National Action Plan for Health Security (NAPHS 2021-2025)

1.1. Namibia Country Profile ..................................................................................................................... 5

1.1.1 Political and socio-economic profile .......................................................................................... 5

1.1.2 Situation Analysis-burden of Public Health Emergencies - in terms of morbidity and mortality .................................................................................................................................................... 6

1.2. Joint External Evaluation (JEE) and other assessments ................................................................... 11

1.2.1. The Joint External Evaluation of Namibia ................................................................................ 11

1.2.2. Other assessments ...................................................................................................................16

1.3. Namibia journey from IHR JEE to Country Planning for Health Security ......................................... 22 2. VISION, MISSION, OBJECTIVES, GUIDING PRINCIPLES AND CORE VALUES .............................................. 23

2.1. Vision ................................................................................................................................................ 23

2.2. Mission ............................................................................................................................................. 23

2.3. Specific Objectives ........................................................................................................................... 23

2.4. Guiding principles and core values .................................................................................................. 24 3. METHODOLOGY AND PROCESS OF DEVELOPING THE NAPHS................................................................. 25

3.1. Review of JEE and other assessm ents recommendations ............................................................... 25

3.2. Prioritisation of activities by technical areas ................................................................................... 27 National Action Plan for Health Security (NAPHS 2020-2025) -

3.3. Linkage with other programmes/initiatives ...................................................................................... 28

3.4. Sector Wide Approach ..................................................................................................................... 28

3.5. Strategic partnership for planning ................................................................................................... 29 4. COMPONENTS OF THE ACTION PLAN ...................................................................................................... 29

4.1. Strategic actions/strategic Interventions......................................................................................... 29

4.2. Planning matr ix of priorities ·- short term (12 months) to long term (> 12 months) ...................... 38 4.3. Costing of activities and summary of cost categorisation by JEE thematic areas ........................... 40

4.4. Cost breakdown by JEE thematic area over years ........................................................................... 41

4.5. Cost breakdown by technica I area over year s .................................................................................41

4.6. Summary of cost analysis .................................................................................................................. 43 4.7. Financing of National Action Plan (Domestic, external funding and further donor engagements) 45

4.8. Risk appraisa l, assumptions and management ................................................................................ 45

4.9. Platform for National Action Plan .................................................................................................... 46

4.9.1. Linkage with existing plans ......................................................................................................46

4.9.2. Interplay between relevant sectors ......................................................................................... 47

4.9.3. Other enablers ......................................................................................................................... 47

4.9.4. Contribution to Health system strengthening, Universal Health coverage (UHC) and Sustainable Development Goals (SDGs) ..................................................................................................48 5. DELIVERY OF ACTION PLAN ...................................................................................................................... 49

5.1. Stakeholders analysis ............................................................ ........................................................... 49

5.2. Roles and Responsibilities of Key stakeholders ............................................................................... 50

5.2.1. Office of the President .................................................. ........................................................... 50

5.2.2. The parliament ......................................................................................................................... 50

5.2.3. Office of the Prime M inister ................ ........................ ............................................................ 51

5.2.4. Line ministries ............................................................... ................................................,........... 51

5.2.5. Others ....................................................................................................................................... 54 5.3. Coordination mechanisms and framework for delivery of action plan ........................................... 55

5.3.1. At the National Level. ................................................... ............................................................ 55

5.3.2. Sub-national level. ......................................................... ........................................................... 58

5.3.3. Alignment of internal stakeholders .......................................................................................... 59

5.3.4. Alignment of external stakeholders ......................................................................................... 59 National Action Plan for Health Security (NAPHS 2020-2025) -

5.3.5. WHO-Strategic Partnership Porta l-SPP .................................................................................... 59

5.4. Monitoring and evaluation of the plan ............................................................................................ 59 5.4.l. Strategies for NAPHS monitoring and evaluation .................................................................... 60

5.4.2. Techniques and Tools used for monitoring and evaluation .................................................... 60 ANNEXES .......................................................................................................................................................... 63 Annexe 1: Matrix for detailed roles and responsibilities ............................................................................. 63 Annexe 2: Terms of Reference of National Multi-Agency Coordination Committee (The One Health Platform) ...................................................................................................................................................... 65 Annexe 3: Indicators, milestones and targets ............................................................................................. 68 Annexe 4: Implementation plan and estimated or projected annual action plan matrix ........................... 72 REFERENCES: ................................................................................................................................................... 154 National Action Plan for Health Security (NAPHS 2020-2025) - FOREWORD Namibia is signatory to the International Health Regulations (IHR) 2005, which mandates member states to strengthen capacities for health security. The West Africa Ebola epidemic of 2014 and the current Coronavirus Disease, 2019 (COVID-19) pandemic demonstrated the economic damage that large scale epidemics can create, and raised awareness of the need to have strong coordination mechanisms at all levels to prevent the disease from spreading within and outside the country. The Joint External Evaluation (JEE) that was conducted in Namibia in 2016 revealed critical gaps that need to be filled to protect the population from the next major public health event. These results from the JEE helped to guide the National Action Plan for Health Security (NAPHS) planning process and to develop a roadmap for health security strengthening in the country. Preparedness for health security is like an insurance policy for our national health and prosperity. Strengthening the IHR core capacities and having strong health system will protect lives and increase resilience of the Namibian people to threats of epidemics and disasters. The NAPHS which was developed through a consultative and multi-sectoral engagement, is a tool for the government to comprehensively address the threats to public health security in Namibia. As most epidemics arise from the interface between human and animal health and the environment, the NAPHS will be implemented under auspices of the One-Health framework with technical oversight from the Ministries of Health and Social Services; Agriculture, Water and Land reform; and Environment, Forestry and Tourism. Successful implementation of the NAPHS in Namibia will significantly contribute to improved national health security and attainment of the health- related Sustainable Development Goals (SDGs) as well as Universal Health Coverage (UHC). The country has National and sector-specific Disaster-Risk Management legislation and policies which are expected to be in alignment with IHR 2005. Capacity building is needed to ensure that we can continue our effective legacy of a strong immunization system, workforce development program, keep our food and water supplies safe, improved environmental sanitation and waste management, keep our health workers protected from infections, and ensure that we have routine systems in place for early warning and response to outbreaks and public health events. The activities presented in this document represent the minimum needed investments, and cost approximately NAO 115 264 697 (about USD 8 million) per year. The Ebola epidemic and global pandemics like Severe Acute Respiratory Syndrome (SARS) and COVID-19 costed billions of dollars to contain and have had large effects on economic growth. Small investments in our pubEic health systems now can prevent major economic damage from the next epidemics. We have carefully come to consensus about major priorities for action, based on the JEE, Performance of Veterinary Services assessment, risk assessments, and institutional priorities. We encourage all stakeholders from public and private sectors, to carefully review this ~ment and use it as a country-owned roadmap for health security ~ -.__,/ ·--..lir------ H ~ g u l a , MP Hon.CalleSchlettwein , MP Minister of Health and Social Minister Agriculture, Water and Land Minister Environment, Forestry and Services Reform Tourism National Action Plan for Health Security (NAPHS 2020-2025) - PREFACE Namibia has been confronted with numerous outbreaks since 2006, including Polio, Measles, Influenza HJNI, Cholera, Hepatitis E Virus (HEV) and current COVID-19 pandemic. An outbreak of pandemic influenza H1N 1 was reported in 2009 with 72 confirmed cases and 1 death. During the post- pandemic period (i.e. during 20 I 0) a total of 9,069 HIN I suspected cases were reported, of which I 02 were confirmed. In in 201 l , another HlNl outbreak was reported in Ohangwena with 3,155 cases. A cholera outbreak was also reported in Kunene region from December 2013 to January 2014 with 287 reported cases and I 0 deaths. The country has been battling Hepatitis E outbreak for more than two (2) years, since 2017 with numerous hospitalizations and consequent mortality, especially among pregnant women. The country recorded the first two COVID-19 cases on 13 th March 2020. As of 29 November 2020, a total of 14345 confirmed cases and 151 deaths have been recorded in all fourteen regions. The country has also been experiencing animal disease outbreaks such as Foot and Mouth disease annually as well as Rift Valley Fever between 2009 and 2010, Newcastle disease outbreak in 2016. Anthrax outbreaks have also been reported in Kunene, Oshikoto, Kavango and Zambezi regions over the past few years. Most of these events have caused devastation of animal stocks and resulted in losses in agricultural productivity and food security. The human populations continue to suffer health consequences of zoonosis. Several cases of Crimean-Congo Hemorrhagic Fever (CCHF), rabies and human cases of anthrax have recently been recorded each year. Moreover, the country experiences a number of emergencies related to climate change and environmental safety. Natural disasters such as floods, droughts and desertification with impact on public health have been observed. The environment plays an important role in human health. Environmental degradation with increasing population pressure are steadily playing a role in the transmission of diseases and other public health threats to humans, both in rural and urban settings. These events have highlighted that efficient government collaboration is critical for effective preparedness and response to these emergencies when they arise. Namibia has responded to and contained these events, but further steps must be taken to detect them earlier to prevent illness and death. This National Action p]an for Health Security (NAPHS) will facilitate multi-sector engagement using a One Health approach and guide implementation of activities for progress towards attainment of International Health Regulations (IHR) 2005 core capacities in Namibia, that are Tequired for enhancing Global Health Security. The Government of the Republic of Namibia commit to put necessary resources, systems and processes in V place to support the imp~ation of activities in collabo · with relevant stakeholders, as outlined in this plan. , gombe Mr. Percy Mr. Teofilus Nghitila. Exe utive Director Executive Director Executive Director Ministry of Health and Social Services Ministry of Agriculture, Water and Land MiniSt ry of Environment, Forestry and Reform Tourism National Action Plan for Health Security (NAPHS 2020-2025) - ACKNOWLEDGEMENTS The Government of the Republic of Namibia, through the Ministry of Health as Social Services (MoHSS) would like to acknowledge the multi-disciplinary and multi-sectoral stakeholders and experts of Namibia who contributed to the formulation and finalization ofthe NAPHS. These partners have shown strong support and commitment to strengthening Namibia's public health core ,c apacities required for the implementation of the International Health Regulations (IHR 2005) and included but not limited to the following: Office of the Prime Minister (OPM), Ministry of Agriculture Water and Land Reform (MAWLR); Ministry of Environment, Forestry and Tourism (MEFT); Ministry of Finance (MoF); The National Planning Commission (NPC); Ministry of Urban and Rural Development (MURD); Ministry of Defence (MoD); Agro-Marketing Trade Agency (AMTA); Namibia Port Authority (NAMPORT); National Commission on Research and Science Technology (NCRST); University of Namibia (UNAM); University of Science and Technology (NUST); Namibia Red cross Society (NRCS), Ministry of Home Affairs, Immigration, Safety and Security (MHAI), Ministry of Information and Communication Technology (MICT); Ministry of Works and Transport (MWT); Namibia Airport Company (NAC); Office of the OIE coordinator in Namibia; Namibia Institute of Pathology (NIP) and City of Windhoek; :1. The WHO Head Quarter and WHO AFRO Region for their technical assistance in various phases of the development of this NAPHS; The Senior Management of the MoHSS, including the Executive Director, Mr Ben Nangombe and Ms Bertha Katjivena, amongst others; The NAPHS Task Force and the secretariat that consisted mainly of the following MoHSS staff: Mr. Benson Ntomwa, Mr Gerard Benade, Ms Philomena Ochurus (Director, HIRD), Ms Undjee Kaura, Ms Emmy Ndevaetela, Ms Selma Robert-Matyenyika, Mr Gabriel Joseph and M s N diitodino K Kakehongo; ~ The WHO AFRO consultant NDOUNGUE Donjeu Epse FOSSOUO Viviane, who provided technical assistance in the finalisation, approval and launch of this NAPHS; --. The WHO Country Office for Namibia, particularly the WHO Representative, Dr Charles Sagoe-Moses; the WHE focal person, Dr Petrus Mhata; and the administrative team, including Ms Cathrin Fisch, for the facilitation; and ~ The key partners and particularly CDC, specifically Dr Leigh-Ann Miller and Kathryn Welter Savio, for their constant support throughout this process. National Action Plan for Health Security (NAPHS 2020-2025) - LIST OF FIGURES Figure 1: Real Gross Domestic Product growth rate, Namibia 2017 ................................................................. 5 Figure 2: Map of the 14 political regions in Namibia ........................................................................................ 6 Figure 3: Number of indicators per JEE score (N=48) .................................................................................... 13 Figure 4: Assessments of veterinary services in Namibia ............................................................................... 18 Figure 5: Namibia journey from JEE to NAPHS ............................................................................................. 23 Figure 6: Number of activities per priority level(N=70) .................................................................................. 28 Figure 7: Percentage ofNAPHS budget per thematic area .............................................................................. 41 Figure 8:cummulative NAPHS cost per technical area.................................................................................... 43 Figure 9: The 3 top cost drivers ....................................................................................................................... 44 Figure 10:NAPHS Cost trend per thematic area .............................................................................................. 44 Figure 11: NAPHS cost trend from 2021-2025 ............................................................................................... 44 Figure l2 Core capacities and estimated cost by partners ........................................... .................................... 45 Figure l3: Stakeholders analysis matrix for Namibia NAPHS ........................................................................ SO National Action Plan for Health Security (NAPHS 2020-2025) - LIST OF TABLES Table 1: Distribution of technical areas per average JEE indicator score ........................................................ 13 Table 2:Capacities, indicators and scores achieved during the voluntary JEE assessment, Namibia .............. 14 Table 3: Prioritisation Criteria ,... ,.,.................. ,,.,... ,, ... ,.. ,.,, ....... ,.... ,.,... ,... ,, ..... ,....... ,..,.,..,.......,.. ,... ,..,..,....... ,.. 27 Table 4: Strategic Actions, Baseline and milestones ............................................................................ ........... 29 Table 5: High priority activities with score between 9-12 ............................................................................... 38 Table 6: NAPHS cost breakdown per thematic areas aver years (NAD) ......................................................... 41 Table 7: NAPHS cost breakdown by technical area over years ........................................................... ........... .42 Table 8: The top 3 cost drivers per t hematic area ........................................................................................... 44 Table 9: Summary of risk appraisal, assumptions and management ............................................................... 45 National Action Plan for Health Security (NAPHS 2020-2025) - LIST OF ABBREVIATIONS/ACRONYMS AU African Union AG Attorney General AMTA Agro-Marketing Trading Agency AMR Antimicrobial Resistance CAPSCA Collaborative Arrangement for the Prevention and Management of Public Health Events in Civil Aviation CCHF Crimean-Congo Haemorrhagic Fever CCN Council of Churches in Namibia CDC Centers for Disease Control and Prevention COVID-19 Coronavirus Disease CVL Central Veterinary Laboratory DDRM Directorate of Disaster Risk Management EOC Emergency Operation Centre EU European Union FAO Food and Agriculture Organization FELTP Field Epidemiology and Laboratory Training Program GAP Global Antimicrobial Resistance Plan Global F und Global Fund for AIDS, Tuberculosis and Malaria GHSA Global Health Security Agenda IAEA International Atomic Energy Agency IRR International Health Regulations IOM International Organization for Migration JEE Joint External Evaluation LRDC Law Reform and Development CommlSSIOn MAWLR Ministry of Agriculture, Water and LandReform MoD Ministry of Defence National Action Plan for Health Security (NAPHS 2020-2025) - MEFT Ministry of Environment, Forestry and Tourism MoF Ministry of Finance MFMR Ministry of Fisheries and Marine Resources MGECW Ministry of Gender Equality and Child Welfare MoHSS Ministry of Health and Social Services - MHE Ministry of High Education, Training and Innovation MHAISS Ministry of Home Affairs, Immigration, Safety and Security MITSMED Ministry of Industrialization, Trade and SME Development - MICT Ministry of Information, Communication and Technology MIRCO Ministry of International Relations and Cooperation MoJ Ministry of Justice - MLIREC Ministry of Labour, Industn·al Relations and Employment Creation ·- MME Ministry of Mines and Energy MPESW Ministry of Poverty Eradication and Social Welfare - MPE Ministry of Public Enterprises MSYNS Ministry of Sport, Youth and National Services MURD Ministry of Urban and Rural Development MWT Ministry of Works and T ransport NAC Namibia Airports Cornpany ·- NCCA Namibia Civil Aviation Authority - NCRST National Commission on Research Science and Technology - NMRC Namibia Medicines Regulatory Council NAMPORT Namibia Port Authority NAMPOL Namibian Police NRCS Namibia Red Cross Society NSFAF Namibia Student F inanc1·al Assistance Fund NUST Namibia University of S cience and Technology NAPHS National Action Plan for Health Security NPC National Planning ComnuSSlOn NPID National Public Health Institute OAG Office of the Attorney G eneral National Action Plan for Health Security (NAPHS 2020-2025) - OIE World Organization for Animal Health OPM Office of the Prime Minister PEPFAR President's Emergency Program for AIDS Relief PoE Point of Entry PHEOC Public Health Emergency Operation Centre PPE Personnel Protective Equipment - SPP Strategic Partnership Portal UNAM University of Namibia UNDP United Nations Development Programme UNAIDS Joint United Nations Program.me on HIV/AIDS UNESCO United Nations Educational, Scientific and Cultural Organization UNFPA United Nations Fund UNICEF United Nations Children's Fund WHO World Health Organisation National Action Plan for Health Security (NAPHS 2020-2025) .-J EXECUTIVE SUMMARY The magnitude and frequency of disease outbreaks and health emergencies in Africa, new emerging risks such as Zika, the expansion of known diseases like Cholera and Ebola and the re- emergence of others such as yellow fever, demonstrate the urgent need for sustained preparedness and capacity building in WHO Member States. Namibia is no exception, experiencing outbreaks such as Cholera, Rift Valley Fev,er, Dengue, Anthrax, Hepatitis E and COVID-19 with high morbid!ity, mortality, and socio-economic impact. WHO Member States have agreed to work together to prevent, detect and respond to public health emergencies under the International Health Regulations (2005). A World Health Assembly (WHA) decision in May 2016 requested WHO to develop a global implementation plan that includes immediate planning to improve delivery of the International Health Regulations (2005). The IHR Global Strategic Action Plan recommends that Member States, with the support ofWHO and development partners, develop and implement 5-year national action plans. In August 2016, the AFR Regional Strategy for Health Security and Emergencies was adopted by the Regional Committee in Addis Ababa. It sets the framework and milestones for ensuring health security in the WHO African region. Member States have also agreed to work towards Universal Health Coverage and to build resilient health systems which can adapt and respond to challenges posed by outbreaks and other emergencies. Namibia, like several Member States in the WHO/AFR region, is committed to implementing the WHO IlIR Monitoring and Evaluation Framework. This includes the voluntary Joint External Evaluation (JEE) of IHR core capacities that should be followed with a national action plan to achieve and sustain core capacities. Since adoption of the International Health Regulations, Namibia has carried out several assessments of country capacity to prevent the likelihood and reduce the consequences of outbreaks and other public health hazards, and build national capacities for early detection and effective response to public health emergencies and other events of public health concern. To fulfil Article 54 of the IHR 2005, Namibia conducted the JEE in December 2016. Of the 48 indicators assessed, 8 (16.6%) were rated Green (Demonstrated/Sustainable National Action Plan for Health Security (NAPHS 2020-2025) Capacity), 24 (50%) Yellow, (Limited/Developed Capacity), and 16 (33.3%) Red (No Capacity). - The JEE highlighted the commitment of the government of Namibia to strengthen health security, the importance of national financing for sustainability and the role of parliaments in national funding decisions, the key role of community engagement, private sector engagement and the importance of resilient health systems in health security. The meeting further emphasised that strong government ownership, leadership and advocacy are needed. Furthermore, continuous active partnerships of all sectors are required to develop and implement the NAPHS and to fill identified resource and financial gaps. The plan takes into account a set of guiding principles and core values such as resilience, country ownership and leadership; community engagement; partnership inter-sectoral and multidisciplinary collaboration, evidence-led and forwards looking, and the One health approach. The Preparatory NAPHS Workshop, supported by WHO, was held from 15 - 17 August 2017 in Windhoek, Namibia. Subsequently, the Ministry of Health and Social Services of Namibia (MoHSS) conducted several stakeholder meetings to cost, review and finalize the 5-year National Action Plan for Health Security (NAPHS) based on the JEE recommendations and other complementary assessments. The NAPHS will be a coordination platform to map and ensure interplay between multiple sectors and other existing plans at all administrative. The country adopted a multi-sectoral approached hinged on the principles of 'One Health' with significant participation in the process from stakeholders from relevant government ministries and agencies, including security authorities. These included the OPM, the Ministries of Health, Agriculture, Urban and Rural Development, Environment, Mines, Finance, Defence and National Planning. The NAPHS covers all the 19 technical areas required to effectively prevent, detect, and respond to public health threats. Detailed plans for each technical area were developed by multi-sectoral working groups, to cover the period 2021- 2025. In line with the Strategic Framework for Health Emergency Preparedness, priority activities were framed taking into account the One Health Approach, Health System Strengthening, Societal, all government and sectoral engagement. The MoHSS has ensured that proposed activities are linked with on-going national strategies and guidelines, including the Sustainable Development Goals (SDGs), Universal Health Coverage (UHC), the Sendai Framework, the 5th National Development Plan (NDP5), Disaster Risk National Action Plan for Healt h Security (NAPHS 2020-2025) - management (DRM) policy, the DRM Act, the Health Sector Strategic Plan IV, the Harambee Prosperity Plan (HPP), Public and Environmental Health Act No. I of 2015, the Health Sector National Health Emergency Preparedness and Response Plan (NHEPRP), the AMR National Action Plan and Workforce Capacity strategic plan. The success in the implementation of the NAPHS will depend on the successful management of risks. Potential risks identified in Namibia are of a political, financial and operational order. However, political and security stability, political commitment and macroeconomic stability have been identified as driving forces for the implementation of the NAPHS. Estimated cost to implement all planned activities during 2021- 2025is NAD 576,323,486 (38,421,565 US dollars). In the table below, the annual implementation cost per thematic area (Prevent, Detect, Respond and Other IRR related hazards and Point of entry) is summarized. Table 6 : Total cost of NAPHS by thematic area 2021 2022 2023 2024 2025 TOTAL Prevent 47,998,054 40,823,388 39,728,428 37,057,004 37,460,764 203,067,640 Detect 69,863,479 52,262,554 49,587,348 48,703,440 48,687,348 269,104,169 Respond 27,345,214 6,853,750 2,232,490 2,232,490 2,232,490 40,896,434 Other IHR relat ed 14,076,073 16,927,789 10,843,647 10,564,087 10,843,647 63,255,243 hazards and PoE Total 159,282,820 116,867,481 102,391,913 98,557,021 99,224,249 576,323,486 The top 3 cost drivers are Workforce development: NAD 192,679,462 (33.4%), Antimicrobial resistance: NAD 82,283,344(14.2%) and Point of Entry: NAD 56,768,467 (9.8%). A multi- Agency committee (The One Health platform) will be established to oversees, and when necessary coordinate development and implementation of NAPHS in all sectors to guarantee a systematic and comprehensive approach. It also productively facilitates the collaboration of multi-sector entities in addressing the public health issues that cannot be solved by a single sector. National Action Plan for Health Security (NAPHS 2020-2025) WHO will continue to coordinate a platform for donors and partners to share, inform, and - collaborate in order to strengthen Namibia IHR (2005) capacity and increase our contribution to global health security. 1. BACKGROUND National Action Plan for Healt h Security (NAPHS 2020-2025) -

1.1. Namibia Country Profile

1.1.1 Political and socio-economic profile According to the 2016 Namibia futer Censal Demographic survey (NIDS), Namibia has an estimated population of 2.5 million 1• This figure is the projection from the 2011 population and housing census. The country is situated on the south-western Atlantic coast of the African continent, sharing borders with Angola, Botswana, South Africa, Zambia and Zimbabwe (see figure 1). A large part of the country is covered by two Africa deserts: The Namib to the west and the Kalahari to the east. Namibia is a sovereign, secular, democratic and unitary State, which is divided into the usual three powers of government: Executive, Legislative, and the Judiciary. The head of state is the President who is elected in a national election every five years. Namibia is divided into 14 political regions, which are further sub-divided into 121 regional constituencies. The capital city is Windhoek, which is located in the Khomas Region. Namibia is classified by the World Bank as an upper middle-income country. In 2017, Namibia domestic economy was estimated to have registered a contraction in real value added of 0.9 % compared to a growth of0.6 % recorded in 20162 (Figure 1). In 2018, the DGP was-1.7% at market prices3 • This is the lowest rate recorded over the last ten years. 10.0 •.. .. .. ... ~· S,I S.& ,. . - OJ • •... 0.6 200B 200! 2010 2011 2012 201) 2014 2015 2016 2017 RHI Gron Domntk Product crowth r;II~ Source: Namibia Statistic agency Figure 1: Real Gross Domestic Product growth rate, Namibia 2017 1 2016 Namibia Inter Censal Demographic survey (NIDS) 2 Namibia Statistic Agency : Annual National Account, 2017 3 Namibia Statistic Agency: National accounts, Quarter 4 GDP 2018 tables. https://nsa.org.na/page/pubHcations/ National Action Plan for Health Security (NAPHS 2020-2025) In 2017, taxes remained the main source of government revenue, accounting for 57 .6 %, followed by Southern African Customs Union receipt with 31.2%. Other source of income including - property incomes and other current transfers from rest of world contributed 11.2 percent to government income4. Out of all households in Namibia 17% are classified as poor and 11 percent as severely poor with a GINI-coefficient of 0.560. 5 .,,.__ - ' ... OSHltCOTO llMUSlll / , • ·- ICUNUtl ...... OTJOlONOJUPA. .... ....... '""""o IO'TSWANl AILJ\NTlC OCEAN _,,. -~ - · .- .. '' - ... ---·-- J ,, j .~ / ..,.,. !____,.~ so11r• « AltAS AFRICA . ,c.run., i LEGEND r··, ...,....., l -~ ......_-:,.r' 1· ,. .. ·-1 Coprngtit c 201s www.nHpaorworld.com fC4W.•...-1... llkhreA.,,r.,rt Figure 2: Map ofthe 14 political regions in Namibia

1.1.2 Situation Analysis-burden of Public Health Emergencies - in terms of morbidity and mortality

1.1.2.1 Burden of public health events in human health Namibia has recorded several documented human disease outbreaks since 2006. In 2006, the country reported a polio outbreak, which resulted! in 19 confirmed polio cases. During 2009-2014 the country reported measles outbreak in most regions, which affected chindren, particularly in north western and central regions of Namibia. These outbreaks resulted from low immunization coverage. An outbreak ofpandemic influenza HlNl was also reported in 2009 with 72 con.firmed cases and 1 death. A post- pandemic period reported 9,069 HlNl suspected cases in 2010, ofwhich 4 Namibia Statistic Agency: Annual National Account, 2017. 5 Namibia Statistic agency: Namibia Household income and Expenditure Survey(NHlES} 2016/2016 Report. National Action Plan for Health Security (NAPHS 2020-2025) - 102 were confirmed with subsequent HlNl outbreaks in which 3,155 cases were reported in Ohangwena in 2011 6 • A cholera outbreak was reported in Kunene region between December 2013 to January 2014 in which 287 cases and 10 deaths were recorded. Although the malaria mortality rate in Namibia declined drastically from 96.5 per 100,000 populations in 2000 to 8.4 per 100,000 population in 2008 (WHO Namibia, 2010), outbreaks have been on the increase in 2017. The country reported 7003 malaria cases between January and February 2017 and an increase in malaria cases ranging between 120-700% in Ohangwena, Oshikoto, Oshana and Otjozondjupa regions between 2014 and 2017. Crimean-Congo Haemorrhagic Fever (CCHF) outbreaks have been documented in Namibia since 1986. In 2019, two CCHF outbreaks were reported; one in Onandjokwe district, Oshikoto region and the other in Omusati region. No death was registered. Also, Hepatitis E Virus outbreak has been reported in September 201 7 and has been ongoing to date7 • The country recorded the first two COVID-19 cases on 13 th March 2020. As of 29 November 2020, a total of 14345 confirmed cases and 151 deaths have been recorded. All fourteen (14) regions have reported COVID-19 confirmed cases; Khomas and Erongo regions recorded the highest number with 6435(44.9%) and 4049(28.2%) respectively. Moreover, the country experiences a number of emergencies related to climate change and environmental safety. Natural disasters such as floods and droughts, which resulted in human suffering and loss of life and property, are therefore common. The MoHSS has adopted the Integrated Disease Surveillance and Response (IDSR) approach, and the International Health Regulation National Focal Point to facilitate the implementation of International Health Regulations (IHR, 2005). The MoHSS has also a National Health Emergency Preparedness and Response Plan (NHEPRP) that was approved in 2013. This plan aims at coordinating the preparedness and response activities to disease outbreaks and emergencies in the country. The Directorate of Disaster Risk Management (DDRM) under the Office of the Prime Minister (OPM) supports the MoHSS during emergencies, in collaboration with development partners including the UN and Civil Society Organizations, as per the Disaster Risk Management (DRM) Policy. The government of the Republic of Namibia desires an outcome with respect to infant and maternal mortality as per the Harambee Prosperity Plan (2016-2020), and aims at significantly reducing infant and maternal mortality rate by 2020. Additionally, the National Development Plan (NDP5) targets that by 2022, Namibia's Health Adjusted Life Expectancy (HALE) would have been improved from 58 to 67.5 years. International targets include ensuring healthy lives and promoting the well-being for all at all ages is essential to sustainable development. Significant strides have 6 Revised National Health Emergency Preparedness & Response Plan, 2013 7 National Hepatitis E outbreak Sitrep National Action Plan for Healt h Security (NAPHS 2020-2025) been made in increasing life expectancy and reducing some of the common killers associated with child and maternal mortality. Major progress has been made on increasing access to clean water - and sanitation, reducing malaria, tuberculosis, polio and the spread of HIV/AIDS. The latter is a developmental challenge for Namibia. The high prevalence of HIV at 12.6% 8is leading to the loss of labour force, erosion of the asset base and diminished capacity to care for children and other vulnerable individuals in Namibia. AIDS is contributing to the increase in orphans and vulnerable children leading to increasing burden on government to provide social protection and support. However, many more efforts are needed to fully eradicate a wide range of diseases and address many different persistent and emerging health issues including natural health hazards and disease outbreaks.

1.1.2.2 Burden of public health events in animal and environmental health The country has also been experiencing animal disease outbreaks such as Foot and Mouth disease annually as well as Rift Valley Fever between 2009 and 2010, Newcastle disease outbreak in 2016, Anthrax outbreaks in Oshikoto, Zambezi and Kavango east region. Most of these diseases have a potential to cause disease outbreaks in humans9 • In recent years, the reports on climate related disasters have increased; and extreme climatic events are becoming more frequent and severe globally. Namibia is one of the most arid countries in south of the Sahara. Highly variable climatic conditions are the norm, and the country experiences frequent dry-spells and droughts with sporadic occurrences of flooding in water basins 10• Drought may destroy crops, plant and animal life and cause water shortage/supply problems for the general population. Earthquakes are not entirely excluded as Namibia has records of seismic activities. Namibia has set up measures to respond to climate change in a National Climate Change strategy and Action Plan 2013-2020.

1.1.2.3 Progress towards achievement of international and national targets The Sustainable Development Goals 1112 Namibia recognises the importance of the global agenda 2030 specified through the 17 sustainable Development Goals(SDGs). The country developed in 2019, a Sustainable Development Goals and Fifth National Development Plan Indicator(NDP5) Framework to reflect the level of alignment of the indicator framework ofthe current NDP5 and the SDG indicator framework. It further serves as a framework for a]igning other national development plans for ease ofmonitoring and reporting. This document is a supplement to the SDG baseline report, developed in the same year, where detailed information on the 244 indicators of the SDGs monitoring framework is displayed. The 8 Namibia Population based HIV Impact Assessment- NAPHI 2017 9 MAWF, DVS's national summary report, July 2010. 10 National Climate Change strategy and action plan 2013-2020. 11 Namibia Sustainable Development Goals and Fifth National Development Plan Indicator Framework, 2019. 12 Namibia Sustainable Development Goal Baseline Report, 2019. National Action Plan for Health Security (NAPHS 2020-2025) SDG 3 aims at ensuring healthy lives and promoting well-being for all at all ages. One of the means to achieve SDG targets is to strengthen the capacity of all countries in particular developing - countries, for early warning, risk reduction and management of national and global health risks. The Namibia SDGs baseline report shows that, according to the WHO statistics, Namibia IHR core capacities has increased from 66% in 2014 to 81 % in 2016 and reduced to 79% in 2017 13 . Universal Health Coverage (UHC) 14 UHC means that everyone receives needed health services without financial hardship. Attaining UHC requires a particular emphasis on access to health care; quality of health services,· affordability; efficiency and service delivery. Access to health care services: The MoHSS has defined a set of health service packages for the three levels of health care: Primary Care (Clinics, Health Centres and Community Based Health Services); Secondary level (District Health Services) and Tertiary level (National, Regional Hospitals and Specialized Services). In general access to health care service is hindered by: (i) The non-availability of the service at the designated point of care is caused by laclk of or inadequacy in either or a combination of the following: staff availability; specialised skills or expertise; equipment; pharmaceuticals and clinical supplies; and physical infrastructure; (ii) Geographic, social and economic barriers arising from lack of transport, long distance to facilities, poor road infrastructure and poverty. Quality of Essential Health Services: The quality of the health service is fundamental to attain Universal Health Coverage. It is often reported that the standard of health care service provision in the private sector is better than that offered in the state facilities. As a result, many clients tend to seek service from private service providers. The consequence is that they might suffer financial hardship to access private service providers. Overcrowding, long ques and sub-standards service provision are some the issues that are often reported and observed in state hospitals. Affordabili'ty (Household Out-Of-Pocket (OOP) Health Expenditures): As the last 10 years of data (2004-2013) show, Namibia's OOP expenditures have been on average 18.1 percent lower than the mean for all upper-middle-income countries in WHO's AFRO region. Household OOP health expenditures are relatively low and below the WHO limit of 20 percent of Total Health Expenditure (THE), suggesting that Namibians are protected against the financial risk of health payments. However, low OOP can also be a sign that households are not seeking care when needed pointing to an access to healthcare problem. 13 http://apps.who.int/gho/data/node.main.ENVHEALTHJOINTMPHAP?lang=en 14 MoHSS, 2018: Universal Health Coverage policy framework (Draft). National Action Plan for Health Security (NAPHS 2020-2025) The Government established the Public Service Employees Medical Aid Scheme (PSEMAS) for Government employees to assist them and their dependents with cost of medical care. Standard - contributions are payable by the employees, while the remainder of the claim expenses are covered by the Ministry of Finance. Government Expenditure on Health: During the 2014/15 financial year, the Government made the largest contribution to health spending, by contributing 64% of THE, while Government managed 51 percent of THE. The 2014/15 health accounts show that approximately 36 % of THE is used to provide health services for 19% of the population, while 51% of THE must cover the remaining 81%. Progress is undeiway to reform the health sector with a view to attain UHC. A number of background studies have been completed to support decision making in the path towards UHC. This includes the Public Expenditure Review; Health Finance Review; Burden of Disease; Unit Cost of Health Services; and Efficiencies amongst other. Specific policy decision is required to take the UHC Agenda foiward and for this reason a UHC Policy Framework has been drafted. This framework articulates the basic principles and strategies that Namibia will adopt in the path towards UHC. At the conclusion of this initiative, the specific strategies will be elaborating to make progress towards UHC. Central and top on the UHC agenda, is to ensure unity of purpose and therefore stakeholder consultations have become the guiding strategy to ensure common vision and understanding is achieved among the different sectors of society. The 5 th Namibia Development Plan The Namibian 5th National Development Plan (NDP5) has incorporated the SDG 3which aims at strengthening the capacity of all countries, particularly developing countries, to provide early warning, reduce national and global risks and manage health risks, in the area of human capita development, health and nutrition strategy, by setting as a desired outcome in pillar 2 dedicated to social transformation, to offer quality health care to all Namibians and to improve Namibia Health Adjusted Life Expectancy (HALE) from 58 to 67~5 years by 2022 15 . The Ministry of Health and Social Services strategic plan (2017/2018 - 20/22) Health security is also addressed in the Ministry of Health and Social Services strategic plan 2017/2018 - 2021/2022. The MOHSS has the responsibility of ensuring the wellbeing of the Namibian people. Thus, the first strategic pillar related to "people well-being" is focusing on the improvement ofpublic health with the special effort directed at the implementation of programmes that address communicable and non-communicable diseases. 15 Namibian 5th National Development Plan (NDPS), 2018-2022 National Action Plan for Healt h Security (NAPHS 2020-2025) The Ministry of Agriculture, Water and Forestry strategic plan (2017/18 - 2021/22) - In 2015, the MA WF revised the 1995 National Agricultural Policy and developed the Namibia Food Safety Policy. This is to enhance food and nutrition security at household and national level. One of the key Strategic issue is to Implement and monitor food safety standards, in recognition of the close link between food production and human health; and improve and maintain optimal animal health status and combat zoonosis in Namibia. Among other of the Strategic plan's objective is to promote coordination of the Water and Sanitation sector activities in partnership with relevant stakeholders in order to increase access to potable water and promote hygienic practices.

1.2. Joint External Evaluation (JEE) and other assessments

1.2.1. The Joint External Evaluation of Namibia The JEE identified the country's strengths and weaknesses in the management of public health events and emergencies. The following main points were highlighted: ~ There is political and technical commitment on the part of senior staff in the MoHSS of Namibia, including the minister, the deputy permanent secretary, the former permanent secretary, as well as from senior staff from the Ministry of Agriculture, Water and Forestry (MAWF); .;.J,. Several laws and policies exist to support the implementation ofIHR (2005); • The IHR coordination, advocacy and communication mechanism is designated and includes an IHR national focal point for reporting to WHO, and a delegate for reporting to the World Organisation for Animal Health (OIE) and Food and Agriculture Organization of the U nited Nations (FAO); Health emergency management committees have been established at national, regional and district levels. There is a robust laboratory system and network in both human and animal health, with web- base,d laboratory results shared with regional and district hospitals, and some health centres, with clear oversight by the Namibia Institute of Pathology (NIP); .-.. There is a strong real-time surveillance system, with indicator-based and syndromic surveillance, and some event-based surveillance using the Integrated Disease Surveillance and Response (IDSR) strategy, which also includes surveillance of zoonosis; ,-.. The ongoing investment in the education of health professionals is impressive. Namibia is investing in the future and offering graduates a clear career path in their own country. In areas where the country lacks capacity in human resources, Namibia has established memoranda of understanding (MoUs) with foreign academic institutions, and a Field Epidemiology Training Programme (FETP) has been established; ,,. Regarding zoonosis and the One Health approach, Namibia has well-organized veterinary services and its zoonotic surveillance system has qualified staff at all three levels. There is in National Action Plan for Health Security (NAPHS 2020-2025) country training for veterinary professionals and para-professionals. The zoonotic surveillance system is complimented by well-established human-health sector real-time surveillance. A dog- - related rabies-control program has been initiated as a pilot in one district and this is planned for expansion to the whole country; ~ A great variety of messaging channels are used for risk communication and engages the community at all levels. 4 Notwithstanding the considerable efforts, significant chatnenges remain to be addressed to strengthen the country's health security: There is a lack of clarity around the participation, roles, responsibilities, relationships and authorities of key organizations such as the office of the prime minister, the ministries of environment, wildlife, and home affairs, port authorities, and other relevant stakeholders. This presents a risk in the event of rapidly escalating situations that result in losing precious time for ministerial-level decision making; ~ Clarification in advance through coordination bodies and formal policy documents will ensure all stakeholders can act within clear lines of responsibility and authority. Moreover, there remain challenges with respect to coordination of all relevant stakeholders underpinned by the One Health approach. There is, therefore, a need to improve the participation and engagement of other sectors (such as the agriculture ministry, port authorities, the environment and wildlife sectors, and security agencies) through strengthening the One Health coordination mechanism; Collaboration between human health, animal health and wildlife sholllld be strengthened through the establishment of a One Health platform. This platform could provide a forum for sharing data between sectors; ~ Namibia needs to review its public health workforce strategy to include all relevant professionals for health security, including epidemiologists, veterinarians, social scientists, and logisticians. Furthermore, there will be a need to establish minimum staffing norms for health security at all levels. The JEE colour scoring system The implementation status of each core capacity is indicated by a score, which reflects the country's level of advancement, its capacity to institutionalize technical area competencies, and ensure that they are sustainable. The following describes the level of advancement or scoring witlh. colour coding: 1. No capacity: Attributes of a capacity are not in place. Colour code Red e 2. Limited capacity: Attributes of a capacity are in development stage (implementation has started with some attributes achieved and others commenced). Colour code: J\ 3. Developed capacity: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). Colour code: I National Action Plan for Health Security (NAPHS 2020-2025) 4. Demonstrated capacity: Attributes are in place and sustainable for a few years, and can be measured by the inclusion of attributes or IHR core capacities in the national health sector plan - and a secure :funding source. Colour code: Green• 5. Sustainable capacity: All attributes are functional and sustainable, and the country is supporting one or more other countries in their implementation. This is the highest level of the achievement of implementation of IRR core capacities. Colour code: Green • Out of the 48 indicators assessed, 8(16.6%) were rated Green (Demonstrated/Sustainable Capacity), 24 (50%) Yellow (Limited/Developed Capacity), and 16 (33.3%) Red (No Capacity). (figure 2) 16 15 9 7 1 Sustainable Demonstrated Developped Limited capacity(Score 2) No capacity(Score 1) capacity(Score 5) capacity(Score 4) capacity(Score 3) Figure 3 : Number ofindicators per JEE score (N=48) The following table shows the distribution of the 19 technical areas per JEE score. Table 1: Distribution of technical areas per average JEE indicator score JEE scoring System National Coordi nation, Legislation, Laboratory Communication Policy and System and Advocacy Financing Preparedness Reporting Zoonotic JEE Disease technical Emergency Response Linking Public Food Safety areas Operations Health and Security Authorities Medical - - - - - -R-isk J Immunization Count ermeasures Communication and Personnel Deployment National Action Plan for Health Security (NAPHS 2020-2025) - Points of Entry (PoE) Radiation Real-Time Emergencies Surveillance Chemical Events Workforce Development Biosecu rity/Biosafety I The outcome of the JEE assessment is detailed in the table below: Table 2:Capacities, indicators and scores achieved during the voluntary JEE assessment, Namibia National Action Plan for Health Security ( NAPHS 2020-2025) Technical area I Indicators Sidre ~.; P.1.1 Legislatlon, laws, regulations, administrative requirements, policies or othergov- National legislation, ernment instruments in place are sufficient for implementation of International Health 3 Regulations (IHR) (2005) policy and finandng P.1.2 The state can demonstrate that it has adjusted and aligned its domestic legisla- tion, policies and administrative arrangements to enable oompliance with IHR (2005) IHR coordination, P.2.1 Afunctional mechanism is established for the coordi111ation and integration of communication and relevant sectors In the implementation of IHR advocacy P.3.1 Antimicrobial resistance detection Antimicrobial resistance P.3.2 Surveillance of infections cause<! by resistant pathogens P.3.3 Healthcare associated infection prevention and control programmes P.3.4 Antimicrobial stewardship activities P.4.1 Surveillance systems in place for priority zoonotic diseases/pathogens P.4.2 Veterinary or animal health workforce Zoonotic disea.se P.4.3 Mechanisms for responding to zoonoses and potential zoonoses are established and functional P.5.1 Mechanisms are established and functioning for detecting and responding to Food safety foodborne disease and food contamination P.6.1Whole-of-government biosafety and biosecurity system is in place for human, Biosafety and animal and agriculture facilities biosecurity P.6.2 Biosafety and biosecurity training and practices P.7.1Vaccine coverage (measles) as part of national programme Immunization P.7.2 National vaccine access and delivery

0.1.1 Laboratory testing for detection of priority diseases National laboratory 0.1.2 Specimen referral and transport system 4 system 0.1.3 Effective modern point-of-care and laboratory-based diagnostics 3

0.1.4 Laboratory quality system 4

0.2.1 Indicator-and event-based surveillance systems 3 Real-time 0.2.2 Interoperable, interconnected, electronic real-time reporting system 2 surveillance 0.2.3 Analysis of surveillance data 3

0.2.4 Syndromic surveillance systems 4

0.3.1 System for efficient reporting t,o WHO, FAO, and OIE 2 Reporting

0.3.2 Reporting network and protocols in country 3

0.4.1 Human resources are available to implement IHR core capacity requirements 2 Workforce 0.4.2 Field epidemiology training programme or other applied epidemiology training development programme in place 4

0.4.3 Workforce strategy 2 National Action Plan for Health Security ( NAPHS 2020-2025) R.1.1 Multi-hazard national public health emergency preparedness and response plan Preparedness is developed and implemented R.11 Priority public health risks and resources are mapped and utilized R.2.1 Capacity to activate emergency operations Emergency response R.2.2 Emergency operations centre operating procedures and plans operations R.2.3 Emergency operations programme R.2.4 Case management procedure.s are implemented for IHR relevanl hazards. Linking public R.3.1 Public health and security authorities (e.g. law enforcement, border control, cus- health and security toms) are linked during a suspect or confirmed biological event authorities Medical R.4.1System is in place for sending and receiving medical countermeasures during a countermeasures public health emergency and personnel R.41 System is in place for sending and receiving health personnel during a public deployment health emerg,ency R.5.1 Risk communicationsystem.s (plans, mechanisms, etc.) R.5.2 Internal and partner communication and coordination Risk communication R.53 Public communication R.S.4 Communication engagement with affected communities R.55 Dynamic listening and rumour management PoE.1Routine capacities are established at points of entry Points ofentry PoE.2 Effective public health response at points of entry CE.1 Mechanisms are established and functioning for detecting and responding to Chemical events chemical events or emergencies CE.2 Enabling environment is in place for management of chemical events RE.1 Mechanisms are established and functioning for detecting and responding to Radiation radiological and nuclear emergencies 2 emergencies RE.2 Enabling environment is in place for management of radiationemergencies 2

1.2.2. Other assessments

1.2.2.1. Capacity Assessment of the Disaster Risk Management System in Namibia Namibia experiences a complex combination of factors which renders it vulnerable to disasters and hazards such as floods, drought and desertification with impact on public health. In order to address the challenges posed by the disaster and climate risk facing the country, the Government of Namibia set up a National Disaster Risk Management System (NDRMS). In the wake of the drought triggered by the El Nino phenomenon in 2016 which has affected Namibia along with the Southern Africa sub-region, the Government seized the opportunity to undertake a capacity and needs assessment of the NDRMS. The purpose of the assessment was to identify priority actions required for building the NDRMS capacity at all levels to reduce the risk of National Action Plan for Health Security (NAPHS 2020-2025) disasters, enhance preparedness levels, and to ensure swift recovery capacity after an emergency. A national capacity assessment was thus undertaken under the leadership of the Government of - Namibia through the Directorate Disaster Risk Management(DDRM) in the Office of the Prime Minister. The exercise was supported by the UN System through the UN Country Team, the Capacity for Disaster Reduction Initiative (CADRI) and experts deployed through the United Nations Disaster Assessment and Coordination (UNDAC) system. The national capacity assessment identified existing capacities, gaps and needs related to disaster risk management, and proposed a set of prioritized recommendations 16 on how these capacities can be strengthened including the following: Conduct multi-hazard risk assessment, develop and update regularly a national multi-hazard risk profile of the country; "* Develop SOPs and formalize data and information exchange among various technical institutions, line ministries, DORM, Namibia Statistic Agency (NSA), Universities etc; '*' Develop a national DRM awareness and communication strategy to include, among others public and community awareness campaigns at national and local levels through TV, radio, social media, printed material, dedicated national days; ,:Ji. Increase capacity in disease prediction, mapping, training, simulation and coordination and Develop emergency preparedness plans for hospitals; .._ Budgets should be slowly decentralised, allocated and easily accessible for emergencies; ~ A national roster of trained and prepared volunteers could be established to enhance capacities and support the emergency response activities all-over Namibia, using already trained personnel; ~ Capacities of stakeholders should be built at all levels in contingency planning through training. This will improve their state of preparedness to different hazards in the country.

1.2.2.2. Assessment of core capacities for the implementation of IHR (2005) in Namibia, 20101 7 The assessment of the IHR core capacities was conducted in Namibia between November and December 2010. The purpose of the assessment was to determine the current status of core surveillance, response capacities and other system requirements for the full implementation of the IHR (2005). HR Legislation and Policy, IHR Coordination, Surveillance, Response, IHR Preparedness, Risk Communication, Human Resource, Laboratory and Potential hazards were assessed at national, regional, district, health facilities and points of entry. Key recommendations 13 include: Establish a functional coordinating committee on IHR at all levels; '*'- Review public health legislation and align all relevant policies and guidelines with IHR; 16 Capacity Assessment of the Disaster Rislk Management System in Namibia, 2016 17 5-year plan of action for implementation of International Health Regulations (2005) in Namibia 2012-2016 National Action Plan for Health Security (NAPHS 2020-2025) '"* Advocate and lobby central government and private sector to ensure continuous support of IHR activities; - ,... Incorporate other hazards such as chemical and radioactive into the existing surveillance system and develop surveillance guidelines and manuals to cover zoonotic, nuclear, chemical and other events; --. Develop training programmes on surveillance to cover all relevant staff and role players; .._ Strengthen the functions of international border control including regular cross border meeting and other cross border initiatives; .._ Develop preparedness plan, guidelines, Standard Operation Procedures (SOPs) for preparedness and response to all potential hazards; ,... Establish and train Rapid Response Teams; '* lncrease capacity oflaboratory facilities to cater for confirmation of events of all hazard; ... Institute training courses for health staff; .._ Upgrade technical capacity of PoEs to facilitate designation and establish surveillance structures at designated PoEs.

1.2.2.3. Assessments in the Animal health sector Development and growth of many countries depends on the performance of their agricultural policies and economies. This directly relates to the quality of their Veterinary Services (VS). Important roles for VS include veterinary public health including food-borne diseases and regional and international market access for animals and animal products. To assist in this role, the World Organisation for Animal Health (OIE) and the Inter-American Institute for Cooperation on Agriculture (IICA) have joined forces to develop a tool for the Evaluation of the Performance of Veterinary Services (PVS) of countries. The PVS tool is designed to assist VS to establish their current level of performance, to identify gaps and weaknesses regarding their ability to comply with OIE international standards, to form a shared vision with stakeholders and to establish priorities and carry out strategic initiatives. OIE mission to PVS PVS Gap Southern African Assessment Analysis countries Figure 4: Assessments of veterinary services in Namibia National Action Plan for Health Security (NAPHS 2020-2025) Namibia requested the OIE for this evaluation through the Narnibia;s Agricultural Union as one of its congress' resolution. The assessment was conducted in 2008. Keys findings 18 of this - assessment revealed that: • Namibia has very competent Veterinary Services characterized by extremely well-trained professionals. Unfortunately, the Veterinary Services have too many vacant positions, mostly due to an insufficient number of professionals in the country; .,. Namibia has established a robust animal identification and traceability system, which is mandatory in the FMD surveillance using the Namibian Livestock Identification and Traceability System (NamLITS); '* Though emerging infectious diseases and the threat of a potential pandemic form of avian influenza have reminded the international community of the importance ofa close collaboration between Ministries of Health and Agriculture, there was no apparent evidence of such a link between these two ministries in Namibia; The annual budget for VS operations appeared adequate. However, shortfalls in vehicles and transportation expenses were being covered by salary lapse from the many unfilled vacant positions. The overall monthly distance allowances for vehicle use and the reimbursement amount for official use of private vehicles will need revision. The overall budget for the Central Veterinary Laboratory should also be examined. .._ In 2010, at the request of the Government of Namibia, A PVS Gap Analysis mission was conducted by OIE certified experts from September 27 to October 8. Key inputs to this Gap Analysis exercise were the report of the PVS Evaluation performed by an OIE certified experts team in 2008 and the National Policy for the Eradication of Trans-boundary Animal Diseases in the Northern Communal Areas of Namibia. The PVS Gap Analysis Team19 noted reports of progress made by Namibia since the 2008 PVS evaluation, and in particular: .,. A policy was approved and endorsed for the eradication of trans-boundary animal diseases in the Northern Communal Areas, and plans for (i)enhanced surveillance, (ii)new identification and traceability measures, and (iii) enhanced Border Inspection Posts developed; ~ Laboratory Quality Assurance was implemented, and the Central Veterinary Laboratory (CVL) is in the process of seeking accreditation for certain of its functions adding significant additional space, equipment and biosecurity capacity to the CVL; The Veterinary Council continued with its efforts to incorporate other expertise into the cadre of recognized professionals. It recently was authorized to include animal health technicians as registered veterinary para-professionals. 18 OIE mission report evaluation of the veterinary services of the republic of Namibia, August 11 - 22, 2008 19 Namibia PVS Gap Analysis report, September 27- October 8, 2010. National Action Plan for Health Security (NAPHS 2020-2025) Despite these important accomplishments, there are still many areas that will need to be addressed in the near future, to address the ambitious goals being set out by the Ministry of - Agriculture, Water and Forestry. Improvement priorities, included: As livestock improvement priorities: To provide the necessary facilitating infrastructure and services to the Northern communal Area (NCA), by increasing the number of veterinary field offices and veterinary para-professionals. As Anima1 Hea1tb priorities: * To focus on the steps needed to achieve official OIE recognition ofthe National Foot and Mouth disease (FMD) Control Strategy, leading to FMD freedom in the NCA, as well as the maintenance of the existing free status without vaccination south of the veterinary cordon fence; .i.. To improve its effectiveness by providing meat inspection services, including ante and post- mortem inspections to all non-export abattoirs in the country; * To expand its animal disease surveillance coverage, by including all non-export abattoirs in the national animal disease surveillance system. As Veterinary Public Health priorities, it identified: A commitment to improve the control of zoonotic diseases in the NCA; ._. To improve its effectiveness by providing meat inspection services, including ante and post- mortem inspections to all non-export abattoirs in the country; ~ To expand its animal disease surveillance coverage, by including all non-export abattoirs in the national animal disease surveillance system; A commitment to improve the control of zoonotic diseases in the NCA. Strategies and activities were identified to move toward these ambitious goals. In order to achieve success, there will be a need to: ..._ Increase the number of highly qualified personnel; Provide significant additional physical and financial resources; Maintain an efficiient, functional, sustainable organization. while undergoing these changes; develop sound and adequate legislation; Build an effective information system; and build the required management and leadership capacity. All of these will have to be addressed through a harmonized and coordinated approach in order to be responding to the critical needs of the Veterinary Service. National Action Plan for Health Security (NAPHS 2020-2025) In 2013, OIE experts conducted a mission from 27-30 October20, to southern African countries (Botswana, Namibia, South Africa, Swaziland) and the objective of the mission was to assess the - implementation and compliance with the relevant provisions of the Terrestrial Code to ensure the maintenance of FMD free status. The main emphasis of the visit of the OIE expert mission to Namibia was on assessing the measures in place to protect the status of the OlE allocated free zone for FMD where vaccination is not practiced. At the end of the mission, the experts team was convinced that Namibia is doing all that is necessary to prevent the introduction of FMDV into the free zone. However, they made some observations that might help Namibia to further strengthen its commitment to comply with OIE standards and to assist them in progressing towards the ideal of expanding the official FMD freedom status also to the NCA. Some ofthe findings included: ,.._ The surveillance system was considered satisfactory but needed to extend interventions over and above inspection during vaccination campaigns. When more personnel become available the country should consider institution of regular cycles of routine inspection on establishments in between vaccination campaigns; Diagnostic capacities were also satisfactory. Test confirmation are currently done by OIE FMD Reference Laboratories. However, the team recommended to consider expanding capacity and expertise at CVL to do serology screening; ~ Vaccination was also considered satisfactory. The team recommended to continue with post vaccination monitoring programme on a regular basis; .._ The findings at the border control post were partially satisfactory, it was recommended to consider increasing visibility of Veterinary Services to public on border post reflecting prohibitions and obligations ofpublic. There is need to identify high risk foci on northern border and increase vigilance for illegal movement of animals and animal products. Till date, some improvements have been done by the country. In order to provide veterinary supervision and control of disease surveillance related activities in the country, Namibia has established a decentralized network of veterinary infrastructure managed by qualified personnel. In 2014, the number of human resources have been increased as described in the new structure as part of the strategy to meet the needs of achieving FMD and CBPP freedom in the NCA and to protect the free zone from incursion of any other transboundary animal diseases. In addition, the DYS has also developed an integrated disease surveillance and response manual which contains detailed standard guidelines on how to respond to major animal disease outbreaks. Staffs have been trained on the use of the manual. 01E experts mission, to southern African countries (Botswana, Namibia, south Africa, 20 Swaziland) from 27-30 October 2013, Report on the visit to Namibia (27-30 October 2013) National Action Plan for Health Security (NAPHS 2020-2025) Flalllll

1.3. Namibia journey from IHR JEE to Country Planning for Health Security The development of the Namibia NAPHS began with the voluntary enrolment of Namibia among the countries to undertake the JEE. Namibia was among the first nations in Africa to conduct the JEE from 28th November to 2 nd December 2016. The JEE report and recommendations were shared with all key stakeholders and published on the WHO website. The first coordination meeting for health security action p lanning took place in July 2017 where stakeholders were sensitised on the development of a 5 years NAPHS. Series of workshops were held on pre-planning, finalisation, validation, costing and documenting progress of the p lan as stipulated below: A pre-planning meeting on the development of the NAPHS was held from the 14 th to 17th August 2017 in Windhoek where the objectives were identified, strategies outlined, activities described and an M & E framework laid out; ,... The NAPHS finalization meetings were held from the 25 th to 27th September 2017 and on the 12th October in Windhoek; '!'*- A WHO team from the AFRO regional office supported the country in the validation process from the 31 st October to 2 nd November 2017 in Walvis Bay and later in the costing process from 16-18 April 2018, at Gross Barmen, Okahandja; .._. An external mission of subject matter expert visited Namibia from the 27 th to 31 st May 2019 to measure the progress made in the implementation of the NAPHS and possible outcomes following the implementation oftbe JEE. Recommendations from other IHR M&E framework such as After Action Reviews, Simulation Exercises, State Party Annual Reporting (SPAR) were also examined. The team also intended to identify best practices, challenges and lessons learnt; 4 NAPHS activities were prioritized during a consultative meeting held from 30th September to 2 nd October 2019. The majority (56%) of the activities were considered as high priority activities using established criteria and scheduled for the first 2 years of the 2021-2022 implementation period; and -. The finalized NAPHS was later validated from the 15 th to 16th October 2019, approved by the government of Namibia on the 7 th November 2019 by Executives Directors Forum and on the 12th November 2019 by the Ministry of Health Policy Management Development Review Committee (PMDRC); and officially launched on the 7 th December 2020. National Action Plan for Health Security (NAPHS 2020-2025) UOct-02 28 Nov 23-30May 7,9Nov 70ec Nov· 2017 2019 2019 2020 020ec NAPHS Doc-u_m en NAPHS NAPHS 2016 •1>1>roval Official Reviews& JEE Process launch Validation 15-17 Aue 2017 16-18 A1>r 2011 30S.1>·02Oct 2019 • e • U-14 Nov 2019 NAPHS NAPHS NAPHS NAPHS Develof>ment Costine Review Remaf> & Prioritisation Figure 5: Namibia journey from JEE to NAPHS 2. VISION, MISSION, OBJECTIVES, GUIDING PRINCIPLES AND CORE VALUES

2.1. Vision A well prepared unified One-Health system to prevent, promptly detect, and effectively respond to Public Health threats.

2.2. Mission To develop and maintain a national action plan that is comprehensive, multi-sectoral and collaborative to strengthen the Health Security system and improving emergency response to public lhealth threats in Namibia.

2.3. Specific Objectives 1. To obligate rapid effective multi sectoral national and international response through integrated coordination and communication process; 2. To strengthen and sustain core capacity to prevent and mitigate health consequences of outbreaks, disasters and other public health hazards; 3. To strengthen and sustain efficient core capacity for timely detection, reporting and effective multi sectoral, national and international response to health emergencies and all outbreaks; 4. To strengthen IHR core capacities at designated Points of Entry (PoE) in order to implement specific public health measures required to manage a variety of public health risks; National Action Plan for Health Security (NAPHS 2020-2025) 5. To develop surveillance and capacity for chemical risk events and radio-nuclear hazards with effective communication and collaboration among the sectors responsible for chemical safety, radio-nuclear management, industries, transportation and safety disposal; and 6. To strengthen institutional framework to support Health Security and One Health Approach implementation.

2.4. Guiding principles and core values Resilience: Recognizing the varied staff, programmes, disciplines, sectors and backgrounds with the ultimate aim of reaching a common goal. Country ownership and leadership: the government of Namibia will provide political and technical oversight for all phases of the NAPHS (planning, implementation and Monitoring & Evaluation), including committing domestic resources to fmance the NAPHS. Community engagement: Community engagement will be achieved through a participatory approach in development and implementation of culturally acceptable and scientifically sound risk communication strategies. Individuals in households with adequate knowledge and skills about prevention of illnesses are able to take timely corrective measures and maintain a healthy lifestyle. Therefore, empowering individuals and households by reaching them through various social groupings can improve people's lifestyles which in tum can improve the individuals' overall health status. Partnership, inter-sectoral and multi-disciplinary collaboration: The partnership principle will be facilitated through inter-sectoral collaboration at community and involvement of the wide spectrum of all relevant stakeholders at national level. This entails partnership with other government departments, sectors, development partners, and academia. Evidence-led and forward looking: To take into account emerging trends, risks and health innovations; and Inter country, regional, sub-regional and cross-border cooperation to reinforce timely information sharing and coordinated interventions. One Health Approach: One Health is an approach that addresses public health events such as high impact infectious diseases arising at the intersection of human, animal ( domestic and wildlife), and environmental interface. This NAPHS is underpinned on the one health approach and will ensure that all phases take into consideration the one health approach. National Action Plan for Health Security (NAPHS 2020-2025) - 3. METHODOLOGY AND PROCESS OF DEVELOPING THE NAPHS

3.1. Review of JEE and other assessments recommendations The NAPHS development in Namibia was rooted in the NAPHS guide developed by WHO to guide countries in this process. This guide is intended for national health authorities and stakeholders involved in developing and strengthening national action plans for health security and public health emergencies. It provides a set of principles and key issues for consideration in developing such plans, within the context of assessing, reviewing and strengthening national capacities for health security and public health emergencies. Following the JEE, under the leadership of the MoHSS, critical actors in health security in Namibia was mapped and advocacy conducted for support to the national action planning process. In July 2017, a situation analysis was conducted by the Ministry of Health and Social Services of the country's IHR status was conducted to take stock of the current level of capacities for health security. A review of the JEE report, the 2016 capacity assessment report of the disaster risk management system in Namibia, the 2013 OIE audit report of the animal sector and the 2011 assessment of the core capacities for the implementation of IHR in Namibia was conducted in a participatory and inclusive process. This was complimented by discussion and review by the national experts in working groups drawing representation from IRR-relevant sectors. The JEE report recommendations were reviewed for relevance and to ensure existing weaknesses and gaps are addressed per thematic area. The purpose of this multi-disciplinary and multi-sectoral meeting was to ensure that the planning process takes into account all the available assessments and that a coordinated approach is in the place between different sectors of the government and ministries during the planning and implementation of national action plan for health security. Hence, the stakeholders' meeting was convened by the Ministry of Health and Social services together with WHO - country office and key stakeholders. The specific objectives of the meeting were to: r-k Share the outcome of the Joint External Evaluation (JEE) assessment (JEE country report) with participants; i:-J.. :introduce the IRR implementation plan development process and tools for developing the IBR implementation plan; -.. strengthen stakeholders' collaboration and expedite the implementation of IRR 2005 core capacities in Namibia; ..., To agree on timeline, roles and responsibilities among participants in undertaking the development and implementation of the IHR core capacities in Namibia. From the 14th to 17th August 2017, a pre-planning meeting on the development of the NAPHS took place with the foHowing key stakeholders: Three levels ofWHO (Country Office, AFRO/HQ) worked with Ministry of Health and Social Services, and the following key stakeholders MAWF, MET, NCRST, NPC, MoD, NAMPOL, NAC, MURO, AMTA, MWT, UNAM, NUST, Ministry National Action Plan for Health Security (NAPHS 2020-2025) of Mines, MIRCO, OPM and Namibia Red Cross Society (NRCS) and other health development partners (CDC). The objectives of the Pre-Planning workshop were: - ~ To review, formulate and confirm strategic activities, map out the linkages with wider sector plans and synergies with other existing and relevant national plans and define activity categorization and breakdown (for future costing purposes); ~ To sequence/ phase activities (year 1, 2, 3-5) for operationalization commensurate with anticipated resource availability and financial outlook; For each technical area, to utilise the best available data to categorise activities in terms of domestic or external funding as appropriate; For each technical area, identify responsible Ministries/Offices to take forward agreed activities; 4 To review, formulate and confirm sequencing of activities (within year 1, year 2 and beyond) and appraise prioritisation and identification of responsible authorities. The outcome ofthe pre-planning meeting led to the drafting of a planning matrix with key activities to be implemented to increase the score for each JEE indicator, as well as an analysis of the country's capabilities, gaps, opportunities and challenges, which were later consolidated by the same stakeholders during a workshop held from the 25 th to 27th September 2017. A core team of about 12 people final:ized the plan and made it ready for submission. The finalized planning matrix and the narrative was then submitted to AFRO/HQ on 16th October 2017. The validation and costing of the plan took place in Protea Hotel, Walvis Bay from 16th to 18th April 2018. Three levels of WHO, Ministry of Health and Social Sciences and other health development partners convened as a follow up workshop to validate, facilitate and assist with the final review of priorities, formulation and sequencing of strategies/activities and to cost the activities. In a nutshell, the review and costing exercise reviewed and advised on the following: ..L. Are the activities that are considered for costing realistic, measurable, specific, time-bound and will exert impact and efficiency to corresponding objective(s)? Does the technical area have adequately considered the areas of activities that will allow the country to demonstrate progress from lower to higher score? Likewise, does the plan allow the country to maintain the capacities on areas where it demonstrated capacities (high scores - 4- 5). ,_,. The outcome formulation for the 5-year National Action Plan for Health Security: Does the activities under this (specific) technical area identify/include wider sectors and levels for their participation to deliver it by underpinning One Health, Health System Strengthening equity as/where applicable? -.. Do the activities follow a sequential / phased approach (year l, 2, 3-5) for its operationalization commensurate with resource availability and mobilization by utilizing ongoing fmancial outlook? Does the technical area utilize the best available data to categoriize activities in terms of domestic vs external funding? National Action Plan for Health Security (NAPHS 2020-2025) ..._ Does the technical area identify the responsible Ministries/Offices to take forward agreed activities? - 3 .2. Prioritisation of activities by technical areas Based on the result of the situation analysis, thematic working groups developed objectives and strategic actions that address the weaknesses and gaps in the country's health security across the 19 thematic areas. Responsible directorates, programmes, agencies or authorities for implementation per strategic action were identified and relationships to existing plans, project or activities spelled out. This prioritisation process with cross-sector consensus ensured making the best use of resources, ensuring that the greatest needs are addressed and that both the planning and resource allocation are rational and transparent. Each strategic action was operationalized through development of low nevel activities with coherence to fully address the priority strategic actions, objectives and situation analysis recommendations. A logical framework for coordination and accountability among stakeholders was developed per activity, output and outcomes indicators, and implementation schedule. This will be essential for the monitoring and periodic review of implementation of the plan and inform necessary adjustments to the plan. The prioritisation process will ensure that stakeholders are working towards common goals andl expected outcomes. Six prioritisation criteria were used to select the high priority activities. Each was given a weighted score as described in the table below. Table 3: Prioritisation Criteria High Impact: What is the capacity to contribute to the development of From Oto 3 health security capacities and to strengthen the health system in a sustainable wa ? Low hanging fruit: Is it something that can be done quickly, with From0 to 2 minimal resources? Known Advocate: Is there a national champion who will deploy From Oto 1 energy to support the activity? Not much resources needed: Will it require a lot ofresources to From Oto 2 complete (human, financial and te,chnical)? Existing resources: Are there existing resources or high potential for From Oto 3 obtaining the necessary resources? Complimentarity: Is there compl,ementarity with other plans? From Oto 1 For a given activity, after applying all the criteria, when the total score was between the range of 0 to 4, the activity was low priority, between 5 and 8, the activity was of medium priority and National Action Plan for Health Security (NAPHS 2020-2025) - between 9 -12, the activity was considered a high priority activity to be implemented within the first year of the implementation of the NAPHS. • High priority • Low priority Figure 6: Number of activities per priority level(N=70) Out of the 70 JEE recommendations, 32(46%) activities were considered! to be high priority activities. Those activities are presented in Table 5 below by thematic area and by technical area.

3.3. Linkage with other programmes/initiatives In the process of developing the NAPHS, a comprehensive review of the strategic actions was conducted to identify overlap with existing plans, programmes and activities. While taking note of this overlap for synergy and integration, necessary adjustments in the plan were made for efficiency and to eliminate duplication. The MoHSS has ensured that proposed activities are linked with the Namibia 5th National Development Plan (NDP5) and the MoHSS Strategic Plan (2017/2018-2021/2022) and the MAWF strategic plan (2017/ 18 - 2021/22). This NAPHS is also linked with other on-going national strategies, programs and projects including the Sustainable Development Goals (SDGs), the UHC These linkages will enhance adequate and sustainable resource allocation, advocacy, monitoring, accountability and efficiency during implementation.

3.4. Sector Wide Approach Implementation of the NAPHS will require strong national leadership and ownership by the government. This will improve donor coordination and alignment to reduce or minimize transaction costs, improve aid effectiveness, and increase equity. In the context of One Health, the Government of Namibia will play an overall stewardship and coordination role, and this will be technically led by the MoHSS. Preparedness for and management of health security threats requires a coordinated multi sectoral approach as capacities for surveillance, identification of threats, laboratory confirmation, risk assessment, response and coordination of efforts may involve many sectors outside human health. The process of developing the NAPHS adopted a Sector Wide Approach (SWAp) with the government agencies working together with development partners. National Action Plan for Health Security (NAPHS 2020-2025) During the preparatory period leading to the JEE and to the development of the NAPHS, the MoHSS took leadership and mapped all government agencies and partner organizations who play a role in implementing health security activities. This widened the scope of participation in conducting the JEE and in action planning. The SWAp strategy has created an environment of dialogue on the status of implementation ofIHR (2005), existing challenges and gaps, health sector priorities needs, mechanisms for inter-sectoral collaboration to address these and monitoring and evaluation.

3.5. Strategic pai1nership for planning In line with the WHO Strategic Planning Portal (SPP) framework, Namibia fully kept national and international partner organizations including UN agencies (WHO, FAO, OIE) informed of the preparations and progress during the development of the national action plan. This enabled international partners to support the preparatory activities and the planning workshops. The MoHSS also mobilised strategic partnership with other government ministries and agencies and in-country health partners whose cross-disciplinary expertise was critical to the successful preparation and action planning. This further embeds the One Health approach and integrated health security development in the planning process. The MoHSS will take forward this partnership with all relevant stakeholders and existing frameworks (FAO, OIE, Global Health Security Agenda, World Bank and other development agencies) to support the plan for expedited IRR implementation with transparency and accountability in external investment, progress, and the delivery of action plan. Information from the monitoring and evaluation benchmarks will be openly shared on the WHO SPP platform. 4. COMPONENTS OF THE ACTION PLAN

4.1. Strategic actions/strategic Interventions Table 4: Strategic Actions, Baseline and milestones Technical area Strategic Actions/strategic interventions Baseline 2020 Milestone The National IHR Focal Point should assess the existing By December 2021, legislation, regulations, policies, strategies, plans and public health law guidelines for their content, relevance to IHR (2005) assessed and updated National legislation, and the One Health approach, especially focusing on 0 policy and financing possible overlaps, contradictions and out-of-date practices; and report the findings to the MoHSS and the cabinet committee for legislative evaluation. National Action Plan for Health Security (NAPHS 2020-2025) By December 2022, The mechanisms for multisectoral, multi-stakeholder Mou and SOPS National legislation, collaboration, SOPs and Mo Us for the implementation 0 developed/Reviewed policy and financing of the IHR should be reviewed and developed for IHR accordingly. implementation By December 2022, budget line for National legislation, Adequate funding for the implementation of the I HR at implementation of the 0 policy and financing all levels should be ensured. NAPHS activities will be included in the government budget -By end of March 2021, a multi-sectoral Strengthen IHR coordination by setting up a functional IHR NFP in place IHR coordination, mechanism, body or office to be responsible for - By end of June 2021, communication and 0 IHR coordination and communication and to ensure a One healt h platform advocacy availability at all times. established and functional at national level Implement simulations, drills and post-event action By end of November IHR coordination, reviews in order to recognize weaknesses in the 2021, at least 1 table communication and 0 response processes and continuously monitor and top Simex conducted advocacy develop IHR performance. every year Establish a National Action Plan for AMR that is aligned with the Global Action Plan as requested by the 68th World Health Assembly Resolution, preferably Antimicrobial resistance In place formulated by a multisectoral committee on AMR with collaboration from public health and animal health authorities. By March 2022 AMR Designate AMR reference laboratories for human Antimicrobial resistance 0 reference laboratory health, animal health, food and environment. designated By December 2022, Antimicrobial usage Establish surveillance of antimicrobial usage and AMR data available Antimicrobial resistance in humans and animals, to generate robust national 0 By December 2023, data. AMR pattern surveillance data available Zoonotic diseases Nat ional Act ion Plan for Health Security (NAPHS 2020-2025) Adopt a One Health approach that will bring together 0 By December 2021 a One Health zoonotic - relevant stakeholders to tackle zoonotic diseases. programme (technical team) in place Establish formal mechanisms for sharing information By December 2021a on zoonotic diseases and outbreaks between the One Health zoonotic Zoonotic diseases 0 animal, human and environment/ wildlife sectors at programme (technical national and regional levels. team) in place Establish proper linkages between public health and By April 2023, a Zoonotic diseases animal health laboratories and leverage existing 0 national laboratory capacities. network in place By December 2023, Food safety The monitoring system needs to be expanded to monitoring system Food safety 0 secondary processed foods. expanded to secondary processed food The mechanism for recall, and for t he safety of By December 2025, imported food, needs to be expanded to all regions and recall system Food safety 12 strengthened in terms of human resources and expanded in 14 regions facilities. By March 2021, a task force established Establish a task force with representatives of {at least) By March 2022, Biosafety and biosecurity the MoHSS, the NIP, NCRST, the CVL and the 0 biosecurity/biosafety environment authority to conduct a needs assessment need assessment and develop an integral biosafety and biosecurity plan performed and using the One Health approach. It must include biosecu rity/Bio safety legislation and regulation gaps. plan developed Conduct a comprehensive training needs assessment to By March 2023, 100 identify gaps and start to address the capacity building personnel trained on for biosafety and biosecurity, linking animal and human Biosafety/ Biosecurity Biosafety and biosecurity health experts of government agencies, academia, 0 international coo[Peration agencies and / or foreign governments. This should be followed by the implementation of a training program in the country. Organize and conduct simulation exercises addressed By December 2025, 1 to test biosafety and biosecurity with the participation Simex conducted per 0 Biosafety and biosecurity of all stakeholder s at least once year after the training year has ended. National Action Plan for Health Security (NAPHS 2020-2025) Develop and implement regulations for vaccination By December 2022, vaccination regulation - Biosafety and biosecurity (pre-exposure prophylaxis) for laboratory personnel 0 in place for laboratory (Hepatitis B, HIV and other relevant diseases). personnel for relevant diseases Develop and implement laboratory licensing and By December 2021, pathogen control measures including requirements for Lab containment Biosafety and biosecurity physical containment and operational practices, and 0 procedures measures containment and failure reporting systems developed and implemented By December 2021, a Strengthen collaboration between animal and human communication health (under the One Health approach) to prevent and mechanism in place for Immunization respond to outbreaks. This calls for the need to put in 0 human and animal place a mechanism for improved communication and health to improve engagement. immunization By end 2025, Measles Improve routine immunization coverage through Containing Vaccine Immunization increased social engagement with mothers and 80% (in 2018) 21 (MCVl) immunization community leaders to increase uptake. coverage increased from 80% to 81% Community health workers/extension Increase the motivation of community agricultural and Immunization officer are health volunteers/extension officers. employed in government By December 2022, an immunization data Strengthen mechanisms for quality monitoring of both quality assessment Immunization 0 programmes, including data gathering and sharing. technical group in place in human and animal sector Expand testing capacity for IDSR priority diseases. By December 2024, 5 labs with diagnostic National laboratory 0 capacities for IDSR system priority diseases in place Improve laboratory data management and reporting, By April 2023, a National laboratory and develop a laboratory information system (US). 0 national laboratory system network in place. 21 Namibia EPI strategic plan 2018-2022 National laboratory Nat ional Act ion Plan for Health Security (NAPHS 2020-2025) Strengthen the laboratory management quality system across the country. 0 By December 2025, a quality management - system system in place Enhance and expand laboratory infrastructures. By December 2025, 4 human Labs and 3 National laboratory 0 Animal Lab fully system equipped t o perform Point of Care test The establishment and implementation of event-based By December 2022, Real-time surveillance surveillance as outlined in the Namibia IDSR guideline 0 Event based (2011) to complement indicator-based surveillance. surveillance in place The establishment of interoperable, interconnected By December 2021, surveillance systems for both human and animal Interconnected and health, capable of sharing data with different interoperable system Real-time surveillance 0 stakeholders for a timely response. in place between human and animal sector in place Strengthen early reporting to WHO, OIE and FAO, and By December 2025, 1 from community level to national level, through the use Table Top Simex Reporting 0 of simulations of epidemics and exercises. conducted per year for reporting Conduct after-acition reviews (AAR) and Intra-Action By December 2025, Reviews (IAR) to analyse what happened, why it AARand IAR Reporting 0 happened, and how it can be done better by all the conducted after every stakeholders. outbreak. Capacitate the National IHR Focal Point with the By December 2021, authority of reporting to WHO to ensure early IHR NFP capacitated Reporting reporting and therefore rapid response. 0 with communication facilities for timely reporting. Review and improve the design of the current disease By December 2022, reporting system using information and communication IDSR module technologies to improve timeliness, completeness, incorporated in DHIS 2 reliability and to reduce the workload for end users, as and is operational in all Reporting well as facilitate prompt response. 0 health facilities By December 2023, an electronic reporting system in place in the animal sector. National Action Plan for Health Security (NAPHS 2020-2025) Integrate reporting between ministries by facilitating interfaces among· systems already in place, and using Draft MoU developed By December 2025, interoperable system - Reporting common communication channels. between in place ministries Strongly advocate for continued support for the FELTP By December 2025, 40 Lab, 35 EH Ps, 7 to the central government and international maintain the number Workforce development FELTP trainedl organizations. of health personnel every year trained per year Increase the number of students recruited for training Workforce development as laboratorians, ,environmental health professionals and epidemiologists. Develop workforce strategy specific to public health By April 2021, fields in collaboration with the UNAM and the MoHSS Workforce workforce strategy in Workforce development to increase the retention of staff, create a career strategic plan in place ladder, and move people to the places in the country place where they are most needed. Combine the resources of staff and graduates of the By December 2022, FELTP with those of UNAM to maximize expertise for MoU signed between Workforce development 0 training, research, and mentoring in public health. FELTP program, UNAM and NUST Create positions for epidemiologists and other public By December 2025, Workforce development health staff in the organigram and salary plans of the 0 epidemiologists government. position created Create consensus for the development of a National By December 2022, A Public Health Institute (NPHI) as an organ of the MoHSS NPHI in place Workforce development 0 that is intimately related to public health training programmes in the country. By December 2021, NHEPRP updated and The NHEPRP should be updated into a multi-hazard costed to multihazards plan, to include biological, chemical and radiological plan hazards. There should be a One Health approach and whole-society involvement with multisectoral and Preparedness multidisciplinary participation. Additionally, an 0 identifiable allocated budget should be included for every government organization that participates in such a plan, that is the plan should receive full funding to be implemented. External support, including deployment of technical expertise, will be needed and should be strongly considerred. Preparedness National Action Plan for Health Security (NAPHS 2020-2025) Key to the development of a multi-!hazard preparedness and response plan is the need for the By December 2025, country risk profile - THIRA done and country to undertake risk profiling, and undertake, updated every year VRAM process based on the risk profile included in the NHEPRP, an started assessment to map out all the potential hazards in the country. Preparedness A map that includes all hazards possibly threatening By December 2025, Namibia's health security must be prepared, updating hazards mapping THIRA done and existing reports, documents and studies done in updated every year VRAM process different sectors. It must be made available for all started stakeholders at the local, regional, national and international levels. Preparedness National or regional simulation exercises/ drills to must By December 2025, 2 be organized and implemented in order to Identify Table Top 5imex and 1 gaps, raise awareness and improve societal and functional Simex 0 governmental preparation for public health conducted every year emergencies. These drills should relate to the types of hazard that are prevalent in the country. Establish a permanent national PHEOC, with formalized By December 2022, Emergency response standard plans and response programmes in place. 0 PHEOC plan and SOPs operations in place Emergency response Provide ongoing training due to staff turnover, as well By December 2025, 20 operations as coordinator with stakeholders not present in the 0 staff trained at the PHEOC. PHEOC Emergency response Prepare for eme:rgencies with which the country is not By March 2022, 2 operations yet familiar, including disease outbreaks, mass casualty Table Top Simex and 1 0 events such as plane crashes and chemical or radiologic functional Simex disasters through simulations. conducted every year Linking public health and Establish legal agreements (MoUs, acts of parliament) By December 2021, security authorities and SOPs for cooperation between law enforcement review existing MoU to authorities and public health and animal health consider public health authorities In place sector By December 2021, SOPs for cooperation available Linking public health and Share information between relevant authorities and By December 2025, security authorities conduct joint coordinated exercises and simulations. security forces 0 connected to the interoperable system in place Linking public health and Nat ional Act ion Plan for Health Security (NAPHS 2020-2025) Conduct risk analysis of the potential release (spillage) of pathogens and!/ or other hazardous materials. THIRA done aind VRAM process By December 2025, country risk profile - security authorities started updated every year Develop a national plan for deploying Medical Counter By March 2023, MCM Medical Measures (MCM), as well as a personnel deployment and personnel countermeasures and 0 plan. deployment plans in personnel deployment place By December 2025, international 5 southern region countries agreements Medical Develop international or multilateral agreements for rapid deployment countermeasures and between countries and ministries for receiving and of MCM and personnel personnel 0 during emergencies in sending personnel and equipment to manage emergencies. place deployment By December 2022 SOPs for MCM and personnel during emergencies in place Medical Conduct exercises and simulations once plans have By December 2025, 1 countermeasures and been drafted. table top Simex personnel 0 conducted per year deployment Risk communicat ion Strengthen coordination and stakeholder participation By December 2021, a in risk communication, including in development of 0 risk communication plans and implementation of interventions. plan and SOP in place Risk communication Build strong working relationships with all relevant By May 2021, a risk sectors. communication 0 committee/platform in place at the national level Risk communicat ion Review and develop multi-hazard risk communication By December 2021, strategies. 0 Risk communication strategy in place Existing air PoEs need to be reviewed to build IHR core By December 2025, Points of ent ry capacities, including detection, isolation, and patient 0 HIR core capacities transport. assessed in the 4 PoE Points of entry Build models for developing IHR plans at ground PoEs By December 2025, by using the existing excellent Port Health Services 0 health services system system at Walvis Bay. National Action Plan for Health Security (NAPHS 2020-2025) in place in 5 ground PoE Points of entry Identify major potential hazards to prioritize the By December 2025,risk development of the most important control measure at assessment and hazard air and ground PoEs. mapping in place at 0 the 11 PoE (4 airports, 5 ground crossing and 2 seaports) Chemical events A poisons centre needs to be institutionalized. By December 2023, a 0 poison centre in place Chemical events A treatment infrastructure programme that will cleanse By December 2023, a casualties outside hospitals needs to be constructed. treatment center in 0 place for management of chemical events affected patients Chemical! events Medical system personnel need training and practice to By December 2021, 55 coordinate chemical incidents. 0 health profossional trained Chemical! events SOPs to institutionalize multisectoral assessments for By December 2022, the treatment of chemical incident need to be SOPs for management 0 developed. of chemical events in place Chemical! events Regular controls and unannounced controls need to be By December 2025, performed to maintain safe transportation of chemicals 0 quarterly field vists inside and outside enterprises. conducted Strengthen the regulatory capacity and consider By December 2021, 3 networking with other regulatory bodies in the region MoU signed with for the control of the import/ export of radiation foreign bodies for Radiation emergencies 0 sources. control of import/export of radiation sources Finalize the national radiological emergency By December 2021, preparedness and response plan and conduct drills. Radiation emergency Radiation emergencies Draft preparedness and response plan in place Radiation emergencies The national radiological emergency response plan By December 2021, must be integrated into the national disaster risk The national 0 management plan. radiological emergency response plan integrated into the National Action Plan for Health Security ( NAPHS 2020-2025) national disaster risk management plan Radiation emergencies Strengthen the advisory role of the Atomic Energy By December 2022 Board to control and manage regional and local Atomic energy Act Atomic Energy Act authorities on matters relating to radiation safety and reviewed approved radiological emergencies. Radiation emergencies Assess the needs in terms of technical capabilities and By December 2023, develop risk assessment procedures, especially at Po Es 0 need assessment to ensure control and monitoring of radiation sources. conducted in 11 PoEs Radiation emergencies Strengthen the regulatory infrastructure, especially the By December 2025, development of radiation emergency response and Atomic Energy Act is preparedness plans at all facilities and by all national 0 revised in order to institutions that are involved with radiation sources. strengthen the Atomic Energy Board.

4.2. Planning matrix of priorities - short term (12 months) to long term (> 12 months) Using the six prioritization criteria described in the prioritization section above, the following key activities were considered as high priority activities to be carried out within the first year of implementation of the NAPHS. Table 5: High priority activities with score between 9-12 Technical High priority activities areas National The National IHR Focal Point should assess the existing legislation, regulations, policies, legislation, policy strategies, plans and guidelines for their content, relevance to IHR (2005) and t he One and financing Health approach, especially focusing on possible overlaps, contradictions and out-of- date practices; and report the findings to the MoHSS and the cabinet committee for legislative evaluation. IHR coordination, Strengthen IHR coordination by setting up a functional mechanism, body or office to communication be responsible for and advocacy IHR coordination and communication and t o ensure availability at all times. Antimicrobial Establish a National Action Plan for AMR that is aligned with the Global Action Plan as resistance requested by the 68 th World Health Assembly Resolut ion, preferably formulated by a multisectoral committee on AMR with collaboration from public health and animal health authorities. Antimicrobial resistance National Action Plan for Health Security (NAPHS 2020-2025) Designate AMR reference laboratories for human health, animal health, food and environment. - Antimicrobial Establish surveillance of antimicrobial usage and AMR in humans and animals, to resistance generate robust: national data. Zoonotic diseases Establish formal mechanisms for sharing informat ion on zoonotic diseases and outbreaks between the animal, human and environment/ wildlife sectors at national and regional levels. Zoonotic diseases Establish proper linkages between public health and animal health laboratories and leverage existing capacities. Biosafety and Establish a task force with representatives of (at least) the MoHSS, the NIP, the CVL biosecurity and the environment authority to develop a needs assessment and to prepare an 1 integral biosafety and biosecurity plan using the One Health approach. It must include legislation and regulation gaps. Biosafety and Develop and implement regulations for vaccination (pre-exposure prophylaxis) for biosecurity laboratory personnel (Hepatitis B, HIV and other relevant diseases). Immunization Strengthen collaboration between animal and human health (under the One Health approach) to prevent and respond to outbreaks. This calls for the need to put in place a mechanism for improved communication and engagement. Immunization Improve routine immunization coverage through increased social engagement with mothers and community leaders to increase uptake. Immunization Strengthen mechanisms for quality monitoring of both programmes, including data gathering and sharing. Strengthen the :laboratory management quality system across the country. laboratory system Real-time The establishment and implementation of event-based surveillance as outlined in the surveillance Namibia IDSR guideline (2011) to complement indicator-based surveillance. Real-time The establishment of interoperable, interconnected surveillance systems for both surveillance human and animal health, capable of sharing data with different stakeholders for a timely response. Reporting Strengthen early reporting to WHO, OIE and FAO, and from community level to national level, through the use of simulations of epidemics and exercises. Reporting Conduct post-action reviews to analyse what happened, why it happened, and how it can be done better by all the stakeholders. Reporting Capacitate t he National IHR Focal Point with the authority of reporting to WHO to ensure early reporting and therefore rapid response. Reporting Integrate reporting between ministries by facilitating interfaces among systems already in place, and using common communication channels. Workforce Strongly advocate for continued support for t he FELTP to the central government and development international organizations. Workforce development National Action Plan for Health Security (NAPHS 2020-2025) Develop workforce strategy specific to public health fields in collaboration with the UNAM and the MoHSS to increase the retention of staff, create a career ladder, and - move people to the places in the country where they are most needed. Workforce Combine the resources of staff and graduates of the FELTP with those of UNAM to development maximize expertise for training, research, and mentoring in public health. Workforce Create positions for epidemiologists and other public health staff in the organigram development and salary plans of the government. Workforce Create consensus for the development of a public health instit ute as an organ of the development MoHSS that is intimately relat ed to public healith training programmes in the country. Prepare for emergencies with which the country is not yet familiar, including disease response outbreaks, mass casualty events such as plane crashes and chemical or radiologic operations disasters through simulations. Linking public Establish legal agreements (MoUs, acts of parliament) and SOPs for cooperation health and security between law enforcement authorities and public health and animal health authorities authorities Linking· public Share information between relevant authorities and conduct joint coordinated health and security exercises and simulations. authorities Risk Build st rong working relationships with all relevant sectors. communication Existing air PoEs need to be reviewed to build IHR core capacities, including detection, isolation, and patient transport. Points of entry Existing air PoEs need to be reviewed to build IHR core capacities, including detection, isolation, and patient transport. Radiation Strengthen the rregulatory capacity and consider networking with other regulatory emergencies bodies in the region for the control of the import/ export of radiation sources. Radiation Finalize the national radiological emergency preparedness and response plan and emergencies conduct drills.

4.3. Costing of activities and summary of cost categorisation by JEE thematic areas Overall, Namibia will require nearly NAD 576 323 486 (38 421 565 US dollars) over a period of 5 years to implement the NAPHS ( costs for 11 thermal scanners not included). The highest cost will be allocated for Detect technical area accounting for about 4 7% of the total NAPHS budget. National Action Plan for Health Security (NAPHS 2020-2025) - Iii Prevent Iii Detect Q Respond ~ Other Figure 7: Percentage ofNAP HS budget per thematic area

4.4. Cost breakdown by JEE thematic area over years The government of Namibia through the relevant Ministries and agencies will allocate approximately NAD 144 080 871 (USD 9 million) annually to support implementation ofNAPHS. This amount will arise from human resource costs, direct allocation to specific interventions in the priority sectors and other sector related operational costs. Table 6: NAPHS cost breakdown per thematic areas aver years (NAD) 2021 2022 2023 2024 2025 TOTAL Prevent 47998054,32 40823388,3 39728428,3 37057004,3 37460764,3 203067640 Detect 69863479 52262554 49587348 48703440 48687348 269104169 Respond 27345214 6853750 2232490 2232490 2232490 40896434 Other I HR related 14076073 16927789 10843647 10564087 10843647 63255243 hazards and PoE Total 159282820,3 116867481 102391913 98557021,3 99224249,3 576323486

4.5. Cost breakdown by technical area over years Table? below shows cost of the NAPHS by thematic and technical area. The 3 top cost drivers are workforce development, Antimicrobial resistance and point. of entry. National Action Plan for Health Security (NAPHS 2020-2025) ~ Table 7: NAPHS cost breakdown by technical area over years Legislation, Policy and Financing 2. IHR Coordination 174000 174000 174000 174000 174000 870000 Communication and Advocacy 3. Anti-Microbial 14580328 15544308 18624852 16016928 17516928 82283344 Resistance 4. Zoonotic Disease 9784588,32 9712540,32 9632188,32 9632188,32 9632188,32 48393693,6 @ ood Safety - - 13894380 I 4981620 L 5076920 [ 5964520 I 48672w] 3478472?] 6. Biosafety and 1760812 6563052 972600 451500 22500 9770464 Biosecurity 8. National 7603839 2533440 2293000 2293000 2293000 17016279 Laboratory System 9. Real Time 19239528 l 2215448 2215448 1690448 1315448 26676320 Surveillance [_§. Reporting 680866u = 7615580 ] 6222256 1 5863348 1 6222~ 32732108 ] 11. Workforce 36211444 39898086 38856644 38856644 38856644 192679462 Response Operations 14. linking Public 456838 279560 279560 279560 279560 1575078 Health and Security Authorities 15. Medical 1398386 1572200 172200 172200 172200 3487186 Countermeasures and Personnel I Deployment 16. Risk 5491448 3752190 530930 530930 530930 10836428 ICommunication National Action Plan for Health Security (NAPHS 2020-2025) Other IHR related hazards and PoE 17. Points of Entry 12258679 14397447 10037447 10037447 10037447 56768467 (PoE) 18. Chemical Events 1649444 526640 806200 526640 806200 4315124 19. Radiation 167950 2003702 0 0 0 2171652 Emergencies Workforce Development 192679462 Anti-Microbial Resistance 82283344 Points of Entry (PoE) 56768467 Zoonotic Disease 48393693.6 Food Safety 34784720 Reporting 32732108 Real Time Surveillance 26676320 Immunization - 23512580 Emergency Response Operations 21263942 National Laboratory System 17016279 Risk Communication • 10836428 Biosafety and Biosecurity • 9770464 Chemical Events I 4315124 Preparedness I 3733800 Medical Countermeasures and Personnel, .. I 3487186 National Legislation, Policy and Financing I 3452838 Radiation Emergencies I 2171652 Linking Public Health and Security Authorities I 1575078 IHR Coordination Communication and Advocacy J 870000 Figure 8:cummulative NAPHS cost per technical area

4.6. Summary of cost analysis The 5-year cost estimate developed during the planning exercise for implementing the Namibia NAPHS is approximately NAD 576 323 486 (38 421 565 US dollars. The 3 top cost drivers are workforce development, Antimicrobial resistance and Point of Entry (figure 9). The costs of implementation are heavier on the first year of the NAPHS implementation period with the costs almost evenly distributed over the rest of the 4 years. (Figure 10 and figure 11) National Action Plan for Health Security (NAPHS 2020-2025) Figure: NAPHS 3 top cost drivers • Points of Entry (PoE) Anti-Microbial 82,283,344 11 Anti-Microbial Resistance Prevent Resistance • Workforce Development Zoonotic Disease 48,393,693 Food Safety 34,784,720 Detect Workforce 192,679,462 Development Reporting 32,732,108 Real Time 26,676,320 Surveillance Respond Emergency 21,263,942 Response Operations Risk Communication 10,836,428 Figure 9: The 3 top cost drivers Preparedness 3,733,800 OtherIBR Points of Entry (PoE) 56,768,467 related Chemical Events 4,315,124 hazards and Point of entry Radiation 21,71,652 Emergencies Table 8: The top 3 cost drivers per thematic area ~ ------ 2021 2022 2023 2024 2025 - Prevent - Detect - Respond Other 2021 2022 2023 2024 2025 Figure 10:NAPHS Cost trend per thematic area Figure 11: NAPHS cost trend from 2021-2025 National Action Plan for Health Security (NAPHS 2020-2025)

4.7. Financing of National Action Plan (Domestic, external funding and further donor engagements) After a resource mapping exercise, partner's contribution in the NAPHS per technical area is presented in figure 12 below. Zoonotic diseases and preparedness are the technical areas receiving most support from partners. Zoonotic diseases 7839990 Prep a redness 2368396.343 Workforce Development Rapid Response Surveillance 528449 Points of Entry 208226.616 Risk Communication I s2649.29898 Linking Public health 13347.86 IHR Coordination 8820 Radiation 0 Laboratory 0 Immunization 0 Food Safety 0 (blank) 0 Medical countermeasures 0 Chemical Events 0 AMR 0 Figure 12 Core capacities and estimated cost by partners

4.8. Risk appraisal, assumptions and management The success in the implementation of the NAPHS will depend on the successful management of risks. Potential risks identified in Namibia are of a political, financial and operational order. These risks have been classified according to 2 criteria: probability (Likelihood of Occurrence) and impact (Level of Severity). A rating scale was used to describe each type of risk (low, medium, high). The table below summarizes risk appraisal, assumptions and management in the implementation of the NAPHS and proposes strategies for management. Table 9: Summary of risk appraisal, assumptions and management •Government ownership and buy-in •Continued political support and advocacy Poor governance Medium High •Alignment of domestic legislation to facilitate im lementation National Action Plan for Health Security (NAPHS 2020-2025) •Advocatte for increased domestic funding tol MoHSS, MA WF, through parliament. • Mobilize additional funding from donors and partners • Improve coordination of implementation ofdonor Financial High High funded programmes and projects constraints •No change in government allocation of domestic funds for implementation of programmes including NAPHS Ensure financial accountability and transparency in funds management I Insufficient multi- • Sustain effective stakeholder engagements. sectoral • Sustain a multi-sectoral approach in Low Medium collaboration and implementation and M&E for the NAPHS coordination •Limit the high staff turn over Human resource Medium Low •Ensure staff motivation - ~ - ~ •Ensure availability of 'll.!_alified human resource • Ensure technological watch Rapid changes in High Low •Ensure in service training of human resources to technology Lowcommunity - - Medium - - High remain u to date •Sustained community involvement through the engagement ~ ~ ~ - relevant strategies Delays in •Develop coordination mechanism for implementa tion of High High implementation activities •Conduct M&E of the N APHS Unknown (Man- •Ensure adequate preparedness and effective made/natural Low High response to known event or hazard disaster)

4.9. Platform for National Action Plan

4.9.1. Linkage with existing plans The Namibia NAPHS is aligned with the following plans: ~ The Namibia 5th National development plan; n'-1 The Ministry of Health and Social Services strategic plan (2017/2018-2021/2022); • The Ministry of Agriculture, Water and Forestry Strategic Plan (20 17/20 18 - 2021/2022); 4. National Disaster Risk Management Plan 2011 ; ~ National Disaster Risk Managem ent Policy; Harambee Prosperity Plan (2016/17 - 2019/20); National Health Emergency Preparedness and Response Plan 2013 - 2017; Port Health strategy. National Action Plan for Health Security (NAPHS 2020-2025)

4.9.2. Interplay between relevant sectors - Successful, multi-sectoral collaboration is dependent on political, economic, social factors compliance and commitment from all parties working together. The Government of Namibia will make efforts to collaborate with various stakeholder groups: government sectors, UN agencies, international organizations, partners, civil society, and private sector to jointly achieve the desired purpose of the NAPHS implementation. By engaging multiple sectors, partners can leverage knowledge, expertise, scope, and resources, benefiting from their combined and varied strengths as they work toward the shared goal of securing Namibia health security capacity. The public health iissues are complex, and most often, a single health issue may be influenced by interrelated social, environmental, and economic factors that can best be addressed with a holistic, multi- sectoral approach. By leveraging the strengths and varied approaches of partners, effective multi- sectoral coordination will eliminate implementation barriers, facilitate scale-up, and increase the impact that one sector or partner cannot have alone. Coordination across government ministries, for example, is essential for identifying intersections among the sectors and opportunities for collaborative planning.

4.9.3. Other enablers Political stability: Since Namibia gained independence from South Africa on 21 March 1990, a significant progress towards political stability and economic growth have been made. The country has been on a path of reconciliation, reconstruction, and stabilisation. Namibia is one of Africa s most remarkable success story led by a democratically elected and stable government. This level of political stability provides a conductive environment for the implementation of the NAPHS. Security stability: Namibia is ranked high as a peaceful nation according to the Global Peace Index. It is one of the eight countries with high level of peace and security on the continent of Africa, essentially in terms of rule of law and degree of internal and external conflict. The country also ranks high relative to other African countries in terms of the quality of governance and the government ability to support human development, sustainable economic opportunity, rule of law and human rights. Such high level of internal stability sets the foundation for strong and sustainable investment in health security. Political commitment: The Government of Namibia and the development partners are committed to the realization of health sector goals as stated in the constitution and the NDP5. The Ministry of Health and Social Services strategic plan (2017/2018-2021/2022) has served to focus attention, resources, and investments on the most pressing issues facing the health sector. Health remains a priority sector and there is increased and sustained funding from the government and development partners for most programmes in this sector. Macroeconomic stability and sustainable economic growth: Namibia is ranked as an upper- middle-income developing country with plenty of natural resources, solid infrastructures, a free press and an economy that has grown on average by 4,6 % per annum over 2012-2016 period22. 22 sth Namibian Development Plan National Action Plan for Health Security (NAPHS 2020-2025) This growth has been primarily driven by large investments in the extraction sector, favourable export prices and high government expenditures. Foreign direct investment is projected to grow - gradually as a result of the strategic initiatives proposed by the NDP5, the effects of the 2016 investment conference and adoption of the economic diplomacy policy. Investment in economic infrastructures such as water, energy and transport is expected to support economic growth. This will ensure additional domestic funding for health programme. Multisectoral and M ultidisciplinary collaboration: The Namibian Government has a platform and mechanisms for donors, international organizations, intergovernmental organizations, UN agencies and other development partners to contribute to national development. As outbreaks in Africa have shown, public health security is a complex, costly, and information intense undertaking. This requires strong national and multi-sectoral leadership, infrastructure, cross- border collaboration, capacity to identify problems rapidly and design real-time evidence-based solutions. In addition, well-trained and well-equipped workforces, well-functioning laboratories and service-delivery systems, capacity to sustain interventions, and ability to respond to unexpected events are required. These can only be achieved through comprehensive, multisectoral, collaborative strategies. The National Action Plan for Health Security reflects the solidarity and commitment of all stakeholders to strengthen Namibia's collective effort and capacity to respond to potential public health emergencies of international concern and other public health risks. Human resource capital : Health workforce is a crucial pillar in a well-functioning resilient health system. The importance of strong human resource system for health was demonstrated during the recent Ebola Virus Disease (EVD) outbreak from 2014 to 20]5. The National Human Resource for Health Strategic Plan (2020-2030) provides a clear vision for the health workforce over the next ten years. Its principles, values, goal and objectives are geared towards strengthening the health workforce to provide high-quality, equitable, and accessible health services to all Namibians. It was developed The Ministry has also made headway in developing a comprehensive Cornml!lDity Based Health Care(CBHC)programme to enhance the health workforce's ability to cover the hard-to-reach populations and marginalised communities. The Ministry of Agriculture Water and Forestry has a program that supports training of veterinary doctors. The University of Namibia, under the Faculty of Agriculture and Natural Resources has opened a 3 years Diploma in animal health and a 6 years Bachelor degree ofVeterinary Medicine. Other relevant programmes also covered by other institutes such as the NUST include the bachelor degree in agriculture (crop science, animal science, food science), the bachelor in environmental/public health and the Msc epidemiology.

4.9.4. Contribution to Health system strengthening, Universal Health coverage (UHC) and Sustainable Development Goals (SDGs) Through the substantial investments in the different health systems blocks: Leadership and governance, Service delivery, Human resources for health, Health financing, Medical products and health technologies, Health information systems and research, Health security and emergencies, Comml!lDity engagement and health promotion, the implementation of the NAPHS will contribute to building a robust, resilient and responsive health system for Namibia. This plan forms the foundation for better health security, preventing deaths, tackling diseases, strengthening the health National Action Plan for Health Security (NAPHS 2020-2025) - system and improving the health and well-being of the population. An effective health care system will contribute to attainment of Universal Health Coverage (UHC) by ensuring that people have access to the health care they need without suffering financial hardship. It also helps to drive better health and development outcomes. This approach is key to ending extreme poverty and increasing equity and shared prosperity. It is also an essential part of the Sustainable Development Goals (SDGs). SDG 1, with the goal to end poverty in all its forms everywhere, is in peril without UHC, as hundreds of millions of people are impoverished by healthcare costs every year and SDG 3 which includes a target to "achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all. 5. DELIVERY OF ACTION PLAN

5.1. Stakeholders analysis A stakeholder analysis was perfonned and the matrix below classifies them according to their level of influence and interest in the NAPH S implementation and health security issues in Namibia. Level of interest is how much a stakeholder(s) care about the outcomes, if they are beneficiaries or will there be negative effects? Level of influence is the degree to which a stakeholder can make or break the project (such as through funding, legislation, protests). Stakeholders with high influence but low interest need to be satisfied with the implementation of the NAPHS. Their objectives will be considered to ensure they remain strong advocates. The a lignment of the NAPHS with other national policies and plans will contribute in satisfying these stakeholders. Stakeholders with high influence and high interest are those closely implicated with the NAPH S implementation. They will be well managed to build strong relationships and ensure that they retain support. They will be involved in decision-making and will be regularly engaged. Activities of stakeholders with low influence and low interest will be monitored from time to time to stay on top of their involvement because their relevanc,e may change over time. They will be kept informed on the NAPHS implementation and their interest will be encouraged. Stakeholders with low influence but high interest w ill be regularly informed as they have a very high interest in the NAPHS. They will be consulted on their area of interest and their inputs will be used to improve cihances of the NAPHS success. National Action Plan for Health Security (NAPHS 2020-2025) - High n f u e n C e Low High Interest Figure 13: Stakeholders analysis matrix for Namibia NAPHS

5.2. Roles and Responsibilities of Key stakeholders A diversity of stakeholders will be involved for the duration of the implementation of the NAPHS. Their roles will vary from providing leadership to implementation of activities. Some stakeholders are vital in providing support either technical, financial or community engagement. Multisectoral collaboration is critical for the success of the NAPHS implementation. The roles and responsibilities of the various entities that will be involved in the implementation include the following:

5.2.1. Office of the President The President of the Republic of Namibia, as the Head of State, is authorized to declare a national disaster /state of emergency. The declaration of state of emergency is a pronouncement to the international community to assist the Government in responding to the unfolding disaster that is deemed beyond the response capacity of government alone.

5.2.2. The parliament The Parliament of Namibia will be critical to support aspects of the NAPHS related to internal resource mobilization, allocation and legislation. Key responsibilities will include i) review of out National Action Plan for Health Security (NAPHS 2020-2025) dated laws, ii) enactment of new legislation as required by IRR in the NAPHS and iii) approving the national health budget with considerations for resources and policies needed to meet the - aspirations set out in the NAPHS. It is therefore useful for its members to have awareness on NAPHS so as to better defend the health budget, with particular attention to the creation of new budget lines to fund management of public health emergencies.

5.2.3. Office of the Prime Minister The Office of the Prime Minister (OPM) has the overall responsibility of coordinating disaster risk management and implementing the National Policy on Disaster Risk Management. OPM recommends the state of disaster through the DDRM and activates the National Emergency Operation Center. The Executive Director in the Office of the Prime Minister chairs the sub- committee of national disaster risk management committee on the resource mobilization and capacity building23 . The OPM shall host the One Health Platform and shall be responsible for coordinating one health related (multisectoral) activities in the NAPHS, mobilize resources for the implementation of the plan at Government level. Through the One Health Platform, the OPM shall perform annual, mid-term and fmal reviews of the NAPHS with the technical support oftbe IHR- NFP.

5.2.4. Line ministries Ministry of Health and Social Services (MoHSS) The MoHSS as a coordinating ministry of this plan, has the responsibility of ensuring a safe, sustainable, and health-enhancing environment, protected from social, biological, chemical, and physical hazards, and promoting human security before, during and after disasters. As the centrally mandated ministry in the development of health security, the MoHSS shall have overall stewardship and management of the implementation, monitoring and evaluation of the NAPHS. The MoHSS shall talke the leadership role in the coordination of key stakeholders and activities for NAPHS purposes. The MoHSS shall also lead strategic planning for the implementation of the of this plan, including regularly undertaking performance reviews of the implementation of the plan. The MoHSS shall mobilize resources for implementation, monitoring and evaluation of the human health component of the NAPHS. Inter-sectoral collaboration is vital for successful implementation of NAPHS. It shall also bear the responsibility of providing guidance and sponsorship for development of policies, regulations and laws necessary for successful NAPHS implementation as well as making requisite investment in human resomces, infrastructure, equipment, etc. necessary for successful NAPHS implementation. The MoHSS shall also watch the fulfilment of international obligations and reporting requirements of NAPHS and IHR. The 23 Disaster Risk Management Act National Action Plan for Health Security (NAPHS 2020-2025) Executive Director in the MoHSS chairs the sub-committee of national disaster risk management committee on health emergencies24 . - Ministry of Agriculture, Water and Land Reform (MAWLR) The MAWLR deals with Animal health including zoonotic diseases, food security, toxins, phytosanitory, water and sanitation practices and services. It will co-chair with the MoHSS the NAPHS initiatives that are synergistic with One Health Platform themes. MAWLR will exercise stewardship and management of implementation of the animal health centered objectives in the NAPHS. MAWLR shall mobilize resources for implementation, monitoring and evaluation of the animal health component of the NAPHS. MAWLR will also take responsibility for investments in human resources, infrastructure, equipment, etc. necessary for attainment of animal health centered objectives in the NAPHS. It shall be responsible for tracking fulfilment ofinternational obligations and reporting requirements related to animal health and public health emergency management. The MAWLR also bears the responsibility of ensuring that cross border movement of livestock, animal and animal products as well as plants and plant products is managed in a manner that protects the health security of Namibia. Ministry of Environment, Forestry and Tourism (MEFT) The ministry of Tourism shall promote biodiversity conservation in the Namibian environment through the sustainable utilization of natural resources and tourism development for the maximum social and economic benefit of the citizens. It shall also support health facilities and other institutions in proper waste management and ensures the application of biosecurity and biosafety measures in waste management. Ministry of Finance(MoF) The Ministry of fmance will be responsible for the mobilization of domestic resources for implementation of the NAPHS including auditing and monitoring the efficiency and utilization of resources raised for NAPHS implementation. The MoF will also assess the impact of funding sourced for NAPHS implementation to ensure the objectives. are met with a specific target to optimize resources. Ministry of Urban and Rural Development (MURO) The MURD Coordinates sub-national government and traditional authorities. It shall engage in facilitating functional community engagements for the implementation of NAPHS activities at villages, towns, chiefdoms, districts and regional level. 24 Disaster Risk Management Act, 10 of 2012 Ministry of Defence (MoD) National Action Plan for Health Security (NAPHS 2020-2025) - The MoD shall assist with rescue operations, transport (sea, air and land), logistics, (Territorial integrity). It shall support emergency response for disaster level of public health emergencies. It shall also assist in capacity building in various public-sector institutions in emergency preparedness i.e. table top exercises, simulations and drills. Ministry of Mines and Energy The Ministry of Mines and Energy shall be responsible for the management of public health emergencies related to radiation, chemicals, surveillance of earthquakes and tremors. Ministry of Information, Communication and Technology (MICT) The MICT shall be responsible for information dissemination in routine and during public health emergencies. It shall facilitate and support the use of NTIC for surveillance and management of public health threats.. The MITC shall also facilitate access of the MoHSS to media platform for the purpose of risk communication at all levels will facilitate public-private partnerships that will assist the MoHSS in risk communications while supporting the health sector to secure positive publicity on the NAPHS initiatives. Where need arises, the MICT shall assist the MoHSS in rumour surveillance and mitigating mass misinformation through various platforms (e.g. social media). Ministry of International Relations and Cooperation (MIRCO) The MIRCO shall help broker agreements to facilitate meaningful cross border collaboration for health security and also support Namibia in regional cooperation for advancement of health security within the sub Region and globally. Ministry of High Education, training and innovation (MHE) The ministry of technical and high.er education shall update curricula for training of health care workers, to include aspects covered under NAPHS such as disease surveillance, emergency management and risk reduction. It shall also implement a s1!1stainable strategy to increase the workforce of veterinarians in Namibia. Ministry of Gender Equality and Child Welfare (MGECW) The Ministry Gender shall support the MoHSS by reinforcing policy on childhood immunization to ensure that children enrolling for school are required by ministerial regulation to be fully immunized. During the implementation of the NAPHS, the ministry of gender will partner with health sector in community disaster risk and vulnerability assessments. It shall also be key in safeguarding the welfare of frontline health workers and surge staff during response to large scale health emergencies, including compensation for loss, injury, disability or death.

5.2.5. Others National Action Plan for Health Security (NAPHS 2020-2025) - Directorate of Disaster Risk management(DDRM) As the national authority mandated for disaster management, the DDRM oversees development of disaster risk reduction and disaster management in all ministries and sectors of the economy as set out in the Hyogo protocol and the Sendai framework. It shall work with the MoHSS to establish clear communication and coordination lines with the Public Health National Emergency Operat.i .ons Centre and the National Emergency Operations Centre. National Planning Commission (NPC) The national planning commission shall assist m planning for national development and Coordinates External Developmental Funding for the implementation of the NAPHS. Ministry of Home Affairs, Immigration, Safety and Security (MHAlSS) The ministry of Home affairs, hnmigration, Safety and Security shall be responsible for the control ofpassenger's travel history during Public Health Emergency of International Concern(PHEIC) at point of entry. It shaU also assist the MoHSS in contract tracing during PHEIC.The Ministry shall ensures protection of civilians, protection of evidence, crowd control, burials during public health emergencies. Ministry of Works and Transport As the ultimate regulatory authority for air, land and sea transport the ministry of transport will support the MoHSS and stakeholders in attaining the objectives set out in the NAPHS especially in regard to food importation, transportation of goods/chemicals, movements of humans and animals during critical times such as an outbreak. It shall also facilitate IHR public health measures implementation in air, sea and road transport. The ministry of transport shall the establishment of frontal health post at the designated Point of Entry. The Namibia civil aviation authority, the Namibia maritime administration and the Namibia Ports Authority have roles to play in the implementation of the NAPHS. WHO, OIE, FAO, other UN Agencies, CDC, National and International Agencies These non-governmental organizations have capacity to trigger development in various areas that they partner with the government. The international agencies will be on standby to provide National Action Plan for Health Security (NAPHS 2020-2025) technical support for development, implementation, monitoring and evaluation of the NAPHS. They will also support the country's efforts to raise funds for the NAPHS. - Academic Institutions Groups. of reflexion and academic institutions are important in accelerating the growth of new knowledge and in leading scientific and operational research. In the implementation of the NAPHS, some surveys will need to be carried out either as baseline studies, mid-term evaluations or for end of implementation documentations. Academic institutions can be very useful in designing and conducting evaluations due to their expertise and neutrality. They will also be a source of technical expertise to guide implementation of NAPHS. Civil Society Civil society organizations play an important role in enhancing transparency and good governance by contributing to increased public debate on issues surrounding the formulation and implementation of public sector plans as well as in supporting greater transparency. There is a dynamiic civil society in Namibia and their critique will be considered as we· expend resources in NAPHS implementation. The Media The media plays a role in creating and shaping of public opinion. It has the duty to inform, to educate and to entertain the community. The media in Namibia should watch to protect public interest against malpractice, create public awareness and give platforms to citizens to give feedback on how NAPHS implementation is affecting their lives. In the implementation of the NAPHS, the media will be key to highlighting the various initiatives to secure the health of citizens. The media is also directly involved in the implementation of several activities under risk communications.

5.3. Coordination mechanisms and framework for delivery of action plan The Namibian Government through the MoHSS will provide overall stewardship, oversight and coordination of the NAPHS. Partners and key stakeholders will support implementation of the plan. The IHR-NFP in the Health Information and Research Directorate supported by Primary Health Care Directorate serves as the reference point for the implementation of the NAPHS.

5.3.1. At the National Level The M ulti-Agency Committee (The One Health Platform) The Multi-Agency Committee (The One Health Platform) is the highest decision-making body responsible for policy formulation and coordination oversight and decision-making. The Committee will present to cabinet and the Presidency IHR and NAPHS related concerns including emergencies and public health threats and secure high-level strategic decisions when necessary. The One Health Platform will facilitate the collaboration of multi-sector entities in addressing National Action Plan for Health Security (NAPHS 2020-2025) public health issues that cannot be implemented by a single sector, and/or delivery of service which requires joint action. The One Health Platform exercises its functions in routine (before occurrence - of public health events), during public health events and after public health events. Before the occurrence of public health events, the One Health Platform will support multi-sectoral preparedness efforts to strengthen IHR core capacities for prevention, detection and response. During public health events, the focus its efforts to promptly interrupt any outbreak using the multi- sectoral capabilities and expertise, and after public health events, the focus will be to ensure smooth recovery and documentation of lessons learned. Members of the Multi Agency committee (The One Health Platform) are as follow: '* Office of the Prime Minister; .._ Line Ministries; -i.. Directorate of Disaster Risk Management; ~ Non-Governmental Organizations; ..._ Namibia Red Cross Society; World Health organisation (WHO); .._ Centre for Disease Control and Prevention (CDC); -. World Health Organization for Animal Health (OIE); ~ Food and Agriculture Organization (FAO); 4 Other UN agencies; ~ The IHR-NFP is the secretariat of the One Health Platform. National Action Plan for Health Security (NAPHS 2020-2025) - The Internationa l Health Regulation Nationa l Focal Point (IHR-NFP) The Namibia International Health Regulations National Focal Point (IHR NFP) was established in 2016 within the MoHSS. However, according to 5-year plan of action for implementation of the IHR (2005) in Namibia (2012-2016)25, NFP existed as a person rather than a national centre. Hence, it was not fully operational. According to the International Health Regulations (IHR (2005), National IHR Focal Point is defined as "the national centre, designated by each State Party which shall be accessible at all times for communications with WHO IHR Contact Points under these Regulations". Therefore, for NFP to be fully operational, IHR NFP should exist as a national centre with appointees from relevant ministries. IHR NFP will led day-to-day IRR-relevant event assessment, reporting and coordination efforts on public health events, including emerging/re-emerging diseases, such as Viral haemorrhagic fever outbreaks and other communicable disease outbreaks, contaminated medical products, and vaccine preventable diseases, among others. The work of the IHR NFP will contribute to global health security policy development and recognition that communicating the evidence-based possibility of a major pl!lblic health event is critical to protecting Namibia and global populations from future public health threats. In the delivery of the NAPHS, the IHR-NFP is responsible of the: ~ Development of a national strategic plan that take into accounts all recommendations of the JEE, all IHR core capacities, and/or any health security events every 4-5 years; ,... Review and update the plan annually with relevant sectors and other implementing partners; '* Engage the parliament with the legal office in the MoHSS and relevant stakeholders on the legislation, policies and administrative arrangements to enable compliance with the IHR (2005) with the guidance of relevant partners; "* Mobilization of resources including domestic financing for the implementation of the NAPHS and monitor the use ofthe resources for any health security event with the IHR (2005) with the guidance of MoF and relevant partners. NFP Structure and functions26 IHR NFP is a national centre with appointees from relevant ministries with technical and support staff. The IHR NFP is responsible for the day-to-day operations and management of procedures for communication and coordination. IHR NFP technical staff operate under a 24/7/365 duty schedule to ensure continual monitoring of and t imely response to domestic and international public health events. The IHR NFP oversees all core IHR NFP activities, such as: ~ Notifying potential public health emergency of international concern (PHEIC) to th e WHO; .-. Receiving, triaging and directing IRR-related communications to ministries, departments and agencies and other internal partners and stakeholders; 25 5-year p lan of action for implementation of the IHR (2005) in Namibia (2012-2016) 26 WHO guidelines for the establisment of International Health Regulation National Focal Points. National Action Plan for Health Security (NAPHS 2020-2025} - 4 Preparing and disseminating official IRR-related messages to relevant domestic and international stakeholders; ~ Coordinating and facilitating communications and information sharing between Namibia ministries, the WHO and other countries' NFPs in order to facilitate efficient public health communications and information sharing. IHR NFP specific responsibilities include: 4 Overseeing and coordinating inter-agency assessment of events that may constitute potential PHEICs; ~ Collaborating with relevant technical agencies to perform public health risk assessment using Annex 2 of the IHR; ..,._ Identifying and resolving government policy issues related to international public health reporting; ~ Overseeing domestic IHR obligations and coordinating IHR-relevant policies, positions, and process implementation efforts; .-. Coordinating the monitoring and evaluation of IHR core capacities, and annually reporting on the status of IHR core capacities to WHO; .i. Advising interagency leadership and technical staff on IRR-relevant policy; eJ. Coordinating IRR-relevant efforts with international partners, organizations, and the Namibian government; .._ Leading efforts on bilateral policy exchanges with foreign NFPs. IHR NFP should have a communication capability for 24 hours a day/7 days a week/365 days a year for monitoring, situational awareness and communication requirements of the IHR NFP. This will enable the IHR-NFP to receive and transmit communications as needed. The IHR- NFP plays a vital role in receiving and routing communications properly during a public health emergency, as well as maintaining general, public health situational awareness.

5.3.2. Sub-national level Until the coordination structures and mechanisms established at the national level are fully operational, the District Health Management Teams (DHMT) will be responsible of the implementation of the NAPHS at the operational level. In fact, the DHMT is in charge of the implementation of various national health policies and strategies at the operational level. The implementation ofNAPHS at the sub-national level will leverage on the existing coordinating structures at the district level including: The Public Health Emergency Management Committee (PHEMC) which is under the leadership of the District Management Officer (DMO); the District Disaster Management Committee which requires strong participation of the DMO as a member. The DMO in collaboration with the Sub Divisional Officer will oversee, and be responsible for updating relevant ministries and other stakeholders through existing fora. The Sub Divisional Officer will ensure strong collaboration, effective information sharing and coordination with relevant ministries and agencies in the districts. In addition, the district structures will share information regularly and report on the implementation ofNAPHS with National Action Plan for Health Security (NAPHS 2020-2025} - national structures. The MoHSS may establish one or more sub-comnu.ttees as may be necessary.

5.3.3. Alignment of internal st akeholders The internal partners and stakeholders comprises all implementing partners, academic institutions, civil society organizations, community stakeholders, etc. The role of internal partners and stakeholders is to: "* Engage in the process of developing, supporting, and implementing the NAPHS; "* Jointly participate in the monitoring and evaluation of the NAPHS under the guidance of IHRNFP; 4 Receive and shares IHR-related information and directing communications from IHR NFP; Support the resource mobilization process, utilization and accountability in line with other relevant documents.

5.3.4. Alignment of external stakeholders The external stakeholders are donor partners, bilateral agencies, UN agencies, international NGOs and others. The role of external partners in health security is to: -. Support the countries as peer reviewers in assessing the country capacity during the Joint External Evaluation; rk Engage in the process of developing, supporting, and implementing the NAPHS; ,.Ji. Support the resource mobilization process on the behalf the government to support health security related activities; ,-. Liaise with IHR NFP in monitoring and evaluation of the NAPHS; .-. Receive and shares IHR-related information and communications from IHR NFP.

5.3.5. WHO-Strategic Partnership Portal-SPP In 2015, Member States, partners and donors mandated WHO to establish a Strategic Partnership Portal (SPP) to monitor the health security capacity of countries by helping them identify needs, gaps and priorities in national, provincial and local health security; by mapping and sharing information on global health security investment and resources; and by creating a platform for collaborating on global health security. In 2018, the SPP expanded from a one- stop information platform to a mechanism for collaboration and partnership and became the Strategic Partnership for Health Security (SPH). This platform will also serve as partnership for Namibia NAPHS and after the launch, the plan will be published on the SPH.

5.4. Monitoring and evaluation of the plan Upon the fmalization of the costed NAPHS, strategic actions will be collected to create a checklist of common health security strengthening interventions. The logical framework (matrix) for the implementation of the plan which includes a SMART Indicator Checklist tailored to the NAPHS was developed. In addition to it, a prediction of the impact ofNAPHS National Action Plan for Health Security (NAPHS 2020-2025} - on the selected health and economic parameters will be also provided by WHO, to predetermine the effectiveness of the plan and make required changes. The model will be developed prior to the implementation ofNAPHS and will show virtually the impact of NAPHS on global health security before it is implemented itself. WHO technical team is determined to develop virtual models to the countries to know exactly what will be the· impact of the NAPHS on their health system and economical gains, if development of NAPHS is opted for. This will not only increase the chance of success in the plan but also the predetermined modelling will help attracting donors and partners. Supervision and monitoring are essential to ensure that the plan developed is effectively implemented. Therefore, the plan includes supervision and monitoring of prevention, preparedness, response and recovery at all levels. Besides, annual reviews of the NAPHS will be done by the coordination committee to tract level of implementations of activities and development of Namibia capacities to prevent, detect and respond to public health emergencies.

5.4.1. Strategies for NAPHS monitoring and evaluation Periodic supervision Periodic supervision will be done to ensure the activities are implemented according to the agreed targets. These activities will be integrated in to the routine quarterly supervision schedules within respective sectors. The supervision will be carried out at all levels; starting from the National level i.e. Ministry supervising staff at regional levels including staff at Local Government authorities; and Local Government Authorities staff supervising those working beneath them. Monitoring and evaluation of the surveillance systems in human and animal health This plan, meant to adopt measured behaviours, policies and/or practices that minimize the transmission of zoonotic diseases from animals into human populations. Measure should be put in place to ensure the One Health approach that will bring together relevant stakeholders to tackle zoonotic diseases is effective. Evaluate formal mechanisms for sharing reports on zoonotic diseases and outbreaks between the animal, human and environment/ wildlife sectors at national and regional levels.

5.4.2. Techniques and Tools used for monitoring and evaluation Intra-Action and After Action Reviews The intra-action and after action reviews (IAR &AAR) help to review actions taken to respond to an emergency or outbreak. It provides an opportunity to identify what worked well, challenges, lessons learned and best practices. Namibia will conduct JAR and AAR during and afterresponse to any public health event in the country. National Action Plan for Health Security (NAPHS 2020-2025} - Annual reporting using the SPAR Tool Namibia will continue to report annually on the development of the IRR (2005) core capacities in conformity with its obligation to the World Health Assembly (WHA) on the implementation of IRR (2005). Simulation exercises National or regional simulation exercises I drills wiU be organized and implemented in order to test the functionality and to validate the functional capacities of the IHR (2005), to identify gaps, raise awareness and improve societal and governmental preparation for public health emergencies. These drills will be related to the types ofhazard that are prevalent in the country. The findings from the simulation exercises can provide an indication on the level of capacities across the nineteen technical areas. Joint External Evaluations (JEE) JEE is an important component of the post 2015 IRR supervision monitoring and evaluation framework because they provide an objective basis for the development of national action plans for health security. They involve an Inclusive multi-stakeholder approach to: accelerate and coordinate objective country assessment processes; they facilitate engagement between countries, international organizations, donors, and technical experts involved in the assessment process; promote transparency in exchanging information on the results of assessments, in particular to donors interested in funding the development. The JEE conducted in 2016 highlighted strengths, weaknesses and recommendations that helped in the development of the NAPHS. A follow up Joint External Evaluations (JEE) will be conducted in 2022 to measure country specific status and progress in achieving the targets on the 19 technical areas as part of the end evaluation of the NAPHS. Annual Review of NAPHS Annual reviews of the plan will be conducted to show progress, identify challenges and provide recommendations to guide implementation of the NAPHS in the remaining implementation period. The annual review will be led locally by the MoHSS through the IHR- NFP with support of partners. Regular reports Information sharing (report) between sectors will be strengthened and formalized; this will enable and strengthen monitoring. Internal Evaluation Evaluation of the NAPHS will be done at the end of the first year of implementation, midway and at the end of the period. Evaluation should be done by a team comprised of Multi-Agency Committee and will take the form of selected site visits across the country. To ensure National Action Plan for Health Security (NAPHS 2020-2025} - transparency and impartiality the evaluation team will include internal and external stakeholders. The, outcome of the evaluation will be used to revise the NAPHS. Other Assessments Other assessments in human and animal health as well other relevant agencies will also be used to assess implementation of the NAPHS. This include: (i)Annual health sector reviews, (ii)Performance for veterinary services, (iii) Environmental assessments. ANNEXES National Action Plan for Health Security (NAPHS 2020-2025} -

Annexe 1: Matrix for detailed roles and responsibilities ."' a, ... Stakeholders ."' ~CV . ... C 0 CV 1,1 "' a, ·;: c"' C CV 0. -0 ·c::s ~ C ... ... CV C QI 0 C a, -0 C QI E :E Ill Ill I'- 0. I'- z . tlO 'ii 0 u C CV C ;:;: 0 < E E 0 u > .. 0 c.:, 0. c.:, . z . ·u; a, 0. .!! 't: CV 0. :E 0. 0 a: 0 0 l: 0 :E 3: < :E I a: :!: I'- 0 :E 0 :E a: ::::, :E 0. a: z C i a, .s:. 0 0 l: 3: 0 < I'- u C u 0 z ::::, a, ... .s:. 0 Role Government artners High level coordination of Ministries Declaration of public disaster Declaration of public health emer enc Outbreaks) Legislatiton (enactment of laws Enforcing laws and health re uirements Overall NAPHS implementation mana ement Implementation co- mana ement Inter-sectoral coordination Collaboration in the NAPHS im lementation Attend coordination and review meetin Overall NAPHS Monitoring and Evaluation Implementation of activities M&E Reporting of progress of im lementation Membership to IHR NFP IHR NFP coordination & communication Resource mobilization Financial resource allocation Accountability and audit mana ement Facilitating Community en a ·ement Nationa l Action Plan for Health Security (NAPHS. 2020-2025) - .. "' G/ C "'Ill .. "' C -~u ·.:·c..."' 0 t: ra Q. ~ra ra 'a St akeholders 'i: C i ... ... ra t: Ill ::1 u E > 0 ... ...z ...'ii.. C 1111 . ::c ~ C C Ill 'a Ill E ~ II) II) Q. 0 ra C 0 < E 0 u ~ 0 z.. . "' Q. 'iii =c"' ~ a:: ::c ~ i:.:: a:: Ill 0 0 Ill Ill Q. Q. Q. 0 0 0 ~ 0 < ~ ai: :!: ~ 0 ~ 0 ::> ~ Q. a:: z C ~ ... .t:. 0 ~ 0 ... < u Q u z ::> ... .t:. 0 Public health risk communication Public health emergency communication Facilitating bi and multilateral collaboration Technical support for the development of olicies/ ideline Logistical support during emer encies National Action Plan for Health Security (NAPHS 2020-2025} -

Annexe 2: Terms of Reference of National Multi-Agency Coordination Committee (The One Health Platform) Plllrpose The purpose of the multi-agency Committee (One Health Platform) is to productively facilitate the collaboration of multi-sector entities in addressing the public health issues that cannot be solved by a single sector. The One Health Phatform oversees, and when necessary coordinate development and implementation ofNAPHS in all sectors to guarantee a systematic and comprehensive approach. Scope The One Health Platform addresses all aspects of the NAPHS framework, such as inception, development and implementation related activities in the country. Roles and responsibilities The One Health Platform The health platform exercises its functions before, during and after the occurrence of public health events and emergencies as follows: 1. Before public health events and emergencies:, the One Health Platform: .._ Coordinates multi-sector One Health activities by promoting institutional development to include coordinating resource mobilization for preparedness, risk and vulnerability reduction among Government and other implementing partners; ~ Conducts joint evaluation / assessments within major line ministries and agencies; ~ Institutionalizes the One Health approach to address any public health event and/or pandemic that poses health threats; .-. Ensures that appropriate measures are taken for the prevention of events, or the mitigation of their effects, and for capacity building for effective response to events; '* Conducts mapping of existing sources of funding for OH activities; ~ Advocates for the multi-sector approach to: Problem solving and planning, reviewing, monitoring and evaluating Early Warning Reports in accordance with identified risks and vulnerabilities; ilk Develops preparedness/contingency plans for the country, and coordination ofrisk and vulnerability assessment/analysis and mapping of the hazards; ...._ Facilitates capacity building for multi-sector collaboration and resources in achieving information and knowledge management including: Facilitating training, research, simulations, education, public communication and awareness campaigns on event risk management; .._ Maintains inventory of national capacity building, assets and resources. 2. During public health events and emergencies, the One Health Platform: ,.. Fosters collaboration among stakeholders and trigger response mechanism through the activation of the Incident Management System (Action Plan); National Action Plan for Health Security (NAPHS 2020-2025} - i Facilitates joint rapid event assessment and its impact within 24 hours and documents impacts, produces situation reports, recommend necessary actions, and communicate information to all stakeholders; Reactivates and/or establish various pillars of the Incident Management System for effective coordination and response led by the responsible sector to be managed by experienced persons with clear roles and responsibilities; ~ Notifies and/or liaises with: Development partners, national and international organizations, private sector, UN agencies, donor community, other non-governmental organizations and community based organizations, and local authority/leadership on possibility of partner support for assessment and coordination; ~ Notify and initiate cooperation with event management authorities in neighboring countries if the event is Linked to cross-border effects; 4 The incident management system will hold meetings, through the platform, to discuss recommended necessary interventions from the technical committees and/or technical working groups; -. Ensures timely and adequate response to the affected communities. 3. After public health events and emergencies, the One Health Platform: -. Evaluates the event and its operations; .. Generates post event reports within a quarter after official declaration of the end of the event; "* Secures all the government and other properties/assets used in the event; -. Carries out a detailed needs and risk assessments for: Rehabilitation, recovery and reconstruction; ,... Develops activity plans linked to human health, animal / wildlife health, and the environment; .-. Initiates and coordinates rehabilitation, recovery and reconstruction programmes for implementation; ,;J.. Conducts a detailed training, research, education and public awareness campaign on risk reduction linked to human health, animal / wildlife health, environmental as identified by post needs assessment gap identified; .,. Takes necessary steps to ensure that recommended follow-up actions are undertaken within short-term, medium-term, and long-term interventions for risk reduction. Technical working groups Purpose The One Health Platform establish technical working groups mandated with specific tasks, such as providing technical inputs in different one health related programmes (linked to the JEE technical areas), conducting situation analyses or drafting the NAPHS. National Action Plan for Health Security (NAPHS 2020-2025} - Scope, roles and responsibilities The One Health Platform shall establish the terms of reference for the technical working group that including details on the scope, roles and responsibilities. These will be focused on areas identified from situation analysis based on various assessments. ~ The technical working groups will be national groups and shall interact with country representatives of the required sectors, as determined by the scope of work; -. The technical working groups are mandated by the One Health Platform who defines its the terms of references; 4 The technical working groups should regularly report and communicate with the One Health Platform; '* Activities of the technical working groups would include: contributing to country situation analyses, development of activities and monitoring and evaluation indicators, and prioritization", which are required for the development and implementation ofNAPHS. Membership Depending on the technical areas/capacities, and the purpose, scope and tasks of the technical working group, membership will include people from any of the relevant technical specialties. National Action Plan for Health Security (NAPHS 2020-2025} -

Annexe 3: Indicators, milestones and targets Indicator Data eriod Technical Arca Baseline Source 2021 2024 2025 National Public law updated Public Draft and approved Draft health MoHSS 0 availa National Legislation, finalized law ble policy and Financing enforced Availability of national MoHSS 0 5% 7% 10% 12% 15% budget line for NAHPS Multi-sectoral (One health) coordination MoHSS mechanism established at 0 1 MAWF national level UlR Coordination, Number of Ministries/ Communication Institutions with lHR MoHSS 0 2 3 4 5 and Advocacy focal points Number ofIHR review End meetings Mid-term Term MoHSS 0 0 None None evaluation evaluati ve AMR plan available Plan MoHSS available Number of health facilities conducting MoHSS HCA! and prevention TBD 25% 50% 75% 100% 100% Ant imicrobial MAWF control Resistance Number of labs in human and animal health MoHSS designated for AMR 0 2 3 4 5 detection and reporting MAWF Timeliness and completeness of reporting MAWF TBD 50% 75% 80% 100% 100% to OIE Availability of functional In place Zoonotic zoonotic disease and In [n In Diseases surveillance in human and MAWF 0 In place fully place place place animal health function al Proportion of zoonotic disease outbreaks that are MAWF TBD 25% 50% 75% 85% 100% responded to within 48hrs Food borne disease 25%fu 75% 85% 100% surveillance system 50% function MoHSS 0 nction functi funcri established functional al onal onal al Food Safety Availability of food safety law MoHSS 0 Yes Yes Yes Yes Yes Number offunctional food safety laboratories MoHSS 0 2 2 I 2_ l _2 l 2 Technical Area Indicator National Action Plan for Health Security (NAPHS 2020-2025} Data Source Baseline 2021 eriod 2024 -2025 Availability of legislation on biosafety and MoHSS 0 Yes Yes Yes Yes Yes biosecuri ty Biosafety and Availability ofbiobank Biosecurity MoHSS 0 Yes Yes Yes Yes Yes Number of personnel trained on biosafety and MoHSS 0 10 25 50 75 100 biosecurity Proportion of children fully-immunized MoHSS/ through the urban EPI 90% 92% 94% 96% 98% 100% immunization strategy reports Immunization Immunization coverage in high risk communities MoHSS/ with Vaccine Preventable EPI 80% 80% 80.5% 80.5% 80.1% 81% Diseases outbreaks reports Number ofregiona[ labs with diagnostic capacity MoHSS 0 2 3 4 5 for IDSR priority diseases Number of health personnel trained on MoHSS TBD 100 150 200 250 300 National specific diagnostics La boratory System Proportion of specimens received at National Reference Laboratory on MoHSS 75% 85% 95% 100% 100% 100% time and in good condition Lab policy, strategic plan and guidelines available MoHSS 0 Draft Yes Yes Yes Yes Proportion of health facilities with 2 staff MoHSS 25% 50% 75% 100% 100% 100% trained on IDSR Proportion of health facilities submitting MoHSS/ complete surveillance Surveill 95% 100% 100% 100% 100% 100% Real Time reports to the national ance SurveiJlance level on time database Proportion of health MoHSS/ districts with 5 volunteers Surveill 0 25% 50% 75% 100% 100% trained on EBS ance reports Number of sentinel sites for influenza surveillance MoHSS 0 2 3 4 5 6 Number ofNFPs trained on IHR/OIE reporting MoHSS 0 2 4 5 5 s Proportion of potentially R eporting PHEIC reported on time MoHSS 0 100% 100% 100% 100% 100% Availability of guidelines In In In for lliR NFP and IOE MoHSS 0 In place In place place place place D~ ates Technical Area Indicator National Action Plan for Health Security (NAPHS 2020-2025} Data Source Baseline lml)lementation ~eriod 2021----1-022 1 - 2023.........2o~'LLJ~ Number of persons trained in FETP and MoHSS FETPV (human and 29 7 7 7 7 7 animal health) MAWF Workforce Development Availability of health workforce development MoHSS In place Yes Yes Yes Yes Yes strategy MAWF Number of counties that conducted all hazard risk Done MoHSS MoHSS assessment and mapping (Drat) Preparedness Availability of national multi-hazard_Q!an Availability of health MoHSS DDRM Yes Updat e Yes Yes Yes l Yes facility isolation capacity MoHSS 0 Yes Yes Yes Yes Yes action plan Number of trained multi- disciplinary MoHSS rapid Response Teams 0 5 10 15 20 25 (RRTs) MAWF Availability of updated Public Health Emergency Operations Plan (PHEOP) Emergency and EOC Standard MoHSS 0 Yes Yes Yes Yes Yes Response Operations Procedures Operations (SOP) Linking Public Health with Functionality of PHEOCs Availability of MOU and SOPs for collaboration MoHSS MoHSS 1 l l Security between public health and MOD 0 Yes Yes Yes Yes Yes Authorities the security authorities MOJ Availability of plan for Medical sending and receiving Countermeasure MoHSS 0 0 Yes Yes Yes Yes medical countermeasures Availability of risk communication guidelines MoHSS NO Draft Yes Yes Yes Yes Availability of media Risk communication policy MoHSS NO Draft Yes Yes Yes Yes Communication and strategic plan Availability of epidemic MoHSS 0 prone communities' map Points of Entry Proportion of main designated PoEs adequately equipped MoHSS/ Port Health 0% 25% 50% 60% 70% L 80% Technical Arca Indicator National Action Plan for Health Security (NAPHS 2020-2025} Data Baseline Im lementation eriod - Proportion of PoEs Source 2021 2022 I 2023 I 2024 - 2025 MoHSS/ conducting routine screening P ort 0% 10% 25% 50% 60% 75% for travellers Health Availability of contingency plans and MoHSS 0 Draft Yes Yes Yes Yes SOPs at designated. PoEs Availability of regt.llation on chemical events MET No Yes Yes Yes Yes Yes Chemical Events Availability of guidelines for management of chemical events MET No Yes Yes Yes Yes Yes Availability of Radiological and N uclear NRPA No Yes Yes Yes Yes Yes Radiation hazards response plan Emergencies I Number of persons trained in the respome to NRPA 25 50 75 100 120 150 radio-nuclear events National Action Plan for Health Security (NAPHS 2021-2025) -

Annexe 4: Implementation plan and estimated or projected annual action plan matrix PREVENT 1. Nati, I Le!dslati, Poli dF' Years of Monitoring and evaluation implementation Frequency Related of existing measure Lead Potential plan/frame .... N ff') ..., Ill Output/ Outcome (monthly, Source of N N N N N Key activities work/progr Unit Cost Q Q Q Q Q Total cost Proce,ss Agency partners N M N N N indicator quarterly, verificatfon amme or indicator six ongoing monthly, activities annually Objccth c Harmonizing all relevant Acts to support full implementation of International Health Regulations by December 202S Desktop analysis of all Acts, regulations and policies to highlighting inconsistencies by 2021. By December 2025all MoHSS Existing Signed relevant Acts Hire a national consultant with a HIS/ WHO, Consultant agreement Acts, 1 147300 harmonized Monthly legal background for 25 Legal UNDP 147300 report and in working days office/ Regulations and Policies alignment AGs with IRR By December MoHSS Draft 2025 all Existing Workshop Conduct a 3 days workshop HIS/ WHO, 15390 report of relevant Acts Acts, report and with a working group to assess Legal UNDP 1 15390 desktop harmonized Monthly Regulations attendance legislative documents office/ analysis of and in and Policies registers AGs Acts alignment with IHR National Action Plan for Health Security (NAPHS 2021-2025) - - By December MoHSS 2025 all Existing Final Conduct a I day meeting for tbe HIS/ WHO, relevant Acts Meeting report Acts, desktop validation ofreport of working Legal UNDP 7554 L 7554 harmonized Monthly and attendance Regulations analysis of group office/ and in registers and Policies Acts report AGs alignment witblHR By December MoHSS 2025 all Organize a press conference to HIS/ Press relevant Acts Articles publish in a press release the Legal 118254 1 118254 conference harmonized Monthly published in results of the harmonized office/ on report and in news paper legislation AGs alignment with IRR Implementation of the harmonizing of acts, regulations, policies to alleviate all contradictions and perceived areas of concern end of 2025. Draft By December recommen 2025 all Recruit 5 national consultants Existing dation relevant Acts for 25 days to develop short to UNDP AG, Acts, reports on harmonized Consultants medium term integrated SOPs, WHO 736500 1 736500 Monthly LARC Regulations SOPs and and in report harmonize the acts and and Policies regulation alignment regulations, policies to be with IRR amended By December 2025 all Conduct 1 public meeting to Existing Amended present amended Acts, AG, VNDP Acts, 709 524 Acts/ relevant Acts Meeting report 709 524 1 harmonized Monthly and attendance regulations and policies for long LARC Regulations regulations and in registers term harmonization and Policies / SOPs alignment withIHR Establish mechanism for multisectoral and multi stakeholder collaboration for the implementation of lHR by 2024. MORSS- National By December Develop MOU for IHR Focal IRR focal Plan for 2025 all Group to coordinate all aspects MOUs group Disaster No cost l No cost relevant Acts Yearly SignedMOUs of the NAHPS for Health developed Risk harmonized Security in Namibia Management and in National Action Plan for Health Security (NAPHS 2021-2025) alignment withIHR - National By December Plan for 2025 all Develop TORs for the IHR Disaster relevant Acts MOHSS- Focal Group to coordinate all Risk harmonized IHR focal TORs six Approved aspects of the NAHPS for Management No cost l No cost and in group developed monthly TORs llealtb Security in Namibia , National alignment Action plan with IHR for AMR By December National 2025 all MOHSS- Plan for Develop SOPs within each of relevant Acts IHR focal Disaster SOPs six Approved the relevant ministries No cost I No cost harmonized group Risk developed monthly SOPs and in Management alignment with IHR National By December Plan for 2025 all FAO Disaster relevant Acts MOHSS- Meeting WHO Risk M&E harmonized Conduct annual IllR focal IlIR focal 1245300 report, group review meetings group UNDP Management 249060 1 I L 1 l Reports and in Annually attendance UNICEF , National alignment sheets PEPFAR Action plan withIHR for AMR National Action Plan for Health Security (NAPHS 2021-2025) - - 2. IHRC dinaf C .f dAd Year of Monitoring and Evaluation im lementation Related Frequency existing of measure Lead Potential plan/ ..... NN (") '<t .,., Output/ Outcome ( monthly, Source of N N N N Key activities framework/ Unit Cost 0 0 0 0 0 Total cost Process quarterly, Agency partners N N N N N indicator verification programme indicator six or ongoing monthly, activities annuall o b·cctive: To establish a functional coordination mechanism that inte ates all relevant sectors in the im lementation of IHR b December 202S Stren coordination ea acit of the IRR National Focal Point includin the table to simulations b 2025. National Plan for By December FAO Disaster 2021, a WHO Conduct a meeting to develop Risk Cornmunic functional Report, UNDP a communication and MoHSS Management No cost 1 No cost ation inter- Monthly attendance UNICEF advocacy strategy for IHR , National strategy ministerial sheet PEPFAR Action plan coordination for AMR established National Plan for By December FAO Disaster 2021,a WHO Conduct a workshop to orient Risk IHR functional Report, MOHSS UNDP 174000 870 000 IHR focal point members on Management I 1 1 1 1 members inter- Annually attendance HRD UNICEF their roles , National sensitized ministerial sheet PEPFAR Action plan coordination for AMR established 3. Anti-Microbial Resistance ):'ears o{ National Action Plan for Health Security (NAPHS 2021-2025) - M onitoring and Evaluation im lementation Related Frequency existing of measure Lead Agency Potential partners plan/ framework/ Unit Cost- 0 N N N N 0 N <') N 0 N ..,,. tr) N g N 0 N Total cost Output/ Process Outcome indicator (monthly, quarterly, Source of verification programme indicator six or ongoing monthly, acti vities annuall Objective I To establish a structure for multisectoral collaboration overnance and communication on AMR by D ecember 2025 ldentif existin ovemance structures into which an AMR multi-sectoral committee ma be ositioned b 2025. B y December 2025,an WHO effecti ve UNDP Nominate AMR focaJ Focal multisectoral MoHSS PEPFA, IHR, NAAP, Designation person(s) for MoHSS & No cost 1 No cost persons AMR Monthly GoJ,GIZ GAP act MWAF for 5 years designated collaboration, governance& communicatio n established By December 2025,an suitable effective Conduct a lday meeting with UNDP structure multisectoral Report, 30 participants to determine MoHSS WHO IHR, GAP, for No cost 1 No cost AMR Quarterly attendance most suitable structure for PEPFAR NAAP governanc collaboration, sheets governance on AMR FAO eonAMR governance & determined communicatio n established Members By December for the 2025,an UNDP Nominate and appoint key GAP, NAAP AMR effective MoHSS WHO Nomination stakeholders as representative No cost 1 No cost multi- multisectoral Quarterly PEPFAR Act members for the AMR multi- sectoral AMR PAO sectoral committee. committee collaboration, nominated ovemance& National Action Plan for Health Security (NAPHS 2021-2025) - - communicatio n established By December 2025,an Conduct annual M&E WHO, effective meetings with 30 participants Meeting FAQ multisectoral ( 14 regional) to ensure MoHSS IHR, GAP, 401 640 M&E reports and functionality of governance PEPFAR NAAP 80328 l I 1 l I reports AMR Annually attendance ,UNDP collaboration, structures through M& E sheets governance& processes communicatio n established Ob"ective 2: To establish a laborator network for the surveillance of AMR b desi atin AMR reference laboratories b J une 2022 Laboratory By June Identify and assign reference WHO, network for Signed GAP,NA 2022, laboratories for both human FAQ AMR laboratory MOHSS IHR,GAP, No cost I No cost reference Annually and animal health for the PEPFAR surveillance network legal NAAP Labs. surveillance of AMR ,UNDP established by framework identified June 2022 Objective 3 : To establish surveillance of antimicrobial usa e and AMR in humans and animals to enerate robust national data b December 2025 Create and implement a data WHO, AMR source system for Improved MORSS, FAQ IHR, GAP, surveillance Central antimicrobial use and AMR No cost 1 No cost data Annually MAWF PEPFAR NAAP system database for both humans and animals system , UNDP functional Laboratories To establish mechanisms for coordinating to strengthening Infection Prevention and Control (IPC) initiatives at aU levels of healthcare to prevent the Ohjecthe 4: s read of disease b December 2025 Stren en and ex and ovemance structures includin IPC committees and IPC trained coordinators at all levels of healthcare. Conduct a workshop to train WHO NAAP; By December UNDP 40 IPC Report and IPC coordinators (40 MoHSS MoHSS in- TBD TBD 2025, PEPFAR ] l 1 1 1 coordinato Annually attendance healthcare workers) every 2 service mechanism in Min of rs trained register years training place to Hi er educatio 0 curriculum ooIPC Nat ional Action Plan for Health Security (NAPHS 2021-2025) strengthen !PC practices - By December 3 students 2025, Send three professionals to go NASFAF 1 TBD with mechanism in for 3 year postgraduate MoHSS NAAP TBD 1 Annually Diploma postgrad place to Diploma in !PC Dip in IPC strengthen IPC oractices By December I student 2025, Send 1 person to go for MSc NASFAF with mechanism in MoHSS NAAP TBD 2 2 2 2 2 TBD Annually Diploma IPC training program postgrad place to Dip in IPC strengthen IPC practices Ensure healthcare workers are familiar with the content of iruidelines and protocols on !PC in all healthcare facilities bv 2020 By December !CAT 2025, Infection Printing of 500 IPC guidelines MoHSS CDC 250000 500 copies mechanism in Guidelines Control tool 250000 Bi and protocols HR UNDP I of place to and protocols Guideline Annually GF guidelines strengthen IPC in place MoHSS IPC practices curriculum Dissemination of iruidelines and protocols on IPC in all healthcare facilities by 2023 By December 2025, mechanism in Conduct workshops to train !CAT place to 40 district district level healthcare CDC Infection strengthen IPC Attendance health workers on IPC protocol and WHO Control tool 2876664 2 876 664 practices register MOHSS 1 1 1 workers Quarterly guidelines (40 health workers GF Guideline mechanism in Training trained on from the14 regions) MoHSS IPC place report IPC curriculum Eauip heath facilities with commodities and sunnlies for IPC bv 2024. National Action Plan for Health Security (NAPHS 2021-2025) - - By December MOHSS Infection WHO 2025, Procure adequate PPEs for (HRD) Control Procurement CDC PPEs mechanism in usage in an infectious the Emergency Guideline 5100000 1 1 1 1 l 25 500 000 Annually receipts FAO procured place to treatment centers contingency and strengthen IPC fund Protocols practices 22 Pre- By D ecember Infection fabricated 2025, Procure and erect 22 Pre- CDC Control Procurement isolation mechanism in fabricated isolation units for MOHSS WHO Guideline 33,000,000 33 000 000 Annually receipts units place to highly pathogenic diseases and acquired strengthen IPC Protocols 1 erected oractices Monitor and evaluate the implementation of IPC practices (developing kev performance indicators) throuah health facilitv audits bv November 2024 WHO, By December Conduct quarterly supervisory CDC 4 2025, Annual IPC visits to facilities on use the GF ICAT supervisio 1216 200 mechanism in Bi- training report, ICAT once a year and submit MOHSS Intra- MOHSS IPC 60810 4 4 4 4 4 ns place to annually Attendance results to QA unit Health Curriculum conducted strengthen IPC list UNICEF per year practices By December 2025, mechanism in WHO, place to Conduct meetings at IPC unit IPC CDC 4 Self- strengthen IPC to develop a self -assessment Guideline, GF assessment practices tool to be used by health MOHSS- NAAP, Quarterly Intra- No cost 4 4 4 4 4 No cost tool Quarterly facilities and submit quarterly QA WHO core meeting report Health performed self -assessment report to IPC component UNICEF per year on lPC Establish feedback mechanisms on the outcome of the audits and implement continuing quality improvement initiatives. WHO, IPC National Action Plan for Health Security (NAPHS 2021-2025) By December - Copy of Compile quarterly national CDC, Guideline, Quarterly 2025, approved feedback report and give GF MOHSS- NAAP, national mechanism Quarterly feedback during National lPC QA Intra- WHO core I No cost 4 4 4 4 4 No cost feedback in place to Quarterly national steering committee meetings Health component report strengthen feedback on the status of IPC practices UNICEF on IPC IPC report ractices By Based on National feedback WHO, IPC December Approved report findings and CDC, Annual Guideline, 2025, annual recommendations, determine GF support MOHSS - NAAP, mechanism support facilities for annual support QA Intra- WHO core I No cost 1 No cost supervisory in place to Quaterly supervisor visits and for QI initiatives Health visit report component strengthen y visit implementation to address the UNICEF compiled onIPC IPC report identified gaps ractices Objerthe S: To promote awareness on AMR in both human and animal health sectors at health facility and community levels by December 202S !ncorporate the WHO national AMR awareness week into the annual ministerial calendars by 2020 National AMR By Submit a letter to offices of awareness December WHO, EDs ofMOHSS & MOWAF week 2025, MOHSS, PEPFA, Ministeria on inclusion of World IRR, NAAP No cost No cost incorporated Improved I Annually MOWAF FAO 1 calendar Antibiotic Awareness Week in into the community to ministerial calendars annual Awareness ministerial onAMR calendars Develop and implement communication Ian (throu AMR Awareness Week) by 2020 updated annuall_,. Recruit 1 international By consultant for 30 days to December develop key messages WHO, Key AMR 2025, Printed collaboratively with key MoHSS, PEPFA, 11-IR, awareness stakeholders for animals and MAWF FAO NAAP 366600 1 833 000 messages Improved I Annually key community messages humans sectors (AMR, AMU, developed Awareness withdrawal period, carcass on AMR disposal National Action Plan for Health Security (NAPHS 2021-2025) - By December WHO, Document 2025, Develop and produce TV, MoHSS, PEPFA, IHR, 26000 l I 1 l 1 Ads/scripts Improved Annually ation of printed and radio ads/scripts MAWF FAO NAAP 130 000 developed Ads/script community s Awareness on AMR By Conduct a I day meeting to 500 opinion December WHO, Conferenc engage 500 opinion (50 from leaders 2025, MoHSS, PEPFA, IHR, I e reports, regions) leaders on advocacy 880100 1 I 1 l 4 400 500 engaged on Improved Annually MAWF FAO NAAP attendance for the prevention of AMR in AMR community registers humans and animals, advocacy Awareness on AMR By Implement the December communication plan WHO, AMR 2025, Document (Production of thematic MoHSS, PEPFA, IRR, communicatio 844400 1 I 1 1 1 4 222 000 Improved Annually ation and posters, banners, leaflets and MAWF FAO NAAP nplan community archives branded T-shirts, caps and implemented Awareness water bottles) on AMR By December WHO, Radio Produce Radio advertisements 2025, Advert MoHSS, PEPFA, IRR advertisement (In English and 10 other local 353760 1 1 1 1 l Improved Annually script MAWF FAO NAAP l 768 800 s languages) community copy implemented Awareness on AMR By December WHO, Newspaper 2025, Produce advertisements in 10 MoHSS, PEPFA, IHR, advertisement Newspape 77000 1 1 1 1 l 385 000 Improved Annually half-page News Papers MAWF FAO NAAP s rs copy community implemented Awareness on AMR National Action Plan for Health Security (NAPHS 2021-2025) By December - WHO, TV 2025, MoHSS, PEPFA, IRR, advertisement Script Feature in l OTV broadcasts 104500 1 1 I 1 l 522 500 Improved Annually MAWF FAO NAAP s copy community implemented Awareness onAMR By Regional December Provide support grants to the WHO, AMR 2025, 14 regions to organize the MoHSS, PEPFA, IRR, awareness Event 231000 1 l 1 1 1 1 155 000 Improved Annually Regional AMR awareness MAWF FAO NAAP week reports community week commemorate Awareness d on AMR 4. Zoonotic disease Year of Monitoring and Evaluation im lementation Related Frequency existing of measure plan/ ...... N Output/ ~ Lead Potential 0 '<t Outcome (monthly, Source of N N N N Key activities framework/ Unit Cost 0 0 0 0 0 Total cost Process Agency partners N N N N N indicator quarterly, six verification programme indicator monthly, or ongoing annually activities Objective I To establish a s stem for the surveillance for zoonotic diseases b December 2024 Si MOU between MOHSS MAWF MET and other stakeholders By December 2025, Conduct a meeting to prepare MoHSS WHO NHEMC MOU Signed No cost 1 No cost surveillanc Quarterly tbeMoU MAWF OTE IDSR developed MOU e system for zoonotic National Action Plan for Health Security (NAPHS 2021-2025) - diseases established To review and prioritize zoonotic diseases under surveillance. By December WHO 2025, OIE Zoonotic surveillanc Conduct a meeting to prioritize MORSS, NI-IEMC Attendance SADC No cost 1 No cost diseases e system Monthly zoonotic diseases MAWF IDSR register AU/ prioritized for lBAR zoonotic diseases established Establish the rapid notification system for priority zoonotic diseases under surveillance By December WHO 2025, Hire an international consultant OIE Notification surveillanc MORSS, NHEMC 147 300 147 300 Consultant for 30 days to establish the rapid MAWF SADC IDSR 1 system in e system Quarterly report notification system AU/ place for lBAR zoonotic diseases established Evaluate, validate and implement the develooed rapid notification system. By December 2025, surveillanc Conduct a 1 day meeting with e system 10 people (the National Health for Emergency Management Notification NHEMC 5100 5 100 zoonotic Attendance Preparedness and Response MORSS, 1 system Quarterly IDSR diseases register committee), for the validation MAWF validated established reporting system developed by the consultant National Action Plan for Health Security (NAPHS 2021-2025) Conduct TOT on use of rap id notification system. The national consultant will train trainers on use of the rapid notification and information sharing system. - By December Conduct a 1 day TOT 2025, 30 Attendance workshop, facilitated by the surveillanc MORSS, NHEMC 80 352 80 352 participants register, consultant, with 30 people (26 e system Annually MAWF IDSR trained on Attendance from the regions) for notification certificates zoonotic diseases established To have a responsive Animal Health and Veterinary workforce by 2024 Advocate to the OPM for recruitment of all necessary vacant positions in the animal sector for an efficient surveillance of diseases By Recruit 1 Chief Veterinarin, 1 December Control Veterinary Technician, Positions 2025, 9 632 188 48 160 942 Recruitment 20 Animal Health Technicians, MAWF MAWFstaff 1 approved for responsive Quarterly contracts l OSenior Agricultural OPM structure recruitment animal Inspectors and 10 Agricultural workforce Inspectors in place National Action Plan for Health Security (NAPHS 2021-2025) - Year of Monitoring and Evaluation im lementation Frequency of measure (monthly, Related quarterly, six existing plan/ Lead Potential framework/ Unit 0 N .... N N N M N "'" N Outpu t/ Outcome monthly, Source of Key acti vities 0 0 0 0 0 Total cost Process annually Agency partners programme or Cost N N N N N indicator verification indicator ongoing activities Objective I By December Mechanisms 2025, a for detecting functioning Hire a national consultant for 25 and mechanisms working days to develop Consultati responding for detecting functioning mechanisms for MoHSS 147300 1 147300 Annually on TOR to food and detecting and responding to and report safety responding food safety incidents incidents to food developed safety incidents in lace Develo draft Food Safet Bill re lations By Consolidat December ion report Conduct a 2-day workshop to 2025, a of t he develop draft Food Safety Bill Draft Bill functioning Port Health 229520 1 229520 Quarterly inputs regulations with 55 participants, regulations mechanisms generated 20 from the regions for detecting from the and consultativ National Action Plan for Health Security (NAPHS 2021-2025) to food safety - e workshop. incidents in place Harmonize the Acts, rej{ulations. 1,olicies bv develooin2 short to medium term intem-a.ted SOPs and technical re rulations addressed in National Le~slation Pillar. By December 2025, a Consolidat functioning Bill ion report mechanis ms Conduct a 2-day meeting to regulations ofthe for detecting harmonize the Acts, regulations, MoHSS No cost 1 No cost harmonized Quarterly inputs and policies and SOP generated respondi ng developed from the to food workshop safety incidents in olace By December 2025,a functioning Conduct a 2 days meetings to SOPs and mechanisms develop short to medium term SOPs and technical for detecting integrated SOPs and technical Port health No cost 1 Quarterly technical regulations and regulations addressed in regulations developed responding National Legislation Pillar. to food safety incidents in place Staff reinforcement of point of entrv to implement food safety related activities. By December 20 20 health 2025, a 4867280 employme Recruit 20 Health Officers Posts MoHSS 1 1 1 1 1 24 336 400 officers post functioning Annually nt recruited mechanisms contracts for detecting and National Action Plan for Health Security (NAPHS 2021-2025) - responding to food safety incidents in place Caoacitv building for POE personnel throullh training of trainers on Risk based Inspection on SPS related matters on food safety_ By December l.Worksho 2025,a p report by Conduct a training of trainers of functioning Consultant 50 people all from regions by AMTA, mechanisms 2. Training international consultant (for 5 MAWF, 50 certified for detecting manuals 407400 1 I 814 800 Annually working days, 15 from AMTA, MOHSS, trainers and for trainers 15 MA WF, 15 from MOHSS, 5 NCRST responding 3. NCRST). to food Certificates safety of50 incidents in trainers place Acquiring food safety devices at points of entry and centrall, to increase testing capacity. By December 20 2025,a additions Food safety functioning of food devices mechanisms safety Procure and deploy 20 food deployed for detecting MoHSS 5000 000 1 5 000 000 Annually devices safety devices centrally and and into each at point of responding Govemme entrance to food nt asset safety register incidents in place Capacitv building of trainers on how to use the food safety devices By 1.Worksho Conduct a 2-day training 20 certified December p report workshop for 20 trainers ( 15 MoHSS 109240 I 109240 trainers 2025, a Annually 2. Training from the regions) on use of food functioning manuals safety devises mechanisms for trainers National Action Plan for Health Security (NAPHS 2021-2025) for detecting and -. 3. Certificates responding of20 to food trainers safety incidents in olace Acquiring rapid test kits for testing mvcotoxins to increase testing capacity for maior points of Entrv By December 2025,a 20 rapid functioning test kits for 20 rapid test mechanisms mycotoxin Procure 20 rapid test kits for kits for for detecting registered MoHSS 400000 1 400000 Annually mycotoxin testing mycotoxin and into procured responding Govern.me to food nt asset safety register incidents in place Develop Food Safety Inspection System software and aoolication 1. Food safety By Inspection December System 2025, a software National real functioning 2. time Food H ire a National Software mechanisms Applicatio Safety Developer to develop software for detecting n that can MoHSS 353520 1 353520 Inspection Annually for real time Food Safety and be used on software and Inspection responding Tablets application to food and developed safety smartphon incidents in es and place sends informatio n to a National Action Plan for Health Security (NAPHS 2021-2025) - central server Procure software licensin2 and oooulation of Food safetv Insoection Svstem By December Annual 2025,a Real time software functioning (up to date) licensing mechanisms Procure software licensing and and online procured and for detecting populate the Food Safety MoHSS 1570000 I I 570 000 Annually Food functional to and Inspection System Safety Food Safety responding Inspection Inspection to food System System safety incidents in place Procure tablets and laptops for food safetv data entrv By December 2025,a 80 tablets functioning and 20 80 tablets mechanisms laptops Procure 40 tablets and I 0 and20 for detecting registered laptops for food safety data MoHSS 235000 I 1 470 000 Annually laptops and into entry procured responding Governme to food nt asset safety register incidents in olace Caoacitv building of trainers on using the real time insoection svstem By 1.Worksho December p report Conduct a 3 days training of 50 50 certified 2025, a 2. Training trainers on using the real-time MoHSS 345 600 1 1 691 200 trainers functioning Annually manuals inspection system (30 from the mechanisms for trainers regions) for detecting 3. and Certificates National Action Plan for Health Security (NAPHS 2021-2025) responding to food - of50 trainers safety incidents in olace Benchmark of food safetv best oractices By December 2025, a Pan for tour functioning to Conduct a I day meeting to plan mechanisms Meeting benchmark for inter-ministerial tour to for detecting report and MoHSS 5100 1 5100 food safety Yearly benchmark of food safety best and attendance best practices responding register practices to food available safety incidents in place Conduct benchmarking tour by the inter-ministerial team By December 1. 6 flight 2025,a tickets and functioning proof of Conduct 7-day benchmarking Food safety mechanisms payment of tour (6 people, 2 from each 209640 best for detecting MoHSS 209640 1 Annually 6 DSA ministry to visit the identified practices and payments country) report responding 2. Internal to food traveling safety report incidents in place National Action Plan for Health Security (NAPHS 2021-2025) - Year of Monitoring and Evaluation im lementation Related Frequency existing plan/ of measure ...... N ("> "'1" V'I Output/ Lead Potential framework/ Outcome (monthly, Source of Key activities Unit Cost N0 N 0 N 0 N 0 N 0 Total cost Process Agency partners programme or N N N N N indicator quarterly, six verification indicator ongoing monthly, activities annual! Objective I Establishment of a functional interministerial talk force to develo and biosecuri s stem b December 202S By December JTC FAO 2025, an members for Nominate and appoint JTC UNICEF integral MoHSS existing Appointme members to work on existing WHO No cost I No cost biosafety Monthly MAWF legislation nt letter legislation UN-RC and appointed by CDC biosecurity June 2021 system develo ed Updated By regulations December that included 1, FAO 2025,an Con duct a 2-day consultation animal, Meeting UNICEF integral workshops to update regulations MoHSS agricultural minutes WHO 248080 I 248080 biosafety Quarterly to include animal, agricultural MAWF UN-RC and health and 2. Report and health sectors sectors in a on updated CDC biosecurity community regulation system health by developed March2020 By June By 1. Report FAO 2022the December on cross- Conduct 2 cross-sector Animal health UNICEF increased 2025,an sector coordination meetings to MoHSS act Nol of WHO 90456 2 180 912 cross-sector integral Once off coordinatio harmonize SOPs to improve MAWF 2011 and its UN-RC coordination biosafety n biosafety systems Regulations CDC and and 2. Updated harmonized biosecurit SOPs National Action Plan for Health Security (NAPHS 2021-2025) SOPs in the biosafety system developed - 3. Desktop report systems by 4. one desktop Workshop activity and report and two in-house minutes meetings (For 20 people from 14 from the regions) By December FAO 2025,an Biorisk 1. TORfor Hire an International trainer for MoHSS UNICEF integral management consultanc 3 days to develop a Bio-risk MAWF WHO 57720 1 57720 biosafety Annually procedure y management procedure MET UN-RC and developed 2. Contract CDC biosecurity system develooed l .Worksho By p report by December Consultant FAO 2025,an Conduct a 3-day Training of20 2. Training MoHSS UNICEF 20 JTC integral JTC members on bio-risk manuals MAWF WHO 146580 1 14 6580 members biosafety Annually management (14 from the for trainers MET UN-RC trained and regions) 3. CDC biosecurity Certificates system of20JTC developed members By l. Five of Conduct series of 5 workshops FAO December workshops !costed of working committee (20 MoHSS UNICEF 2025,an reports national bio- people. 14 from the regions) to MAWF WI-10 131808 l 131808 integral Annually 2. risk develop a costed national bio- MET UN-RC biosafety Attendance management risk management strategic plan CDC and registers strategic biosecurity and National Action Plan for Health Security (NAPHS 2021-2025) - plan system minutes for developed developed 20 participant s 1 benchmark report from By 1. 15 flight 3 different December tickets Conduct visits to three different FAO countries on 2025, an 2. Three countries (5 JTC members) to UNICEF existing integral visit MoHSS benchmark w ith existing WHO 474300 1 474300 biosafety biosafety Annually reports (ITC) biosafety and biosecurity UN-RC and and 3. F inal system CDC biosecurity biosecurity Benchmark system by 5 system ing report JTC developed members 1. Three By workshops December reports By June Conduct three workshops to FAO 2025, an 2. 2022develop develop a strategic national UNICEF integral Attendance MoHSS ed strategic laboratory plan with WHO 9 11700 1 9 11700 biosafety registers (ITC) national Annually stakeholders for biosafety and UN-RC and and laboratory biosecurity CDC biosecurity minutes for plan system 50 developed participant s 1. Two By workshops By December reports FAO November 2025,an 2. Conduct two meetings of 20 UN1CEF 2023 a integral Attendance MoHSS JTC members to develop the WHO 38400 38400 national biosafety Annually registers (ITC) 1 national laboratory plan UN-RC laboratory and and CDC plan biosecurity minutes for developed system 20 developed participant s Review labelline r- 11lations to handle and shin daneerous oatho2ens National Action Plan for Health Security (NAPHS 2021-2025) By - 20members December FAO of the review 2025,an Conduct a visit to meet private UNICEF committee integral 20 and public transport services to MoHSS WHO No cost 1 No cost nominated biosafety Annually Nomirnltion nominate 20 members of the (ITC) UN-RC by public and letter review committee CDC transport biosecurity services system developed By June By 1. Two 2022 December workshops reviewed 2025, an reports Conduct 2 in-house meetings of existing integral 2. FAO 20 review committee members regulations, biosafety Attendance UNICEF to review existing regulations, MoHSS guidelines and registers WHO 10200 1 10200 Annually guidelines and procedures to be (ITC) and biosecurity and UN-RC in accordance with WHO procedures system minutes for CDC guidelines to be in developed 20 accordance participant with WHO s P-nidelines By August By 1. Three 2022 December consultatio community 2025,an n consulted integral workshops the reviewed biosafety reports Conduct 3 larger one day FAO existing and 2. stakeholder consultation UNICEF MoHSS 376620 376620 regulations, biosecurity Attendance workshops in a community hall WHO 1 Annually (ITC) guidelines system registers for 50 (20 from regions) UN-RC and developed and stakeholders CDC procedures minutes for to be in 50 accordance participant with WHO s (20 from l!uidelines relrions) National Action Plan for Health Security (NAPHS 2021-2025) - stakeholder s By December by 2022 December reviewed 2025, an Conduct a 1 day meeting of the FAO final existing integral review committee members to UNICEF regulations, MoHSS biosafety Final include recommended WHO No cost 1 No cost guidelines Annually (ITC) and Report amendments and submit final UN-RC and biosecurity report CDC procedures system to be in developed accordance integrated with WHO rruideli nes Develop an inventory of pathogens found monthly in both human and animal health laboratories By June By 2021 the December pathogens 2025, an Animal health has an integral Designation of one person to FAO act No 1 of updated list biosafety submit an inventories every 6 UNICEF 2011 and its of all and MoHSS& Designatio months of all pathogens WHO Regulations, No cost No cost pathogens biosecurity 6 monthly NIP n letter identified by each human and UN-RC Public health found 6 system animal health laboratory CDC act, Medicine monthly in developed act human and animal health laboratories Enforce remations to orotect II ersonnel worldn2 at laboratories H ainst laboratorv-acouired infections under the labor act Animal health By June By act No 1 of 2022 fifty December Designation of 50 health 50 2011 and its health 2025, an inspectors in 14 regions by the appointme MoHSS Regulations, No cost 1 No cost inspectors in integral Annually MoHSS Occupational Health nt letters Public health 14 regions biosafety Officer (OHO) issued act, Medicine identified and act biosecurity National Action Plan for Health Security (NAPHS 2021-2025) system develo ed - 1. Training workshops By by reports Animal health November December 2. act No 1 of 2022 fifty 50 2025,an Attendance Conduct a 3-day workshop by 2011 and its health integral registers OHO to train 50 health MoHSS Regulations, 429000 1 1 858 000 inspectors biosafety Monthly 50 inspectors how to enforce Public health trained on and participant regulations. act of 2003, how to biosecurity s Medicine act enforce system 3. regulations developed Developed Training manuals by By Animal health December December 20 act No 1 of 2025,an 50 Health inspectors undertake 2023 Health Inspections 2011 and its integral once every 6 months inspections inspectors reports Mol-ISS Regulations, 22500 l I 1 l 1 112 500 biosafety 6 monthly to enforce regulation at district undertake at with Public health system level least 20 recommen act of 2003, biosecurity inspections dations Medicine act plan per year develo ed Objective 2 December 2023 a s By December Signed By June 2023capacit MOU and 2021 Joint yofMoHSS TOR of Sign MoU between MoHSS and MoHSS Technical andNCRST Establish a NCRST and Establish a Joint and No cost 1 No cost 6 monthly Committee on biosafety Joint Technical Committee (JTC) NCRST (JTC) and Technical established biosecurity Committee based on a (ITC) One Health National Action Plan for Health Security (NAPHS 2021-2025) - Approach developed By December 2023 By capacity of September MoHSS and Report 2021 need JTC Conduct (10 members) a MoHSS NCRSTon with assessment need assessment to identify gaps and 421680 l 421680 biosafety 6 monthly identified to identify in 4 regions for 14 days NCRST and gaps in 4 gaps in 4 biosecurity regions regions based on a conducted One Health Approach developed By December 2023 capacity of By February MoHSS and Conduct a 3 day, in-house 2022training Meeting MoHSS NCRSTon meetings of JTC to develop a plan that report and and 14100 1 14100 biosafety 6 monthly training plan that addresses the addresses attendance NCRST and gaps the gaps by register biosecurity developed based on a One Health Approach developed By By June December 2022implem 2023capacit Conduct a 1 day meeting of JTC entation of Meeting MoHSS yofMoHSS members to develop plan on the training report and and No cost 1 No cost andNCRST 6 monthly how to implement Biosafety and plan that attendance NCRST on biosafety Biosecurity training plan addresses register and the gaps by biosecurity developed based on a National Action Plan for Health Security (NAPHS 2021-2025) One Health Approach - developed By 1. Training December workshops By October 2023 reports 2023, thirty capacity of 2. stakeholders MoHSS and Attendance Conduct a training workshop on from 14 MoHSS NCRSTon registers Biosafety and Biosecurity for 30 regions for 2 and 188880 I 188880 biosafety 6 monthly 30 stakeholders from 14 regions for days byJTC NCRST and participant 2 days by JTC members members in biosecurity s Biosafety based on a 3. and One Health Developed Biosecurity Approach Training develooed manuals Develooin2 interval short trainin2 workshoos (tbeofrand practicalffo .raise awareness amon2 laborator ~ wo·rkforce of biosafet, and biosecuri V By December 2023 capacity of Minutes By MoHSS and with Conduct a meeting with December MoHSS NCRSTon nomination responsible Authorities to 202lmember and No cost 1 No cost biosafety 6 monthly s of nominate members of working s of working NCRST and members committee committee biosecurity of working nominated based on a committee One Health Approach develooed Conduct a 3 day in-house By March By meeting of working committee Curriculum 2022 review December Meeting members, 20 people to review MoHSS and training existing 2023 report and existing curriculum and training and strategies for 27000 l 27000 curriculum capacity of 6 monthly attendance strategies for biosafety and NCRST biosafety and and training MoHSS and register biosecurity at participating biosecurity strategies for NCRSTon universities biosafetv biosafetv National Action Plan for Health Security (NAPHS 2021-2025) - and and biosecurity biosecurity reviewed based on a One Health Approach developed By 1. Training December workshops By July 2023capacit reports 2022training yofMoHSS 2. Conduct a 2 day training of of working andNCRST Attendance working committee (20) MoHSS committee on biosafety registers members in a hotel on how to and 59200 I 59200 on raise and 6 monthly 20 raise awareness to biosafety and NCRST awareness to biosecurity participant biosecurity workforce biosafety based on a s and One Health 3. biosecurity Approach Developed developed Training manuals By 1. Training By September workshops December 2022 for 3 reports 2023capacit Conduct 2 Training workshop days 2. yof MoHSS (one being a refresher),30 Institutional Attendance aodNCRST people (14 from the regions) of Mo.HSS training of registers on biosafety biosafety and biosecurity and 381360 I 381360 working 6 monthly 30 and workforce by working NCRST committee participant biosecurity committee members in their on raise s based on a respective institutions awareness to 3. One Health biosafety Developed Approach and Training developed biosecurity manuals Imolement raoid and advanced testin2 offood imoorted into Namibia for GMOs By By MoHSS Border Document border assessment in September December and No cost 1 No cost 6 monthly assessment a report 2021Border 2023capacit NCRST report assessment v of MoHSS National Action Plan for Health Security (NAPHS 2021-2025) report completed andNCRST on biosafety - and biosecurity based on a One Health Approach developed By By February December 2022 rapid 2023 Rapid testing kits capacity of testing (20 per MoHSS and kits, Procure rapid testing kits (20 MoHSS border every NCRSTon fridges and per border every year), fridges and 4818000 I 4818000 year), biosafety 6 monthly computers (2 per border), computers (2 per NCRST fridges (2 and into each border) per border), biosecurity Governme computers (2 based on a nt asset per border) One Health register procured Approach developed By 1. December l lTraining 2023 workshops By July capacity of reports 2022border Train all border personnel on MoHSS and 2. 11 personnel use of the Rapid test kits at 11 MoHSS NCRSTon Attendance trained on borders, 2 trainers going to and 66264 1 66264 biosafety 6monthly registers of use of the points of entry for I day at each NCRST and participant Rapid test point of entry biosecurity s kits at 11 based on a 3. borders One Health Developed Approach Training developed manuals Hire an International trainer to MoHSS By June By TOR and train local scientists on GMO and 183560 1 183560 2022Intemat December 6 monthly contract testing NCRST ional trainer 2023 National Action Plan for Health Security (NAPHS 2021-2025) - - to train local capacity of for scientists on MoHSS and consultant advanced NCRST oo GMO testing biosafety appointed and biosecurity based on a One Health Approach developed B y October By Training 2022, ten lab December workshops personnel 2023capacit reports trained on yofMoHSS 2. Conduct a traini.t1g of lab identificatio and NCRST Attendance personnel on identification and MoHSS n and on biosafety registers of testing of GMOs. (10 local and 63600 1 63600 advanced and 6monthly 10 scientists for 14 days by an NCRST testing of biosecurity participant international trainer GMOs based on a s One Health 3. Approach Developed developed Training manuals 7. Immunization National Action Plan for Health Security (NAPHS 2021-2025) - Year of im lementation Monitorin and Evaluation Related Frequency Lead existing plan/ of measure ( N M .,., ;:i; N Output/ Source of Unit Cost N Agency/Bu Potential framework/ N N Outcome monthly, Key activities 0 0 0 0 0 Total cost Process verificatio dget line partners programme or N N N N N indicator quarterly, six indicator n holder ongoing monthly, activities annuall Objective: Establish a mechanism to ensure the reliabili of immunization covera e data b 2024 Develo a user friendl vaccinations from rivate facilities. By Conduct a 1 day meeting with December 20 people from MoHSS and WHO 2024,a relevant stakeholders including UNDP mechanism Meeting EPI Consultation private practitioners to review MoHSS PEPFAR in place to report and Immunization 60400 1 I 1 1 l 302 000 meeting 6 monthly the immunization and EPI Unit GF ensure the attendance guidelines report surveillance status/trend, and UNFPA reliability of register strengthen the reporting system UNICEF immunizatio of Public Health perspective. n coverage data By December WHO 2024,a MoHSS UNDP mechanism Publish newsletter to encourage EPI 6 Approved Copies of EPI Unit& PEPFAR in place to reporting from stake holders Immunization 20 000 2 2 2 2 2 200 000 newsletters 6 monthly newspaper Epidemiol GF ensure the (100 copies bi-annually) guidelines publication s ogy UNFPA reliability of UNICEF immunizatio n coverage data By WHO Number of December MoHSS UNDP Conduct supervisory support of EPI immunizatio 2024,a EPIUnit& PEPFAR Supervisio subnational staff on Immunization 3231900 1 I 1 l l 16 159 500 n support mechanism 6 monthly Epidemiol GF n reports immunization guidelines guidelines visits in place to ogy UNFPA conducted ensure the UNICEF reliabili of National Action Plan for Health Security (NAPHS 2021-2025) - immunizatio n coverage data Develop, print and disseminate WHO Internal and l 00 immunization registers that UNDP cross EPI l 00 registers will capture cross border MoHSS PEPFAR boarder Immunization 30000 l 1 1 l 120 000 printed and Annually In voice populations, strengthen internal BPI Unit GF irnmunizatio guidelines distributed registration , cross border UNFPA n data meetings UNICEF strenrrthens By December 1000 WHO 2024,a Print and distribute 1000 copies immunizatio UNDP mechanism of immunization guideline to EPI n guidelines MoHSS PEPFAR in place to both public and private health Immunization 400000 l 1 I l 200 000 printed and Annually In voice EPI Unit GF ensure the facilities. 1000 copies / 80 pages guidelines distributed UNFPA reliability of IN$5 to health UNICEF irnmunizatio facilities n coverage data By December WHO 2024,a UNDP mechanism lREC Hire an International consultant EPI MoHSS PEPFAR TOTs in place to consultant for 10 working days for REC Immunization 137800 l 137 800 Annually EPIUnit GF prepared ensure the contract training ofTOTs guidelines UNFPA reliability of signed UNICEF immunizatio n coverage data By WHO December UNDP 2024, a Training Conduct a 5 days TOT training EPI MoHSS PEPFAR 60TOT mechanism Once report of 60 workers from the District Immunization 788880 1 788 880 EPIUnit GF trained in place to Attendance and Region on RED, guidelines UNFPA ensure the register UNICEF reliability of immunizatio National Action Plan for Health Security (NAPHS 2021-2025) n coverage data - contributing to data accuracv By December WHO 2024, a UNDP mechanism Training Conduct training for district and EPI EVM MoHSS PEPFAR in place to report regional health workers on Immunization 1604400 1 1604 400 training Annually EPIUnit GF ensure the Attendance EVM guidelines report UNFPA reliability of register UNICEF immunizatio n coverage data By December 2024,a mechanism Signed To partner with NGOs to UNICEF MOUs/Partn MoHSS in place to Quarterly MOU/Part improve awareness creation on WHO No cost 1 No cost ership EPIUnit ensure the meetings nership immunization USAIDS document reliability of document immunizatjo n coverage data By December Three fully 2024,a MoHSS furnished mechanism Immunizat To create immunization stations EPJUnit& UNICEF structures in place to ion at targeted POEs for 5 years Public/Env WHO 1000000 l l 1 3 000 000 (vaccination 6 monthly ensure the creation period. iromental USAIDS room, reliability of Acts Health examination immunizatio room) n coverage data National Action Plan for Health Security (NAPHS 2021-2025) - - DETECT 8. National laborato Year of implementation Monitoring and Evaluation Related existing plan/ Frequency of Output/ measure Key activities Lead Agency Potential partners framework/ programme or -1 I Unit Cost I NN N 0 NI Ml 0 N N N VI N~ N 0 N 0 0 Total cost Process indicator Outcome indicator (monthly, quarterly, six monthly, Source of verification ongoing annually) activities Built capacity for personnel of the Regional Laboratories for both human and animal health by December 202S Conduct an inventory of skills for human and animal in S Regional laboratories (4 human and 1 animal lab) urnan Capital Conduct one training on human evelopment ~kills Report an and animal skill needs assessment ICVL/NIP ventory 0 1strategy (NIP), lno cost 1 INo cost Biannual atte.ndance ·eport WFTraining lregister 1available lan(CVL) Conduct training of the Laboratory Personnel to perform the required tests on priority disease for 4 regional labs Conduct a 5 day training meeting uman Capital yDecember Meeting workshop of2participant per labs evelopment 025, lO staff reportand at central level ICVL/NIP 0 1strategy (NIP), 146704 1233 520 Yearly ·ained WF Training lattendance ·egister lan(CVL) Conduct a yearly training of the Animal Laboratory Personnel to perfonn Brucella serology testing Conduct a l week training in the central laboratory, per diem and uman Capital National Action Plan for Health Security (NAPHS 2021-2025) yDecember - Meeting evelopment 025, travel costs for 2 people from the umber of eport and CVL/NIP 0 strategy (NIP), I 1676 1 I I I l 58 380 capacities for yearly lab staff trained attendance WF Training umanand register lan(CVL) nimal lab buiJ Conduct yearly support supervisory visits to the 6 labs (4 Human & 2 Animal) Conduct a 5 days supervisory uman Capital yDecember visits from central level to the 5 evelopment 025, labs, once a year, 1 person per supervisory Supervision CVUNIP 0 strategy (NIP), 4630 1 l l l l 23 150 apacities for yearly visit 1s1ts report WF Training wnanand conducted lan(CVL) animal lab built Objecth e 2: , troduce Point of Care (POq technology for priority diseases at 6 human Laboratories and 3 Animal Labs by March 2025 Identify priority diseases for POC testing in 6 human regional labs and 3 Animal Labs, to enable them to perform the POC tests yMarch 025, POC Meeting Conduct al day meeting to ist of ecbnology report, identify priority diseases for POC NIP WHO/CDC o cost I No cost priority Yearly introduced for attendance testing diseases assessment riority register iseases Equip the laboratories with the POC testing equipment for priority diseases Equipment Procure the equipment as per the quipment echnology IP/CVL 0 JOO 000 I 100 000 Yearly inventory, required specification rocured · troduced for invoices riority diseases Finalize the POC testing guidelines developed in 2015 National Action Plan for Health Security (NAPHS 2021-2025) - Conduct a meeting to finalize the oc Report and 2015 POC testing guidelines ICVL/NIP 0 No cost o cost attendance ridebnes finalized ~ ~o~uced bnology for !Yearly ! ·e gister .:1onty seases yMarch Conduct an orientation meeting to umbe, of ~25, POC raining staff _echnology staff members and implement POC testing !CVL/NIP 0 ocost o cost rented 1 trodu"" for IYeady nont register and !report seases !Maintain and increas.e the capacity in laboratory Quality Management System of 20 human labs and 3 Animal labs by March 2025 Conduct Training in QMS in 20 human labs using 2 local and 2 International trainers Conduct 3 sessions of 5 days of IQMS training on QMS with 20 20 staff rainfog participants (l staff from 20 labs WHO 967566 1 837 830 trained on hhe 20 human !Yearly 1 lr eport per year, at central level, over 18 QMS 1 bod 3 animal months training) iQMS Hire 2 international to train Staff raining Laintained in human lab staff on QMS !trained in report, 0 552240 12 761 200 e 20 human lyearly a human nd 3 animal atte_ndance labs lregister labs Train staff in 3 animal labs on QMS using 2 local and 2 international consultants National Action Plan for Health Security (NAPHS 2021-2025) - QMS raining Conduct a 5 days training with 15 aintained in 15 staff report, participants from 3 animal labs on CVL 110839 1 110839 the 20 human Yearly ained attendance QMS at central level nd 3 animal register Hire 2 international trainers to aintained in train animal lab staff on QMS raining Consultant CVL 206960 1 206960 he20 human Once off performed report nd 3 animal Objerthe .t · ppraise and Review the laboratory quality management system, through periodic quality audits across the country by December 2025. Conduct periodic quality assessment and disseminate findings to relevant stakeholders for human labs yDecember 025, 40 labs udited for Conduct field visit to assess QMs 0 Labs QMS Audits WHO 110184 l l I l I 550 920 yearly in 40 human labs isited reports yDecember 025, 40 labs udited for Disseminate findings of periodic umber of QMS Audits quality assessment to relevant CVL o cost 1 I 1 1 1 o cost abs Yearly reports stakeholders for animal labs visited National Actio n Plan for Health Security (NAPHS 2021-2025) - - Conduct an external assessment for accreditation for human labs yDecember Assess 2 labs human labs per year ccredifati ~25, 40 labs ~ ccreditation for the purpose of accreditation 0 1200000 II ll 11 11 11 11 000 000 Ion report udited for yearly hecklist available MS esult !Increase the scope and scale from 15 to 20 the number of Labs that are internationally accredited by March 2025 Conduct an external assessment for accreditation of vet labs ccreditati !additional Jabs Pay annual accreditation IS ADCAS ICVL 1400000 l l 12 000 000 re !Yearly !Invoice membership fee ebsite .temationally fee paid ~ccredited Review and Equip sentinel laboratory capacity in both the public and private sector for improved volume of diagnostic and surveillance testing. yMarch 025,5 dditional labs ,r e Procurement of 3 Vitex, to equip intemationally the 3 identified AMR sentinel 3 Vitex accredited surveillance lab ICVL ational Action lan on AMR 15100000 5100000 !e quipment rocured l !Yearly Invoice National Action Plan for Health Security (NAPHS 2021-2025) Build the sentinel laboratory capacity among Technologists in both the public and private sector for increase number of diagnostic and surveillance testing. - Conduct a training of 6 lab technologists on AMR curricula for 3 days in Windhoek once 6 Sentinel lab !National action k'\ttendance Vitex equipment has been CVL 33480 1 33480 technologis capacity Yearly tplan for AMR register installed ~ trained developed 9. Real time surveillance Year of Monitoring and Evaluation implementation Related existing Frequency plan/ of measure Output/ (monthly, Lead Potential I Unit Cost Outcome Source of Key activities Agency partners I framework/ programme lij l~l~ l~I~ Total cost Process indicator indicator quarterly, six monthly, verification or ongoing annually) activities Establish and implement event-based surveillance as outlined in the Namibia IDSR guideline (2011) to complement indicator based surveillance by March 2025 Establish real time event based surveillance in animal and human health at all levels IDSR By March Conduct a 1 week Peer to peer MoHSS- (2011), Peer to 2025, event visit to a country with a well HIRD, NIPH 214400 214 400 Peer visit based Annually Travel report functional event based MAWF- Weekly conducted surveillance surveillance systems EPID IDSR in place reporting National Action Plan for Health Security (NAPHS 2021-2025) - based system By March MoHSS- Software Procure software and devices for lDSR 2025,event HIRD, and event based surveillance (2011), 13420000 I 13 420 000 based Annually Invoices MAWF- devices (cellphones and laptops) NIPH surveillance EPID procured in place Software Employ an international By March Consultant MoHSS- on EBS consultant for 15 days to install IDSR 2025, event report HTRD, installed the software, orient the national (2011), 195000 1 195000 based Annually MAWF- into Training counterpart and conduct five-day NIPH surveillance EPID various report training of trainers in place devises Curriculu m revised Revised &content By March curriculum MoHSS- IDSR on 2025, event with content Revise the curricula to include the EPID, (2011), No cost l No cost surveillan based Annually on content on surveillance staff time MAWF- NIPH ce surveillance surveillance EPID expanded/ in place expanded/inc incorporat orporated ed Conduct a 5 days training of By March MoHSS- trainers with 70 Health and WHO IDSR 2025, event EPID, 70ToT Training agricultural extension workers (201 l), 920360 1 920360 based Once off MAWF- CDC trained report and health facility nurses in Event NIPH surveillance EPID based surveillance in place Conduct a training of3500 community Health workers and MoHSS- WHO IDSR National Action Plan for Health Security (NAPHS 2021-2025) Number By March 2025, event - HIRD, 0, 0, 0, Training agricultural technicians and health (2011), 2700000 2 700 000 of staff based Yearly MAWF- CDC 33 33 33 reports facility nurses in Event based NIPH trained surveillance EPID surveillance in place Hire an international consultant to By March MoHSS- Adapted conduct l week adaptation IDSR 2025,event HIRD, National Consultant workshop ( and TOT) for new WHO (2011), 103480 1 103480 based MAWF- IDSR report version ofIDSR with a WHO NIPH surveillance EPID Guideline Consultant in place By March MoHSS- Adapted Workshop Conduct I week workshop (and IDSR 2025, event HIRD, National report, TOT) for adaptation of IDSR WHO (2011), 455864 1 455864 based Yearly MAWF- IDSR attendance guideline with a WHO Consultant NIPH surveillance EPID Guideline register in place Conduct a 1 week National MoHSS- Capacity Training for health workers IDSR Number HIRD, developed Training (Doctors, Nurses and BHP) on the WHO (2011), 1291448 l 1 l 1 l 6 457 240 of staff Yearly MAWF- for health reports IDSR Guidelines in two clusters NIPH trained EPID workers plus annual refresher training 1500 IDSR MoHSS- guidelines Guidelines Printing IDSR Print and disseminate 1500 IDSR HIRD, and disseminated invoices, WHO (2011 ), 375000 1 1 750 000 Yearly guidelines and training modules training to all disseminatio IEC NIPH modules facilities and n report printed in use MoHSS- Number Conduct consultative meetings IDSR Revision HIRD, of Meeting with the UNAM, NUST, School WHO (2011), No cost 1 I No cost schedule for Yearly MAWF- consultati minutes of Medicine, NHTC and other NTPH the EPID ve National Action Plan for Health Security (NAPHS 2021-2025) - nursing schools on the revision of meeting curriculum is the curriculum conducted agreed upon Conduct 2 day workshop to Curriculum review and update the pre service revised, training curricula to include IRR, MoHSS- Workshop Workshop IDSR 88800 88800 surveillance ONE HEALTH & performance HIRD, conducted report WHO (2011), 1 content Yearly indicators of diseases targeted for MAWF- and report NIPH included and elimination and eradication, new EPID available it is emerging diseases concepts and approved innovation for all institutions Objecti,e 2 Activate information sharing between human and animal health by December 2022 Establish an interconnected real time reporting system by 2021 By December MOU 2022, MoHSS- Submitted Establish an MOU between information HIRD, through MOU MoAWF, MoHSS, and MET for NIPH No cost I No cost sharing 6monthly MAWF- legal Document interconnecting the information activated EPID departmen systems between t human and animal sector By Agenda December point 2022, Conduct a 1 day meeting with MoHSS- discussed information NHEMC & CCA-MAWF and HIRD, Meeting NIPH No cost I No cost and sharing 6 monthly MET to discuss on ONE MAWF- Minutes resolution activated HEALTH agenda EPID agreed between upon hum an and animal sector Enhance timely data analysis and reporting by September 2025 National Action Plan for Health Security (NAPHS 2021-2025) - Encourage the use of data for action By Conduct 2 training with 60 September Training participants of operational levels MoHSS- IDSR 60 staff 2025 timely reports, data WHO 961920 l I l 961 920 Yearly (district, health facil ity) to EPID Guideline trained data analysis analysis improve surveillance data analysis and reporting report enhanced Surveillan ce bulletin By Bulletin, is September MoHSS/MA Fast track establishment of fDSR developed MoHSS- 2025 timely WF periodic surveillance bulletin One WHO Guideline, 24000 l I l 1 l 120 000 and quarterly EPID data analysis Websites, Health monthly bulletin EPR Plan shared and reporting with I Emails enhanced I stakeholde rs By September 2025 timely data analysis and reporting HR Critical enhanced Advocate for the fil l of vacant Critical posts for improved analysis of MoHSS- WHO position list/ l 1 l ) l positions I yearly I Critical HIRD HIRD position list data filled Structure National Action Plan for Health Security (NAPHS 2021-2025) - - Sustain and Improve the syndromic surveillance reporting at all levels (community, facility, district, regional, national) Maintain timely (within 24 hours) Improved Reporting of syndromic IDSR Report timeliness Weekly surveillance diseases as required MoHSS- IDSR Weekly WHO No cost 1 1 1 1 l No cost send on and and (Immediate, weekly monthly etc) EPID Guideline report and time completeness immediate CIFs of data Advocate and motivate for positions and infrastructures at POEs to improve Syndromic surveillance 22 port Training Conduct a training of 22 Port health report, health officials in 11 POEs) on 289256 1 289256 officials attendance the screening trained register 10.Reporting Year of M onitoring and Evaluation implementation Related existing Frequency plan/ of measure Output/ (monthly, Lead I Potential I framework/ I Unit Cost Outcome Source of Key activities Agency partners programme l~lij l~l~I~ Total cost Process I indicator indicator quarterly, six monthly, verification or ongoing annually) activities To have an improved system for efficient reporting to WHO, CDC, FAO, SADC, AU-ABR and OIE during outbreaks/events/emergencies by Objective I December 202S I • OIE and FAO, and from community level to national level Conduct 10 days field investigation of events by 7 IDSR National Action Plan for Health Security (NAPHS 2021-2025) All cases By December 2025, all - Notification MoHSS/ Guidelines, sheets personnels to investigate within reporter events MAWF- WHO OIE 2778380 1 1 1 1 l 13 891 900 Monthly 72 hours from the event reporting as reported Investigation EPID Regulation, to report all events within 24 required within 24 and reports IHR2005 hours to WHO 72 hours Use of simulations of epidemics and exercises to improve the future response activities By December IDSR 2025,all Table top events Conduct table top simulation MoHSS/ WHO Guidelines, Simulation exercise reported exercise on notification of MAWF- OIE 185120 2 2 2 2 2 1 851 200 Yearly exercise CDC conducte within 24 and potential PHEIC EPID Regulation, report d 72 hours IHR2005 4 By December superviso 2025,all IDSR MoHSS/ ry visits events Guidelines, Conduct quarterly supervisory MAWF- per year reported Activity WHO OIE 173072 4 4 4 4 4 3 461 440 quarterly visits Regional supervisi within 24 and reports Regulation, office on visits 72 hours IHR2005 conducte d I By December IDSR national 2025, all Conduct a national annual MoHSS/ Guidelines, support events Activity supervisory visit to operational MAWF- WHO OIE 185020 l 1 1 l l 925 100 supervisi reported yearly reports levels (Regions and Districts) EPID Regulation, on visits within 24 and available IHR2005 conducte 72 hours d National Action Plan for Health Security (NAPHS 2021-2025) - Objccti, c ~ To report 80% of events to WHO, FAO and OIE within 24 hrs by December 2025 Conduct after action reviews to analyse what happened, why it happened, and how it can be done better by all the stakeholders. By December Data 2025, 80% of lDSR review potential Meeting Conduct biannual data review MoHSS- WHO Guideline, biannual PHEICare reports 1698208 1 1 1 1 I 8 491 040 6 monthly meetings with all regions EPID CDC HIRD meeting reported to Attendance Annual plan conducte WHO, FAO register d andOIE within 24 hrs By December 2025, 80% of IDSR potential Feedback WHO Monthly MoHSS- Guideline, PHEICare reports Share the feedback with all No cost I I 1 l I No cost feedback Monthly EPID CDC HIRD reported to shared, Regions/districts monthly shared Annual plan WHO,FAO emails list and OIE within 24 hrs By December 2025, 80% of Hire an 1nternational consultant lDSR Desk potential for 15 days to conduct a desk MoHSS- WHO Guideline, review PHEICare Desk review 195000 1 195 000 Yearly review (including the DQA EPID CDC HIRD conducte reported to report Activity and planning) Annual plan d WHO,FAO and OIE within 24 brs Conduct a DQA in 17 districts with 3 staff (International consultant, national, regional driver) Hire an international consultant WHO By December MoHSS- IDSR DQA for 9 days to conduct a DQA in l 1 2025, 80% of Yearly DQA Report EPID CDC Guideline, 126360 252 720 conducte 17 districts potential HIRD Annual plan National Action Plan for Health Security (NAPHS 2021-2025) din 17 districts PHEICare reported to - WHO,FAO and OIE within 24 brs By December 2025, 80% of IDSR DQA potential Conduct a 7 days field visit for WHO MoHSS- Guideline, conducte PHEICare DQA National, regional and 12852 1 1 25 704 Yearly DQA Report EPID CDC HIRD din 17 reported to driver of7 days Annual plan districts WHO, FAO and OIE within 24 hrs By December Data 2025, 80% of Quality IDSR potential Meeting WHO Improve Conduct meeting to evelop a data MoHSS- Guideline, PHEIC are reports, No cost 1 1 No cost ment Yearly quality improvement plan EPID CDC HIRD reported to attendance Plan Annual plan WHO, FAO register develope and OIE d within 24 hrs By December External 2025, 80% of Recruit an international consultant IDSR review potential for 14 days to conduct an external MoHSS- Guideline, conducte PHEICare Consultant WHO 1445080 1 1445080 yearly surveillance review and share EPID HIRD d in all reported to report recommendations Annual plan identified WHO,FAO districts and OIE within 24 hrs Organize a 14 days field visits to MoHSS- External By December Review WHO IDSR 25704 1 25704 Yearly conduct an external surveillance EPID review 2025, 80% of Report Guideline, review and share conducte potential National Action Plan for Health Security (NAPHS 2021-2025) - recommendations, with 7 teams HIRD din all PHEICare consisting of 1 intl consultant, l Annual plan identified reported to national and I regional member districts WI-1O,FAO and one driver andOIE within 24 hrs conduct a refresher/orientation of By December all IRR focal point members and 2025, 80% of Number stakeholders to ensure IHR potential Meeting of staff fonctionality and efficiency (50 MoHSS- Documents, PHEICs are report, WHO 420660 1 420660 oriented Yearly participants 48 from regions, 3 EPID HIRD reported to Attendance onlHR days training) Annual plan WHO, FAO register and TOR andOIE within 24 brs Standardise the reporting tools at lower level and national level and integrate it in DHIS 2 to reduce workload for end users By December Integrate weekly IDSR Report Weekly 2025, 80% of DHIS 2 into the existing Web based IDSR potential Website, DHIS2 to maintain and strengthen WHO Reportin MoHSS- PHEIC are IDSR the existing surveillance reporting NIPH No cost l 1 1 1 l No cost g tool Monthly EPID CDC reported to weekly with the electronic reporting tools integrate WHO,FAO reporting dinto and OIE form DIDS2 within 24 brs Establish cross access to the MAWF web-based database with MoHSS to share information Recruit an international consultant for 20 days to establish the Interoper By December ability of 2025, 80% of Activity interoperable system to share WHO MoHSS- the potential report, relevant information between NIPH, HIS 252200 l 252200 Yearly E PID CDC informati PHEJCare DH1S2 MOHSS, MA WF, and on reported to Website Laboratories (including private labs) systems WHO, FAO National Action Plan for Health Security (NAPHS 2021-2025) establish ed and OIE within 24 hrs - Integrate reporting systems between minis1ries by facilitating interfaces among systems already in place, and using common communication channels. Interoper By December Conduct a meeting to orient the ability of 2025, 80% of relevant staff and managers on tbe the potential Meeting MoHSS- WHO informati PHEICare report, use and create accessibility of NIPH, HIS 498120 1 1 1 1494 360 Yearly information to users EPID CDC on reported to DHIS2 systems WHO,FAO Website establish and OIE ed within 24 hrs Strengthen the national IHR focal point in order to coordinate PHEIC reporting in the country. By December conduct quarterly meetings for 2025, 80% of IHR Focal point to review and Quarterly potential MoHSS- WHO meetings PHEICare Meeting coordinate the PHEIC reporting IHR No cost 4 4 4 4 4 No cost Quarterly system EPID CDC conducte reported to minutes d WHO, FAO and OIE within 24 hrs National Action Plan for Health Security (NAPHS 2021-2025) - 11.Workforce development Year of Monitoring and evaluation implementation Related Frequency existing plan/ of Output/ measure( Lead I Potential framework/ I Unit Cost Outcome monthly, Source of Key activities Agency partners programme or l~l~l~ l~I~ Total cost Process indicator indicator quarterly, six verification ongoing monthly, activities annually) Support the development and finalization of the National Human Resources for Health Strategic Plan,2020-2030, (HRHSP) by March 2021 Conduct an orientation to stakeholders involved in the HRHSP development By March 2021, the National Situational Establish Ta technical working TWG Human TOR, analysis on group and Draft TOR MoHS Intra Establishe Resources Minutes for human No cost No cost Monthly S-HRD Health <land TOR for Health theTWG resource for drafted strategic meetings health plan 2020- 2030 available By March Conduct a stakeholders meeting 2022, the for 5 days with 30 participants to Stakeholde National MoHS Intra- 295194 295194 Six Meeting sensitize on the importance of rs Human HRHSP S-HRD Health Resources monthly report sensitized for Health strategic plan 2020- National Action Plan for Health Security (NAPHS 2021-2025) 2030 available - Development and finalize the HRHSP By March 2022, the National Recruit an international consultant Human for 30 days to support the Consultant MoHS Intra HRHSP Resources Six development of the HRHSP 362040 1 362040 TOR and S-HRD Health developed for Health monthly report strategic plan 2020- 2030 available Develop the Implementation plan for HRHSP By March 2022, the Recruit an international consultant National for 30 days to support the Human development of the HRHSP Consultant MoHS Intra Resources Six implementation plan of the 362040 1 362040 Imp lement Tor and S-HRD Health for Health monthly HRHSP ation plan report strategic plan 2020- 2030 available Hold a validation workshop for the HRHSP Conduct a 5 days stakeholders By March Meeting Meeting with 30 participants ( 13 MoHS Intra- HRHSP 2022, the Six report, resident) 132168 I 132168 National S-HRD Health validated monthly attendance Human register Resources National Action Plan for Health Security (NAPHS 2021-2025) - for Health strategic plan2020- 2030 available Create positions for epidemiologists and other public health staff in the organogram and scale up the restructuring process in the MORSS to improve Objective 2 the human resource capacity especially at the. district level and POEs by the December 2025 Budget in the workplan the newly approved positions for the Epidemiologists and other Public Health Officials Create 8 oew positions: By Epidemiologists, December MoHS WHO, Public Health officials HIRD-Annual 8new 2025, S- CDC, 1766624 1 8 833 120 Quaterly Organogram plan positions required HIRD UNDP created positions filled Combine the resources of staff and graduates of the FELTP with those of UNAM to maximize expertise for training, research, and mentoring in Objective 3 public health by December 2025 Train staff members for the Short term programme for FELTP Training report, scientific Conduct 3 workshops to train 25 By presentation staffs for short term training in MoHS I WHO FELTP 25 staff December reports, FETP SI Strategic plan 1315500 25 I 25 I 25 I 25 I 25 I 164 437 500 trained 2025, more I yearly certificate EPID CDC staff trained issued in FETP National Action Plan for Health Security (NAPHS 2021-2025) - Train staff members for the Intermediate level program for FELTP Send 25 staff per year in South By WHO Africa for 1 year for training in MoHS 25 staff December FELTP certificate the FETP intennediate program SI CDC 22000 20 25 25 25 25 2 530 000 trained per 2025, more yearly Strategic plan issued EPID year staff trained NSFAF in FETP Train staff members for the long-term (2yr) training programme year 1 WHO By Send 10 staff in South Africa for MoHS December FELTP 10 staff certificate the 1st year of the training in long s CDC Strategic plan 1117320 1 1 1 1 1 5 586 600 trained 2025, more yearly issued tennFETP /EPID staff trained NSFAF in FETP Send staff members for the long-term (2yr) training programme year 2 By WHO Send 10 staff in South Africa for December MoHS FELTP 10 staff certificate the 2nd year of the training in CDC 2535200 1 1 1 1 10 140 800 2025, more yearly S/EPID Strategic plan trained issued long term FETP staff trained NSFAF inFETP Advocate for the sustainability of the FELTP after donor funding ends By December Advocate for continued funding MoHS FELTP Advocacy 2025, more Enrolment for FELTP s, No cost 1 1 1 1 l No cost yearly Strategic plan conducted staff trained register EPID in FETP National Action Plan for Health Security (NAPHS 2021-2025) - RESPOND 12.Prepared Year of Monitoring and evaluation im lementation Related Frequency existing of measure plan/ N M 'Sf" V) Output/ (monthly, Lead Potential N N N N N Outcome Source of Key activities framework/ Unit Cost 0 0 0 0 0 Total cost Process quarterly, Agency partners N N N N N indicator verification programme indicator six or ongoing monthly, activities annuall Objecti,e I , date and im lement a multi-hazards NHEPRP at all levels by December 202S Review, update and disseminate multi-hazard NHEPRP multi- Conduct a 5 days workshop with By December hazard Report, stakeholders (20 regional 2025, multi MoHSS WHO, 262960 I 262 960 draft plan annually attendance participants) to develop the multi hazards plan develope register hazards plan implemented d multi- By December hazard Consultant 2025, multi Recruit an international consultant WHO 103480 I 103 480 draft plan Annually TOR and hazards plan for 7 days to facilitate develope report implemented development plan workshop d National Action Plan for Health Security (NAPHS 2021-2025) Launch By December - Launch the multi hazards plan I MoHSS I WHO I I No cost I 1 I I I I I No cost I multi- 2025, multi I Annually Launch hazard hazards plan I report NHEPRP implemented One Health By December Use the One Health approach in approach MoHSS/ IOE/WH 2025, multi Launch the development oftbe multi No cost I No cost used in Annually hazards plan MAWF 0 the hazards plan I I report implemented NHEPRP Plan 2 table Conduct 2 table top simulation top By December exercise of the national multi MoD/Co Simex 2025, multi Simex MoHSS 248080 2 2 2 2 2 2480 800 Annually hazards plan w conducte hazards plan I I Reports dper implemented year - 1 functionn By December Conduct 1 functional simulation MoD/Co al Simex 2025, multi Simex exercise of the national multi MoHSS TBD l I I 1 1 TBD Annually hazards plan once a year w conducte hazards plan I I Reports dper implemented year Objective 2 To define the country's risk and hazards profile by December 2022 Develop a more comprehensive list of all ootential health risks Conduct a 5 days workshop with By December Workshop NSA Hazard 20 participants to assess risk and 2023 country report, MoHSS NCRST 262960 1 I I 262960 maps Yearly map out potential hazards in the risk profile attendance WHO produced country defined register Consolid By December Meeting Conduct a I day multi-sectoral ated list 2023 country report, meeting to consolidate MoHSS WHO No cost l 1 l No cost of all Annually risk profile attendance reports/documents health defined register risks National Action Plan for Health Security (NAPHS 2021-2025) - Conduct a meeting to assess and Resource By December Meeting map human, logistics and WHO, s 2023 country report, MoHSS No cost I I 1 No cost Annually financial resources, and develop inventory risk profile attendance inventory map defined re_gister By December Meeting Conduct an annual 2 days Updated WHO, 623 600 2023 country report, workshop with 20 stakeholders to MoHSS 124720 l 1 1 l 1 risk Annually risk profile attendance update the country risk profile profile defined register 13.E R, 0 ti Year of Monitoring and Evaluation im lementation Related Frequency existing of measure plan/ N M '<t" V) Output/ (monthly, Lead Potential N N N N N Outcome Source of Key activities framework/ Unit Cost 0 0 0 0 0 Total cost Process quarterly, Agency partners N N N N N indicator verification programme indicator six or ongoing monthly, activities annually) Objective 1 To have hazard s ecific SOPs and uideline to activate the PHEOC b December 2025 idelines SOPs and guidelines Conduct a 3 days meeting with 20 IHR PHEOC to activate Report, stakeholders to develop the CDC N HERP SOPs and MoHSS 171600 1 l 1 171600 PHEOC Annually attendance PHEOC guidelines and SOPs WHO IAPHI guidelines available by register NDRMplan developed December 2023 SOPs and guidelines Hire an international consultant IHR PHEOC to activate Consultant for 5 days to support the CDC/ NHERP SOPs and PHEOC MoHSS 80600 1 I 1 80600 Annually TOR and development of the PHEOC WHO IAPHI guidelines available by report guidelines and SOPs NDRM plan developed December 2023 Objective 2 National Action Plan for Health Security (NAPHS 2021-2025) eration Center b December 2025 By - December 2021 a Nominate lO multi-sectoral staff MAWF IRR 10 multi functional with clear roles and MoHSS NHERP No cost I management Quarterly Appointment NIP No cost sectoral responsibilities to manage the IAPHI letters MoHSS staff system PHEOC NDRMplan established for the PHEOC By December 2021 a Training Conduct a 2 day workshop to lOPHEOC functional modules, train the 10 appointed PHEOC WHO MoHSS 62960 1 62960 Staff management Annually report, staff in emergency management CDC trained system attendance and established register for the PHEOC By December Hire 2 national Consultants for 12 2021 a Activity days to draft the PHEOC WHO PHOEC functional Report, guidelines and SOPs including MoHSS CDC 120680 1 120680 SOPs management Annually attendance procedures for Incident developed system register Management Structure established for the PHEOC By 50 First December responders 2021 a trained on Training Conduct a 5 days workshop to WHO functional various report, train 50 first responders in MoHSS CDC 599020 1 599020 management Annually potential Attendance different potential hazards system hazards' list established SOPs and for the guidelines PHEOC National Action Plan for Health Security (NAPHS 2021-2025) - - By December 2021 a Meeting Conduct a 1 day meeting with 75 PHEOC functional WHO minutes, participants to validate PHEOC MoHSS 158790 1 158790 SOPs management Quarterly CDC Attendance SOPs and guidelines validated system register established for the PHEOC Objective 3 ublic health EOC b December 2025 ove ublic health emer enc o Develop a concept note to OPM ByPHEOC WHO Concept to serve as a commanding agency legal Complete MoHSS CDC No cost 1 No cost note Quarterly for PHEOC as a Type B Structure framework concept note developed available MoHSS WHO ByPHEOC Prepare a Cabinet submission for Cabinet CDC legal Approval financial resource allocation for No cost 1 No cost submission Quarterly framework letter thePHEOC prepared available Procurement of tools and MoHSS WHO ByPHEOC equipment, refurbishing of center, CDC legal Invoice, Equipment computers, laptops, monitors, PA 15815000 1 15 815 000 framework Quarterly Inventory procured system, emergency vehicles for available list thePHEOC MoHSS WHO ByPHEOC Appoint a staff member to serve 1 EOC CDC legal Appointment as Public Health Emergency 503000 1 1 1 1 1 2 515 000 Manager Quarterly framework letter Manager recruited available MoHSS WHO ByPHEOC Provide a 2 days in-service lO EOC Training CDC legal training for the 10 staff operating 62960 2 2 2 2 2 629 600 Staff Quarterly report/attend framework at thePHEOC trained ance register available Objective 4 Establish an o erational framework for the full functionin of the PHEOC b December 2025 Devel SOPs for the mana ement ofdifferent hazards Hire an international consultant WHO SOPs for By Consultant for 45 days to integrate existing MoHSS CDC 538200 1 538200 manageme December Quarterly TOR and 0 erational Res onse Plans and nt of 2025 a re ort develop SOPs for management of different hazards National Action Plan for Health Security (NAPHS 2021-2025) different hazards PHEOC operational - developed framework in lace SOPs for Hire 1 national consultant for 45 Develop manageme days to work with the SOPs for the Consultant WHO nt of international consultant on the MoHSS 271530 1 271530 management Quarterly TOR and different development of SOPs for of different report hazards management of different hazards hazards developed By SOPs for December Conduct a 1 day meeting with 75 manageme WHO 2025,a Report and participants for the validation of nt of MoHSS CDC 108750 l 108750 PHEOC Quarterly attendance SOPs for management of different different operational register hazards hazards framework validated in lace Develop copies of 500 copied SOPs for the SOPs for Print 500 copies of SOPs for MoHSS, WHO 125000 1 125000 SOPs management Quarterly management management of different hazards CDC printed of different of different hazards hazards Objective 4 ecific mR bazards"b December 2025 Devel By Report, Conduct a 4 days meeting on risk December attendance WHO Risk mapping with experts for fHR 67 212 2025, Case register, MoHSS CDC 67212 1 mapping Quarterly priorities hazards (chemical, management Case done nuclear, zoonotic and food safety) framework management in lace idelines Conduct a meeting to develop Case By guidelines and SOPs to manage manageme December Meeting WHO public health emergencies nt SOPs 2025, Case report, MoHSS CDC No cost No cost Quarterly including referral and and management attendance transportation, quarantine and framework register isolation in lace National Action Plan for Health Security (NAPHS 2021-2025) - 14. Linkin2 Public Health and Security Authorities Year of Monitoring and Evaluation implementation Related Frequency Lead existing of measure Agency/ plan/ - N (") '<t Vi Output/ (monthly, Source of Urut·cost Potential NNNNN T I cost Process Outcome Key activities Budget framework/ o o o o o ota . d" quarterly, partners 1ll 1cator . verification line holder programme or ongoing I N N N N N . . md1cator I six monthly, activities annuall Establish a functional multi-sectoral response incloding the capacity to link public health, animal health, environmental health and law enforcement Objel·ti\e authorities by March 2023 !leview MOUs between O/M/As and incorporate public health sector and other related law enforcement authorities By March 2023, MoU between Existing public Conduct a 2 days meeting with MOUs health, stakeholders to review existing Report, between animal MOUs between MoHSS, MA WF, MoHSS WHO 24000 1 24 000 Quarterly attendance lines health, MET and law enforcement register ministries environment authorities reviewed al health and law enforcement established By March 2023,MoU between public health, Endorsement of the revised MoU I MoHSS I WHO I No cost I No cost I MoU I animal I Quarterly I MoUs Signed by the relevant authorities (ED) I I1 I I I I endorsed health, environment al health and law enforcement established National Action Plan for Health Security (NAPHS 2021-2025) By March 2023, MoU - between public health, 100 copies n.eproduction of 100 copies of the animal MoHSS 5000 l 5 000 of MoU Quarterly MoUs revised multisectoral MoU health, printed environment al health and law enforcement established By March 2023, MoU between public Conduct a l day orientation health, Training MoHSS, 75 people meeting with 75 participants from animal report, MoD, WHO, 148278 I 148 278 sensitized Quarterly the 14 Regions to sensitize on the health, Attendance MSS onMoUs content of the MoU environment register al health and law enforcement established By March 2023, MoU between public One health, Conduct l table top simulation WHO, Report, simulation animal exercise per year to test the MoHSS MoD, 279560 l I 1 1 l l 397 800 Annually Attendance exercise health, operationality of the MoU CDC register conducted environment al health and law enforcement established National Action Plan for Health Security (NAPHS 2021-2025) - 15.Medical C t dP IDepl 0 men.t Year of Monitiring and Evalauation im lementation Related Frequency Lead existing of measure Agency/ Potential plan/ ..... N (") '<t .,., Output/ Outcome (monthly, Source of N N N N N Key activities Budget framework/ Unit Cost 0 0 0 0 0 Total cost Process quarterly, partners N N N N N indicator verification line programme indicator six holder or ongoing monthly, annuall Objective 1 ublic health emer encies b December 202S Devel By Conduct a 5 days workshop with December Report, 15 stakeholders to draft a plan and MCMplan 2025, a WHO, Minutes SOPs for medical MoHSS 109650 1 109 650 and SOPs national Quarterly CDC Attendance countermeasures during public developed. protocol for list health emergencies MCMin lace By December Hire 1 national consultant 7 Report, MCMplan 2025,a working days to support the Minutes MoHSS 42238 1 42238 and SOPs national Quarterly development of the MCM plan Attendance developed. protocol for and SOP list MCMin lace Medical By counterme December Report, Conduct a 1 day meeting with 75 asure plan 2025, a CDC Minutes relevant authorities to validate MoHSS 171300 1 171 300 endorsed national Quarterly WHO Attendance and endorse the MCM plan by75 protocol for list participant MCMin s. lace By Conduct l table top exercise per Table top Report, CDC December year to test the MCM plan and MoHSS 172200 l I 1 I 1 861 000 Simex Quarterly Attendance WHO 2025, a SOP (30 participants, 2 days) conducted list national National Action Plan for Health Security (NAPHS 2021-2025) protocol for MCMin - lace By Medical December stock 2025,a Review MOUs and supplier supplier Reviewed MoHSS WHO No cost l No cost national Quarterly agreement for medical stock agreement MoU signed protocol for andMOUs MCMin revised lace Objective 2 ment durm emer encies national rotocols b December 202S Guidelines By Hire an international consultant and legal December for 15 days to support the framework 2025,a Consultant development of guidelines and of sending National TOR and MoHSS WHO 195000 1 195 000 Quarterly legal framework of receiving and and protocol for Report sending personnel during receiving personnel emergencies personnel deployment develo ed in lace Guidelines By and legal December Hire a national legal consultant framework 2025, a Consultant for 30 days to develop guidelines of sending National TOR and and legal framework ofreceiving MoHSS WHO 181020 I 181 020 Quarterly and protocol for Report and sending medical personnel receiving personnel during emergencies personnel deployment developed in place By Personnel December Conduct a 5 days workshop with deploymen 2025,a Report 25 stakeholders to develop a plan tand National MoHSS WHO 328700 1 328 700 Quarterly Attendance for deployment and receiving receiving protocol for list personnel during emergencies plan personnel developed. deployment in lace National Action Plan for Health Security (NAPHS 2021-2025) - 200 copies By Framewor December kfor 2025,a Reproduction of 200 copies of personnel National Distribution personnel deployment and MoHSS WHO 50000 1 50 000 deploymen protocol for Quarterly sheet/list receiving plan t and personnel receiving deployment disseminat in place ed By December Conduct a 1 day training meeting 75 2025,a with 75 participants from 14 Attendance participant National regions to disseminate the plan for MoHSS WHO 148278 1 148 278 Annually list s sensitized protocol for deployment and receiving report on the plan personnel personnel during emergencies deployment in place By RRT team December Designate members of the rapid memebers 2025, a response team and Obtain WHO designated National RRT MoHSS WHO No cost 1 No cost Annually and Namibian accreditation for and protocol for database RRT accredited personnel byWHO. deployment in olace By December 2025, a RRTteam Data base migration and data base CDC, National MoHSS 1400000 I l 400 000 data base Annually Database development WHO protocol for developed personnel deployment in place Cost By 5 database Training of 5 database managers CDC, covered in Cost covered in December Attendance MoHSS I managers Annually for 3 days WHO database database tender 2025, a register trained tender National National Action Plan for Health Security (NAPHS 2021-2025) protocol for personnel - deployment in place 16.Risk Communication Year of Monitoring and Evaluation implementation Related Frequency existing of measure plan/ ..... N (") -st- ori Output/ t (monthly, Lead Potential . N N N N N 0 u come Source of .Key activities framework/ Urut Cost o o o o o Total cost Process . d" quarterly, Agency partners N N N N N . . Ill 1cator . verification programme indicator six or ongoing monthly, activities annual) To establish a risk communication system to efflciently and effectively respond to public hea lth emergencies by December 2025 O bjertiw I p evelop multi-hazard/multisectoral risk communication plan Risk Conduct a 5 days workshop with Risk communic 25 participants to develop the cornmunicati multi-sectoral risk communication WHO, on section ation I Report section to be integrated in the MoHSS CDC 328700 328 700 developed in system in I Annually Attendance place by list multi-hazard preparedness and the multi- December response plan hazard plan 2025 Risk Hire a national consultant for 7 Risk communic I Consultant communicati report and days to develop a multi-sectoral ation WHO/C on section ToR risk communication section in the MoHSS 42238 42 238 system in Annually DC developed in multi-hazard preparedness and place by response plan the multi- December I Multi-hazard hazard plan plan 2025 Hire a national consultant for 30 days to develop SOPs on risk WHO, Plans, SOP on Risk I Risk coromunic Attendance MoHSS 181020 181 020 Annually list communication during CDC communicati ation Report emergencies system in National Action Plan for Health Security (NAPHS 2021-2025) - on developed I place by December 2025 Risk Risk communic Establish a dedicated core team Communicat ation List of responsible for risk WHO, MoHSS No cost 1 No cost ion team system in Annually commisione communication during CDC commissione place by dteam emergencies d December 2025 Risk communic Conduct 1 Table top simulation I Table ation I Report CDC, top simulatio exercise to test the MoHSS 157400 l l l l 1 787 000 system in Annually communication system WHO n exercise place by I Attendance conducted list December 2025 Ohjectin• 2 To establish a collaboration and co-ordination mechanism among stakeholders by D ecember 2025 Develop a multi-sectoral communication strategy and advocate for increased budget Coordinati Risk on and Communicat collaborati Mapping of risk communication stakeholders to establish the MoHSS WHO No cost l ion on I Bi- I Stakeholder stakeholder mechanism annually database database mapping in place by available December 2025 Coordinati on and Risk ooll•borati I Conduct a 5 days workshop with I Report coromunicati 25 stakeholders to develop a risk MoHSS WHO 328700 1 328700 on strategy on h . mec arusm Quarterly Attendance communication strategy list available in place by December 2025 National Action Plan for Health Security (NAPHS 2021-2025) Coordinati on and - 4 collaborati Conduct quarterly risk coordination on Minutes of communication coordination MoHSS WHO No cost 4 4 4 4 4 No cost meetings mechanism Quarterly the meeting meetings with all stakeholders conducted in place by per year December 2025 Objective 3 Continuous} en e different media By Different Conduct 5 days field visits with 4 December media participants to organize quarterly 2025 platforms Minutes, meetings with different media strategies Bi- houses to share public health MoHSS WHO 64680 1 1 1 1 1 323 400 indentified for public annually Attendance and list, information (Media tour in the cornmunic information affected communities) ation shared develo ed %of By Conduct media survey through 14 population December days field visits with 10 reached by 2025 enumerators to determine messages strategies Survey message reach among target MoHSS WHO 172620 1 172 620 and best for public Annually report audience and determine the best communicati communic method to reach different on method ation audience identified develo ed By December 2025 Public validation meeting I day Communicat Report strategies 75 participants PLUS newspaper MoHSS WHO 175800 I 175 800 ion methods for public Annually Attendance advertisement 20000 NAD Validated list communic ation develo ed Findings of the surveys to be used Media By Survey to plan and implement best risk MoHSS No cost 1 1 1 1 1 No cost survey December Annually report communication methods findin s to 2025 National Action Plan for Health Security (NAPHS 2021-2025) - - be strategies incorporated for public in the communic implementati on I ation developed Design and implement effective s9cial and behaviour change communication interventions to build resilience among affected community by December Objective 4 2025 Pevelop interventions to address be~vior chan~e communi~ation for affect~ communi!l'. Best communic ation List of risk Map out communication Stakeholders I interventio communicati stakeholders at all levels I MoHSS I WHO I I No cost I1 I I I I I 1 map ns Annually on available indentified stakeholders by December 2025 Best 30 communic Conduct a training of 30 stakeholders ation Report and stakeholders for 5 days with 5 trained on interventio 6 442 520 attendance facilitators, on risk MoHSS 6442520 0,5 0,5 Risk ns Annually list of communication in the community communicati indentified participants in all the regions on in the by community December 2025 Best communic ation ListoflEC 14 lEC focal interventio Appointment of 14 regional lEC focal focal positions at sub-national I MoHSS I WHO I No cost I No cost I persons ns Yearly personnel at levels I I I1 I I I available in indentified sub-national all regions by level December 2025 Caoacitv buildinll and monitoriniz and evaluation of focal noints in the affected communities National Action Plan for Health Security (NAPHS 2021-2025) Best - communic 14 atioo Conduct 14 supervisory visits and Supervisory interventio monitoring of focal points (in 61770 5 5 5 5 5 1544250 visits ns Annual1y Reports affected communities) conducted indentified per year by December 2025 Best communic SOPs on ation Conduct a meeting to develop development interventio Report Bi- SOPs on development of IEC MoHSS WHO No cost 1 No cost oflEC ns Attendance annually materials materials indentified list available by December 2025 To sensitize affected communities on oossible risks and hazards Best communic Quarterly ation Conduct quarterly community community interventio Minutes of meetings during public health MoHSS WHO 31480 1 31480 engagement ns Quarterly the meetings emergencies meetings indentified held by December 2025 Best Appropriate communic Use different media platforms media ation Assessment appropriate to affected MoHSS WHO No cost 1 1 1 I 1 No cost platforms interventio Quarterly report on community used during ns media used emergencies indentified by National Action Plan for Health Security (NAPHS 2021-2025) - December I 2025 Establish system for svstematicallv ntherin2 misinfonnation and usin2 information for sha ,ine: resnonse Best communic SOPs ation Conduct a 5 days workshop with forgathering interventio Reports 25 stakeholder to design the MoHSS- WHO 328700 1 328 700 and listening ns Monthly Attendance system and SOPs for gathering PHC to rumour indentified list and listening to rurnors available by December 2025 Best cornmunic ation Formally designate PRO to Designated interventio MoHSS- Appointment manage rumors during public WHO No cost 1 No cost PRO ns Monthly PHC letter. health emergencies available indentified by December 2025 Best cornmunic Response ation Conduct assessment to evaluate and ability to interventio Assessment the response and the ability to MoHSS- address WHO 150000 l 150 000 ns Quarterly Report address rurnors and PHC rumors and indentified misinformation misinformati by on assessed December 2025 National Action Plan for Health Security (NAPHS 2021-2025) - OTHER IHR HAZARDS & PoE Year of Monitoring and Evaluation im lementation Frequency Related Lead of measure existing plan/ Agency/ ...... M v (monthly, k ey activities Budget Potential framework/ Unit Cost N 0 N N 0 N 0 N 0 "' N 0 Total cost Output/ Outcome quarterly, Source of partners programme or N N N N N Process indicator indicator verification line six ongoing holder monthly, activities annuall Objective I 2025. Stren en IHR core ea Core Physical Detection. MoHSS personnel & 11 scanners capacities WHO Every 6 verification Procure thermal scanners for the (PHC, salary TBD 1 TBD available for each established UNDP months at PoEs, 11 priority PoEs. DIRI) structure PoE at PoEs by Invoice recommended 2025 b MoHSS Recruit 30 Port health officers (Walvis Bay= 8, Windhoek= 8 Luderitz = 4, Ariamsvlei = 4, Core Employment Oshi.kango = 8, Ngoma = 4, WHO Staff capacities MoHSS 30 Port Health contracts of Wenela = 1, Katwitwi = 1, UNDP Establishment 9266747 1 1 1 1 1 46 333 735 established Yearly (PHC) Officers recruited Port Health Noordoewer = 3 SOEs Plan atPoEs by Officers Buitepos = 3, Ondangwa = 0) 2025 18 Agriculture technicians, ins ectors and Senior Construct holding facilities at the NAC, Ports Master MoHSS Core Physical 11 PoEs and the provision of all Customs, Plans, Holding facilities (Plannin 4360000 I 4 360 000 capacities Annually Building/Ro relevant equipments (PPE, NAMPO MoHSS constructed g) established om E ui ment buildin , RT Strate ·c Plan National Action Plan for Health Security (NAPHS 2021-2025) - Transportation - number of WHO, atPoEs by ambulance). Ministry 2025 of Works Coordination & Communication at prioritized WHO, Core PoEs. UNDP, National Port Consultative capacities Attendance Conduct a 5-day Stakeholder MoHSS Port Health 606380 1 606 380 Meetings established Annually Register consultative meetings/workshops Authoriti Strategy completed atPoEs by with 55 participants (35 regional) es 2025 Coordination & Communication at prioritized WHO, Core PoEs. UNDP, National Port Consultative capacities Conduct a consultative l day Attendance MoHSS Port Health 334640 1 l 1 1 1 I 673 200 Meetings established Annually meeting/workshop twice a year Register Authoriti Strategy completed atPoEs by with all relevant stakeholders at es 2025 National level Establish social media platform Core WHO, (WhatsApp) with all stakeholders MoHSS National Port capacities NAMPO WhatApp Group Communicat for communication and (PHC, Health No cost l l 1 l 1 No cost established Quarterly RT, established ion log information sharing amongst the Port Strategy atPoEs by NAC 11 PoEs Health) 2025 Capacity building. Core Conduct in service training of MoHSS WHO, National Port capacities Training staff of the 11 PoEs on detection, (PHC, NAMPO In-house training Health No cost I I I 1 I No cost established Quarterly records isolation, coordination and Port RT, conducted Strategy at PoEs by (attendance) communication. Health) NAC 2025 Core capacities Monitoring and evaluation. MoHSS WHO, established Records of National Port 2 supportive visits Conduct Supportive supervision (PHC, NAMPO atPoEs by Every 6 visits to Health 132720 2 2 2 2 2 1327200 conducted to visits for 5 days with 2 teams of 4 Port RT, 2025 months PoEs Strategy Identified PoEs supervisors twice a year Health) NAC (Report) Objective 2 National Action Plan for Health Security (NAPHS 2021-2025) ublic health events at the desi - ated PoEs b December 2025 Risk Conduct consultative profile meeting/workshops of all relevant MoHSS WHO determined stakeholders to update the National Port Consultative Workshop (PHC, NAC at emergency plan at PoEs to Health 279560 l 279560 Workshop Annually Attendance Port NAMPO designated integrate public health risk and Strategy completed register Health) RT PoEs by hazards December 2025 Risk profile Conduct an inception meeting to MoHSS WHO determined National Port Workshop develop terms of references and (PHC, NAC at Health No cc.est 1 No cost ToR develop ed Quarterly Attendance scope of the risk assessment Port NAMPO designated Strategy register process Health) RT PoEs by Decem ber 2025 Risk profile Conduct multi sectoral field visits MoHSS WHO determined for 30 days for risk assessment National Port Risk (PHC, NAC Risk Assessment at aiming at determining the maj or Health 362040 1 362040 Quarterl y Assessment Port NAMPO completed designated potential hazards at each PoEs. Strategy Reports Health) RT PoEs by December 2025 Risk profile determined at Conduct a 1 day workshop with MoHSS WHO National Port National designated 70 participants for the validation (PHC, NAC Attendance Health 182800 I 182800 Workshop PoEs by Annually of the risk profile at the assessed Port NAMPO Register Strategy completed December PoE Health) RT 2025 National Action Plan for Health Security (NAPHS 2021-2025) - Objective 3 Establish a functional inter sectoral collaboration mechanism with all stakeholders involved in ublic health res onses at all ma·or PoEs b December 2025 Create and stren en inter sectoral collaboration with all relevant Stakeholders By December 2025,a MoHSS WHO Map key stakeholders and functional (PHC, NAC establish MoUs for inter sectoral National Port inter Port NAMPO Signed collaboration in a 1 day Health 170620 1 1 1 1 1 853 100 MOU signed sectoral Annually Health, RT, line MOUs consultative meeting for 55 Strategy collaborati Attorney ministrie participants on General) s established at priority PoEs By December 2025,a WHO Conduct a 5 days workshop with functional MoHSS NAC 55 participants to develop a National Port inter (PHC, NAMPO SOPs updated and Attendance harmonized SOPs on inter Health 606380 1 606 380 sectoral Annually Port RT,Line harmonised Register sectoral collaborations, Strategy collaborati Health) Ministrie on s established at priority PoEs By December 2025,a WHO functional MoHSS NAC Attendance National Port inter Conduct a 5 days TOT with 14 (PHC, NAMPO TOT workshop Register, Health 184072 1 184072 sectoral Annually participants on hannonized SOPs Port RT,Line conducted Report of Strategy collaborati Health) Ministrie Workshop on s established at priority PoEs Chemical events National Action Plan for Health Security (NAPHS 2021-2025) - Year of Monitoring and Evaluation imolementation Key activities Lead Potential Frequency Related Agency/ partners of measure existing plan/ Budget Output/ (monthly, framework/ I Unit Cost line progr8ID?1e or I -~N I O~N I o~N I O~N I N I Total cos1 g Process Outcome indicator quarterly, Source of verification holder indicator six ongomg monthly, activities annuall Establish a surveillance system for chemical risk or events, with effective communication and collaboration among the sectors responsible for chemical safety, industries.1 transportation and safety disposal by December 202S. ,oison centre Hire an international consultant By December for 30 days to establish a poison 2025,a centre and develop a chemical surveillance events plan: system for 1. Conduct a task resource Emergency chemical Consultant analysis. Preparedness Poison centet risks/events in report and 2. Benchmarking within SADC. MET WHO and Response 366600 366 600 established place Annually ToR, Physical 3. Technical specifications of the Plan poison centre facility By December 2025,a surveillance Establish a Technical Working system for TWGlist, Technical Group for chemical events WHO National chemical meeting Working surveillance and conduct quarterly MET UN-RC Chemicals 88144 88 144 risks/events it Quarterly report, group meetings with 14 participants Plan(TBA) place attendance established register National Action Plan for Health Security (NAPHS 2021-2025) - TrainiDI! of medical oersonnel (and suonort nersonnnel) on the handlin2. mana2ement and coordination of chemical incidents/events Conduct a 3-day workshop to By December train 55 medical personnel and 2025,a Training support personnel on the case WHO National surveillance 55 personnel Report, management of chemical event MET UN-RC Chemical 388500 1 388500 system for Annually trained Attendance patients Response Plan chemical Register risks/events in olace Develon SOPs and institutionalize multisectoral assessments for the treatment of chemical incidents/events Conduct meeting to develop a By December harmonized SOPs for managing 2025,a Chemical Meeting of chemical events WHO National surveillance events report, MET UN-RC Chemical No cost I No cost system for Annually management attendance Response Plan chemical SOPs register risks/events in olace Perform rem.dar controls and unannounced controls to maintain safe tranmortation of chemicals inside and outside enterprises. By December 2025,a Conduct quarterly field visits with Surveillance WHO National surveillance 3 supervisors for 5 days to tracking Tracking MET UN-RC Chemical 61770 4 4 4 4 4 1235 400 system for Annually implement an interlinked system reports Response Plan chemical surveillance and tracking system implemented risks/events in olace By December 2025,a WHO National surveillance Establish effective control permit Permit MET UN-RC Chemical No cost I 1 ] I L No cost system for Annually Permits system implemented Response Plan chemical risks/events in olace By December Inspection checklist and WHO National Inspection 2025, a MET point I above Costs of visits for UN-RC Chemical No cost ] 1 1 I 1 No cost Checklist surveillance Annually Checklists inspections Response Plan implemented system for chemical National Action Plan for Health Security (NAPHS 2021-2025) risks/events in place - By December 2025,a Conduct a 2 days meeting with 55 stakeholders (35 residents) to MET WHO National Multi sectoral surveillance Reports and UN-RC Chemical 279560 1 1 1 1 1 1397800 inspectorate system for Annually Structure of establish a competent multi Response Plan established chemical inspectorate sectoral inspectorate risks/events in place Develoo a national oro2nUllIIle for medical treabnent of chemical incidents/events By December Establish a multi sectoral advisory 2025,a committee in charge of Multi sectoral WHO National surveillance Advisory developing the national advisory MoHSS UN-RC Chemical No cost l No cost system for Annually committee programme for medical treatment committee Response Plan chemical Charter of chemical incidents/events. established risks/events in place By December 2025,a Ministry 1 table top Simulation Conduct a 2 days table top of Mines WHO National 838 680 Simex surveillance Report and UN-RC Chemical 279560 I I 1 1 l system for Annually simulations exercises with 55 and completed attendance Response Plan chemical participants on chemical events Energy every year register risks/events in every year place National Action Plan for Health Security (NAPHS 2021-2025) - 18.Radiation Emere:encies Year of Monitoring and Evaluation implementation Related Frequency existing of measure Lead I Unit Cost Output/ (monthly, I ~ I ~ I ~ I ~ I ij I Total cost Agency/B Potential plan/ Outcome Source of Key activities framework/ Process quarterly, udget line partners indicator verification programme indicator six holder or ongoing monthly, activities I I I I I I I I I I annuall Establish a surveillance system for radionuclear hazards/events/emergencies with effective communication and collaboration among the sectors responsible for Objective radionuclear management by 2025 and consider networking with other re. atory bodies between countries for the control of the im1 By December 2025, a Hire I international consultant for WHO National surveillance 10 days to orient on the Software ToRof UN-RC Single Orientation on system for requirements for control of MoHSS 137800 1 137 800 Annually Consultant, IAEA Window software given radionuclear imports and exports of radiation (Radiation report Project hazards/events sources before acquisition. Authority) /emergencies in place Procure equipment (50 computers By December with licenses) for 55 Port Health 2025,a Electronic Officers in 11 PoEs to establish WHO National 0, 0, surveillance 0, 0, Trading platform an electronic platform to improve MoHSS UN-RC Single 11 11 system for 850000 1 76 11 76 ll I 250 000 platform Annually available at the control of imports and exports (Radiation IAEA window 76 radionuclear 8 established all identified of radiation sources Authority) Project 5 5 hazards/events PoE /emergencies in 12lace By December 2025,a National WHO surveillance Training Conduct a 1 day meeting to train Radiation 20 Port health UN-RC system for report, 20 Port Health Officers on the use MoHSS Emergency 66530 I 66 530 officers Annually IAEA radionuclear Attendance of the electronic platform Response trained hazards/events Register Plan /emergencies in place Finalize the national radioloe:ical emere:encv orenaredness and resoonse olan and conduct drills. National Action Plan for Health Security (NAPHS 2021-2025) By December - 2025,a Conduct meetings to fmalize the WHO surveillance Meetings MoHSS UN-RC system for report, national radiological emergency NREPRP No cost 1 No cost Plan finalized Annually (NRPA) IAEA radionuclear Attendance preparedness and response plan hazards/events Register /emergencies in place By December Conduct a 2 day workshop with 2025,a 40 participants to conduct 1 Table WHO surveillance Top simulation exercise to test the Table top Table Top MoHSS UN-RC system for national radiological emergency NREPRP 118400 1 1 1 1 l 592 000 simulation Annually simulation (NRPA) IAEA radionuclear preparedness and response plan conducted report hazards/events every year /emergencies in olace By December WHO Conduct a drill with 40 2025,a UN-RC participants to test the national surveillance lAEA Drill report, radiological emergency MoHSS system for Uranium NREPRP No cost 1 1 No cost Annually attendance preparedness and response plan (NRPA) radionuclear Institute register every 2 years hazards/events /emergencies in place Integrate the National Radiological Emergency Response Plan (NREPRP) into the National Disaster Risk Management Plan (NDRMP) by December 2025. By December 2025,a surveillance Conduct a 3 days workshop with NREPRP system for WHO NREPRP 50 participants to incorporate the Atomic radionuclear Report and MoHSS UN-RC 70500 incorporated NREPRP into the NDRMP Energy Act I 70500 hazards/events Quarterly Attendance (NRPA) IAEA into the (5 of2005), /emergencies Register NDRMP DRMAct in place National Action Plan for Health Security (NAPHS 2021-2025) - Strenlrthen the advisorv role of the Atomic Enerll 'i Board to control and manalle re2ional and local authorities on matters relatin2 to radiation safetv and radiolofrical emer2encies. By December 2025,a Revise the Atomic Energy Act to WHO Atomic surveillance strengthen the Atomic Energy MoHSS UN-RC Draft revised system for Signed legal Energy Act No cost 1 No cost 6 monthly Board. (NRPA) IAEA Act radionuclear Act (5 of2005) hazards/events /emergencies in place By December 2025,a Conduct a 2 days workshop with WHO Changes in the surveillance Workshop Atomic 20 participants to present changes MoHSS UN-RC Act presented system for report, Energy Act 59200 1 59 200 6 monthly in the Atomic Energy Act to (NRPA) lAEA to radionuclear attendance (5 of2005) stakeholders stakeholders hazards/events register /emergencies in olace By December 2025,a Conduct a l day meeting to WHO Public surveillance Attendance Atomic publicly present the signed MoHSS UN-RC presentation of system for register, E nergy Act 108750 I 108 750 Annually Atomic Energy Act to (NRPA) lAEA A tomic radionuclear minutes of (5 of2005) stakeholders Energy Act h azards/events meeting /emergencies in place Assess the needs in terms of technical caoabilities and develoD risk assessment orocedures esneciallv at PoEs to ensure control and monitorimi: of radiation sources. By December Hire 2 international consultants 2025,a for 15 days to conduct a need Needs WHO surveillance assessment of PoEs capacities to Atomic Assessment Technical MoHSS UN-RC system for control and monitor radiation Energy Act 200220 l 200 220 and risk Quarterly Assistance (NRPA) lAEA radionuclear sources and perform risk (5 of2005) assessment Report hazards/events assessment completed /emergencies in olace Conduct 15 days fields visit with WHO Atomic Needs By December MoHSS Field visits 4 people and the international UN-RC Energy Act 338040 I 338 040 Assessment 2025,a Annually report (NRPA) consultants to assess PoEs IAEA (5 of2005) and risk surveillance capacities to control and monitor radiation sources and perform risk National Action Plan for Health Security (NAPHS 2021-2025) assessment completed system for raclionuclear - assessment hazards/events /emergencies in olace By December Needs 2025,a Conduct a l day workshop with WHO Atomic Assessment surveillance Attendance 55 stakeholders to disseminate MoHSS UN-RC and risk system for register, Energy Act 173140 1 173 140 Annually risk assessment and need (NRPA) IAEA assessment radionuclear Meeting (5 of2005) assessment results results hazards/events Minutes dissiminated /emergencies in place By December 2025,a Conduct a 2 days workshop with Minutes of 47 port health officials for a WHO 47 port health surveillance workshop MoHSS UN-RC system for training control and monitoring of (NRPA) NRPA 295912 1 295 912 officials Annually and IAEA radionuclear radiation sources at PoEs. trained attendance hazards/events register /emergencies in olace Strengthen the regulatory infrastructure, especially the development of radiation emergency response and preparedness plans at all facilities and by all national institutions that are involved with radiation sources. By December 2025, a Conduct a 2 day workshop with Minutes of all entities dealing with radiation WHO Regulation on surveillance workshop MoHSS UN-RC facilities and system for in the country and 8 officials to NRPA 23680 1 23680 Annually and (NRPA) IAEA institutions raclionuclear discuss on facilities and attendance discussed hazards/events institution regulations register /emergencies in place Radiation By December List of Support Facilities and institutions WHO emergency 2025, a facilities and to develop and submit radiation MoHSS UN-RC preparedness surveillance institutions NR.l>A No cost l No cost Annually emergency preparedness and (NRPA) IAEA and response system for with response plans plans radionuclear radiation developed hazards/events emergency National Action Plan for Health Security (NAPHS 2021-2025) - /emergencies preparedness in place and response olans By December 202S,a Conduct a S days capacity WHO surveillance 40 First Attendance building workshop on First MoHSS UN-RC system for NRPA 467S40 1 467S40 responders Annually Registers of responders during radiation (NRPA) IAEA radionuclear Trained participants emergencies with 40 participants hazards/events /emergencies in place By December 202S,a Hire 1 national consultant for S WHO surveillance Consultant days to conduct the training of MoHSS UN-RC Training system for NRPA 30170 1 30170 Annually ToR and First responders during radiation (NRPA) IAEA conducted radionuclear report emergencies hazards/events /emergencies in olace Finalization of the National Radiolosrical Resoonse and Preoaredness Plan By December 202S,a Reproduction of SOO copies of the WHO surveillance SOO Copies National Radiological Response MoHSS UN-RC system for Invoice of NRPA 475000 I 47S000 reproduced Annually and Preparedness Plan (NRPA) lAEA radionuclear reproduction and distributed hazards/events /emergencies in place National Action Plan for Health Security (NAPHS 2021-2025} - REFERENCES: • 5-year plan of action for implementation of International Health Regulations (2005) in Namibia 2012-2016. • Capacity Assessment of the Disaster Risk Management System in Namibia, 2016. • Disaster Risk Management Act (No 10 of2012) . • Harambee Prosperity Plan (2016/17 - 2019/20). • Joint External Evaluation Report 2016 Namibia, http://www.who.int/ihr/publications/WHO-WHE-CPI-REP-2017.36/en/ • MAWF, DVS's national summary report, July 2010 . • MoHSS, 2018: Universal Health Coverage policy framework (Draft) . • Namibia's 5th National Development Plan (NDP5) 2017/18 - 2021/22. • Namibia EPI strategic plan 2018-2022 . • Namibia Inter Censal Demographic Survey (NIDS), 2016 . • Namibia Population based HIV Impact Assessment - NAPHIA 2017. • Namibia Sustainable Development Goals and Fifth National Development Plan Indicator Framework, 2019. • Namibia PVS Gap Analysis report, September 27- October 8, 2010 . • Namibia Sustainable Development Goal Baseline Report, 2019 . • Namibia Statistic Agency: Annual National Account, 2017 . Namibia Statistic Agency: National accounts, Quarter 4 GDP 2018 tables, https://nsa.org.na/page/publications/. • Namibia Statistic Agency: Namibia Household income and Expenditure Survey(NHIES) 2016/2016 Report. National Climate Change strategy and action plan 2013-2020. • National Disaster Risk Management Plan 2011. • National Hepatitis E Outbreak Situational report, 2019 . • 01E mission report evaluation of the veterinary services of the republic of Namibia, August \ l - 22, 2008. National Action Plan for Health Security (NAPHS 2021-2025} - • OIE experts mission, to southern African countries (Botswana, Namibia, south Africa, Swaziland) from 27-30 October 20 13, Report on the visit to Namibia (27-30 October 2013). • Revised National Health Emergency Preparedness & Response Plan 2013-2017. Strategic Partnership Portal (SPP) https://extranet. who.int/spp/ihr-monitoring evaluation. • WHO guidelines for the establishment of Intemationan Health Regulation National Focal Points. NOTES NOTES