IASC Inter-Agency Standing Committee Global Health Cluster Minutes Face-to Face Meeting 6-7 June 2006 WHO HQ, Geneva Participating agencies CDC, IASC Nutrition Cluster, IASC WASH Cluster, IASC Secretariat, IFRC, IMC, IOM, Merlin, OCHA, Terre des Hommes, UNHCR, UNICEF, WFP, World Vision International, WHO. Regrets AHA, ICRC, IRC, IASC Recovery Cluster, ICMH, UNFPA, Save the Children USA Agenda 6 June 2006 0. Pre-meeting on Cluster Budget 1. Opening remarks 2. Cluster Mission Statement 3. Profile for Health Cluster Coordinator at field level 4. Briefing by the representatives of the Nutrition and WASH Clusters 5. Breakout sessions on Training (HEARNET), Assessment (Tracking Service) and the Cluster Mission Statement and Profile for Health Cluster Coordinator 7 June 2006 6. Briefing by Head of OCHA Humanitarian Reform Support Unit 7. Cluster Budget 8. Cluster roll out in DRC. Special guest: DSRGS for DRC, Ross Mountain 9. Current crises: Indonesia-Java, Timor Leste, Horn of Africa, Cholera in Angola and occupied Palestinian territories 10. Work Plan for next six months 11. Dates for Virtual Triple Cluster meeting and next face to face Health Cluster meeting 12. Closing remarks 0. Pre-meeting on Cluster Budget A proposal for the Cluster Budget was prepared by IMC, IOM, UNICEF, WFP and WHO, which was discussed by the Health Cluster, see agenda item 7. 1. Opening remarks by the representative of the WHO Director General for Health Action in Crises, Ala Alwan Moment of silence for the memory of Dr. J.W. Lee. Welcome to participants. Special welcome to Jamie McGoldrick from OCHA and the representatives of the Nutrition and WASH Clusters. Important achievements were made over the past year, including several cluster meetings, preparation of cluster project proposals, cluster role-out in Pakistan and working together in the cluster pilot countries (DRC, Liberia, Somalia and Uganda). 1
Resolution WHA 59.22 on emergency preparedness and response was adopted at the WHA 2006. With the resolution the Member States emphasized the need for coordination in emergency preparedness and response. OCHA is acknowledged as playing an important role in the coordination. Action points need to be formulated for the coming months. 2. Cluster Mission Statement Two important issues need to be addressed: o When to activate the Cluster Approach? o How does the Health Cluster progress to the recovery phase? It was mentioned that there is a lack of clarity and guidance at field level. Capacity building and commitment to improve the overall health management in crises is a prerequisite for timely response and recovery. It is important to engage NGOs at the field level. Country teams are encouraged to do so. Agreed to further discuss the Mission Statement in a breakout session. 3. Profile for Health Cluster Field Coordinator The preliminary guidance note on implementation of cluster leadership application is still under discussion in the IASC. A copy of the April version, discussed by IASC principles, was made available to the meeting participants. The IASC is working on a revised and updated version, which WHO will share with the Health Cluster partners as soon as it is available. Acute and chronic emergencies require different cluster approaches. Donors are concerned that the Health Cluster will form another layer. This is not the case. Agreed to further develop the TOR for the Health Cluster Field Coordinator in a breakout session. Agreed that there is a need to define minimal qualifications for recruiting coordinators at the field level. 4. Briefing on Nutrition Cluster by CDC, Muireann Brennan, on behalf of the Nutrition Cluster Key objectives of the Nutrition Cluster were presented, as well as key indicators and benchmarks for 2006. The Nutrition Cluster has developed a detailed workplan with responsibilities assigned to partner agencies. The training and rapid assessments subgroups have been established and are communicating regularly. There is a need for close coordination and collaboration between the above and corresponding subgroups in the Health Cluster. Discussion on the presentation: The nutrition and health clusters have lots in common and need to be better linked. A question was raised on the absence of MSF in the Health Cluster. MSF will be involved in the Tracking Services, but for the moment will not take part in the Health Cluster. Agreed that key performance benchmarks are also needed for the Health Cluster. Briefing on WASH Cluster by the representative of the WASH Cluster, Jean McCluskey Currently, ACF, CARE, CONCERN, CRS, ICRC, IFRC, OCHA, Oxfam, UNHCR, UNICEF, WHO are members of the WASH Cluster. Coordination and its instruments (human resources capacity: standardization - e.g. assessment) are crucial for timely response and recovery. The next WASH Cluster meeting will take place in Geneva on 12 and 13 June 2006. 5. Breakout sessions on Training (HEARNET), Assessment (Tracking Service) and the Cluster Mission Statement and Profile for Health Cluster Coordinator In preparation of the breakout sessions two plenary presentations were given on: 2
o o HEARNET (WHO, Gaya Gamhewage) Benchmarks (WHO, Alessandro Loretti) About HEARNET (Gaya Gamhewage): A Health Cluster training group will be established. Preparations for a manual are in progress. Criteria need to be established for entry into training courses. It is important to use training experiences from different agencies. A suggestion was made that different agencies host trainings. All agencies are invited to nominate training focal points. Breakout sessions 5a. Training Currently, CDC, ICMH, IMC, IOM, IRC, Merlin, Save the Children USA, TDH, UNHCR, UNICEF and WHO are in the Health Cluster subgroup on training. The Health Cluster subgroup on training will develop TOR and define the scope of and competencies for health leadership and rapid assessment and response health teams. The Health Cluster needs to develop the purpose and TOR of rapid response team. The subgroup identified the following training priorities: o Priority should be given to training Health Cluster Field Coordinators (who could be from outside WHO and then seconded). o As a second priority, the training of rapid assessment/mapping/planning health o teams for country level support was identified (UNDAC for health). Thirdly, a joint effort in capacity building in relevant areas of public health should be undertaken at all levels (country, individual agencies and collective actions). Questions were raised about HEAR NET and whether, in its current format, it supports the above priorities. Many partners felt it did not. Human resources expertise is required to define criteria for interviewing, selecting, core competencies, secondment and training and coordination. Possible partners are: IFRC, ICRC, Epicentre, RedR/(health)IHE Agreement was reached to identify all organizations to be included in the Health Cluster subgroup on training, and to convene the first subgroup teleconference as soon as possible to agree on the subgroup's broad TORs. There was a broad consensus that the subgroup will build on existing capacities/training packages from all agencies. 5b. Assessment (Tracking Service) Reestablish Health Cluster tracking group. Currently WHO, UNICEF, WFP, FAO, IRC, OCHA, SAVE US, Nutrition Cluster, IOM are members of the Health Cluster assessment group. Missing members are WASH Cluster, UNHCR. An interagency meeting will be held in Geneva on 22 and 23 June to finalize the draft tracking proposal. The finalized document will be discussed by the IASC working group (July 2006). 5c. Cluster Mission Statement and Profile for Health Cluster Field Coordinator Agreed that the Mission Statement and Health Cluster core commitments had to be finalized before the profile and TOR of the health cluster field coordinator could be drafted. To be finalized and circulated for final approval. 6. Briefing by Head of OCHA Humanitarian Reform Support Unit Presentation by Jamie McGoldrick, Head of new HRSU established by OCHA. The unit aims to pull together lessons learned from cluster operations in pilot countries and 3
identify what implications this has for future application of the cluster approach. Expected outcome is more effective, integrated, coherent, professional approach and more accountable humanitarian leaders. Unit aims to be action oriented and will focus on enhancing communication between clusters, enhancing partnerships with NGOs and supporting the change process. Health cluster partners warmly welcomed Jamie and expressed their support although several aspects need to be revisited in the near future. 7. Cluster Budget Discussion centered on the revised mission statement and core commitments thereby highlighting implications for the cluster budget. Original core commitments document has been revised several times. Cluster members have been asked to review the versions 4 and 5 from 6 and 7 June respectively and submit their comments to WHO by end June. WHO will then redistribute the final version by 10 July 2006. Agreed that revised version should include cluster hub support. Funding for this will come from within the current budget of US$4.2M. Agreed that the revised version narrative and budget needs to incorporate training discussion outcomes, prioritizing recruitment and training of 20-30 Health Coordinators within Cluster budget. Public Health Coordinator training could be outsourced. Agreed that recovery should more strongly emphasize within the core commitments document and through enhanced engagement with the early recovery cluster. Agreed that bulk of funding for the health, nutrition and mortality Tracking System project will be secured through separate funding proposal (US$12M). US$2M will allocation will remain in original cluster budget. Agreed the urgent need for a clear Work Plan for the next 6 months. Agreed the need to re-emphasize the original purpose of the Health Cluster i.e. identifying and filling gaps and providing strong health leadership. Agreed that mission statement should include prevent and reduce morbidity and mortality and that surveillance is implicit within the term evidence-based. Agreed that core commitments should reflect both global and country level actions. 8. Cluster roll out in DRC. Presentation by DSRGS for DRC, Ross Mountain: Delighted that the Health Cluster is meeting regularly in order to improve capacity on the ground. Clusters have to be inclusive and result oriented. The main goal in DRC is to improve the health situation. More partners are needed. The challenge is to make the cluster approach work in the nine regions of DRC and then work back from the regional plan. Currently, the third line of action plan is carried out, working in collaboration with the new government. 200 areas/villages have been identified and a plan of work is being discussed with donors. The cluster approach should result in maximum humanitarian impact at national level through involvement of key actors. Cluster response needs to be results oriented through partnership and strong leadership. Discussion by health cluster: Cluster members agreed that current roll out in DRC is problematic. Multiple causes including ineffective coordination mechanism, poor international response to funding requests, no transitional funding mechanism, weak links with recovery cluster and poor advocacy by health sector. WHO, OCHA and ECHO initiated high level action through recent meetings and impending country level visit. Aim is to strengthen health leadership and secure 4
increased health sector funding to address ongoing emergency in eastern DRC. Re-roll out health cluster in coordination with OCHA. There is no identified funding channel for the link with recovery. Many donors either focus on development or on humanitarian action. Recovery is neither considered a development issue nor a humanitarian action issue. It is important for the Health Cluster in acute emergencies to ensure the foundation for recovery on day one of the response. In complex emergencies the situation is different and recovery is carried out in the transition phase. Recovery must be dealt with in all clusters. The challenge is not to repeat action in each cluster. Emphasis is needed on functional, decentralized, outcome oriented planning. Interagency coordination is important. 9. Current crises: Indonesia-Java, Timor Leste, Horn of Africa, Cholera in Angola and occupied Palestinian territories Presentations: o Indonesia-Java, Timor Leste, Horn of Africa and Cholera in Angola (WHO, Pino Annunziata) o Occupied Palestinian territories (WHO, Khalid Shibib) Key issues raised through discussion included: How is the cluster approach best implemented in a context where there is strong government willingness and capacity to respond to a local emergency? (e.g. Java) Many country level agency staff remain unfamiliar about the roll of the cluster, how they should relate to it and what they can expect from it (e.g. added value) How can the cluster approach be implemented effectively at sub-regional level? (e.g. in Horn of Africa sub regional support is more necessary than country level support). What is the Health Cluster role in major public health emergency such as current cholera outbreak in Angola? Should it be a tool to improve collective response? Need for improved gap identification and analysis and greater emphasis on health advocacy? Health cluster role in averting health system crises (e.g. opt)? Following the WHA (Resolution WHA 59.3) WHO is organizing a meeting in Geneva on 12 June on the impact of the current funding crises on health in opt. Can/should the health cluster be rolled out in response to every crisis or should there be more specific criteria and clear mechanism to activate, roll-out and close a health cluster response? Do we need a cluster-lite approach (context specific)? To be discussed at next joint IASC WG meeting. Can/should the health cluster be activated as a single group or must it always be part of the wider cluster roll-out decision based on field driven analysis and decision making? Concern that too much emphasis on theoretical cluster concept rather than providing members with field tools. Many NGOs remain uncertain as to the added value of the cluster due to unrealized expectations about enhanced access to funding and technical toolkits. 10. Work Plan for next 6 months The agreed Work Plan is attached. 11. Dates for Virtual Triple Cluster meeting and next Face to Face Health Cluster meeting A Virtual Triple Cluster meeting (health, nutrition and WASH clusters) by video conferencing will be held around September (tbc). The next face to face meeting of the Health Cluster is planned to take place around the UNHCR meetings (last week of September/first week of October) (tbc). 12. Closing remarks by Ala Alwan 5
WHO is fully committed to the Health Cluster and will do its utmost to ensure follow up. It is important to act in close coordination with other clusters to avoid stove piping. Proactive involvement of all partners (UN and non-un) is crucial for inter-agency health coordination. WHO is organizing a health cluster meeting in Nairobi from 14-18 June to ensure consistent approaches to the health needs of the most vulnerable populations in the Horn of Africa, under a common strategic framework and along best public health practices. We cannot work in isolation. WHO is looking at gaps in emergencies and crises: chronic disease, maternal and new born health and mass casualty management. The WHA again emphasized WHO needs to expand its activities in the field of humanitarian action. WHO can only attempt to meet targets in close collaboration with others, and especially through the Health Cluster partners. WHO will discuss with its Regional Offices, to disseminate concept of joint work and the health cluster approach with all levels of the organization. 6