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and do no necessarily reflect the views or policies of the Asian Development Bank
(ADB), or its Board of Governors, or the governments they represent. ADB does not
guarantee the accuracy of the data included in this paper/presentation and accepts no
responsibility for any consequence of their use. Terminology used may not necessarily
be consistent with ADB official terms.

Health security in health

facilities
Azusa Sato
Southeast Asia Regional Department
 Health facilities in outbreaks
PREMISE

• Many health facilities struggle to provide basic and emergency services

under normal operations
• When health security threats (in particular, outbreaks) occur, pressure is
further increased
• Ensuring surge capacity to operate beyond ‘business as usual’
• Outpatient and inpatient capacity for triage, treatment and tracking of patients
• Maximize conventional capacity and plan for contingency capacity (adapting spaces) and
crisis capacity (adapting level of care provided)
• Surge discharge – transfer of patients who could be treated elsewhere
 Planning for outbreaks
NEED
• Facilities at all levels need to be well prepared and effectively functional prior,
during and post outbreaks
• Hospital Emergency Risk Management/Preparedness and Response plan
• Mechanisms/committee responsible for developing, implementing updating the plan
• Hospital personnel know their roles during outbreaks, including how to continue providing
day-to-day hospital services
• simulation exercises, drills
• Build on existing knowledge, practice, capacities within the hospital, health system and community
• Dependency and cooperation: other sectors (water, energy, waste
management, transport etc.), facilities working together, and beyond borders
• Legislation - IHR framework should facilitate early detection report and
response
• Appropriate funding
Role of non-stationary facilities
Responding to outbreaks:
Communication networks

1
BEST PRACTICE
 Bangladesh, Bhutan, Indonesia, Maldives,
Southeast Asia situation Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste

• multi-level/multisectoral coordination
• multidisciplinary rapid response teams
• public communication and social mobilization
• drills in international airports
• training on personal protective equipment

• inadequate risk assessment and risk communication

• gaps in data management and analysis for surveillance
• weak lab diagnostic techniques and capacity
• limited planning for surge
• Limited advice to inbound travelers
• inadequate isolation rooms
• Inadequate appropriate infection control practices, triage
systems in hospitals, contact tracing
• Insufficient danger pay to staff to ensure continuity of care
ADB’S INVOLVEMENT IN HEALTH SECURITY

$28m
Regional malaria and $92m
$30m GMS CDC
$18m project other Comm. Strengthening
HIV/AIDS Diseases Threats Local health
Trust Fund $40m Avian Influenza Trust Fund care (Viet
HIV/AIDS & ADF IX Project Nam)
Comm. 2% for health;
eligibility for all
Diseases $52m
ADF DMCs
ADF grant mobilized
SARS $27m $125m
CDC 2 GMS Health Security
project
CDC2 results
GMS HEALTH SECURITY PROJECT

GMS Health Security project

($125m)

Project components
Rationale
• Regional cooperation and
Emerging diseases and
CDC in border areas
outbreaks
• National disease surveillance
and outbreak response
Impact
systems strengthened
GMS public health
• Lab services and hospital IPC
security strengthened
improved

Outcome Financing
GMS health system • 125m + 7.2m counterpart
performance, with regard • March 2017-2022
health security, improved
SUMMARY

• Ensuring surge capacity to operate beyond ‘business as usual’ is

critical
• Hospital Emergency Risk Management/Preparedness and Response
plan is necessary
• Working together across different networks and beyond borders is
essential
• Asian countries’ facilities still have a long way to go to ensure health
security