Sample Proposal on “Resilient Health Systems: Preparing for Public Health Emergencies in the Middle East”

Executive Summary

The Middle East region has faced a range of public health crises in recent years—from the COVID-19 pandemic to conflict-related disruptions, refugee displacement, and environmental hazards. These emergencies have exposed significant gaps in national health systems, especially in terms of preparedness, surveillance, response coordination, and continuity of essential services. This proposal seeks to strengthen the resilience of health systems across the region to better prevent, detect, and respond to public health emergencies.

Our program will focus on building the capacity of health institutions, training health professionals, enhancing surveillance and early warning systems, and fostering cross-border collaboration. Through strategic partnerships with governments, NGOs, academic institutions, and international agencies, we aim to reduce the human and economic toll of health emergencies while promoting equitable access to care in both stable and fragile settings.

Introduction

The Middle East faces an evolving landscape of public health threats—from infectious disease outbreaks and climate-related disasters to protracted conflicts and mass displacement. These complex emergencies have exposed deep vulnerabilities in the region’s health systems, many of which are under-resourced, fragmented, and ill-prepared to respond effectively. The COVID-19 pandemic underscored the urgent need for robust preparedness, revealing critical gaps in surveillance, coordination, workforce capacity, and community engagement. Without strategic interventions to build resilience, the region risks prolonged recovery periods, rising mortality, and further erosion of public trust in health systems.

This proposal aims to strengthen health system resilience across the Middle East by investing in emergency preparedness, training frontline health workers, upgrading early warning and response mechanisms, and promoting inclusive community engagement. Through multi-sector collaboration, localized capacity building, and sustainable digital innovation, the program will empower countries to detect, respond to, and recover from public health emergencies more effectively. By transforming reactive crisis management into proactive resilience, this initiative aspires to protect lives, stabilize health systems, and ensure continuity of essential services in even the most challenging environments.

Problem Statement

The Middle East continues to face complex and recurring public health threats that strain already fragile health systems. From outbreaks of communicable diseases such as cholera and COVID-19 to natural disasters like floods and earthquakes—and compounded by ongoing conflict, displacement, and economic instability—these emergencies frequently overwhelm national capacities to respond swiftly and effectively. In many areas, decades of underinvestment in public health infrastructure and the compounding effects of conflict have left systems ill-equipped to withstand shocks.

• Several critical gaps undermine the region’s ability to respond to public health emergencies:

  • Weak surveillance and early warning systems limit the ability to detect and respond to outbreaks in a timely manner. Inconsistent data collection, poor integration between local and national systems, and insufficient digital tools mean that early signs of health crises often go unnoticed until they escalate.

  • Limited emergency preparedness and coordination mechanisms contribute to delays, inefficiencies, and duplication of efforts during responses. National response plans are either underdeveloped or inadequately implemented, while coordination among government agencies, humanitarian actors, and civil society remains fragmented.

  • Fragmented healthcare service delivery in crisis zones results in uneven access to essential health services. Conflict-affected and remote areas often lack operational health facilities, consistent supply chains, and trained staff—leaving already-vulnerable populations without adequate care during emergencies.

  • Insufficient trained workforce in emergency response means that frontline health professionals are frequently underprepared to manage disease outbreaks, trauma cases, or disaster-related injuries. There is a critical need for specialized training in emergency medicine, epidemiology, and crisis logistics across all levels of the health system.

  • Lack of community engagement and trust during crises hampers the effectiveness of public health measures. Misinformation, cultural mistrust, and limited outreach infrastructure prevent communities from receiving or acting on life-saving information. This reduces the uptake of preventive behaviors and increases the spread of disease.

Goals and Objectives

• Goal
  • To build resilient and responsive health systems in the Middle East that can effectively prevent, detect, and respond to public health emergencies, thereby reducing morbidity, mortality, and the long-term social and economic consequences of such crises.
• Objectives

  • Strengthen national and regional emergency preparedness and response plans

    • Support the development, harmonization, and operationalization of comprehensive emergency response frameworks that align with international standards such as the International Health Regulations (IHR). This includes scenario planning, contingency protocols, emergency logistics systems, and surge capacity strategies at both national and regional levels.

  • Train healthcare professionals in emergency management and crisis response

    • Build the technical competencies of frontline health workers—including doctors, nurses, epidemiologists, and emergency personnel—through structured training programs. Topics will include outbreak investigation, mass casualty management, infection prevention and control (IPC), mental health in emergencies, and rapid risk assessment, ensuring readiness to act during health crises.

  • Establish robust disease surveillance and early warning mechanisms

    • Implement or upgrade integrated disease surveillance systems capable of real-time reporting, analysis, and information sharing. Introduce mobile and digital tools for data collection, strengthen laboratory networks, and establish early warning systems to detect and contain outbreaks before they escalate.

  • Improve coordination among governmental, humanitarian, and civil society actors

    • Facilitate the creation of cross-sector coordination bodies and platforms that bring together key stakeholders involved in emergency response. Develop joint action plans, conduct multi-agency simulation exercises, and establish clear roles and communication channels to avoid duplication and enhance response effectiveness.

  • Promote community-level health awareness and risk communication

    • Launch inclusive and culturally sensitive campaigns to educate communities on emergency health behaviors, hygiene practices, and when and how to seek care during outbreaks. Empower local leaders, community health workers, and volunteers to serve as trusted messengers, ensuring information reaches vulnerable groups and fosters community trust and cooperation.

Target Beneficiaries

This initiative is designed to serve a wide range of stakeholders who are directly or indirectly affected by public health emergencies. The program will prioritize support to those most vulnerable, while also strengthening the capacity of institutions and personnel responsible for delivering emergency health services.

• Public Health Agencies and Ministries of Health

  • These institutions are at the forefront of emergency preparedness and response. The project will enhance their ability to coordinate, plan, and lead multi-sectoral responses through technical assistance, training, and the development of early warning and surveillance systems. Strengthening institutional capacity will ensure that public health systems are equipped to manage emergencies efficiently and sustainably.

• Healthcare Professionals and First Responders

  • Doctors, nurses, paramedics, laboratory technicians, and emergency workers are critical to managing health crises. This program will provide them with specialized training in outbreak response, triage, infection prevention and control, and mental health support. Equipping frontline workers with the knowledge, skills, and tools they need will improve the speed and quality of health interventions during emergencies.

• Populations Living in High-Risk or Crisis-Affected Areas

  • People living in conflict zones, disaster-prone areas, informal settlements, and underserved rural regions often lack access to timely and adequate healthcare. The initiative will deliver targeted interventions to these communities, including mobile health services, risk communication, and community-based preparedness training to reduce their vulnerability and enhance resilience.

• Refugees and Internally Displaced Persons (IDPs)

  • Displaced populations face heightened health risks due to overcrowding, poor sanitation, and limited healthcare access. The project will work closely with humanitarian partners to ensure the inclusion of refugees and IDPs in health emergency plans, provide culturally appropriate care, and strengthen referral systems in camps and urban settings.

• Community-Based Organizations and Volunteers

  • Local CBOs and volunteers are essential partners in delivering grassroots health education, early warning alerts, and emergency support. This initiative will empower them through training, resource support, and inclusion in emergency planning efforts. By building local capacity and fostering ownership, the program ensures a more responsive and sustainable health emergency system at the community level.

Key Activities

• Capacity Building and Training
  • Conduct national and regional workshops on emergency response.
  • Develop e-learning modules and simulation exercises for health staff.
  • Train rapid response teams on infection control, triage, and coordination.
• Surveillance and Early Warning Systems
  • Strengthen Integrated Disease Surveillance and Response (IDSR) systems.
  • Deploy digital health tools for real-time data collection and reporting.
  • Build regional databases to facilitate information sharing.
• Infrastructure and Supply Chain Resilience
  • Support the development of emergency logistics and cold chain systems.
  • Establish mobile health units and stockpiles in vulnerable areas.
  • Rehabilitate damaged health facilities in post-conflict zones.
• Multi-Sectoral Coordination and Governance
  • Form national emergency operation centers (EOCs).
  • Facilitate joint planning between health, disaster management, and defense sectors.
  • Host regional roundtables to standardize response protocols.
• Community Engagement and Risk Communication
  • Launch culturally appropriate public awareness campaigns.
  • Train community health volunteers in early detection and referrals.
  • Develop multilingual materials on hygiene, vaccination, and emergency actions.

Partnership Strategy

We will collaborate with the following partners:

• Governmental Partners: Ministries of Health, Civil Defense Authorities

  • National Ministries of Health will play a central role in guiding program implementation, aligning activities with national health strategies, and ensuring regulatory compliance. Civil Defense Authorities will be key actors in emergency coordination, logistics, and rapid response. Their involvement will ensure integration with national disaster preparedness frameworks and enhance inter-agency cooperation during crises.

• International Agencies: WHO, UNICEF, UNHCR, IFRC

  • These agencies bring technical expertise, global best practices, and emergency response experience. WHO will provide guidance on surveillance, disease protocols, and health system strengthening. UNICEF will support efforts in risk communication, immunization, and child-focused health interventions. UNHCR will be a critical partner in addressing the health needs of refugees and displaced populations. The International Federation of Red Cross and Red Crescent Societies (IFRC) will assist with community outreach, first aid training, and humanitarian logistics.

• Local NGOs and Community-Based Organizations (CBOs)

  • Local civil society organizations will be instrumental in reaching vulnerable, marginalized, and remote communities. Their deep community ties will enhance trust-building, facilitate culturally appropriate health education, and support rapid mobilization during emergencies. These partners will also help implement grassroots-level training and feedback mechanisms.

• Academic Institutions

  • Universities and public health schools will contribute to training health professionals, conducting operational research, and supporting M&E activities. They will help institutionalize knowledge and build local research capacity, ensuring the sustainability of training programs and evidence-based policymaking.

• Private Sector

  • Private companies will be engaged to provide innovative solutions in areas such as supply chain logistics, telemedicine, data analytics, and digital health platforms. Their expertise will be essential for improving the efficiency of emergency response systems and integrating cutting-edge technologies into public health infrastructure. Strategic public-private partnerships will also help mobilize additional resources and technical know-how.

Monitoring and Evaluation

A robust Monitoring and Evaluation (M&E) framework will be integrated throughout the program to ensure that activities are implemented effectively, outcomes are measured accurately, and lessons are documented for future scale-up. This framework will combine both quantitative and qualitative tools to assess progress against objectives, measure impact, and inform adaptive management throughout the project lifecycle.

• Key Indicators:

  • Number of trained emergency responders and healthcare professionals

    • Regularly track the number, roles, and geographic distribution of individuals trained under the program. Pre- and post-training assessments will be used to measure changes in knowledge, skills, and preparedness levels among healthcare workers, first responders, and public health officials.

  • Number of functional surveillance and reporting units established

    • Monitor the establishment and operationalization of digital and field-based surveillance units, including their capacity to collect, analyze, and report health data. Indicators will include coverage, reporting accuracy, frequency of updates, and integration with national systems.

  • Time taken to detect and respond to outbreaks

    • Measure the time elapsed between the first signs of a public health threat and the official detection and initiation of response actions. This will assess system responsiveness and help identify bottlenecks in coordination, data flow, and decision-making processes.

  • Community knowledge and trust scores before and after interventions

    • Conduct baseline and follow-up community surveys to assess levels of awareness regarding emergency health practices, trust in the health system, and willingness to comply with health advisories. These surveys will help gauge the effectiveness of risk communication and community engagement efforts.

  • Functionality of Emergency Operations Centers (EOCs) and coordination bodies during simulations

    • Use emergency drills and tabletop exercises to evaluate the performance of coordination mechanisms, including the ability of EOCs to mobilize resources, communicate effectively, and lead a multi-sectoral response. Performance metrics will include response time, clarity of roles, and resource deployment efficiency.

• Evaluation Strategy:

  • Ongoing Monitoring:

    • Program teams and local partners will conduct routine data collection and field monitoring visits to ensure activities are being delivered as planned. A centralized M&E dashboard will support real-time tracking of key indicators and flag areas requiring corrective action.

  • Annual Assessments:

    • Comprehensive annual reviews will evaluate program progress against output and outcome indicators. These assessments will involve stakeholder consultations, financial reviews, and field observations to inform planning for the subsequent year.

  • Final Evaluation:

    • An independent endline evaluation will assess the overall impact, cost-effectiveness, and sustainability of the initiative. It will provide actionable recommendations and identify best practices for replication or scaling in other contexts.

Sustainability Strategy

• Institutionalize training programs within national health systems

  • Integrate emergency preparedness and response training modules into the standard curriculum of medical, nursing, and public health institutions. Collaborate with Ministries of Health to embed regular simulation exercises and refresher courses into national health workforce development plans, ensuring continuous skill-building beyond the project lifecycle.

• Advocate for increased domestic funding for emergency preparedness

  • Work with policymakers to prioritize health emergency preparedness in national budgets. Support evidence-based advocacy campaigns that highlight the long-term cost savings and life-saving potential of investing in resilient health systems. Encourage the allocation of sustainable funding streams within national health and disaster risk reduction frameworks.

• Develop public-private partnerships for long-term infrastructure support

  • Engage private sector stakeholders—including logistics companies, technology firms, and pharmaceutical suppliers—to co-invest in emergency health infrastructure. Foster partnerships that leverage private innovation, supply chain expertise, and corporate social responsibility initiatives to strengthen national emergency response capabilities.

• Engage local universities to continue capacity building

  • Partner with academic institutions to develop certificate and degree programs in public health emergency management. Encourage research and innovation around context-specific emergency preparedness solutions. Support faculty development and knowledge exchange to ensure that capacity-building efforts are embedded in local educational ecosystems.

• Transfer digital tools and data platforms to government ownership

  • Ensure that all surveillance systems, early warning tools, and data dashboards developed during the program are adapted for government use. Provide training and technical support to local IT departments and health informatics teams. Establish maintenance protocols and licensing agreements that allow for sustained use and upgrades by national authorities.

Budget Summary