1. Accommodating interim changes to the IEHK

2. IEHK 2011 IEHK has been revised on average every 5 years Process is proposed to accommodate interim updates, especially to recognize changes in treatment guidelines or unavailability of products

3. Current request Proposed changes, malaria products – Phase out artemether 20 and 80 mg injection and quinine 300mg/ml with and replace with artesunate 60 mg injection in keeping with revised treatment guidelines.

4. Propose process Interagency Coordination Group (ICG) should note problems or anticipated revisions every 6 months Agencies (UNICEF, WHO, UNFPA, MSF, ICRC, MSF) to update their focal points Interim changes should be proposed and confirmed with the relevant WHO programme and the ICG focal points

5. Proposed process, continued Once agreed, the changes would be notified in writing to all procurement agencies A six month period for transition would be permitted to avoid wastage and disruption Printed copies of an amendment would be included in all shipments

6. Longer term changes Develop additional modules e.g., NCD module for emergencies that have longer duration Revise packing e.g., weight limits are not in alignment with occupational safety standards and are also resulting in damage and loss Inventory system could be reviewed for the number of kits packed and stored versus held in revolving inventory

7. Longer term changes A data base of inventory where agencies who provide kits voluntarily upload information on which kits are available, and where in order to better coordinate emergencies.

8. Usage of kits, WHO 2013 Regions Countries IEHK basic unit IEHK suppl. module Reproduc-tive health kit IDDKTrauma kitSSKTotal AFRO Angola, Benin, CAR, Chad, DRC, Eritrea, Ethiopia, Guinea-Bissau, Ivory Coast, Kenya, Liberia, Mali, Mozambique, Niger, Nigeria, Rwanda, Senegal 51571958922641,633 AMRO N/A EMRO Afghanistan, Jordan, S.Sudan, Somalia, Sudan, Syria, Yemen 2,23475 12251282,510 EURO Turkey 606 7 73 SEARO DPRK 18249 3372 WPRO Philippines, Solomon Islands 102 13 2 115 Total kits per type 2929154102021687354405 Coverage per kit, patients 1,00010,00050700100

9. IEHK in disasters Original design- “to meet the initial primary health-care needs of a displaced population without medical facilities…” Additional language- “or a population with disrupted medical facilities in the immediate aftermath of a natural disaster or during an emergency”

10. Caveats “No equipment for resuscitation or major surgery… in situations of war, earthquake or epidemic, specialized teams with medicines and medical devices will be required” “further supplies should be ordered according to assessed need” …. i.e. don’t send more of the same after initial supply “the kit is neither designed nor recommended for re-supplying existing healthcare facilities”

11. The FMT Initiative http://www.who.int/hac/ global_health_cluster/fmt /en/index.html http://www.who.int/hac/ global_health_cluster/fmt /en/index.html FMT Secretariat e-mail nortoni@who.int nortoni@who.int

12. Summary Revision of IEHK content and design/logistics based on changes in treatment protocols and feed-back from users. Additional modules- NCDs, Pain Mx etc Revision of messaging about usage and purpose Clear messaging to national medical teams and FMTs on use of IEHK’s in disasters and complex emergencies Standard medical response kit for such teams?