National Public Health Institutes Commit to Advancing Public Health, Resilience and Sustainability

On February 7 and February 8, 2024, National Public Health Institutes (NPHIs) from around the world met in Kigali, Rwanda to discuss how to strengthen the resilience of health systems and communities to the growing threat of disease, persistent and increasing health inequity, climate and environmental change, and other hazards to health.   

The world is at an important decision point. Following the COVID-19 pandemic, political commitment and funding were mobilized to strengthen health security and build back better. We now have an opportunity to draw on these resources, and on the lessons learned from the pandemic, to continue to advance the public’s health and reduce inequities.

NPHIs in many countries are at the forefront of action to mitigate the impact of current and future threats to health as well as improving population health and wellbeing. The IANPHI Annual Meeting recognized the importance of collaboration and action to strengthen the capacity of all health systems to deliver the Essential Public Health Functions (EPHFs), a core set of capabilities defined and published jointly by the World Health Organization (WHO) and IANPHI. EPHFs are considered the foundation for public health action that all countries should strive to deliver.

In his opening address, Minister of Health of Rwanda Dr. Sabin Nsanzimana asked the meeting to reflect on the many effective collaborations and partnerships between NPHIs realized during the COVID-19 pandemic.

"United in purpose, NPHIs commit to advancing public health, resilience, and sustainability. This is a testament to our collective resolve in building a healthier, more resilient world," said Dr. Nsanzimana.

The IANPHI Annual Meeting was hosted by the Rwanda Biomedical Centre and had strong representation from across Africa. The African Union, through the Africa Centres for Disease Control and Prevention Strategic Plan 2023-2027, has made strengthening the continent’s NPHIs a priority. Africa’s leadership role in promoting NPHIs, and therefore championing the EPHFs, was commended. IANPHI members and partners have identified peer-to-peer support and collaboration between NPHIs and ministries of health as well as the leadership role on these agendas NPHIs can play, as central to the ambition to deliver the EPHFs and strengthen resilience and sustainability.

The role of NPHIs in the management of emergency preparedness and response and their leadership in support of the development of integrated health systems and strengthened surveillance was illustrated through the case studies and achievements presented at the meeting. There was recognition that approaches which strengthen country capacities to address all the EPHFs will help ensure public health action addresses communicable and non-communicable disease, other hazards to health, and the structural and environmental determinants of health. 

WHO Director-General Dr. Tedros Adhanom Ghebreyesus also addressed the conference. He highlighted the importance of the partnership between WHO and IANPHI, signed in October 2022. 

“To achieve universal health coverage and health security around the world, we must coordinate our efforts to support all countries in building the public health capacities needed to protect and promote health and achieve equitable access to services, said Dr. Tedros. ”The work of IANPHI and its member institutions and the impactful partnerships they forge supports our shared ambition of sustainable and resilient health systems that can deliver Health for All”. 

The IANPHI Annual Meeting specifically recognized the importance of multi-sectoral and interdisciplinary collaboration, the value of partnership, and the leadership role of NPHIs in building the alliances needed to deliver the EPHFs.

We, the International Association of National Public Health Institutes (IANPHI), gathered in the city of Kigali for the IANPHI Annual Meeting held on February 7-8, 2024, affirm that:

• NPHIs are a vital resource to build resilient and sustainable health systems. To achieve this, NPHIs need to have the confidence and trust of politicians, the public and civil society organizations. They need scientific independence to generate, interpret and present the evidence base essential for effective decision-making and action.
• Advances in technology present important opportunities to improve health and build resilience and sustainability. However, the costs and benefits of technologies need to be assessed and any risks, including the potential to increase global inequity through their use, need to be anticipated and mitigated. The role of public health institutes in assessing the potential benefits and risks of vaccines, pharmaceuticals, behavioral interventions and technologies such as artificial intelligence, is critical to the effective, efficient, economic and equitable use of these innovations.
• All countries need to be able to deliver the full range of EPHFs. This requires a clear understanding of the institutional and workforce capacity and of the skills and competencies needed for their delivery. IANPHI is committed to working with WHO to support countries deliver the Roadmap to Build the Public Health and Emergency Workforce which was developed jointly by WHO, IANPHI and other partners. IANPHI commits to supporting action to map and measure workforce and institutional capabilities and to develop partnerships with the public health schools and academic institutions responsible for the development of public health skills and competencies across the health, public health, and emergency workforces.
• Recognizing the importance of building resilient and sustainable health systems, IANPHI commits to work in collaboration with ministries of health and partners in countries and with regional and global organizations, in  building capacity and strengthening  the primary healthcare systems needed to advance progress towards Universal Health Coverage (UHC) and health security  for all.
• Recognizing the evolution of the global architecture to support future pandemic response, IANPHI members are committed to strengthening surveillance systems to improve prevention, detection, and response to all health threats. IANPHI is committed to strengthening the partnerships needed to support collaborative surveillance, emergency management, and resilience and recovery from crises.
• Acknowledging that the impacts of public health events are not the same for everyone, IANPHI is committed to supporting the promotion of health, recognizing that the active engagement of communities in all efforts to address the determinants of health, will be of critical importance to long term health resilience and sustainability. This ambitious agenda requires greater collaboration between sectors at country level and between communities, governments and private sector agencies at national, regional and global levels.
• Recognizing the opportunities created by new funding mechanisms and networks, such as the Pandemic Fund and the International Pathogen Surveillance Network, as well as efforts to develop greater emergency response capacity, IANPHI is committed to supporting NPHIs actively engaged in the evolving global health architecture to help shape and realize action to ‘build back better’ resilient health systems. 

IANPHI commitment to action:

Many IANPHI member countries have suffered from the impact of climate and environmental change over the past year, with extreme weather events and resulting migratory pressures further stretching limited public health capacity. Many IANPHI members play a key role in response to the huge impact of conflict on individuals, communities and populations, including their access to health care. Active collaboration between IANPHI members to bolster capacity and provide mutual support during times of crisis remains a central principle of IANPHI. 

The IANPHI Annual Meeting reaffirmed the Stockholm Statement, endorsing the view that NPHIs bring critical support at country level in the response to crises affecting health. With humanity facing multiple simultaneous emergencies, the need for collaboration between countries, for work in partnerships and for peer-to-peer support between NPHIs has never been more urgent.

Adopted on February 8, 2024 in Kigali by the IANPHI Executive Board on behalf of the IANPHI Members.

• Prof. Duncan Selbie, IANPHI President, former Chief Executive of Public Health England, & Chief Adviser, Public Health Authority of the Kingdom of Saudi Arabia
• Prof. Meerjady Sabrina Flora, IANPHI Vice-President, Director, Institute of Epidemiology Disease Control & Research, Bangladesh
• Prof. André van der Zande, IANPHI Immediate Past President, former Director, National Institute for Public Health & the Environment, The Netherlands
• Dr.Juan Ángel Rivera Dommarco, former Director, National Institute of Public Health, Mexico
• Dr. Theresa Tam, Chief Public Health Officer, Public Health Agency of Canada (PHAC)
• Prof. Geneviève Chêne, former Chief Executive, Santé publique France (the French Public Health Agency)
• Prof. Hongbing Shen, Director General, China Center for Disease Control and Prevention, China
• Dr. Yanaris Lopez Almaguer, General Director, “Pedro Kourí” Institute of Tropical Medicine (IPK), Cuba
• Dr. Abdullah Al Gwizani, Chief Executive, Public Health Authority of the Kingdom of Saudi Arabia
• Prof. Lars Schaade, President, Robert Koch Institute (RKI), Germany
• Dr. Eduardo Samo Gudo, Director General of the National Institute of Health, Mozambique
• Dr. Mesay Hailu Dangisso, Director General, Ethiopian Public Health Institute, Ethiopia
• Dr. Tracey Cooper, Chief Executive, Public Health Wales, United Kingdom