o n th e de ve lo pm en t a nd im pl em en ta tio n of in fo rm at io n sy st em s fo r e m er gi ng z oo no tic a nd in fe ct io us d is ea se s co nn ec te d be tw ee n hu m an a nd a ni m al h ea lth d at ab as es / Z oo no tic In fo rm at io n Sy st em s an d Em er gi ng In fe ct io us D is ea se s (S IZ E) x x • In cr ea si ng N um be r o f P ro vi nc es / D is tr ic ts / C iti es th at R ec ei ve T ra in in g on Te rr or is m / E m er ge nc y N uc le ar B io lo gi ca l C he m ic al (N U BI KA ) BN PT (N at io na l Co un te rt er r or is m Ag en cy ) 75 75 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R .3 .1 P ub lic H ea lth a nd S ec ur ity A ut ho rit ie s, (e .g . L aw E nf or ce m en t, Bo rd er C on tr ol , C us to m s) a re li nk ed d ur in g a su sp ec t o r c on fir m ed b io lo gi ca l ev en t → 2 01 7 Ca pa ci ty le ve l 4 • Re vi si on o f t he S ea a nd A ir Q ua ra nt in e La w t o La w o n H ea lth Q ua ra nt in e) M O H H U KO R x • Re vi si on o n In fe ct io us d is ea se L aw x x • Fi na liz at io n of th e • In st ru ct io n on E nh an ci ng A bi lit y to P re ve nt , D et ec t a nd R es po nd to D is ea se O ut br ea ks , G lo ba l P an de m ic a nd N uc le ar E m er ge nc y, B io lo gi ca l a nd C he m ic al x • Co m pl et in g M O U s an d SO Ps o n th e de ve lo pm en t a nd im pl em en ta tio n of in fo rm at io n sy st em s fo r e m er gi ng z oo no tic a nd in fe ct io us d is ea se s co nn ec te d be tw ee n hu m an a nd a ni m al h ea lth d at ab as es / Z oo no tic In fo rm at io n Sy st em s an d Em er gi ng In fe ct io us D is ea se s (S IZ E) x x • In cr ea si ng N um be r o f P ro vi nc es / D is tr ic ts / C iti es th at R ec ei ve T ra in in g on Te rr or is m / E m er ge nc y N uc le ar B io lo gi ca l C he m ic al (N U BI KA ) BN PT (N at io na l Co un te rt er r or is m Ag en cy ) 76 76 TA M ED IC AL C O U N TE RM EA SU RE S AN D P ER SO N N EL D EP LO YM EN T Ta rg et : A na tio na l fr am ew or k fo r tr an sf er rin g (s en di ng a nd r ec ei vi ng ) m ed ic al c ou nt er m ea su re s an d pu bl ic h ea lth a nd m ed ic al p er so nn el am on g in te rn at io na l p ar tn er s du rin g pu bl ic h ea lth e m er ge nc ie s JE E Re co m m en da tio ns : • Re vi ew a nd u pd at e le gi sl at io n an d st an da rd s fo r in te rn at io na l d ep lo ym en t of h ea lth p er so nn el a cc or di ng t o in te rn at io na l s ta nd ar ds , in or de r t o en co ur ag e fu rt he r d ep lo ym en ts • D ev el op re gu la tio ns fo r s en di ng m ed ic al c ou nt er m ea su re s, b as ed o n in te rn at io na l s ta nd ar ds • D ev el op S O Ps o n ho w to m on ito r a nd e va lu at e th e w or k of n at io na l a nd in te rn at io na l r es po ns e te am s du rin g em er ge nc ie s • M ap a va ila bl e re sp on se te am s an d he al th c ar e fa ci lit ie s (in cl ud in g th os e ru n by N G O s, g ov er nm en t, an d ot he r a ct or s) c ap ab le o f i nt eg ra tin g fo re ig n pe rs on ne l d ur in g em er ge nc ie s • Ad vo ca te a nd e nc ou ra ge a ct iv ity a nd g re at er in vo lv em en t of t he h ea lth s ec to r in in te rn at io na l/ re gi on al c oo rd in at io n pl at fo rm s su ch a s AS EA N ’s A H A Ce nt re . 77 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R .2 .1 C ap ac ity to A ct iv at e Em er ge nc y O pe ra tio ns → 2 01 7 Ca pa ci ty le ve l 3 • Ad vo ca cy a nd d is se m in at io n of th e ro le o f t he M O H in th e m ec ha ni sm o f m ed ic al co un te r m ea su re s to c ro ss p ro gr am s / se ct or s M O H PK K x x x x x • M ob ili za tio n fo r l og is tic / m ed ic in e x x • Co un tr y pa rt ic ip at es / ha s fo rm al a gr ee m en t i n re gi on al / in te rn at io na l p ar tn er sh ip s (i. e. A AD M ER , W H O G O AR N e tc ) x x x x x In di ca to r R .2 .2 E m er ge nc y O pe ra tio ns C en tr e O pe ra tin g Pr oc ed ur es a nd P la ns → 2 01 7 Ca pa ci ty le ve l 2 • Re gu la tio n/ p ol ic y fo r E m er ge nc y M ed ic al T ea m (E M T) re fe rr in g to g lo ba l s ta nd ar d an d In do ne si a co nd iti on (c lu st er in g) , i nc lu di ng : •P er so nn el re gi st ra tio n• Pe rs on ne l c er tif ic at io n• Pe rs on ne l d ep lo ym en t M O H PK K x • D at ab as e of H ea lth p er so nn el (H ea lth w or ke r d at ab as e w ho c an b e m ob ili ze d fo r em er ge nc y an d ou tb re ak ) M O H PK K x x x x x • D at ab as e/ M ap pi ng o f h ea lth c ar e fa ci lit ie s (in cl ud in g th os e ru n by N G O s, go ve rn m en t, an d ot he r a ct or s) c ap ab le o f i nt eg ra tin g fo re ig n pe rs on ne l d ur in g em er ge nc ie s M O H PK K x x x x x • M on ito rin g an d ev al ua tio n of in te rn at io na l m ed ic al / pe rs on ne l c ou nt er m ea su re s M O H PK K x x x x x • M ob ili za tio n fo r h ea lth p er so nn el M O H PK K x x x x x 77 77 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R .2 .1 C ap ac ity to A ct iv at e Em er ge nc y O pe ra tio ns → 2 01 7 Ca pa ci ty le ve l 3 • Ad vo ca cy a nd d is se m in at io n of th e ro le o f t he M O H in th e m ec ha ni sm o f m ed ic al co un te r m ea su re s to c ro ss p ro gr am s / se ct or s M O H PK K x x x x x • M ob ili za tio n fo r l og is tic / m ed ic in e x x • Co un tr y pa rt ic ip at es / ha s fo rm al a gr ee m en t i n re gi on al / in te rn at io na l p ar tn er sh ip s (i. e. A AD M ER , W H O G O AR N e tc ) x x x x x In di ca to r R .2 .2 E m er ge nc y O pe ra tio ns C en tr e O pe ra tin g Pr oc ed ur es a nd P la ns → 2 01 7 Ca pa ci ty le ve l 2 • Re gu la tio n/ p ol ic y fo r E m er ge nc y M ed ic al T ea m (E M T) re fe rr in g to g lo ba l s ta nd ar d an d In do ne si a co nd iti on (c lu st er in g) , i nc lu di ng : •P er so nn el re gi st ra tio n• Pe rs on ne l c er tif ic at io n• Pe rs on ne l d ep lo ym en t M O H PK K x • D at ab as e of H ea lth p er so nn el (H ea lth w or ke r d at ab as e w ho c an b e m ob ili ze d fo r em er ge nc y an d ou tb re ak ) M O H PK K x x x x x • D at ab as e/ M ap pi ng o f h ea lth c ar e fa ci lit ie s (in cl ud in g th os e ru n by N G O s, go ve rn m en t, an d ot he r a ct or s) c ap ab le o f i nt eg ra tin g fo re ig n pe rs on ne l d ur in g em er ge nc ie s M O H PK K x x x x x • M on ito rin g an d ev al ua tio n of in te rn at io na l m ed ic al / pe rs on ne l c ou nt er m ea su re s M O H PK K x x x x x • M ob ili za tio n fo r h ea lth p er so nn el M O H PK K x x x x x 78 78 TA R IS K CO M M U N IC AT IO N Ta rg et : S ta te s Pa rt ie s sh ou ld h av e ris k co m m un ic at io n ca pa ci ty w hi ch is m ul ti le ve l a nd m ul ti fa ce d, r ea l t im e ex ch an ge o f i nf or m at io n, a dv ic e an d op in io n be tw ee n ex pe rt s an d of fic ia ls o r pe op le w ho fa ce a t hr ea t or h az ar d to t he ir su rv iv al , h ea lth o r ec on om ic o r so ci al w el l-b ei ng s o th at th ey c an ta ke in fo rm ed d ec is io ns to m iti ga te th e ef fe ct s of th e th re at o r h az ar d an d ta ke p ro te ct iv e an d pr ev en tiv e ac ti on . I t i nc lu de s a m ix of c om m un ic at io n an d en ga ge m en t st ra te gi es li ke m ed ia a nd s oc ia l m ed ia c om m un ic at io n, m as s aw ar en es s ca m pa ig ns , he al th p ro m ot io n, so ci al m ob ili za tio n, s ta ke ho ld er e ng ag em en t a nd c om m un ity e ng ag em en t JE E Re co m m en da tio ns : • Fu rt he r i nt eg ra te a nd a lig n th e cr os s ag en cy ri sk c om m un ic at io n sy st em • In cr ea se ri sk c om m un ic at io n sk ill s in lo ca l g ov er nm en t, pa rt ic ul ar ly fo r n on n at ur al d is as te rs • Fu rt he r d ev el op a nd re gu la rly u pd at e ris k co m m un ic at io n gu id el in es a nd S O Ps fo r t he h ea lth s ec to r • U pd at e co m m un ic at io n st ra te gi es , i nc lu di ng m es sa gi ng a nd m ed ia s tr at eg y • In cr ea se t he n um be r of d is as te r al er t vi lla ge s, a nd in cr ea se d is as te r ed uc at io n in s ch oo ls a nd t he c om m un ity , e sp ec ia lly in d is as te r pr on e ar ea s. 79 79 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R .5 .1 . Ri sk C om m un ic at io n Sy st em s fo r U nu su al /U ne xp ec te d Ev en ts a nd E m er ge nc ie s → 2 01 7 Ca pa ci ty le ve l 3 • To d ev el op n at io na l h ea lth ri sk c om m un ic at io n gu id el in e M O H RO KO M x • To re gu la te n at io na l h ea lth ri sk c om m un ic at io n gu id el in e x In di ca to r R .5 .2 . I nt er na l a nd P ar tn er C om m un ic at io n an d Co or di na tio n fo r E m er ge nc y Ri sk C om m un ic at io n → 2 01 7 Ca pa ci ty le ve l 3 • An nu al m ee tin g w ith m ul ti se ct or al a nd m ul ti st ak eh ol de r f or co m m un ic at io n M in is tr y of In fo rm at io n an d Te ch no lo gy (M O IT ) x x x x x • Re gi on al m ee tin g w ith m ul ti se ct or al a nd m ul ti st ak eh ol de r M O IT x x x x x • Re gu la r/ an nu al m ee tin g w ith m ul ti se ct or al a nd m ul ti st ak eh ol de r PM K x x x x x • Re gu la r/ an nu al m ee tin g w ith m ul ti se ct or al a nd m ul ti st ak eh ol de r f or co or di na tio n a nd c om m un ic at io n M O H RO KO M x x x x x In di ca to r R .5 .3 P ub lic C om m un ic at io n fo r E m er ge nc ie s → 2 01 7 Ca pa ci ty le ve l 4 • Av ai la bi lit y of M O H c om m un ic at io n pl an o r r is k co m m un ic at io n pl an M O H RO KO M x x x x x • Ap po in te d an d tr ai ne d go ve rn m en t s po ke sp er so n in e ve ry g ov er nm en t m in is tr y an d ag en cy M O H RO KO M x x x x x • En ga ge m en t w ith M as s M ed ia a nd s oc ia l m ed ia M O H RO KO M x x x x x • En ga ge m en t w ith S oc ia l M ed ia M O IT x x x x x In di ca to r R .5 .4 C om m un ic at io n En ga ge m en t w ith A ff ec te d Co m m un iti es → 2 01 7 Ca pa ci ty le ve l 4 • Re gu la r b rie fin g, tr ai ni ng a nd e ng ag em en t o f s oc ia l m ob ili za tio n an d co m m un ity e ng ag em en t t ea m s in cl ud in g vo lu nt ee rs M in is tr y of S oc ia l A ff ai r (M O SA ) x x x x x • Co m m un ity o ut re ac he s (H ot lin e) M O H RO KO M x x x x x In di ca to r R .5 .5 . A dd re ss in g pe rc ep tio ns , r is ky b eh av io ur s, a nd m is in fo rm at io n→ 2 01 7 Ca pa ci ty le ve l 4 • Co m m un ity c on su lta tio n m ec ha ni sm s ar e in p la ce M O H RO KO M x x x x x • Co nt en t c om pl ai nt s (c om m un ity re po rt in g sy st em fo r h oa xe s) a nd ru m ou rs s ur ve ill an ce . E xa m pl e: A du an ko nt en M O IT 80 80 TA P O IN TS O F EN TR Y Ta rg et s: S ta te s Pa rt ie s sh ou ld d es ig na te a nd m ai nt ai n th e co re c ap ac iti es a t t he in te rn at io na l a irp or ts a nd p or ts (a nd w he re ju st ifi ed fo r p ub lic he al th r ea so ns , a S ta te P ar ty m ay d es ig na te g ro un d cr os si ng s) w hi ch im pl em en t sp ec ifi c pu bl ic h ea lth m ea su re s re qu ire d to m an ag e a va rie ty of p ub lic h ea lth ri sk s JE E Re co m m en da tio ns : • Co nd uc t a hu m an r es ou rc es n ee ds a ss es sm en t at d es ig na te d po in ts o f en tr y (P O E) t ha t sy st em at ic al ly i de nt ifi es g ap s in p er fo rm an ce , re du nd an ci es a nd fu tu re p er fo rm an ce n ee ds (e .g . f or tr ai ni ng , s ta ff re cr ui tm en t) • Re vi ew n at io na l p ol ic y on in fo rm at io n sh ar in g an d si m ul ta ne ou s co m m un ic at io n of p ub lic h ea lth e ve nt s be tw ee n IH R N at io na l F oc al P oi nt s an d ot he r c om pe te nt a ut ho rit ie s at n ei gh bo ur in g co un tr y PO Es , e sp ec ia lly a t g ro un d cr os si ng s • Ev al ua te e ff ec tiv en es s in re sp on di ng to p ub lic h ea lth e ve nt s at P O Es a nd p ub lis h th e re su lts • Re vi ew a dd iti on al P O Es t ha t co ul d be d es ig na te d fo r IH R im pl em en ta tio n, c on si de rin g ge og ra ph y an d th e nu m be r an d di st rib ut io n of ex is tin g PO Es . 81 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P O E. 1. R ou tin e ca pa ci tie s ar e es ta bl is he d at P oE → 2 01 7 Ca pa ci ty le ve l 4 • Ad eq ua te ly tr ai ne d he al th p er so nn el : • D et ec tio n an d Re sp on se fo r P ub lic H ea lth E m er ge nc y Co nt ai nm en t T ra in in g in PO E fo r P or t H ea lth O ff ic er M O H KA RK ES x • Fl ig ht S ur ge on a nd F lig ht N ur se T ra in in g fo r P or t H ea lth O ff ic er x • Tr ai ni ng fo r H ea lth Q ua ra nt in e Ca pa ci ty x x x x • Av ai la bi lit y of n at io na l p ol ic y on in fo rm at io n sh ar in g an d si m ul ta ne ou s co m m un ic at io n of p ub lic h ea lth e ve nt s: a. Ad vo ca cy a nd d is se m in at io n of H ea lth Q ua ra nt in e La w M O H KA RK ES x b. D ev el op D ra ft G ui de lin es o f H ea lth Q ua ra nt in e x x • Ad di tio na l d es ig na te d PO Es : Re vi ew a dd iti on al 1 29 d es ig na te d PO Es M O H KA RK ES x x x x • Ad eq ua te ly e qu ip pe d PO E: M ai nt ai n PO E th at a re a de qu at el y eq ui pp ed (I nf ra st ru ct ur e, re fe rr al , e qu ip m en t, et c) x x x x x In di ca to r P O E. 2. E ffe ct iv e Pu bl ic H ea lth R es po ns e at P oi nt s of E nt ry → 2 01 7 Ca pa ci ty le ve l 4 • Im pr ov e ca pa ci tie s on p re pa re dn es s at P O E: 1. P re pa re dn es s at P O E M O H KA RK ES x x x x x • Im pr ov e in fo rm at io n sh ar in g an d co m m un ic at io n w ith re la te d st ak eh ol de rs : 1. H ea lth Q ua ra nt in e Im pl em en ta tio n in G ro un d Cr os si ng W or ks ho p M O H KA RK ES x x x x 2. S ha rin g in fo rm at io n sy st em w ith re la te d st ak eh ol de rs (i m m ig ra tio n, fi na nc e, h om e af fa irs , m ar iti m e) x x 3. D ev el op M O U w ith ri sk c ou nt rie s (i. e. A fr ic an c ou nt rie s) o n va cc in at io n re qu ire m en ts a nd c er tif ic at e x x 4. In te gr at io n of H ea lth Q ua ra nt in e Pr og ra m w ith re la te d m in is tr ie s an d st ak eh ol de rs x x x x 81 81 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r P O E. 1. R ou tin e ca pa ci tie s ar e es ta bl is he d at P oE → 2 01 7 Ca pa ci ty le ve l 4 • Ad eq ua te ly tr ai ne d he al th p er so nn el : • D et ec tio n an d Re sp on se fo r P ub lic H ea lth E m er ge nc y Co nt ai nm en t T ra in in g in PO E fo r P or t H ea lth O ff ic er M O H KA RK ES x • Fl ig ht S ur ge on a nd F lig ht N ur se T ra in in g fo r P or t H ea lth O ff ic er x • Tr ai ni ng fo r H ea lth Q ua ra nt in e Ca pa ci ty x x x x • Av ai la bi lit y of n at io na l p ol ic y on in fo rm at io n sh ar in g an d si m ul ta ne ou s co m m un ic at io n of p ub lic h ea lth e ve nt s: a. Ad vo ca cy a nd d is se m in at io n of H ea lth Q ua ra nt in e La w M O H KA RK ES x b. D ev el op D ra ft G ui de lin es o f H ea lth Q ua ra nt in e x x • Ad di tio na l d es ig na te d PO Es : Re vi ew a dd iti on al 1 29 d es ig na te d PO Es M O H KA RK ES x x x x • Ad eq ua te ly e qu ip pe d PO E: M ai nt ai n PO E th at a re a de qu at el y eq ui pp ed (I nf ra st ru ct ur e, re fe rr al , e qu ip m en t, et c) x x x x x In di ca to r P O E. 2. E ffe ct iv e Pu bl ic H ea lth R es po ns e at P oi nt s of E nt ry → 2 01 7 Ca pa ci ty le ve l 4 • Im pr ov e ca pa ci tie s on p re pa re dn es s at P O E: 1. P re pa re dn es s at P O E M O H KA RK ES x x x x x • Im pr ov e in fo rm at io n sh ar in g an d co m m un ic at io n w ith re la te d st ak eh ol de rs : 1. H ea lth Q ua ra nt in e Im pl em en ta tio n in G ro un d Cr os si ng W or ks ho p M O H KA RK ES x x x x 2. S ha rin g in fo rm at io n sy st em w ith re la te d st ak eh ol de rs (i m m ig ra tio n, fi na nc e, h om e af fa irs , m ar iti m e) x x 3. D ev el op M O U w ith ri sk c ou nt rie s (i. e. A fr ic an c ou nt rie s) o n va cc in at io n re qu ire m en ts a nd c er tif ic at e x x 4. In te gr at io n of H ea lth Q ua ra nt in e Pr og ra m w ith re la te d m in is tr ie s an d st ak eh ol de rs x x x x 82 82 TA C H EM IC AL E VE N TS Ta rg et : S ta te s Pa rt ie s sh ou ld h av e su rv ei lla nc e an d re sp on se c ap ac ity f or c he m ic al r is k or e ve nt s. T hi s re qu ire s ef fe ct iv e co m m un ic at io n an d co lla bo ra tio n am on g th e se ct or s re sp on si bl e fo r c he m ic al s af et y, in du st rie s, tr an sp or ta tio n an d sa fe d is po sa l JE E Re co m m en da tio ns : • Fi na liz e th e up da te d le gi sl at io n on c he m ic al h az ar ds t ha t w ill a pp ly t o al l r el ev an t ag en ci es a nd w hi ch w ill s er ve a s a ba si s fo r th e na ti on al ch em ic al e m er ge nc y pr ep ar ed ne ss a nd r es po ns e pl an ; p ro vi nc ia l/ di st ric t co nt in ge nc y pl an s fo r ch em ic al e ve nt s; t ec hn ic al g ui de lin es ; a nd pr ot oc ol s fo r r es po ns e ac tio ns • D ev el op a n at io na l sy st em at ic s ur ve ill an ce s ys te m f or c he m ic al e ve nt s, s up po rt ed b y ap pr op ria te i nf ra st ru ct ur e (i. e. p oi so n ce nt re s) , la bo ra to ry a nd c lin ic al to xi co lo gy c ap ac iti es , a nd re le va nt te ch ni ca l e xp er tis e on ri sk a ss es sm en t a nd c as e m an ag em en t • D ev el op n at io na l p ro gr am m es a nd s er vi ce s fo r e ns ur in g a su st ai na bl e av ai la bl e w or kf or ce /s ur ge c ap ac ity fo r p re pa re dn es s an d re sp on se to ch em ic al e m er ge nc ie s • St re ng th en in fo rm at io n ex ch an ge a nd c oo rd in at io n am on g re le va nt s ec to rs a nd s ta ke ho ld er s at a ll le ve ls (l oc al , n at io na l a nd in te rn at io na l), ac ro ss p re ve nt io n, p re pa re dn es s, re sp on se a nd re co ve ry . 83 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r C E. 1. M ec ha ni sm s ar e es ta bl is he d an d fu nc tio ni ng fo r d et ec tin g an d re sp on di ng to c he m ic al e ve nt s or e m er ge nc ie s → 2 01 7 Ca pa ci ty le ve l 2 • G ui de lin e Pr ep ar at io n fo r P ar tic ip at or y Ap pr oa ch fo r C om m un iti es in S m al l-S ca le G ol d M in in g Ar ea s (P ES K) M O H Ke sl in g x x • St re ng th en in g th e Ch em ic al L ab or at or y N et w or k M O EF x • Re vi si on o f G ov er nm en t R eg ul at io n N o. 7 4/ 20 01 o n M an ag em en t o f H az ar do us a nd To xi c M at er ia ls M O EF x • Pr ep ar at io n of M in is tr y of E nv iro nm en t R eg ul at io ns c on ce rn in g B3 e m er ge nc y re sp on se s ys te m s an d B3 w as te M O EF x • Re vi ta liz at io n of th e N at io na l M er cu ry R es ea rc h Ce nt er M O EF X • H ea lth O ffi ce r T ra in in g M od ul e Pr ep ar at io n fo r t he Im pl em en ta tio n of P ar tic ip at or y Ap pr oa ch fo r C om m un iti es in P ES K M O H • Pr ep ar at io n of M in is tr y of In du st ry re gu la tio n on c he m ic al s th at a re p ro hi bi te d an d re gu la te d fo r w ea po ns a nd fo r p re cu rs or s M in is tr y of In du st ry (M O I) x • Re vi si on o f M in is tr y of In du st ry re gu la tio n N o. 2 3/ 20 13 o n La be lin g ba se d on G H S M O I x • Pr ep ar at io n of M in is te r o f I nd us tr y Re gu la tio n on li st c he m ic al s an d or ga ni c ch em ic al s M O I x • M in is tr y of M an po w er re gu la tio n N o. 5 / 20 18 o n th e Sa fe ty a nd H ea lth o f t he W or k En vi ro nm en t ( la un ch in g Ju ly 1 8, 2 01 8) M in is tr y of M an po w er (M O M ) x In di ca to r C E. 2. E na bl in g en vi ro nm en t i s in p la ce fo r m an ag em en t o f c he m ic al e ve nt s → 2 01 7 Ca pa ci ty le ve l 3 • Re vi ew a nd u pd at e of N at io na l I m pl em en ta tio n Pl an o n PO Ps M O EF x x • Cr os s Pr og ra m C oo rd in at io n, C ro ss M in is tr ie s an d In st itu tio ns re la te d to C he m ic al Ev en ts re sp on se M O EF x x x x • Pr ep ar at io n of R oa dm ap fo r C he m ic al E ve nt s M O EF x • M ap pi ng o f t he d is tr ib ut io n an d po te nt ia l r is ks o f c he m ic al in du st ry o n Ja va is la nd M O EF x • Ev al ua tio n on th e im pl em en ta tio n of n at io na l a ct io n pl an s fo r r ed uc in g an d el im in at in g m er cu ry M O EF x x x x x 83 83 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r C E. 1. M ec ha ni sm s ar e es ta bl is he d an d fu nc tio ni ng fo r d et ec tin g an d re sp on di ng to c he m ic al e ve nt s or e m er ge nc ie s → 2 01 7 Ca pa ci ty le ve l 2 • G ui de lin e Pr ep ar at io n fo r P ar tic ip at or y Ap pr oa ch fo r C om m un iti es in S m al l-S ca le G ol d M in in g Ar ea s (P ES K) M O H Ke sl in g x x • St re ng th en in g th e Ch em ic al L ab or at or y N et w or k M O EF x • Re vi si on o f G ov er nm en t R eg ul at io n N o. 7 4/ 20 01 o n M an ag em en t o f H az ar do us a nd To xi c M at er ia ls M O EF x • Pr ep ar at io n of M in is tr y of E nv iro nm en t R eg ul at io ns c on ce rn in g B3 e m er ge nc y re sp on se s ys te m s an d B3 w as te M O EF x • Re vi ta liz at io n of th e N at io na l M er cu ry R es ea rc h Ce nt er M O EF X • H ea lth O ffi ce r T ra in in g M od ul e Pr ep ar at io n fo r t he Im pl em en ta tio n of P ar tic ip at or y Ap pr oa ch fo r C om m un iti es in P ES K M O H • Pr ep ar at io n of M in is tr y of In du st ry re gu la tio n on c he m ic al s th at a re p ro hi bi te d an d re gu la te d fo r w ea po ns a nd fo r p re cu rs or s M in is tr y of In du st ry (M O I) x • Re vi si on o f M in is tr y of In du st ry re gu la tio n N o. 2 3/ 20 13 o n La be lin g ba se d on G H S M O I x • Pr ep ar at io n of M in is te r o f I nd us tr y Re gu la tio n on li st c he m ic al s an d or ga ni c ch em ic al s M O I x • M in is tr y of M an po w er re gu la tio n N o. 5 / 20 18 o n th e Sa fe ty a nd H ea lth o f t he W or k En vi ro nm en t ( la un ch in g Ju ly 1 8, 2 01 8) M in is tr y of M an po w er (M O M ) x In di ca to r C E. 2. E na bl in g en vi ro nm en t i s in p la ce fo r m an ag em en t o f c he m ic al e ve nt s → 2 01 7 Ca pa ci ty le ve l 3 • Re vi ew a nd u pd at e of N at io na l I m pl em en ta tio n Pl an o n PO Ps M O EF x x • Cr os s Pr og ra m C oo rd in at io n, C ro ss M in is tr ie s an d In st itu tio ns re la te d to C he m ic al Ev en ts re sp on se M O EF x x x x • Pr ep ar at io n of R oa dm ap fo r C he m ic al E ve nt s M O EF x • M ap pi ng o f t he d is tr ib ut io n an d po te nt ia l r is ks o f c he m ic al in du st ry o n Ja va is la nd M O EF x • Ev al ua tio n on th e im pl em en ta tio n of n at io na l a ct io n pl an s fo r r ed uc in g an d el im in at in g m er cu ry M O EF x x x x x 84 84 TA R AD IA TI O N E M ER G EN CI ES Ta rg et : St at es P ar tie s sh ou ld h av e su rv ei lla nc e an d re sp on se c ap ac ity f or r ad io n uc le ar h az ar ds /e ve nt s/ em er ge nc ie s. T hi s re qu ire s ef fe ct iv e co m m un ic at io n an d co lla bo ra tio n am on g th e se ct or s re sp on si bl e fo r r ad io n uc le ar m an ag em en t JE E Re co m m en da tio ns : • Fi na liz e/ es ta bl is h na tio na l a nd lo ca l r es po ns e pl an s fo r ra di ol og ic al /n uc le ar e m er ge nc ie s, s up po rt ed b y gu id es a nd p ro to co ls a nd b as ed o n fo rm al ly e st ab lis he d cr ite ria f or t rig ge rin g ur ge nt p ro te ct iv e an d ot he r re sp on se a ct io ns s uc h as s he lte rin g, e va cu at io n, i od in e th yr oi d bl oc ki ng ( IT B) , fo od a nd d rin ki ng w at er r es tr ic tio ns , et c. , as w el l as c as e m an ag em en t pr ot oc ol s fo r cl in ic ia ns . Ac tio ns c ou ld i nc lu de de ve lo pm en t o f g ui de lin es a nd p ro to co ls fo r s pe ci fic e m er ge nc y sc en ar io s, tr ea tm en t s tr at eg ie s or p ro te ct iv e ac tio ns . • St re ng th en th e ca pa bi lit ie s of d es ig na te d he al th c ar e fa ci lit ie s (i. e. h os pi ta ls a nd la bs ) b y de ve lo pi ng th e ne ce ss ar y in fr as tr uc tu re ; p ro vi di ng eq ui pm en t an d se rv ic es in cl ud in g bi oa ss ay s an d cy to ge ne tic b io do si m et ry s er vi ce s an d a na tio na l s to ck pi le ; a nd t ra in in g th e w or kf or ce in ra di ol og ic al /n uc le ar e m er ge nc y re sp on se — es pe ci al ly a t p ro vi nc ia l l ev el in a re as a dj ac en t t o nu cl ea r r ea ct or fa ci lit ie s. • D ev el op s us ta in ab le tr ai ni ng p ro gr am m es to s tr en gt he n hu m an re so ur ce c ap ac iti es fo r n uc le ar /r ad io lo gi ca l e m er ge nc y re sp on se , e sp ec ia lly at p ro vi nc ia l a nd n at io na l l ev el s, th ro ug h re gu la r t ra in in g an d ex er ci se s ta ilo re d to s pe ci fic ta rg et g ro up s an d ar ea s (e .g . f irs t r es po ns e, p re ho sp ita l r es po ns e, c lin ic al c as e m an ag em en t, in te rn al c on ta m in at io n as se ss m en t an d m an ag em en t, lo ng t er m f ol lo w u p, m an ag em en t of no n ra di ol og ic al h ea lth c on se qu en ce s, e tc .). • D ev el op a dv oc ac y (a w ar en es s ra is in g) a nd r is k co m m un ic at io n m at er ia ls (f re qu en tly a sk ed q ue st io ns /F AQ s, fa ct s he et s, in fo gr ap hi cs , e tc .) an d pr ov id e ris k co m m un ic at io n tr ai ni ng fo r e m er ge nc y re sp on de rs o n ris k co m m un ic at io n. 85 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R E. 1 M ec ha ni sm s es ta bl is he d an d fu nc tio ni ng fo r d et ec tin g an d re sp on di ng to ra di ol og ic al a nd n uc le ar e m er ge nc ie s → 2 01 7 Ca pa ci ty le ve l 2 • M in is te r o f H ea lth 's R eg ul at io n on th e Es ta bl is hm en t o f t he N at io na l Re fe rr al H os pi ta l f or N uc le ar D is as te r M O H KE SL IN G x x x • D oc um en ts fo r t he c on tin ge nc y pl an o f t he B an du ng N uc le ar a re a BA TA N (N at i on al N uc le ar En er gy Ag en cy ) x x • D oc um en ts fo r t he c on tin ge nc y pl an o f t he Y og ya ka rt a N uc le ar a re a BA TA N x x • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Se rp on g nu cl ea r a re a BA TA N x x x x • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e D IY n uc le ar ar ea BA TA N x x x x • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Ba nd un g nu cl ea r a re a BA TA N x x x x • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Pa sa rJ um at nu cl ea r a re a BA TA N x x x • N uc le ar e m er ge nc y re sp on se BA PE TE N (N uc le ar En er gy Re gu la to ry Ag en cy ) x x x x x In di ca to r R E. 2 En ab lin g en vi ro nm en t i n pl ac e fo r m an ag em en t o f r ad ia tio n em er ge nc ie s → 2 01 7 Ca pa ci ty le ve l 3 • G ui de lin es fo r S af eg ua rd in g th e Im pa ct o f R ad ia tio n on H ea lth M O H KE SJ AO R x x • M in is te r o f H ea lth re gu la tio n on G ui de lin es fo r M ed ic al M an ag em en t f or N uc le ar Em er ge nc y an d Ra di ol og y M O H KE SL IN G x x • Pr es id en tia l R eg ul at io n on N at io na l N uc le ar a nd R ad ia tio n Sa fe ty P ol ic ie s an d St ra te gi es BA PE TE N x x x 85 85 AC TI VI TI ES A N D TI M EL IN E PR IO RI TY A CT IV IT IE S M IN IS TR Y U N IT 20 18 20 19 20 20 20 21 20 22 In di ca to r R E. 1 M ec ha ni sm s es ta bl is he d an d fu nc tio ni ng fo r d et ec tin g an d re sp on di ng to ra di ol og ic al a nd n uc le ar e m er ge nc ie s → 2 01 7 Ca pa ci ty le ve l 2 • M in is te r o f H ea lth 's R eg ul at io n on th e Es ta bl is hm en t o f t he N at io na l Re fe rr al H os pi ta l f or N uc le ar D is as te r M O H KE SL IN G x x x • D oc um en ts fo r t he c on tin ge nc y pl an o f t he B an du ng N uc le ar a re a BA TA N (N at i on al N uc le ar En er gy Ag en cy ) x x • D oc um en ts fo r t he c on tin ge nc y pl an o f t he Y og ya ka rt a N uc le ar a re a BA TA N x x • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Se rp on g nu cl ea r a re a BA TA N x x x x • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e D IY n uc le ar ar ea BA TA N x x x x • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Ba nd un g nu cl ea r a re a BA TA N x x x x • M ee tin g on n uc le ar p re pa re dn es s an d em er ge nc y re sp on se c oo rd in at io n of th e Pa sa rJ um at nu cl ea r a re a BA TA N x x x • N uc le ar e m er ge nc y re sp on se BA PE TE N (N uc le ar En er gy Re gu la to ry Ag en cy ) x x x x x In di ca to r R E. 2 En ab lin g en vi ro nm en t i n pl ac e fo r m an ag em en t o f r ad ia tio n em er ge nc ie s → 2 01 7 Ca pa ci ty le ve l 3 • G ui de lin es fo r S af eg ua rd in g th e Im pa ct o f R ad ia tio n on H ea lth M O H KE SJ AO R x x • M in is te r o f H ea lth re gu la tio n on G ui de lin es fo r M ed ic al M an ag em en t f or N uc le ar Em er ge nc y an d Ra di ol og y M O H KE SL IN G x x • Pr es id en tia l R eg ul at io n on N at io na l N uc le ar a nd R ad ia tio n Sa fe ty P ol ic ie s an d St ra te gi es BA PE TE N x x x 86 86 • Re vi si on o f t he P as ar Ju m at n uc le ar a re a' s em er ge nc y pr ep ar ed ne ss a nd re sp on se p ro gr am do cu m en t BA TA N x x x • Re vi si on o f t he S er po ng n uc le ar a re a' s em er ge nc y pr ep ar ed ne ss a nd re sp on se p ro gr am do cu m en t BA TA N x x x • N uc le ar e m er ge nc y pr ep ar ed ne ss & re sp on se tr ai ni ng a t t he B an du ng n uc le ar a re a BA TA N x x • N uc le ar e m er ge nc y pr ep ar ed ne ss & re sp on se tr ai ni ng a t t he P as ar Ju m at n uc le ar a re a BA TA N x x • Th e pr ep ar at io n of th e IE C M ed ia fo r t he C om m un ity a ro un d th e Ar ea BA TA N x x 87