WORKING SESSION
Disaster Risk Management for Healthy Societies
Brief & Concept Note
Brief
1. Why is this topic important ?
Protecting people’s health from the risk of emergencies and disasters is a social, economic
and political necessity. The health and lives of millions of people are regularly threatened by
hazards, while disasters are considered, first and foremost, in terms of their health
consequences, for example:
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More than 110,000 deaths were recorded annually on average due to natural and
technological hazards from 2004-2013, while 1.7 billion people have been affected
by disasters in the same period.
More than 1.5 billion people live in countries marked by repeated cycles of political
and criminal violence, including conflicts. 172 million were affected by conflict in
2013 alone.
Furthermore, it is estimated that for every large-scale event, there are hundreds of
smaller scale events which cause deaths, injuries, and disabilities.
While a focus on reducing deaths and saving lives should remain a high priority for disaster
risk management, concerted action is also required to reduce injuries, disease, psychosocial
effects, and disabilities from disasters.
There is also a need to ensure that disaster risk management protects hard-earned gains in
health development and population health by strengthening community and national
resilience, including the resilience of health systems. Health effects of disasters result in
tremendous economic losses to society. It is estimated that a severe influenza pandemic
could cost the global economy more than $US3 trillion, through its effects on health,
productivity, trade, and travel. Expenditure on hospitals may represent up to 70 percent of
national health budget. A review of 94 assessments in Latin America and the Caribbean
(from 1972 to 2011) estimated the damage from disasters to health infrastructure at
$7.82billion.
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Health status is a key factor for the vulnerability and resilience of people and communities
to disasters, and is a major determinant of development outcomes associated with disaster
risk management, such as:
• livelihoods and economic development, which relies on a healthy, safe and
secure workforce in public, private and community sectors,
• community safety and security, and
• early childhood development and school attendance.
Health is a bridge for effective action in disaster risk management as it promotes cooperation
across different sectors and disciplines which contribute to health. Health is connected with
many aspects of disaster risk management, such as:
 protecting critical infrastructure through action on safe hospitals, and safe
water and sanitation systems;
 the vital role of local health workers in building community resilience through
community care and as first responders in emergency situations; and
 the increasing role of the private sector in health care and health infrastructure.
Communities and countries are actively strengthening their systems to manage the health
risks associated with all types of hazards, emergencies and disasters. 130 countries have
reported to WHO that they have “emergency preparedness and response programmes” in
place.77 countries have implemented activities to make hospitals safe and operational in
emergencies and disasters- one of the more successful achievements of HFA
implementation. This momentum must be built upon in the post-2015 framework for DRR
for all countries. 61 States Parties have reported to WHO that the national core capacity
requirements for the International Health Regulations (2005) have been achieved.
National, sub-national and local governments, civil society, international organizations, the
Red Cross/Red Crescent movement and other stakeholders are building the capacities of
communities, health systems, local health workers and community volunteers for their roles
in reducing local health risks, disaster preparedness, response and recovery. Measures
implemented by communities and countries include: routine child and emergency
immunization programmes, provision of safe drinking water, safe human waste
management, safe hospitals, psychosocial support for disasters, trauma care services, first
aid training, disease surveillance and early warning systems. These activities are supported
by policies, legislation and capacity assessments, evidence-based information on risks and
resources, health and inter-sectoral coordination mechanisms, emergency response
planning and exercises, training of health personnel, financial resources and research.
2. What gaps need to be filled?
The health sector is usually well-integrated into national disaster risk management systems
in those countries with well-developed capacities. In other countries, there is a greater need
to strengthen the limited capacity of the health sector for disaster prevention,
preparedness, response and recovery.
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Despite the centrality of health to disaster risk management, barriers have existed which
have reduced the attention to health in the discourse, policy and practice of DRR. They
include the following :
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People’s health is not often explicitly expressed or recognised as a primary purpose
of disaster risk management. Health is often masked by other references, such as
social outcomes, which do not do justice to health as a key imperative for disaster
risk management.
Implied references are often made to health in terms of saving lives or reducing
mortality. While this should be a focus of health and disaster risk management,
there are many other dimensions to health effects, including injury, disease and
disability, and how these affect social functioning.
Health is often simply described as another sector rather than referring to people’s
health. While health is a vital sector, people’s health is a concern and outcome to
which all sectors contribute.
Disaster risk management rarely mentions epidemics and pandemics as major
sources of risk to communities. They have the potential to cause emergencies and
disasters on a scale comparable to other hazards.
When disaster risk reduction focuses on risk prevention, reduction of existing risks
and preparedness, the important role of effective response and recovery in reducing
health risks and improving health outcomes are missed. A holistic approach to
managing risks which includes prevention preparedness, response and recovery, is
required.
Implementation of people-centred disaster risk management, including the post2015 framework for DRR, is critical to secure the health and wellbeing of people. To
ensure this, there is a need to actively support, increase resources and intensify the
focus on reducing health risks and better health outcomes through a multi-sectoral
and integrated approach to disaster risk management at community and country
levels.
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A health lens could be brought to priority actions to emphasize for multi-sectoral
collaboration to achieve health outcomes and address health issues.
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All sectors and stakeholders should address the needs of groups and subpopulations
whose vulnerabilities are associated with their health status, including the aged,
people with disabilities, pregnant and lactating women, children, people with
communicable and non-communicable diseases. There needs to be a continuing focus
on working with these populations to manage their risks of disasters and to draw upon
their capacities for effective community action.
All sectors and stakeholders should work together to reduce risks to health by taking
of an all-hazards approach to disaster risk management, including for risks associated
with biological hazards, epidemics and pandemics.
Action and resources to strengthen the resilience of health systems and develop the
capacity of the health sector in disaster prevention, preparedness, response and
recovery are needed to:
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a. integrate disaster risk management practice into primary health care at local
level and throughout all parts of health systems.
b. develop institutional capacity and scale up good practice across all disciplines
in health and other sectors at local, national, regional and international levels.
c. develop the capacity of the health workforce for disaster risk management
practice, advocacy and policy development.
d. support community health groups who have vital information on vulnerability
and community capacities.
e. improve local and national health emergency response (including international
coordination, such as foreign medical teams), safe hospitals, primary care,
compliance with the International Health Regulations (2005).
f. More specifically, health services for women, especially those requiring antenatal, emergency obstetric and post-natal care, should remain a priority
before, during and after emergencies.
4) The Safe Hospitals Initiative should be a global priority for action for disaster risk
management to ensure that new and existing health facilities remain operational in
emergencies and disasters. Health facilities, especially hospitals, are critical assets for
communities before, during and after disasters. 77 countries have reported that they
have taken action to make hospitals safe and operational in emergencies and disasters.
Building on this momentum, countries are called upon to support the implementation
of the Safe Hospitals Initiative, national safe hospital programmes and scale up of
actions to:
a. enable hospitals to continue to function and provide appropriate and sustained
levels of healthcare during and following emergencies and disasters;
b. protect health workers, patients and families;
c. protect the physical integrity of hospital buildings, equipment and critical
hospital systems; and
d. make hospitals safe and resilience to future risks, including climate change
Further attention is also required to address the following risks to people’s health and gaps
in capacities.
Climate variability and climate change: Major risks to public health are due to extreme
weather and climate-related hazards such as extreme temperatures, cyclones and floods,
droughts and climate-sensitive diseases such as malaria.
Private sector involvement: Greater engagement with the private sector in DRM for health
is required as there is an increasing role for the private sector in health care, including in
hospitals; and an emphasis on the health and safety of workforce before, during and after
disasters.
Increased attention to non-communicable diseases: Increased attention is needed to the
risks of disasters for people who are vulnerable to disasters due to non-communicable
diseases, and associated dependence on life-saving medications or health services.
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Displaced and refugee populations: More than 50 million internally displaced people and
refugees face major health risks from conflict and other hazards. The result is an
increasingly high demand on local health systems and the international community.
Urbanization: Increasing unplanned urbanization and industrial not only creates risks for
people’s health, but also places increasing pressure on improving access to basic and
emergency health services in urban areas.
Communicable diseases from animals to humans (zoonotic diseases), epidemics and
pandemics: Epidemics and pandemics have the potential to overwhelm local and national
resources and cause widespread health, social, economic and environmental effects on a
scale comparable to other hazards. The transmission of disease-causing agents (pathogens)
from wild and domestic animals to humans is influenced by livestock production and food
preparation practices, as well as the societal context and the ecosystems within which
human-animal interactions take place. The movement of people and animals, human
behaviour and modifications to natural habitats (associated with other risk factors for
disasters such as urban encroachment on wildlife habitat) has a substantial influence on the
emergence of diseases.
WHO and partners are developing a global framework on emergency and disaster risk
management for health (EDRM-H) brings together core elements of multisectoral DRM,
health systems and the International Health Regulations (2005). This framework aims to
identify the capacities which countries should have in place to manage health risks
associated with disasters effectively, resulting in better health outcomes. EDRM-H is closely
allied with developments in the disaster community towards a more proactive, risk-based
and community-centred approach involving all sectors and disciplines.
3. What commitments are expected?
Country and stakeholders commitments to implementing the post-2015 framework for DRR
are expected to include the establishment of the Safe Hospitals Initiative and the launch of
the 2015 Hospital Safety Index, a rapid diagnostic tool for assessing the safety and
preparedness of hospitals.
Other themes including: strengthening multi-hazard country capacities on emergency and
disaster risk management for health; building the resilience of local and national health
systems through community preparedness, primary care and optimizing opportunities in
disaster recovery; advancing mechanisms to improve scientific evidence and research
including health; initiatives to address climate and health; and strengthening health and
medical education.
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Concept Note
Schedule
Sunday 15 March 2015, 14:00-15:30
Room and Venue
Hagi Hall, Sendai International Conference Centre
Organizing Team
World Health Organization, UNAIDS, Mexico Ministry for Social
Security, Public Health England, United States Centers for Disease
Control and Prevention, Ministry of Health (Islamic Republic of Iran),
New Zealand Ministry of Health, UNFPA, UNICEF, UNSIC,
International Federation of the Red Cross and Red Crescent Societies,
International Federation of Medical Students Associations (IFMSA),
Disaster and Development Network (DDN).
Session
Point
Focal Jonathan Abrahams (abrahamsj@who.org), Chadia Wannous
(chadia.wannous@undp.org)
Background and
Rationale
Health is a central concern of all communities, especially those at risk
of emergencies and disasters. Health is also fundamental to wellbeing: a well person in a healthy, resilient community is central to
development and disaster risk management.
While there are many examples of communities, governments and
their partners are working together to reduce health risks associated
with disasters, there is much more that needs to be done within and
across all sectors and countries. The future of many people’s health
remains at stake if future action does not put health at the centre of
action to manage future risks of emergencies and disasters.
Placing health prominently in the implementation of the disaster risk
management, including the post-2015 framework for DRR, will
contribute to improved health outcomes, not only in terms of saving
lives, but also reducing illness, injury and disability, improving the
quality of life of the affected population, and building the resilience
of health systems to all types of hazards before, during and after
disasters.
Session
Objectives
Promote and provide the opportunity for countries, UN agencies and
stakeholders to:
 advocate for and reinforce the centrality of health for disaster risk
management and for the implementation of the post-2015
framework and associated global, regional, national and local
policies, plans and practice;
 share progress made and challenges faced in reducing emergency
and disaster risks to health, and
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Discussion
agenda and
structure
make voluntary commitments to reduce risks to health and
strengthen capacity across and within all sectors in countries for
emergency and disaster risk management for health.
1. Opening by the Moderator (5 min)
2. Panel of speakers (5 speakers estimated at 8 minutes each) (40
min)
3. Open dialogue (30 min)
4. Summary of key points, actions, commitments,
recommendations, next steps (15 min)
The Moderator will facilitate an interactive dialogue among panellists
and WCDRR delegates on actions to strengthen people’s health
status, health-related systems and services as pillars of risk
management and community resilience.
The Moderator will set the context by present an overview of the
centrality of health to disaster risk management and make reference
to the way in which health is addressed in the post-2015 framework
for DRR. Representatives from countries and other stakeholder
organisations will be invited share health and multisectoral
perspectives from community, local, national and global perspectives.
Success stories, progress reports and future directions for
strengthening the integration of multi-sectoral disaster risk
management will be presented. They will be invited to share their
commitments towards the implementation of the post-2015
framework for DRR, including their plans for strengthening capacities
and resources for health at community and country levels, and their
commitments to the Safe Hospitals Initiative as a priority action for
disaster risk management.
There will be opportunities for other commitments to be shared, and
for an interactive discussion between delegates and panellists on
disaster risk management for health. This discussion will be facilitated
by the Moderator.
Expected
outcomes
 Commitments to action to reduce risks to health with an emphasis
on implementation of the health-related aspects of the post 2015
framework for DRR.
 Specific commitments to support and implement the Safe Hospitals
Initiative.
 Recommendations to governments and partners for advancing
implementation of emergency and disaster risk management for
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health, including through the post-2015 framework for DRR and
related frameworks, in the health and other goals of the
Sustainable Development Goals, and in negotiations at the 2015
United Nations Climate Change Conference.
Commitment /
Commitments to the establishment of the Safe Hospitals Initiative
special
and the launch of the Hospital Safety Index 2015
announcement in
Other announcements TBC
support of a
post-2015
framework for
DRR
Expected number 150-300
of participants
Background
documents
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