E4H Punjab TA: Technical Support for Convening IHR Coordination (Taskforce & TWG) Meetings

Programme Overview

Evidence for Health (E4H) is a Foreign, Commonwealth & Development Office (FCDO)-funded programme aimed at strengthening Pakistan's healthcare system, thereby decreasing the burden of illness and saving lives. E4H (2023–2027) provides technical assistance (TA) to Punjab, Federal, and KP governments, implemented by Palladium in partnership with Oxford Policy Management (OPM).

Through its flexible, embedded, and demand-driven model, E4H supports governments to achieve a resilient health system that is prepared for emergencies, responsive to evidence, and delivers equitable, quality, and efficient healthcare services. Specifically, E4H delivers TA across three outputs:

• Output 1.3: Functional governance structures and coordination platforms for health emergency preparedness and response.
• Output 2: Strengthened evidence-based decision-making for accountability and performance.
• Output 3: Improved implementation of Universal Health Coverage (UHC).

Background

• Following the Joint External Evaluation (JEE 2023) of 19 technical areas under the International Health Regulations (IHR 2005), a National Action Plan for Health Security (NAPHS) 2024-28 was developed in consultation with all provinces, with technical assistance (TA) from the Evidence for Health (E4H) Programme.  It also includes a governance and coordination mechanism for IHR (2005) to oversee the implementation of NAPHS in Punjab under the provincial operational plan.
• Approved during the second E4H Steering Committee meeting, this governance and coordination framework established and defined the roles for health, livestock, environment, PDMA, Rescue 1122, and food sectors to enhance inter-sectoral coordination and improve preparedness for health security threats, particularly those linked to climate change.
• Despite the framework’s approval, operationalisation remains incomplete, with gaps in routine coordination meetings and weak linkages between provincial and national IHR focal points.
• The Health & Population Department (H&PD) requires structured support to institutionalise the coordination mechanism, revitalise the IHR Taskforce, and advocate for the formation of Technical Working Groups (TWGs) across the Prevent, Detect, and Respond pillars, ensuring alignment with the IHR 2005 framework and federal-level NAPHS milestones.

Problem Statement

Although a governance and coordination mechanism for IHR has been established within NAPHS 2024-28, it has not been effectively operationalised. Weak linkages between provincial and federal functions, along with the absence of routine coordination forums, constrain Punjab’s ability to implement the NAPHS priority activities and therefore hinder the health security preparedness in Punjab.

Goal and Objective(s)

The overall goal of this TA is to strengthen cross-sectoral coordination and efficiency through the operationalisation of the IHR coordination mechanism in Punjab.

Specific objectives include;

• Objective 1: To activate the IHR Taskforce/Technical committee and establish functional Technical Committees/Working Groups (Prevent, Detect, Respond) as routine coordination mechanisms.
• Objective 2: To support the convening of at least two IHR Taskforce/Technical Committee meetings focused on reviewing progress and initiating implementation of priority NAPHS II activities.
• Objective 3: To document and follow up on agreed action points to ensure visible and sustained progress on IHR coordination and implementation efforts across the province.

Strategic Approach

Contributions to health systems strengthening

The operationalisation of the IHR governance mechanism in Punjab represents a strategic continuation of work initiated under the first phase of TA in 2024, which established the foundational framework. With formal approval secured through the E4H Steering Committee, the current TA shifts focus to embedding this mechanism into institutional routines, strengthening structured coordination, aligning resources, and instituting performance monitoring. This effort enhances Punjab’s ability to prevent, detect, and respond to health emergencies through an integrated, multi-sectoral approach under the One Health paradigm.

Alignment with other E4H TAs/investments

This TA builds directly on the earlier E4H-supported development of the IHR governance framework within NAPHS from 2024 to 2028. It complements ongoing health security efforts by formalising roles, enabling routine engagement across health, livestock, environment, and food safety sectors, and supporting coordinated decision-making and crisis response.

Alignment with other donors

The TA aligns with Pakistan’s commitments under the International Health Regulations (IHR 2005) and contributes to progress on the JEE recommendation during 2023. By tracking and advancing the NAPHS Punjab operational plan, this TA ensures coherence with national benchmarks, creates accountability, and directly complements other donor-supported health security investments.

Scope of Work and Methodology

The scope of TA encompasses notifications, operational rollout, and institutional embedding of a multi-sectoral IHR governance mechanism and a monitoring and evaluation (M&E) framework previously developed through E4H support in Punjab. The TA will adopt a participatory, systems-based approach, incorporating policy reviews, stakeholder consultations, and coordination support, to enhance the province’s compliance with NAPHS 2024–28. It will be delivered over seven months in three sequential phases:

Phase 1: Inception and Planning

• Conduct initial consultations with H&PD and key one-health departments (SH&MED, livestock & poultry, environment, food safety, Rescue 1122, and PDMA).
• Develop a concise Inception Report and accompanying slide deck that outlines the scope, stakeholder roles, risks, and a coordination plan.

Phase 2: Convening and Embedded Support

• Facilitate two IHR Taskforce/Technical Committee meetings to track progress against the implementation of NAPHS recommendations for Punjab and one meeting each for the three TWGs after being notified.
• Advocate and document agendas (thematic agendas addressing the prevent, detect, and respond pillars of IHR), support the preparation of presentations, minutes of meetings, and agreed-upon follow-up actions.
• Provide embedded support to the Director of Health Services, CD & EPC, for coordination and documentation.

Phase 3: Reporting and Finalisation

• Develop a final report and a conclusion slide deck that comprises the minutes of meetings and progress against agreed-upon action points.
• Submit deliverables for institutional knowledge, record, and follow-up.

Sustainability: Capacity Building, Institutionalisation, and/or Transition Planning

• It will strengthen the lead role of the human health sector in multisectoral IHR governance and coordination, within the broader context of health security.
• Knowledge products, including meeting minutes, action trackers, and final reports, will be archived within H&PD for ongoing reference and replication.
• Building on the earlier E4H-supported development of the NAPHS framework, TA will reinforce institutional ownership and continuity of progress at the provincial level.
• It will build upon the existing capacity of the CD&EPC program and enable the Provincial Disease Surveillance and Response Unit (PDSRU) to better prepare for public health concerns.

Deliverables

1. Inception Report & Readiness Note (incl. Slide Deck).
2. IHR Taskforce Meeting Report 1.
3. Three TWG Meeting Reports (Prevent, Detect, Respond).
4. IHR Taskforce Meeting Report 2.
5. Conclusion Slide Deck & Final Report.