Emergencies: Humanitarian Health Action

The primary objective in an emergency, whether natural or human-made, is to reduce avoidable loss of life and the burden of disease and disability.

Every day, hundreds of millions of people face threats to health and livelihoods because local and national systems that support their health and lives are overwhelmed or too weak to withstand crises and extreme events.

WHO is committed to working better with Member States and other stakeholders so that suffering and death in crises are minimized and systems are protected and repaired. We want to help national authorities and communities to:

• Prepare for crises by strengthening their overall capacity to manage all types of crises;
• Mitigate against the effects of crises by taking measures to reduce the effects of disasters and crises on systems that support good public health;
• Respond to crises by ensuring effective, efficient and timely action to address public health priorities so that lives are saved and suffering is reduced;
• Recover from crises by ensuring that the local health system is back to functioning.

During crises, humanitarian health partners, led by the Inter-Agency Standing Committee (IASC) Health Custer under the leadership of WHO will empower humanitarian country teams to better address the health aspects and crises.

At all levels of WHO, whether it be in Country Offices, Regional Offices, and headquarters, the WHO network for Emergency Risk Management and Humanitarian Response serves as a convener and conduit. It provides information and services, and mobilizes partners to agree on standards and courses of action.

The easiest way to find information is to consult the web page www.who.int/disasters.

The regional office web pages are another important source of information.

• Regional Office for Africa: (http://www.afro.who.int)
• Regional Office for the Americas: (http://www.paho.org)
• Regional Office for South-East Asia: (http://www.searo.who.int)
• Regional Office for Europe: (http://www.euro.who.int)
• Regional Office for the Eastern Mediterranean: (http://www.emro.who.int)
• Regional Office for the Western Pacific: (http://www.wpro.who.int)

All of the Regional Office web pages are linked to the Humanitarian Health Action website.

The reform process, started in 2005 with the Humanitarian Response Review, represents a considerable change in the international scene and has vast implications for the work of WHO. The Humanitarian Reform is underpinned by three pillars:

• Improving the predictability of funding through the Central Emergency Response Fund (CERF);
• Coordinating effective response through the Cluster Approach, and
• Strengthening the Humanitarian Coordinator System.

The three pillars of humanitarian reform are secured by a foundation of strong and collaborative partnerships.

Strengthening commitment to coordination at the field level by all humanitarian partners is another pillar of the humanitarian reform process. The IASC self-assessment of the cluster roll-out brought to the fore that humanitarian coordination operations are very much related to the success of inter-cluster relations and efficient cluster roll-out. The two agendas converge. WHO chairs the IASC Humanitarian Coordinators Training Core Group set up to fill an existing gap and improve the ability of the Emergency Relief Coordinator to propose for HC position individuals whose skills, performance and background meet the expectations of leadership and experience of the IASC.

When emergencies occur, coordination is necessary. No one organization can respond to a health crisis alone. The Global Health Cluster is a platform for organizations to work in partnership to ensure collective action results in more timely, effective and predictable response to health emergencies. WHO is the Cluster Lead Agency.

There are over 900 partners at country level of which 56 partners engage strategically at global level. Currently there are 30 Health Clusters/Sectors, of which 2 are regional coordination mechanisms. These Health Clusters are working to meet the health needs of approximately 68 million people worldwide.

The Global Health Cluster exists to support Health Clusters countries, and it can make a difference by: providing the right expertise at the right place at the right time; building the capacity of Health Cluster Coordinators; gathering and disseminating sound and relevant information to guide partners’ response; identifying and addressing gaps in technical knowledge and available guidance to ensure the health response follows global best practices and standards; and, promoting and advocating for the importance of humanitarian health action on the global stage, to help ensure that Health Clusters receive the political and financial support they need.

The cluster approach was developed by the Inter-Agency Standing Committee as part of the humanitarian reform in 2005, to increase the effectiveness of humanitarian response by building partnerships. Clusters are groups of humanitarian organizations, both UN and non-UN, in each of the main sectors of humanitarian action (e.g. water, health and logistics) with clear responsibilities for coordination. The aim of the cluster approach is to strengthen system-wide preparedness and technical capacity to respond to humanitarian emergencies by ensuring that there is predictable leadership and by enhancing the accountability and transparency of humanitarian response.

• For more information visit the Health Cluster website

The CERF is a United Nations emergency relief fund officially launched on 9 March 2006 by the Secretary-General. In December 2006, pledges to the CERF totalled US$345 million. The objective of the CERF is to provide urgent and effective humanitarian aid to regions threatened by, or experiencing, a humanitarian crisis, and UN agencies and their partners can access the funds within the crucial first 72 hours of a crisis.

The CERF has immediately become an essential funding mechanism of WHO’s emergency work. In 2006, CERF grants represented 24% of the funds channelled through WHO’s Health Action in Crises, i.e. more than $24 million, of which $14 million were for rapid response operations and $10.4 million for under-funded emergencies.

The Inter-Agency Standing Committee – Established in June 1992 with the purpose to strengthen humanitarian assistance, the Inter-Agency Standing Committee (IASC) is a unique inter-agency forum for coordination, policy development and decision-making involving the key UN and non-UN humanitarian partners. Under the leadership of the Emergency Relief Coordinator, the IASC develops humanitarian policies, agrees on a clear division of responsibility for the various aspects of humanitarian assistance, identifies and addresses gaps in response, and advocates for effective application of humanitarian principles. WHO is represented in the IASC by its Director-General.

The Global Humanitarian Platform – In July 2006, UN agencies, NGOs, the Red Cross/Red Crescent movement, the IOM, and World Bank agreed to convene a forum (GHP) and bring together the three main families of the humanitarian community. The GHP aims at enhancing effective humanitarian action by maximizing the complementarity of different mandates. The GHP will develop “Principles of Partnership”, which will include diversity, mutual respect, responsibility, and transparency, and support their implementation at country level. The GHD agenda privileges a) accountability to the beneficiary populations, b) the capacity of local actors; c) safety and security of humanitarian staff; and d) situations of transition. The GHP meets annually and a Steering Committee oversees the process and sets the strategic directions.

In order to advocate for humanitarian health action in crises, WHO participates in the annual humanitarian segment of the UN Economic and Social Council (ECOSOC) which allows for substantial debates with all stakeholders involved in humanitarian assistance and for keeping health high on the political/humanitarian agenda.

Also, to bring health action in crises to the forefront of humanitarian action and contribute to inter-agency coordination, WHO works with the UN Department for the Coordination of Humanitarian Action (OCHA), the Inter-Agency Standing Committee (IASC) and other initiatives and entities as relevant. WHO, as a member of the United Nations Development Group (UNDG), is an active player in processes of joint assessments and planning for recovery and reconstruction conducted by the UN and the World Bank. WHO is also part of the United Nations Executive Committee on Humanitarian Affairs (ECHA) which meets on a monthly basis to ensure health as an important component of humanitarian action.

To ensure an adequate representation of health needs in the Consolidated Appeals Process (CAP), WHO provides input on the Consolidated Appeals, Common Humanitarian Action Plans (CHAP) and Flash Appeals.

• WHO participates in the work of IASC Taskforce on Preparedness and Contingency Planning and is part of the Framework Team to review/prioritize countries/situations of concern. WHO participates in the inter-agency process to revise the 2001 IASC Guidelines on Contingency Planning.
• WHO Emergency Risk Management and Humanitarian Response department (ERM) is part of the Inter-Agency Working Group on Disarmament, Demobilization and Reintegration (DDR) and drafted the health chapter of the United Nations Integrated Disarmament Demobilization and Reintegration Standards. It can be seen at http://unddr.org/
• WHO/ERM works with the International Secretariat for Disaster Reduction (ISDR) support the reduction of environmental, human, economic and social losses. WHO aims to mainstream disaster management, incorporating a public health aspect in country resilience to natural hazards and related technological and environmental disasters. WHO also ensures best public health practice in inter-agency disaster assessments and participates in UN Disaster Assessment and Coordination (UNDAC) teams.
• WHO/ERM is part of the IASC Cluster Working Group on Early Recovery, the UNDG-ECHA Working Group on Transitions and the UNDG Technical Working Group on Somalia. WHO and the IFRC jointly issued a publication entitled Tsunami Relief Impact Assessment and Monitoring.
• WHO is part of the newly established IASC Task force on Safe Access to Firewood and alternative Energy in Humanitarian Settings.
• WHO co-chairs the IASC Gender Sub-Working Group. WHO drafted the health chapter of the IASC Gender Handbook for Humanitarian Action Women, Girls, Boys & Men: Different Needs – Equal Opportunities.
• WHO/ERM is part of the Geographical Information Support Team (GIST), an inter-agency initiative promoting the use of geographical data standards and geographical information systems in support of humanitarian relief operations.
• WHO/ERM participates in the inter-agency Contact Group on Good Humanitarian Donorship (GHD), a Members States initiative to streamline humanitarian funding.
• WHO/ERM is part of the IASC Taskforce on HIV/AIDS in emergency settings and promotes the use of the IASC HIV/AIDS Guidelines in Emergency Settings.
• Human Rights and Humanitarian Action. WHO/ERM is part of the newly established IASC Reference Group on Human Rights and Humanitarian Action. Products developed by this Group include the Human Rights Guidance Note for Humanitarian Coordinators (2006) and Frequently Asked Questions on International Humanitarian, Human Rights and Refugee Law (2004).
• In order to further protect persons affected by natural disasters, WHO was part of the IASC process which drew up the IASC Operational Guidelines on Human Rights and Natural Disasters. Chapter B.2 provides information about the provision of essential health services.
• WHO is part of the IASC Information Management Working Group.
• Mental Health and Psychosocial Support in emergencies. The Inter-Agency Standing Committee Working Group endorsed the IASC Guidelines on Mental Health and Psychosocial Support in Emergencies. WHO co-chair this Taskforce.
• Through the Consultative Group on the Use of Military and Civil Defence Assets (MCDA), HAC is promoting cooperation in countries where resources are scarce.

Outside the UN framework, WHO co-operates with a wide network of humanitarian partners worldwide, the Red Cross and Red Crescent movement, Collaborating Centres, universities and other academic institutions, NGOs and senior public health experts. Other key partners are Inter-Governmental institutions such as the African Union, the Council of Europe and the International Organization of Civil Protection.

For instance, In May 2005, IFRC and WHO signed a Joint Letter of Collaboration to further enhance collaboration between Red Cross and Red Crescent Societies and national health authorities.

Collaborating centres are scientific or academic institutions which have expertise and facilities in specific aspects of emergency preparedness and response, including training and research to field operations. Their expertise spans disaster reduction, technological emergencies, hospital mitigation, critical incident management, disaster medicine, complex emergencies, emergency communications and information management.

Emergency Risk Management and Humanitarian Response departments' budget is approved by the World Health Assembly biannually. The budget for the 2008-2009 biennium amounts to USD 218 million, 67% higher than the previous biennium.

This budget covers the core work of WHO in humanitarian emergencies and crises across the three levels of the Organization: HQ, Regional Offices, and Country Offices in the following manner:

• USD 137.9 million at country level;
• USD 50.9 million at regional level;
• USD 29.6 million at global level.

The sources of funding for the core budget of WHO in the Area of Emergencies and Crises for the period 2008-2009 are:

• 8% assessed contributions from Member States (approximately USD 17 million);
• 92% voluntary contributions (approximately USD 201 million).

Voluntary contributions come from different sources:

• Bilateral contributions from Member States earmarked for specific emergencies;
• Unearmarked bilateral contributions from Member States;
• Allocations from the UN Central Emergency Response Fund;
• Allocations from trust funds and humanitarian pooled funds;
• Funds from foundations and health partners.