In , WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives:

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1 TONGA Tonga is a lower-middle-income country in the Pacific Ocean with an estimated population of (2005), of which 68% live on the main island Tongatapu and 32% are distributed on outer islands. The economy is based on agriculture, tourism and to a lesser degree, fishing. Many families are dependent on remittances from relatives living abroad. The publicly-funded health system provides services free of charge and the formal private sector remains small. WHO's programme of technical collaboration is managed by a Country Liaison Officer based in the Ministry of Health. The dominant health problem is the rapidly growing burden of noncommunicable diseases, of which diabetes and complications of diabetes are most prominent. WHO's technical assistance focuses on support of human resources for health, health systems development specifically revitalization of primary health care, noncommunicable diseases prevention and control, in particular for the implementation of the Tonga National Strategy to Prevent and Control Noncommunicable Diseases ( ) and NCD health promotion, primarily through community partnerships. Emergencies and disasters preparedness are also supported. In , WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: 01 To reduce the health, social and economic burden of communicable diseases WP01 Member States supported to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential interventions with immunization and to control or eliminate targeted vaccine preventable diseases (VPDs). Office-specific expected result (OSER) OSER Indicator Baseline Target WP01.TON01 Enhanced and expanded programme on immunization WP01.TON02 High level of Immunization coverage for EPI targeted diseases maintained WP01.TON01.01 Number of new vaccines that undergo formal review process for addition to MOH vaccines schedule WP01.TON02.01 Percent of Infants fully immunized according to immunization schedule. 99% 99% WP01 Effective coordination and support provided to Member States to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases WP01.TON03 Capacity to control dengue and other neglected tropical diseases (NTD's) further development WP01.TON03.01 Number of Trainings in support of surveillance and control of other neglected tropical diseases WP01.TON03.02 Percentage of disease outbreaks responded to WP01.TON03.03 Timely disease surveillance reports shared. NA 100% 4 4

2 WP01 Support Member States to achieve minimum capacities for preparedness, detection, assessment of and response to emerging diseases and other public health emergencies, as required under IHR (2005), through implementing the updated APSED (2010) WP01.TON04 Strengthened national system and capacity for detection, verification, risk assessment of and response to emerging diseases and other public health emergencies including implementation of IHR 2005 and APSED WP01.TON04.01 Review of syndromic based surveillance system. 03 To prevent and reduce disease, disability and premature death from chronic noncommunicable diseases, mental disorders, violence and injuries and visual impairment WP01 Enhanced capacity of Member States to collect, analyse, disseminate and use data on magnitude, causes and consequences of chronic noncommunicable conditions, mental and neurological disorders, violence, injuries and disabilities, visual impairment and blindness WP01.TON05 Strengthened capacity to collect and analyze NCD data that leads to more effective and efficient targeting of health promotion activities WP01.TON05.01 Completed Step Survey with data analyzed and used in programme planning WP01 Enhanced capacity and ability of Member States' health and social systems to prevent and manage chronic noncommunicable diseases, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness WP01.TON06 Strengthened national system and strategies for prevention and management of NCD's with emphasis on lifestyle change WP01.TON06.01 Number of hospital bed days directly related to diabetes WP01.TON07 Public awareness campaigns that impact on community understanding regarding the causes and prevention on NCD's WP01.TON07.01 Number of trainings conducted with emphasis on social marketing strategy that includes NCD prevention WP01.TON07.02 Number of public awareness campaigns conducted.

3 04 To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals WP01 Capacity within Member States strengthened for implementing national plans for the reduction of maternal and newborn mortality, including achieving skilled care for every birth WP01.TON08 Improved neonatal survival and health through effective interventions and progress monitoring WP01.TON08.01 Percent of newborns receiving care that focuses on integrated management of newborn care. 40% 50% WP01 Strengthened technical capacity in Member States for accelerated action towards the achievement of universal access to the essential package of interventions for child survival, including improvement of quality of care WP01.TON09 Strengthened national capacity to improve child and adolescent health and promote healthy ageing WP01.TON09.01 Percent of children in grade 1 and 6 screened for rheumatic heart disease. 94% 98% 05 To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact WP01 Establishment and implementation of national health emergency risk management plans and WHO readiness plans WP01.TON10 Strengthened national health emergency preparedness plans and programmes WP01.TON10.01 Number of health emergency trainings conducted. 06 To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex WP01 Strengthened countries' and areas' health promotion capacity across all relevant programmes, and to establish effective multisectoral and multidisicplinary mechanisms and collaborations to promote health and prevent and reduce behavioural and structural risk factors WP01.TON11 Strong partnerships with Health Promoting Churches, Health promoting Schools, Tonga Health Foundation and MOH in support of high quality health promotion WP01.TON11.01 Number of Health Promoting Churches. 4 30

4 WP01.TON11.02 Number of Health Promoting Schools To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health WP01 Leadership for a healthier environment and policies to tackle causes of environmental threats to health, thru responding to emerging and re-emerging consequences of development on environmental health and altered patterns of consumption and production, etc WP01.TON12 Implementation of primary prevention intervention that protects the environment and enhances access to safe water WP01.TON12.01 Number of community safe water projects with direct WHO collaboration To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development WP01 Partnerships formed and support provided to countries and areas to increase political, financial and technical commitment to addressing nutrition, food safety and food security through intersectoral action WP01.TON13 Formed partnerships and advocacy increased for political and financial commitment to address food safety and food security WP01.TON13.01 Food safety legislation drafted WP01.TON13.02 Review of food safety component of health inspection training programmes. None Not complete Draft completed Review completed 10 To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research WP01 Strengthened country health information systems that provide and use high-quality and timely information for health planning and for monitoring progress towards national and major international goals WP01.TON15 Strengthened health information system that provides appropriate and timely information for health planning and for monitoring progress of country goals WP01.TON15.01 HIS strategic plan developed.

5 WP01 Competent support provided to countries and areas to improve the production, distribution, skill mix, retention and the management of their health workforces WP01.TON16 Improved production, distribution, skill mix and retention of the health workforce WP01.TON16.01 Number of MOH staff receiving long term training in selected priority areas during the biennium WP01.TON16.02 Number of persons who completed a POLHN course during biennium WP01 Health financing data, information and evidence used for developing, implementing and monitoring health financing policies and strategies WP01.TON17 Improved national capacity to administer national health account system WP01.TON17 Number of National Health Account trainings conducted. 11 To ensure improved access, quality and use of medical products and technologies WP01 National policies to improve access, quality and use of essential medicines developed, implemented, monitored or revised WP01.TON18 National commitment for all stakeholders to national medicines policies on access, availability and affordability of essential medicines, medical products and technology development WP01.TON18.01 National Medicines Policy reviewed and National plan developed and implemented.