WHO continues to support countries to assess public health risk across the WHO European Region by supporting national and subnational risk assessment workshops and building the capacity of national facilitators in countries to regularly review their priority risks based on an all- hazards approach.

National facilitators work jointly with WHO lead experts through a step-by-step process, by selecting relevant hazards, assessing their likelihood and impact to determine the level of risk, and creating a country risk profile. The experts then jointly identify key actions to mitigate those risks and better prepare their systems for health emergencies.

The implementation of the STAR methodology has resulted in a multitude of success stories across various countries in the Region and is contributing to enhancing preparedness and readiness for future health emergencies

In the last quarter of 2023, WHO conducted a series of STAR workshops in 4 countries in the Region: Armenia, Sweden, Tajikistan and Turkmenistan.

Armenia

Armenia is subject to a range of hazards, ranging from ecological to geophysical to biological, meaning a multisectoral approach is crucial to better understand risk and mitigation and response activities.

In Armenia, 3 subnational workshops were conducted in October 2023, covering all 10 marzes (provinces) of the country, as a follow-up to a national workshop held in December 2022. Each workshop included participants from the National Centre for Disease Control, relevant departments of the Regional Administrations, the Rescue Service, and the Food Safety Inspection Body.

“Since we have a wide range of hazards, starting from the ecological to geophysical to biological, including zoonoses, a multisectoral approach is crucial to have a better understanding of the risks and mitigation and response activities,” said Dr Lusine Paronyan, National Professional Officer, WHO Country Office in Armenia

By the end of the workshops, each province produced a risk prioritization matrix and a set of priority actions.

“It is always exciting to see the impatience of the participants to get to the risk matrix, but this is not the end of the process,” said Dr Paronyan, referring to the planning and implementation work that follows prioritization. Recommendations have already been used at the national level to adjust the public health emergency operations centre plans and to plan activities at the provincial level. Further training through a “Training of Trainers” is planned to empower the country to continue a programme of regular national and subnational risk assessments.

Sweden

Sweden is leading the way in adapting the STAR methodology for assessing climate change-related risks. STAR is helping. Their December 2023 workshop served to update the climate change risk assessment performed in November 2019. 28 experts, including academic and national authorities, gathered to select the 14 hazards most likely to affect their country as a result of climate change. The updated hazard list included heat waves and flooding – extreme weather events that the country has recently experienced.  

“An understanding of the health risks associated with climate change is essential for the overarching mission of the Public Health Agency of Sweden – to promote health, prevent illness, and protect against various forms of health threats,” said Ida Knutsson, Analyst, Public Health Agency of Sweden.

While the workshop generated useful insights that can benefit every level of government affected by climate change regulation, the process also identified gaps in knowledge, and STAR is helping Sweden to determine areas requiring further research. Sweden’s ambition is long-term, to assess risks over the next 50 years, and assessments will be updated every 5 years.

Tajikistan

Tajikistan, together with partners, organized its first STAR workshop in December 2023, assessing 21 hazards at the national level. Participants from a wide range of government sectors attended, including the Ministry of Health and Social Protection, Agency for Land Reclamation and Irrigation, and Committee for Food Security. All recognized the value of involving various sectors and utilizing an all-hazards approach.

Dr Navruz Jafarov, Head of Division of Sanitary-Epidemiological Security, Emergency Situations and Provision of Emergency Care at the Ministry of Health and Social Protection of Population of the Republic of Tajikistan, spoke of STAR as building on the work of the Joint External Evaluation conducted in 2019. “The STAR exercise became one of the starting points for a better understanding of risks based on an all-hazard approach,” he said. “We hope that the results of the STAR exercise will serve as the basis for the development of the country's preparedness and response plans.” The Ministry of Health plans to repeat the STAR exercise every 3 years.

Turkmenistan

In December 2023, 34 national and regional experts convened, prioritizing 15 risks and developing an action plan to mitigate the effects of the risks on public health. The hazards discussed included earthquakes, drought, dust storms, and the risks of outbreaks of infections, such as seasonal flu.

“This was the first workshop in Turkmenistan, and it was a very good experience for strengthening multisectoral coordination and communication in these areas of work and raising awareness and advocacy among different sectors at the national level,” said Ayjeren Myratdurdyyeva, National Professional Officer, WHO Country Office in Turkmenistan.

The results will be disseminated to relevant national experts and may be used in future policy development for risk assessment and emergency preparedness.   

To further enhance the Region’s preparedness to face health emergencies, STAR workshops will continue throughout the Region in 2024.