Governance Manual of the One Health Coordination Platform

p.1Governance Manual Republic of liberia ONE HEALTH COORDINATION PLATFORM Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority R e p u b l i c o f L i b e r i a Governance Manual May 2018 p.2 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority p.3Governance Manual Republic of liberia TaBle oF conTenTS abbreviations ............................................................................................................................................ 5 Forward ..................................................................................................................................................... 6 1 Background ..................................................................................................................................... 7 2 Purpose of the One Health Coordination Platform ...................................................................... 7 2.1 Vision, Mission, and Values ............................................................................................ 7 2.2 Objectives ........................................................................................................................ 7 2.3 Functions ......................................................................................................................... 8 3 Governance Model ..................................................................................................................... 9 3.1 Government of Liberia… ................................................................................................. 9 3.2 Partnering Organizations ............................................................................................... 10 3.3 One Health Coordination Platform (OHCP) ................................................................... 10 3.3.1 OHCP Steering Committee Membership ...................................................... 10 3.3.2 OHCP Roles and Responsibilities ................................................................... 10 3.3.2.1 Overall Roles of the Steering Committee ................................................... 10 3.3.2.2 Roles and Responsibilities of the Steering Committee Chair .................... 11 3.3.2.3 Roles and Responsibilities of the Steering Committee Vice Chairs…...... 11 3.3.2.4 Roles and Responsibilities of the Steering Committee Technical advisor ........................................................................................11 3.4 One Health Secretariat (OHS) ......................................................................................... 11 3.4.1 OHS Personnel ................................................................................................ 11 3.4.2 OHS appointments and Terms ...................................................................... 11 3.4.3 OHS Roles and Responsibilities ...................................................................... 12 3.4.3.1 Overall Roles of the OHS ................................................................. 12 3.4.3.2 Specific Roles and Responsibilities of the OHS Members ............. 12 3.5 One Health Technical Committee (OHTC) ...................................................................... 14 3.5.1 OHTC Membership .................................................................................................. 14 3.5.2 OHTC Roles and Responsibilities ............................................................................ 15 3.5.2.1 Overall Roles and Responsibilities of the OHTC ............................. 15 3.5.2.2 Roles and Responsibilities of the OHTC Chair ................................ 15 3.5.2.3 Roles and Responsibilities of the OHTC Vice Chairs ....................... 15 3.5.3 Roles and Responsibilities of the One Health Technical Working Groups (TWGs) under the OHTC ............................................................................ 15 3.5.3.1 National Epi Surveillance TWG ........................................................ 16 3.5.3.2 National Laboratory Surveillance TWG .......................................... 16 3.5.3.3 National Preparedness and Response TWG ................................. 17 3.5.3.3.1 Sub-Committees under the Preparedness and Response TWG ............................................................................ 18 3.5.3.4 National anti-Microbial Resistance (aMR) TWG ............................ 18 3.5.3.5 National Human Resources / Workforce TWG .............................. 19 4 Meetings of the OHCP Bodies ........................................................................................................ 20 4.1 Regular Meetings ............................................................................................................ 20 4.1.1 Preparation and documentation for Steering Committee and OHTC meetings ........................................................................................................ 20 4.1.2 after the meetings ........................................................................................... 20 4.2 Special Meetings ............................................................................................................. 20 5 Code of Practice Reports ................................................................................................................ 20 p.4 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority 6 Communication of OHCP activities ..............................................................................................21 6.1 Internal Communication................................................................................................21 6.2 External Communication ...............................................................................................21 7 Funding the OHCP… .......................................................................................................................21 8 Evaluation of Performance ............................................................................................................21 8.1 Monthly assessment ......................................................................................................21 8.2 annual Process ...............................................................................................................21 8.3 Exit Interview Process ....................................................................................................22 9 Role of the OHCP Bodies during Outbreaks of Priority Zoonotic Diseases .................................. 22 9.1 Priority zoonotic events… ............................................................................................... 22 9.2 Process of Notification ...................................................................................................22 9.3 activation of the Incident Management System ..........................................................22 9.4 Re-allocation of Funding ................................................................................................ 22 9.5 Monitoring activities in Response to Priority Zoonotic Diseases ...............................23 aPPENDIX a: Template of regular meeting agenda for the OHCP bodies ........................................... 24 aPPENDIX B: Template of regular meeting agenda for the OHCP bodies ........................................... 25 p.5Governance Manual Republic of liberia AMR antimicrobial Resistance CDC Centers for Disease Prevention and Control EPA Environmental Protection agency EU European Union FAO Food and agriculture Organization FDA Forestry Development authority GHSA Global Health Security agenda HR Human Resource IDSR Integrated Disease Surveillance and Response IHR International Health Regulations LMHRA Liberia Medical Health Regulatory authority M&E Monitoring and Evaluation MFDP Ministry of Finance and Development MICT Ministry of Information, Culture, and MIA Ministry of Internal Affairs MOA Ministry of agriculture MOCI Ministry of Commerce and Industry MOH Ministry of Health NCI National Coordinating Institution NPHIL National Public Health Institute of Liberia OHCP One Health Coordination Platform OHS One Health Secretariat OHTC One Health Technical Committee P4P Planning for Performance REDISSE Regional Disease Surveillance Systems Enhancement Project TWG Technical Working Group UL University of Liberia USAID United States agency for International Development VP Vice President WHO World Health Organization aBBrevIaTIonS p.6 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority FORWARD The Government of Liberia embraces participatory governance as an essential element in the planning and decision-making process. For all entities operating under the Government of Liberia, manuals such as this document are intended to clearly define roles and responsibilities that make governance transparent and efficient. This Governance Manual overviews the administrative and technical organization of the One Health Coordination Platform, the process that ensures effective participation in planning and decision-making processes. To facilitate comprehensive adoption and utilization of the Platform organization, all development institutions, both Liberian run and international agencies, working in surveillance and response (human, animal and environmental health) should align with government plans and submit work plans twice annually to the One Health Secretariat. These plans shall be presented to the Steering Committee to showcase anticipated efforts and recent achievements. The One Health Secretariat and technical working groups under the One Health Technical Committee shall ensure full implementation, supervision and monitoring, communication and reporting responsibilities, as outlined here and in their Terms of Reference. The processes outlined in this document shall fall under the purview of the Office of the Vice President of the Republic of Liberia, and the One Health Steering Committee, with representatives from the National Public Health Institute of Liberia, Ministry of Health, Ministry of agriculture, Environmental Protection agency, Forestry Development Authority, Ministry of Commerce and Industry and others. In order to reflect new issues and processes, the document shall be reviewed and distributed annually. Collaborative and transparent efforts shall enhance and support national success in One Health initiatives. The organizational and governance structures outlined in this document facilitate our commitment to genuine participation in our governance processes. p.7Governance Manual Republic of liberia 1 - BACKGROUND In June 2017, the Vice-President of the Republic of Liberia officially launched the country’s One Health Coordination Platform (OHCP) with the purpose of productively facilitating cross-sectoral collaboration to address public health issues that cannot be solved by a single sector alone. In Liberia, it is recognized that investment in One Health will promote efficient alignment of limited human, financial and material resources. Importantly, a One Health platform will provide the mechanism for building systems that enable earlier detection of emerging threats to human, animal and environmental health, and for mobilizing and deploying interventions to mitigate their potential emergence and spread. The OHCP is organized to effectively achieve its mission with strong administrative and technical support. While the OHCP sits under the Office of the Vice President of Liberia, it is hosted by the National Public Health Institute of Liberia (NPHIL), from where the Secretariat functions. The Secretariat is responsible for the administration and operation of the OHCP. The One Health Technical Committee is headed by the NPHIL Director General and its Technical Working Groups are headed by technicians from line ministries and agencies. In late July and early august 2017, the One Health Technical Committee organized a Planning for Performance (P4P) workshop in Monrovia with financial support from the United States Agency for International Development (USaID) under the Global Health Security agenda (GHSa). The workshop brought together various line ministries, agencies and institutions involved in disease surveillance (Human, animal and Environmental). Using the P4P process and tool, participants at the workshop established capacity baselines, measured organizational performance, and planned for needed support for the Platform. This Governance Manual and the Platform’s first annual work plan were subsequently developed and validated in February 2018. The One Health Coordination Platform (OHCP) Governance Manual documents the objectives of the platform and the structures and processes intended for effectively achieving them. This manual provides guidance on roles and responsibilities to the multi-sectoral stakeholders engaged in the OHCP, either administratively or technically. 2 - PURPOSE OF THE ONE HEALTH COORDINATION PLATFORM 2.1 Vision, Mission and Values The vision of the OHCP is to prevent and prepare for events at the human/animal/ecosystem interface. The mission of the OHCP is to effectively coordinate the national “One Health” approach ensuring multi- sector participation, resource mobilization, accountability and transparency at all levels. all activities of the OHCP shall be conducted in accord with the following values: ww Partnership ww Integrity ww Transparency ww Rights ww Professionalism ww Quality ww accountability ww Cultural Sensitivity 2.2 Objectives The overarching objective of the One Health Coordination Platform is to collaborate and facilitate discussions on issues concerning the health of humans, animals (including wildlife), and the environment that cut across multiple sectors in order to: • Strengthen the institutionalization of a functional One Health approach in Liberia to address Public Health events including zoonotic diseases, • Develop joint planning decisions and guidance for policy on prevention, detection, response, and recovery p.8 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority that harmonize efforts across sectors, • Create cross-sectoral linkages to share data, information, resources, and capacity building expertise, and • Leverage core capabilities of each agency to determine and direct intervention to address possible threats that relate to humans, animals, and the environment that cut across multiple sectors 2.3 Functions The functions of the One Health Coordination Platform (OHCP) are grouped under headings of (a) during non public health events, (b) during public health events, and (c) post public health events. During non-public health events, the OHCP will function in the following ways: • Coordinate 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; • Conduct joint evaluation / assessments within major line ministries and agencies; • Institutionalize the One Health approach to address any public health event and/or pandemic that poses health threats; • Ensure 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; During public health events, the OHCP will function in the following ways: • Foster collaboration among stakeholders and trigger response mechanism through the activation of the Incident Management System (action Plan); • Facilitate joint rapid event assessment and its impact within 24 hours and document impacts, produce situation reports, recommend necessary actions, and communicate information to all stakeholders; • Reactivate 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; After public health events, the OHCP will function in the following ways: • Evaluate the event and its operations; • Generate post event reports within a quarter after official declaration of the end of the event; • Secure all the government and other properties/assets used in the event; • Carry out a detailed needs and risk assessments for rehabilitation, recovery and reconstruction; • Develop activity plans linked to human health, animal / wildlife health, and the environment p.9Governance Manual Republic of liberia 3 GOVERNANCE MODEL The OHCP shall function under the Office of the Vice President of the Republic of Liberia (Figure). The One Health Secretariat will administratively support the institutionalization and general operation of the OHCP, while the Steering Committee shall advocate, mobilize resources and formulate policies and the Technical Committee shall oversee five specialized working groups and provide expertise and technical support for implementing the activities of the OHCP. Each of the levels of this governance model has a distinct but synergistic set of roles and responsibilities, as noted below. Ministries and agencies are represented across levels, although individual membership varies. The roles and responsibilities outlined in this Section correspond with OHCP functions during non-public health events and after public health events. Bodies of the OHCP assume special roles and responsibilities during public health events, as outlined in Section 9. Structure of the One Health Coordination Platform Office of the Vice President One Health Secretariat One Health Steering Committee (Advocacy,Resource Mobilization, Policy) One Health Technical Committee (Technical Directors among Ministries) Epi Surveillance TWG HR / Workforce TWG Preparedness & Response TWG Laboratory Surveillance TWG AMR TWG *Note AMR = Antimicrobial resistance, HR = Human resource, TWG = Technical working group 3.1 Government of Liberia Through the Office of the Vice President, the Republic of Liberia shall ensure ownership and sustainability of national One Health efforts, including those specific to Liberia and those aligned with regional/sub-regional and global initiatives. The Government shall support the institutionalization of the One Health approach in Liberia through the OHCP and maintain it high on the priority list of the country and regional political agenda. Moreover, it shall encourage relevant institutions—both public and private—to implement activities at the county, district and community levels within Liberia and beyond. The Ministries and agencies implementing disease surveillance (human, animal and environmental) will support full implementation of key activities listed in the annual work plan in accordance with Country Roadmaps for the National action Plan for Health Security linked to the Global Health Security agenda (GHSa), the International Health Regulations (IHR), Integrated Disease Surveillance and Response (IDSR) Strategy and the Tool for the Evaluation of Performance of Veterinary Services and in strict compliance with the rules governing operations of the ECOWaS Regional Centre for Disease Surveillance and Control, especially with regard to the provisions relating to the operations of National Coordinating Institutions (NCIs). 3.2 Partnering Institutions Local and international partners shall support Liberia and its implementing agencies in the effective implementation of the One Health approach. Technical and financial partners, including banks, United Nations agencies, multilateral and bilateral agencies, and foundations, shall provide coordinated support to Liberia, through its Institutions and agencies at the p.10 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority national and sub-national levels, to implement activities in the One Health work plan. They will also engage in a strong advocacy for the implementation of the One Health approach in Liberia, Regional and Sub-Regional Levels. 3.3 One Health Coordination Platform Steering Committee 3.3.1 OHCP Steering Committee Membership The OHCP Steering Committee shall reflect a diverse range of expertise from ministries, agencies, academic organizations, faith-based organizations, and partnering technical organizations that are engaged in directly implementing human, environmental, and animal health initiatives or in building capacity to do so. It shall also include other stakeholders, such as entities involved in commerce and tourism, which stand to benefit from a healthier population and environment in Liberia. OHCP membership shall include at least one person, including the head of the organization (e.g., Minister or Director General) and/or his/her designee(s), from each of the following : Ministry of Health (MOH) Ministry of agriculture (MOa) Ministry of Finance and Development Planning (MFDP) Forestry Development authority (FDa) National Public Health Institute of Liberia (NPHIL) Environmental Protection agency (EPa) Ministry of Commerce and Industry (MOCI) Ministry of Internal Affairs (MIA) Ministry of Information, Culture, and Tourism (MICT) Ministry of Gender, Social Protection, and Children Protection Ministry of Foreign Affairs (MOFA) Ministry of Justice (MOJ) Ministry of Public Works (MPW) Ministry of Education (MOE) University of Liberia (UL) Cuttington University Tubman University World Health Organization (WHO) Centers for Disease Control (CDC) US agency for International Development (USaID) Food and agriculture Organization (FaO) International Organization of Migration (IOM) World Bank European Union (EU) Religious Council of Liberia 3.3.2 OHCP Steering Committee Roles and Responsibilities 3.3.2.1 Overall Roles of the Steering Committee The Steering Committee shall have the roles of advocacy, resource mobilization and policy development: • The Platform shall advocate for multi-sectoral approaches to addressing public health challenges through efforts to build relevant capacity (e.g., integration of a veterinary component into the Liberian Field Epidemiology Training Program), enacting legislation to institutionalize One Health action (e.g., regulating points of entry to reduce risk of imported illnesses), and general awareness-raising (e.g., carrying out education campaigns on the importance of maintaining hygienic environments to reduce contact with disease-causing rodents). p.11Governance Manual Republic of liberia • The OHCP shall develop initiatives and coordinate resource mobilization for implementation. This may include grant writing, mapping, and/or development of budget lines for One Health projects using existing funds. • Policies shall be developed by members of the OHCP to support its implementation of activities aligned with the mission. 3.3.2.2 Roles and Responsibilities of the Steering Committee Chair The Vice President of the Republic of Liberia will serve as the Chair of the Steering Committee. The principal role of the chairperson is to manage and to provide leadership to the overall One Health Coordination Platform and ensure that its efforts are encouraging progress towards the Platform objectives and functions. 3.3.2.3 Roles and Responsibilities of the Steering Committee Vice Chairs The positions of Vice Chairs will be held by the Minister of Health and the Minister of agriculture. The principal role of the Vice Chair is to advise the Chair and other Steering Committee members on cross- sectoral priorities and to serve as a point person between the OHCP Steering Committee and the One Health Secretariat. 3.3.2.4 Roles and Responsibilities of the Steering Committee Technical Advisor The Director General of the National Public Health Institute of Liberia (NPHIL), the National Coordinating Institute (NCI) for Liberia will serve as a Technical advisor to the Chair and Vice Chairs of the One Health Steering Committee. In this capacity, he/she will offer support in coordinating among the different bodies of the One Health Coordination Platform, with particular oversight given to the One Health Secretariat. as the Head of the NCI, he/she will advise the Steering Committee Chair and Vice Chairs with multi-sectoral perspective on activities related to prevention, detection, and control of zoonotic diseases. 3,4 One Health Secretariat (OHS) 3.4.1 OHS Personnel a Secretariat shall be established and consist of eight personnel with the following competencies: • One Health Coordinator • Human Health Officer, Ministry of Health (MOH) Liaison • Animal Health Officer, Ministry of Agriculture (MOA) Liaison • Wildlife Officer, Forestry Development Agency (FDA) Liaison • Environmental Officer, Environmental Protection Agency (EPA) Liaison • Monitoring and Evaluation (M&E) specialist • Communication specialist • Project assistant These personnel shall be identified according to processes outlined in Section 3.4.2. Although full-time in the OHS, they could be seconded from the relevant line ministries and agencies. 3.4.2 OHS Appointments and Terms • all positions within the One Health Secretariat are full-time. • The One Health Coordinator will be appointed for a once renewable three-year term by the Office of the Vice President with advisement from the Director General of the NCI, NPHIL (Table). • A candidate for each Liaison officer position (i.e., each of four positions for human, animal, wildlife and environmental health) will be recommended by the Heads of their sectors, including the Minister of Health, Minister of agriculture, Director for the Forestry Development agency, and the Executive Director of Environmental Protection agency, respectively. It is expected that the individual sectors will conduct the relevant vetting processes ahead of submitting their recommendations. The Technical Committee will inform the Vice President’s Office of the individuals identified for the OHS positions. The Liaison officers will be hired for two-year terms with potential for renewal once, pending performance review. Their positions p.12 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority will be within their ministries/agencies and seconded at the OHS. • Other supporting staff, including the Communication and M&E specialists and the project assistant, will be contracted by the NCI, with hiring conducted by the Institute’s Director General through the Deputy Director General of Administration. The hiring process will follow the institution’s standard human resources protocol. 3.4.3 OHS Roles and Responsibilities 3.4.3.1 Overall Roles of the OHS The OHS will take on overall coordination for the OHCP, including the working groups of the One Health Technical Committee. Coordination will include logistics, communication, and supporting review meetings across administrative levels. • The Secretariat will be responsible for organization of logistics for meetings of the OHCP bodies, including the Steering Committee, the One Health Technical Committee and Technical Working Groups. • The OHS will be responsible for clear communication which is essential for effective implementation of activities that require awareness and buy in from the multiple players of the OHCP. Key communication activities will involve the following: 1 - Develop mechanisms for data sharing and analysis across sectors and regions in Liberia, such as maintenance of a One Health Coordination Platform website as well as distribution of printed fact sheets and semi-annual reports. 2 - Conduct data analysis and review for quality assurance 3 - Develop integrated dashboards using agreed indicators to support situational awareness • The OHS will support coordination structures and review processes across administrative levels, such as through the following activities: 1 - Establish and/or strengthen ongoing coordination structures at county, district and community levels including sector focal persons with needed logistics 2 - Support joint supportive supervision (central, county and district level teams) 3 - Provide support to central level semi-annual and county-level quarterly review meetings 3.4.3.2 Specific Roles and Responsibilities of the OHS Members The specific functions and responsibilities of the OHS members are outlined as follows : p.13Governance Manual Republic of liberia Position Functions and responsibilities Process of appointment and office terms One Health Coordinator • Responsible for the development, coordination, and management of programs • Develop and implement program goals, objectives, and outcome measurements • Ensure meetings are effectively organized and minutes are recorded and distributed • Maintain effective records Appointed by the Office of the Vice Pres ident, upon advisement by the Steering Committee Technical advisor. 3-years term with possibility of renewal for a total of 6 years Human Health officer, Ministry of Health (MOH) Liaison • Coordinate representation and participation by the Ministry of Health on the Steering Committee and the TWGs of the Technical Committee • Represent MOH at all meetings for which the designated committee member in unavailable • Serve as Secretary on designated TWG(s) • Ensure submission of required reports and work plan updates from MOH and human health agencies/organizations Designated by the Minister of Health; the One Health Technical Committee informs the Office of the Vice President ahead of hiring 2-year term with possibility of renewal for a total of 4 years Animal Health officer, Ministry of Agriculture (MOA) Liaison • Coordinate representation and participation by the Ministry of agriculture on the Steering Committee and the TWGs of the Technical Committee • Represent MOA at all meetings for which the designated committee member in unavailable • Serve as Secretary on designated TWG(s) • Ensure submission of required reports and work plan updates from MOa and animal health agencies/organizations Designated (as one of three) by the Minister of agriculture; the One Health Technical Committee informs the Office of the Vice President ahead of hiring 2-year term with possibility of renewal for a total of 4 years Wildlife officer, FDA Liaison • Coordinate representation and participation by the FDa on the Steering Committee and the TWGs of the Technical Committee • Serve as Secretary on designated TWG(s) • Represent FDA at all meetings for which the designated committee member in unavailable • Ensure submission of required reports and work plan updates from FDa and agencies/organizations with wildlife conservation in their purview Designated (as one of three) by the Director of the Forestry Development agency; the One Health Technical Com mittee informs the Office of the Vice President ahead of hiring 2-year term with possibility of renewal for a total of 4 years Environmental officer, EPA Liaison • Coordinate representation and partici pation by the EPa on the Steering Com mittee and the TWGs of the Technical Committee • Serve as Secretary on designated WG(s) • Represent EPA at all meetings for which the designated committee member in unavailable • Ensure submission of required reports and work plan updates from EPa and environmental health agencies/organizations Designated (as one of three) by the Executive Director of the EPa; the One Health Technical Committee informs the Office of the Vice President ahead of hiring 2-year term with possibility of renewal for a total of 4 years p.14 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority Monitoring and Evaluation (M&E) Specialist • Support work plan development to ensure that work plan activities are in line with the expected objectives/result • Track progress of the OHCP in successfully completing activities outlined in the annual work plan • Develop presentations for the annual review and projected work plans • Measure success of the OHCP according to the M&E framework • Develop M&E frameworks in consultation with the One Health Hired by the National Public Health Insti tute of Liberia, under advisement of the One Health Coordinator and the NPHIL Director General. annual contract with renewal based on performance-based review Coordinator and liaison officers Communications Specialist • Lead strategic planning, implementation, and monitoring of all communications activities of the One Health Coordination Platform • Direct and oversee all information development, layout, and placement • Develop website content, newsletter content, and other print content • Present and report to the One Health Coordination Steering Committee on communication strategies and progress • Publish high-quality information including newsletters and news articles Hired by the National Public Health Insti tute of Liberia, One Health Coordinator, and the NPHIL Director General. annual contract with renewal based on performance-based review Project assistant • Support the One Health Coordinator with all administrative needs, including sending meeting reminders, compiling meeting minutes, and drafting communication to national and county-level stakeholders • Conduct day-to-day functioning of the One Health Secretariat office through procurement of office supplies, printing of documents, etc. Hired by the National Public Health Insti tute of Liberia, under advisement of the One Health Coordinator and the NPHIL Director General. annual contract with renewal based on performance-based review 3.5 One Health Technical Committee (OHTC) 3.5.1 OHTC Membership The OHTC The OHTC membership will include technical directors or their designees from the following relevant divisions/units of ministries and agencies in Liberia: • National Public Health Institute of Liberia – Division of Infectious Disease and Epidemiology • National Public Health Institute of Liberia – Division of Laboratory and Public Health Diagnostics • National Public Health Institute of Liberia – Division of Environmental and Occupational Health • Ministry of Health – Division of Pharmacy • Liberia Medical Health Regulatory authority (LMHRa) – Laboratory • Central agriculture and Research Institute (CaRI) – Laboratory • Ministry of agriculture – animal Health Sciences / Epidemiological Unit • Ministry of agriculture – Central Veterinary Laboratory • Ministry of Commerce and Industry – National Standard Laboratory • Environmental Protection agency – Compliance / Laboratory • Forestry Development authority – Wildlife Management/Conservation • National Disaster Management agency p.15Governance Manual Republic of liberia • Ministry of Justice – Codification • Ministry of Foreign Affairs – Chemical, Biological, Radiological, Nuclear Platform • Cuttington University Graduate School – School of Public Health • University of Liberia – College of Health Sciences • World Health Organization • Food and agriculture Organization • United States Centers for Disease Control and Prevention • United States agency for International Development • Preparedness & Response • PREDICT 3.5.2 OHTC Roles and Responsibilities of the OHTC Chair 3.5.2.1 Overall Roles and Responsibilities of the OHTC The OHTC will serve as a supervisory body for the technical working groups (TWGs) and membership shall be composed of the heads of the various TWGs, and other technicians. Members of the OHTC will take recommendations, as deemed appropriate, from the Technical Working Groups to Heads of relevant agencies and advocate for action in line with the objectives of the OHCP in Liberia and One Health institutionalization throughout the region. Moreover, the OHTC will serve as a link between the TWGs and the One Health Steering Committee. In the event of an outbreak of a One Health priority zoonotic disease, the OHTC will assume roles and responsibilities as outlined in Section 9. 3.5.2.2 Roles and Responsibilities of the OHTC Chair The Director General of the NCI/NPHIL, will serve as Chair of the OHTC. The Chair will be responsible for overseeing all meetings and making final decisions, after advisement of the Vice Chairs and other OHTC members, on whether and when to elevate activities proposed by the individual TWGs to the attention of Ministers and Directors. 3.5.2.3 Roles and Responsibilities of the OHTC Vice Chairs The Director of the Forestry Development agency and the Director of Veterinary Services, Ministry of agriculture will act as Vice Chairs of the OHTC. The Vice Chairs will help to facilitate meetings of the OHTC and will ensure adequate representation across sectors at the OHTC meetings. 3.5.3 Roles and Responsibilities of the One Health Technical Working Groups under the OHTC Overall, the One Health Technical Working Groups (TWGs) will carry out activities that realize the objectives of the OHCP in routine practice throughout existing and newly developed systems and processes. The Technical Committee is composed of technical working groups. Members of the TWGs are subject matters experts within the One Health implementing agencies (Surveillance, Laboratory, Preparedness and Response, antimicrobial Resistance (aMR) and Human Resource Capacity Development). The core functions of these specialized technical working groups are to develop annual work plans; plan, organize and provide technical assistance to county, district, facility and/or community implementing teams for quality improvement; develop standard operational guidelines; provide technical guidance to frontline field workers and provide technical advice to the One Health Technical Committee as a request for approvals. p.16 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority 3.5.3.1 National Epi Surveillance TWG Terms of Reference : a. Develop technical and operational tools to support the strengthening of national disease control strategies (IDSR, Wildlife, OIE); b. Serve as an inter-ministerial, multi-disciplinary technical group with oversight and ensure technical capacity for human-animal-ecosystem interface for the surveillance system; c. Raise awareness among government, funding agencies and other strategic partners so that surveillance is given higher priority and visibility; d. Establish a mechanism for effective exchange of information; e. Improve collaboration among governments, organizations, institutions, agencies engaged in human animal-ecosystem interface to reduce its impact on the health of people and livestock and pursue integrated cost effective approaches to prevention and control programs; f. Operationalize preparedness and management of zoonotic disease epidemics; g. Enhance efforts to prevent and control zoonotic infection; h. Work with the relevant offices to develop a One Health Communication Strategy, and review curricula of pre-service training institutions; and i. Provide update to the OHTC on trends and analyses of events (Human, animal and Environmental) linked to JEE score on country’s performance. Chair : Director of the Division of Infectious Disease Epidemiology, NPHIL Co-Chair : Director of Animal Health Sciences / Epidemiological Unit, MOA Secretary : OHS Human Health Liaison • Membership: • National Public Health Institute of Liberia – Division of Infectious Disease and Epidemiology • National Public Health Institute of Liberia – National Public Health Laboratory • National Public Health Institute of Liberia – Environmental Health • Ministry of agriculture – animal Health Sciences / Epidemiological Unit • Forestry Development authority – Wildlife Management/Conservation • National Disaster Management agency • Ministry of Foreign Affairs – Chemical, Biological, Radiological, Nuclear Platform Meetings: Meetings will be held monthly on the first Tuesday. 3.5.3.2 National Laboratory Surveillance TWG Terms of Reference : The National Laboratory Technical Working Group shall address lab-related issues in country. The scope is to address all five-strategic global action plan objectives, which have been adopted and adapted in country with prioritizing activities in a step-wise approach : a. Improve diagnostic capacity through training opportunities for laboratory technicians (long- and short term) including revision of curriculum for in-service and pre-service institutions and the conduct of regular supervision and on-site mentoring; b. advocate to institutionalize a laboratory training program within the University of Liberia (Master and PhD level); c. Support and ensure laboratory facilities and/or institutions perform competent diagnostic procedures and calibration to obtain accurate testing results; d. Establish Quality Management System (QMS), including external quality assessment (EQA) and internal quality assessment (IQA); e. Develop and implement standard operating procedures (SOPs) for all testing procedures and ensure adherence at public, private, charity, and concession facilities; f. Initiate and support mandatory licensing of all health facilities (public, private, charity and concession) p.17Governance Manual Republic of liberia using agreed upon criteria including networking for quality control standards and support; g. Strengthening knowledge and evidence base through laboratory and research; h. Conduct inventory for all laboratory equipment in country for human, animal and environmental facilities and ensure functionality; i. advocate got reagents and supplies to ensure continuous diagnostic capacity and avoid stock- outs; j. Ensure regular preventative and curative maintenance of laboratory equipment including generators, air conditioning, water supply, and management and disposal of all waste to support infection prevention; k. Build sustained partnerships nationally and internationally to facilitate development of in- country workforce capacity for laboratory diagnosis; l. Ensure regular information sharing using standard data collection and reporting tools as well as institute effective communication and coordination strategies among all stakeholders (constituencies, sectors and disciplines); m. Monitor and coordinate national and sub-national activities for establishment of laboratory policies, strategies and plans; and n. Submit a regular quarterly report to the OHTC using agreed upon indicators on country’s performance. Chair : Director of Central Veterinary Laboratory, MOA Co-Chair : Director of National Public Health Laboratory, NPHIL Secretary : OHS Environmental Health Liaison • Membership: • National Public Health Institute of Liberia – National Public Health Laboratory • National Public Health Institute of Liberia – Environmental Health Lab • Ministry of Health – Division of Pharmacy • Ministry of agriculture – Central Veterinary Laboratory • Liberia Medical Health Regulatory authority (LMHRa) – Laboratory • Central agriculture and Research Institute (CaRI) – Laboratory • Ministry of Commerce and Industry – Inspector / Laboratory Units • Environmental Protection agency – Compliance / Laboratory • National Disaster Management agency • Ministry of Foreign Affairs – Chemical, Biological, Radiological, Nuclear Platform Meetings: Meetings will be held monthly on the first Wednesday. 3.5.3.3 National Preparedness and Response TWG a. Advocate for the development and dissemination of protocols, guidelines and manuals for different professional levels (human, animal and environmental); b. Jointly develop a national integrated EPR plan prepared at different levels; c. Provide needed human resource capacity at different levels in the context of One Health (human, animal and environmental); d. Develop effective communication strategies and adequate community engagement and participation in events; e. Document available human resource capacity at central, county, district, facility and community levels and suggest support needed to mitigate any gaps identified; f. Organize and hold regular cross-border and intra-county meetings to support information sharing for tracking events including effective networking, monitoring of potential threats and identifying opportunities to collaborate with stakeholders; g. Advocate for the availability of sufficient emergency stockpile (drugs, supplies etc..) to support preparedness and timely response for emergencies in the context of One Health (human, animal and environmental); h. Review and/or update contingency emergency operational manual to support processes for receiving p.18 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority funds during an event/outbreak to avoid bureaucratic procedures, through the Ministry of Finance development planning and development partners to ensure the availability of necessary and essential resources to support timely and prompt interventions/response; i. Provide and allocate all necessary materials and equipment and ensure that they are made available at the right time, and positioned at strategic areas; j. Document interventions/response linked to events from human, animal and environmental health for experiences and lessons learned to support action reviews for unknown event; and k. Support post-event interventions for psychosocial and mental health rehabilitation through counseling and support to those impacted by events. Chair : Director of Epidemic Preparedness and Response, NPHIL Co-Chair : Director of Compliance / Laboratory, EPA Secretary : OHS Wildlife Liaison • Membership: • National Public Health Institute of Liberia – Division of Infectious Disease and Epidemiology • National Public Health Institute of Liberia – National Public Health Laboratory • Ministry of Health – Division of Pharmacy • Ministry of Health – Division of Health Promotion • Ministry of agriculture – animal Health Sciences / Epidemiological Unit • National Disaster Management agency • Ministry of Foreign Affairs – Chemical, Biological, Radiological, Nuclear Platform • Environmental Protection agency – Compliance / Laboratory Meetings: Meetings will be held monthly on the first Thursday. 3.5.3.2.1 Sub-Committees under the Preparedness and Response TWG Content-specific ad hoc groups may be formed as sub-committees under the Preparedness and Response TWG. Examples include sub-committees focused on environmental health and specific priority diseases (e.g., rabies, vaccine preventable diseases). ad hoc sub-committees may be temporary or permanent, depending on the needs of the country. The request to initiate a sub-committee shall be presented to the Chair and Vice Chairs of the OHTC, who will elevate requests that the OHTC approves for consideration by the Steering Committee. 3.5.3.4 National Anti-Microbial Resistance (AMR) TWG The National AMR TWG shall address all AMR-related activities in country. The scope is to address all five strategic global action plan objectives, which have been adopted and adapted in country with prioritizing activities in a step-wise approach: a. Improve awareness and understanding of AMR through effective communication, education and training; b. Strengthen knowledge and evidence-base through surveillance and research; c. Reduce incidence of Infection through effective sanitation, hygiene and infection, prevention and control measures; d. Promote optimal use of antimicrobials agents in human and animal health; e. Identify opportunities for economic investment to ensure sustainability of innovations; f. Build sustained partnerships and work nationally and internationally on containment of aMR; g. Identify other stakeholders and facilitate formation of an inclusive aMR; h. Facilitate, coordinate and monitor the implementation of national action and operational plans for containment of aMR; i. Ensure regular data collection and information sharing by instituting effective communication and coordination among all stakeholders, the members of aMR and their constituencies, sectors and disciplines; p.19Governance Manual Republic of liberia j. Coordinate national and sub-national activities for establishment of aMR surveillance systems; and k. Report on the prevalence of and trends in aMR (evidence-based) to technical committee and partners linked to JEE score on progress on country performance including the global aMR surveillance system Chair : Director of the Division of Pharmacy, MOH Co-Chair : Director of Inspector / Laboratory Units, Ministry of Commerce and Industry Secretary : OHS Animal Health Liaison, MOA • Membership: • National Public Health Institute of Liberia – National Public Health Laboratory • National Public Health Institute of Liberia – Environmental Health • Liberia Medical Health Regulatory authority (LMHRa) – Laboratory • Ministry of agriculture – animal Health Sciences / Epidemiological Unit • Ministry of agriculture – Central Veterinary Laboratory • Ministry of Health – Division of Pharmacy • Environmental Protection agency – Compliance / Laboratory • Forestry Development authority – Wildlife Management/Conservation • Ministry of Commerce and Industry – Inspector/Laboratory Units • National Disaster Management agency Meetings: Meetings will be held monthly on the second Wednesday. 3.5.3.5 National Human Resources / Workforce TWG a. Expand the membership to a multidisciplinary Technical Working Group to support staff capacity for disease surveillance and response; b. Support the development of a disease surveillance workforce strategy to help response to infectious diseases linked to human, animal and environmental health in the context of One Health; c. Conduct assessment to determine capacity needs, available capacity, and gaps for disease surveillance and response in the country in the context of One Health (Epi Surveillance, Laboratory, Preparedness and Response, Coordination and Financial Management); d. Develop disease surveillance training plans (in-pre-service) including short- and long-term across sectors (human, animal and environmental) on how to integrate continuing professional education and continuing professional development as part of scaling to ensure excellence in care, responsive service delivery and sustainable systems; e. Develop training database and track all trainings linked to One Health (human, animal and environmental) by specific professional areas; and f. Review and update criteria for selection link to career ladder in-pre-service (long- and short- term) after accounting for technical and policy guidelines Chair : Director of Training and Capacity, NPHIL Co-Chair : Director of Wildlife Management/Conservation, FDA Secretary : OHS Animal Health Liaison, MOA • Membership: • National Public Health Institute of Liberia – Division of Infectious Disease and Epidemiology • National Public Health Institute of Liberia – Division of Environmental and Occupational Health • Ministry of Health – Division of Pharmacy • Liberia Medical Health Regulatory authority (LMHRa) – Laboratory • Ministry of agriculture – Central Veterinary Laboratory • Environmental Protection agency – Compliance / Laboratory • Forestry Development authority – Wildlife Management/Conservation p.20 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority • National Disaster Management agency • Ministry of Foreign Affairs – Chemical, Biological, Radiological, Nuclear Platform Meetings: Meetings will be held monthly on the second Tuesday. 4 MEETINGS OF THE OHCP BODIES 4.1 Regular meetings Frequency (Per Year) Purpose Notice (When and by Who) OHCP Each semester (2 Meetings) Progress review meeting Two weeks ahead with follow-up reminder one week ahead; VP office OHTC Each quarter (4 Meetings) Planning meeting Progress review meeting #1 One week ahead; One Health Progress review meeting #2 annual review meeting Secretariat OHS at least monthly (12 Meetings) Planning and progress review meetings One week ahead; One Health Coordinator/Project assistant TWG* at least monthly (12 Meetings) Planning meeting Progress review meeting #1 Progress review meeting#2 annual review meeting One week ahead Chair of TWG, with assistance of OHS as needed * TWG meetings will be held on pre-determined days. Location may rotate at the discretion of the Chair and Co-Chair for each TWG. 4.1.1 Preparation and documentation for Steering Committee and OHTC meetings • agendas • List and contacts of participants • Documents • Invitation letters 4.1.2 After the meetings • Finalize document • Sharing of documents • archiving of documents/reports 4.2 Special meetings Special meetings of the Steering Committee, OHTC, OHS, and TWGs may be called at the discretion of the Chair to identify pressing technical or administrative issues. Where possible, at least two days notice should be provided for special meetings. 5. CODE OF PRACTICE REPORTS • The following reports shall be produced in the context of this Manual of Governance: • annual work plan must be submitted to the OHTC and to OHCP each year before august 1st; a draft is due by June 1st • Progress reports before each quarterly meeting of the OHTC • annual Report before the last meeting of the OHTC no later than June 1st p.21Governance Manual Republic of liberia 6 COMMUNICATION OF OHCP ACTIVITIES 6.1 Internal Communication Internal communication will occur via e-mail panlists for the different bodies (i.e., Steering Committee, OHS, OHTC, and TWGs) of the OHCP. The panlists will be developed and shared by the OHS. The OHS shall be included on all internal communication regarding meeting schedules, meeting activities, and documents relevant to the OHCP. all internal communication should be in accord with the communication strategy standard operating procedure (SOP) developed by the Communication Specialist of the OHS. 6.2 External Communication • The Communication Specialist of the OHS will oversee development of all external communication of OHCP activities. External communication will include the following: • a regularly updated website for the OHCP with information on the Platform structure and the leadership and membership of the OHCP bodies; • A quarterly newsletter disseminated as hard copies to stakeholders and electronically through the website; and • Intermittent press releases and news articles on OHCP activities that warrant public attention, such as advocacy events and organization workshops. 7 FUNDING OF THE OHCP It is anticipated that the platform will be funded through government budgetary allocation supported by the legislation in the Office of the Vice-President. Allocated funds shall be released to the OHS through a request. Additional funds may be solicited from public and private sources. To advocate for the inclusion of budget lines are included by individual line ministries and agencies for activities aligned with the objectives of the OHCP, the annual Report and proposed work plan will be presented widely. The One Health Coordination Platform will also be supported with funding from development partners and implementing agencies including other bilateral arrangements. 8 EVALUATION OF PERFORMANCE Assessing effectiveness is an important governance responsibility and is comprised of monthly assessment, annual assessment, and an exit interview process for term positions on the Secretariat. The Secretariat will assume the responsibility of assessment of other OHCP bodies through review meetings. 8.1 Monthly Assessment The Secretariat will review the effectiveness of OHCP activities, in terms of meeting the overall objectives of the Platform, at the conclusion of each month. Using the OHCP M&E Framework for measuring success, the review will include questions that solicit : • What went well; • What could be improved upon; and • What should the OHCP do better going forward. 8.2 Annual Process Each year, the OHS will be engaged in an internal assessment process that includes completion of an assessment questionnaire that will be supplemented by periodic discussions between the Coordinator and leads of each Technical Working Group. The compiled results of the assessment are used as the basis for discussion and to help the OHCP determine changes in its governance processes and policies. p.22 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority In addition, the OHCP work plan and monitoring and evaluation tools are reviewed annually. The work plan identifies OHCP priorities. An annual review meeting will be called to validate the work plan and to monitor its implementation during the preceding year. The results of the internal assessment will likewise be presented. The OHS and OHTC working groups are responsible for implementation of this plan, reporting results and identifying any barriers to implementation. 8.3 Exit Interview Process A face-to-face interview will be conducted with all OHS members, including the Coordinator, liaison officers, and project assistant, whose term has ended. Information from these interviews is compiled and provided to the Vice President’s Office. At the call of the One Health Coordinator, an ad hoc working group may be established to assist in the evaluation process. 9. ROLE OF THE OHCP BODIES DURING OUTBREAKS OF PRIORITY ZOONOTIC DISEASES 9.1 Priority zoonotic events Priority public health events include those zoonotic diseases warranting response across human, animal, and environmental health sectors. a list of priorities at the time of the writing of this governance manual are included in appendix B. The list was derived from activities that include a disease prioritization workshop conducted by NPHIL and a multi-sectoral meeting that provided consensus on the list. The diseases are categorized according to the Ministry heading surveillance and response. In order for an event to warrant response funding through the Contingency Emergency Response Component of the World Bank REDISSE, an eligible crisis or emergency is defined “as an event that has caused or is likely to imminently cause a major adverse economic and/or social impact associated with natural or man-made crises or disasters.” 9.2 Process of Notification Events of priority zoonotic disease shall be reported by the Directors heading human, animal, and environmental health surveillance systems in Liberia to the OHS. Once the OHS becomes aware of a public health event (i.e., any case) involving a priority zoonotic disease, the Chair of the OHTC should be notified. The Chair will call an emergency meeting of the OHTC to initiate multi-sectoral activities for investigation into disease events, according to disease-specific multi-sectoral preparedness and response plans developed under the coordination of the OHCP. The activities will provide information for communicating with the Ministers across sectors. This communication will include reinforcement of response measures stated within preparedness and response plans. The notification process should involve the Chair of the OHTC ensuring timely communication with the Ministry of Finance to allow for appropriate action to ensure any necessary requests to the World Bank and other potential funding sources. The funding shall initially target investigation activities and ultimately response activities, as determined appropriate by the investigation. 9.3 Decision to Activate the Incident Management System (IMS) The recommendation to activate the IMS at national or sub-national levels will be discussed at the emergency meeting called by the Chair of the OHTC. The decision to advocate for activation will be made by the Chair, as Director General of the NCI, after discussion of the Committee’s recommendation with the Ministers of Health and agriculture and the Director of the Environmental Protection agency. 9.4 Re-Allocation of Funding • The Government will seek support from the World Bank to select a list of activities for financing under CERC based on the positive list presented in the REDISSE Project Implementation Manual and priorities identified at the preliminary assessment of the emergency’s impact (damage, needs, both). Likewise, the Government may seek advice from the World Bank in the selection of which Project’s components will reallocate funds to CERC, if necessary. p.23Governance Manual Republic of liberia • The Government will notify officially the Bank of the interest to activate the CERC, summarizing the nature of the emergency. As a second step, an official letter requesting to trigger CERC shall be sent to the World Bank’s Liberia Country Director by the Minister of Finance (MOF), indicating the following information : § Nature of emergency, its impacts (preliminary assessment of damage and/or needs) and confirmation of causal relationship, as supported by the official declaration of emergency, between the event and the need to access the funding through CERC. § Indication of Project’s funding to be reallocated to CERC and the distribution of reallocation across components and disbursement categories. § List of emergency activities to be carried out with estimated cost (brief description). § Implementation modalities with respect to decentralized activities if needed. § Specific steps on procurement will follow the procedures outlined in the Annex (Contingency Emergency Response Component – CERC, Emergency Operation Manual) of the Project Implementation Manual of the Regional Disease Surveillance Systems Enhancement Project of the Republic of Liberia. 9.5 Monitoring Activities in Response to Priority Zoonotic Diseases The OHTC shall be responsible for monitoring the response to ensure alignment with the disease- specific, multi-sectoral preparedness and response plans. The OHTC shall allocate responsibility for documenting response activities and organizing after action meetings to the OHS. after action meetings and reports should be facilitated by the OHS to ensure the players in each response reflect upon how the activities aligned with the multi-sectoral preparedness and response plans. p.24 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority APPENDIX A Template of regular meeting agenda for the OHCP bodies I. GENERAL BUSINESS a. Call to Order b. Introduction of Guests (Introduction of attendees as reasonably feasible) c. approval of Previous Minutes d. Open Comments limited specifically to comments related to OHCP agenda items e. Special Business – New Business II. PRESENTATIONS By outside experts, etc. III. UPDATES IV. ACTION ITEMS V. COMMENTS VI. ADJOURNMENT Illustrative OHCP timetable J F M A M J J A S O N D Planning Drafting of the annual work plan Review and approval by Review and approval by Governance appoint new members Semiannual meeting of the OHCP Progress review meeting #1 Progress review meeting #2 annual review meeting p.25Governance Manual Republic of liberia APPENDIX B List of Priority Zoonotic Diseases No Priority Disease 1 aFP 2 Cholera 3 Lassa Fever 4 Measles 5 Shigella 6 Rabies 7 HPaI 8 H9N5 9 Babesiosis 10 Trypanosomiasis 11 Taeniasis 12 New Castle Disease (NCD) 13 Pest des Petitte Ruminantis (PPR) 14 african Swine Fever (aSF) 15 Food & Mouth Disease (FMD) 16 Contagious Bovine - PleuroPneumonia (CBPP) 17 Rift Valley Fever (RVF) 18 Bovine Brucellosis 19 Bovine Tuberculosis (TB) 20 Lump Skin Disease (LSD) 21 anthrax 22 Meningitis 23 MDR - TB 24 Neonatal Deaths 25 Ebola Virus Disease 26 yellow Fever 27 Maternal Deaths 28 Monkey Pox 29 Dengue Fever 30 Aflatoxin 31 amebiasis 32 Salmonella 33 E. coli (Escherichia coli) 34 Unexplained Cluster 35 Unexplained Deaths p.26 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority p.28 One health coordination platform Ministry of Health, Ministry of Agriculture, National Public Health Institute of Liberia, Environmental Protection Agency and the Forest Development Authority