Attachments
EXECUTIVE SUMMARY Findings from the joint external evaluation The JEE team would like to express its appreciation to the Republic of Uzbekistan for volunteering for a Joint External Evaluation. This act shows high levels of commitment, foresight and leadership at senior levels of government that will be critical to success in building and maintaining Uzbekistan’s core capacities under the International Health Regulations (IHR (2005)). During the JEE mission, Uzbekistan’s capacities in 19 technical areas were evaluated through a peerto-peer, collaborative process that brought national subject matter experts together with members of the JEE team for a week of discussion, collaboration and field visits. This process led to consensus on scores and 75 priority actions across those 19 technical areas. Prior to the COVID-19 pandemic Uzbekistan had been working hard to develop and improve its public health capabilities and capacities. The pandemic accelerated that process. Progress in some areas has been so rapid that there is a need to take stock and ensure that development remains balanced across all sectors and stakeholders, is responsive to current strengths, gaps and capacities, and engages the right people and institutions at the right times and in the right ways. The JEE was an ideal opportunity to review the pace of improvement and identify the most important areas on which to focus. In view of this effort, five overarching recommendations emerged from the week. These address crosscutting challenges affecting Uzbekistan’s capacities across many of the different technical areas that are explored in greater depth in the JEE process.
These overarching recommendations are outlined below.
1. Write a summary plan that describes and facilitates all national processes for responding to IHR related events.
While the JEE process revealed that Uzbekistan has strong and functional legal and operational frameworks for IHR-related activity, these are not explained or organised in a way that most international partners would easily recognise (for example, in a single centralized “pandemic plan,” or a multisectoral all hazards emergency response plan based on a national strategic risk assessment). The lack of such a plan means that international partners and donors fail to recognise the nature and quality of the robust mechanisms in place in Uzbekistan, and potential opportunities for funding, operational partnerships and international recognition are easily missed.
2. Adopt a five-year National Action Plan for Health Security (NAPHS), based on the JEE report and contextualized for Uzbekistan, that prioritizes funding needs and creates time frames for each action.
A NAPHS that emphasizes sustainable funding and intersectoral coordination, and which explicitly addresses staff incentives and retention, will strengthen the foundations for the health sector’s existing efforts to build and maintain core capacities under the IHR (2005).
3. Strengthen the public health workforce across the human and animal health sectors by establishing a National Public Health Institute and a system of national accreditation.
Strengthening intersectoral relationships during training will provide opportunities for future mentoring, subspeciality groupings, and personal and professional development. While the Uzbek workforce is dedicated, the country suffers from an ongoing brain drain of public health specialists. There is also a need to make the public health sector a more attractive career path for graduates. These innovations will allow Uzbekistan to build a robust cadre of public health specialists and make careers in public health attractive and rewarding.
4. Enhance existing programmes for regular training and exercising of all sectors, from local to national level, emphasizing joint work, cooperation and standard procedures, and establishing a mechanism for implementing the lessons thereby identified.
Enhanced programmes should link existing training and exercise programmes in different sectors and ministries, and fill any gaps, under an overarching vision designed to build capacity under the IHR (2005) and strengthen interministerial and intersectoral collaboration. This programme should be carried out as far as possible in collaboration with partner countries and donors.
5. Adopt and implement the One Health and all-hazards approaches throughout government, across sectors and between ministries.
Pathogens of animal origin are a growing global risk, as are antimicrobial resistance and food safety threats. The One Health approach is an urgent necessity for combatting present and future health threats in this era of globalization, emerging diseases and COVID-19. The Implementation of the One Health approach should be accompanied by approval of all necessary administrative mechanisms that formalize communication and coordination across sectors.
The external JEE team is very grateful for the open and honest discussions we had in Tashkent, and Uzbekistan’s willingness to engage with the JEE process.
We sincerely thank all participants in the JEE, and especially the JEE presenters, their teams and the interpreters who facilitated the discussion, for their hard work in preparing, presenting and hosting the team.