W Hotel, Washington, DC
From June 20-July 2, 2016, a six-person External Assessment Team from the UPMC Center for Health Security met with governmental leaders in Taipei, Taiwan to conduct an independent assessment of Taiwan’s capabilities under the Internal Health Regulations (2005) and its related progress toward the “Protect, Detect, and Respond” goals of Global Health Security Agenda.
The Global Health Security Agenda (GHSA) is an effort by nations, international organizations, and civil society to accelerate progress toward a world safe and secure from infectious disease threats. Countries that have signed on to the GHSA are encouraged to submit to external assessments of their global health security capacities and publicly publish the results. In working with the Center, Taiwan is the 14th country to undergo a complete multi-sectoral GHSA assessment and publish the results and only the 8th country to do so using the new WHO International Health Regulations Joint External Evaluation (JEE) Tool.
The JEE Tool provides a standard metric by which countries can assess their current baseline capabilities and measure future progress. The JEE Tool was used to assess Taiwan’s collective capabilities, not just those of the Ministry of Health and Welfare (MOHW) or Taiwan Centers for Disease Control (TCDC). Many of the required capabilities involve other governmental agencies as well, such as agriculture, defense, border control, environmental protection, and nuclear power. Therefore, the external evaluation of Taiwan’s capabilities emphasized cross-sectoral and interagency collaboration.
Related to this assessment, three visiting scholars from TCDC are in residence at the Center in Baltimore for three months, conducting public health policy research and preparing papers to be published in a special issue of our Health Security journal and presented at an international symposium on Assessing Countries' Global Health Security Capabilities, convened by the Center in Washington, DC on October 19, 2016. The symposium was attended by the former TCDC Director General and current TCDC Deputy Director General and technical experts from across TCDC as well as representatives from the US government, including the Department of Health and Human Services and US Department of Agriculture. Subject areas included the public health and preparedness programs in Taiwan and the JEE experience in Taiwan, the United States, and other countries.
9:00 - 9:15 - Welcome
Thomas Inglesby, MD, CEO/ Director, UPMC Center for Health Security
9:15 - 9:20 - Overview of the Joint External Evaluation Health Security
Jennifer Nuzzo, DrPH, UPMC Center for Process
9:20 - 9:35 - Introductory Remarks
Steve Hsu-Sung Kuo, MD, MPH, PhD, Former Director-General, Taiwan CDC
9:35 - 9:55 - Overview of the Taiwan JEE
Yi-Chun Lo, MD, Deputy Director-General, Taiwan CDC
9:55 - 10:10 - Hospital preparedness in Taiwan
Hui-Yun Kao, MSc, Division of Preparedness & EID, Taiwan CDC
10:10 - 10:30 - Taiwan’s national laboratory system and pathogen surveillance
Ji-Rong Yang, MSc, Center for Research, Diagnostics and Vaccine Development, Taiwan CDC
10:30 - 10:45 - Border control & infectious diseases
Li-Li Ho, Division of Quarantine, Taiwan CDC
10:45 - 11:00 - Detection and surveillance of EID
Shu-Wan Jian, DVM, MPH, Epidemic Intelligence Center, Taiwan CDC
11:00 - 11:15 - The role of medical universities in global health security
Nai-Wen Kuo, PhD, MPH, Dean, College of Public Health, Taipei Medical University
11:15 - 11:30 - Lessons learned from the Taiwan JEE
Eric Toner, MD, UPMC Center for Health Security
11:30 - 12:00 - Moderated Q&A
Steve Hsu-Sung Kuo, MD, MPH, PhD, Former Director-General, Taiwan CDC
12:00 - 1:00 Lunch Talk on Recent GHSA Activities
Lawrence Kerr, PhD, Pandemics & Emerging Threats, Office of Global Affairs, HHS
1:00 - 1:20 The importance of JEEs to the GHSA and overview of JEEs in other countries
Jose Fernandez, PhD, Office of Global Health Affairs, US Department of Health and Human Services
1:20 - 1:40 Pakistan and Bangladesh
Kashef Ijaz, MD, Division of Global Health Protection, CDC
1:40 - 1:55 Ethiopia
Lawrence Kerr, PhD, Pandemics & Emerging Threats, Office of Global Affairs, HHS
1:55 - 2:10 Tanzania
William Karesh, DVM, EcoHealth Alliance
2:10 - 2:40 Moderated Q&A
Jennifer Nuzzo, DrPH, UPMC Center for Health Security
2:40 - 3:00 Break
3:00 - 3:25 Overview of the US JEE
Maria Julia Marinissen, PhD Division of International Health Security, ASPR, HHS
3:25 - 3:45 CDC involvement in JEE
Theresa Smith, MD, Division of State and Local Readiness, US CDC
3:45 - 4:00 USDA involvement in JEE
Thomas Gomez, DVM, USDA
4:00 - 4:20 Moderated Q&A
Crystal Boddie, MPH, UPMC Center for Health Security
4:20 - 4:30 Closing Comments
Thomas Inglesby, MD, Director, UPMC Center for Health Security
Yi-Chun Lo, MD, Deputy Director-General, Taiwan CDC
Reception from 4:30–6:30 at the roof-top Point of View Bar overlooking the White House
This is an independent assessment of Taiwan’s capabilities under the International Health Regulations – 2005 (IHR) using the IHR Joint External Evaluation (JEE) tool. The purpose of the evaluation is to guide Taiwan in its progress toward full development of IHR capabilities to prevent, detect, and respond to public health threats, whether they are naturally occurring, deliberate, or accidental. This tool provides a standard metric by which countries can assess their current baseline capabilities and measure future progress. The JEE was used to assess Taiwan’s collective capabilities, not just those of the Ministry of Health and Welfare (MOHW) or Taiwan Center for Disease Control (TCDC). Many of the required capabilities involve other governmental agencies as well, such as agriculture, defense, border control, environmental protection, and nuclear power. Therefore, the external evaluation of Taiwan’s capabilities emphasized cross-sectoral and interagency collaboration. An External Assessment Team consisting of 5 US subject matter experts from the UPMC Center for Health Security and 1 former US CDC official conducted the evaluation in collaboration with a multi-sectoral team of officials from relevant agencies from the Government of Taiwan. The evaluation involved 2 visits to Taipei, Taiwan, including a pre-assessment orientation visit in March 2016 and the evaluation mission which took place from June 21 through July 1, 2016. Prior to the evaluation mission, the Government of Taiwan completed a self-assessment using the JEE tool. During the evaluation mission, Taiwan presented the results of the self-assessment to the External Assessment Team—over the course of 8 working days—followed by structured discussions of each indicator among the Taiwan experts and the External Assessment Team. The External Assessment Team considered the self-assessment, interviewed officials on 19 separate self-assessment teams, and reviewed supporting documentation. The JEE tool addresses 48 indicators that relate to 19 capabilities (elements), with hundreds of corresponding Contextual and Technical Questions. Based on the answers to these questions and supporting documentary evidence, scores were assigned for each of the indicators on a 5-point scale. The scores range from 1 (indicating No Capacity) to 5 (indicating Sustainable Capacity). The scores only apply to the host county and how it compares to the evaluation criteria; the JEE tool is not designed to compare countries to one another. Taiwan’s current strengths, areas which need strengthening, recommended priority actions, and scores were developed through a process of consensus among the External Assessment Team and Taiwan team members. Additionally, the External Assessment Team conducted site visits to a regional health bureau and hospital in the City of Taichung, a large teaching hospital in Taipei, and the TCDC Emergency Operations Center (EOC). At this time, only 7 other countries have completed and published an external assessment using the JEE tool, and Taiwan is the 8 thcountry to publish its results.
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