Evaluating Sri Lanka's malaria re-establishment prevention using IHR and JEE frameworks.

Area of Science:

• Public Health
• Epidemiology
• International Health Regulations

Background:

• The International Health Regulations (IHR) of 2005 provide a legal framework for managing public health emergencies.
• Sri Lanka established an IHR Steering Committee in 2016 to enhance collaboration and health security.
• A Joint External Evaluation (JEE) in 2018 assessed Sri Lanka's IHR core capacities.

Purpose of the Study:

• To investigate Sri Lanka's preparedness for preventing malaria re-establishment.
• To assess this preparedness against International Health Regulations (IHR) criteria.
• To utilize indicators from the 2018 Joint External Evaluation (JEE) for the assessment.

Main Methods:

• Reviewed Joint External Evaluation (JEE) criteria relevant to malaria prevention.
• Authors conducted the assessment using the Delphi technique.
• Evidence was gathered and scored by consensus, following the JEE scoring system.

Main Results:

• The 'prevent' domain scored 5, except for IHR coordination due to a lack of functional mechanisms.
• The 'detect' domain showed sustainable capacity, but workforce development needs improvement.
• The 'response' domain's emergency preparedness subdomain scored 2, indicating limited capacity, particularly in emergency operation centers.

Conclusions:

• The IHR framework is a valuable tool for assessing a country's capacity to maintain malaria-free status.
• Sri Lanka possesses sustainable capacity for malaria prevention 12 years post-elimination.
• Recommends developing malaria-specific IHR tools and conducting evaluations every 5 years for high-risk countries.