Report of the

National Bridging Workshop on the International
Health Regulations (IHR) and the OIE Performance ofVeterinary Services (PVS) Pathway
9-11 May 2017
Islamabad, Pakistan

Organized by WHO and OIE
in collaboration with the Ministry of National Food Security & Research and theMinistry of National Health Services, Regulations & Coordination

Acknowledgments
The organizers of the meeting would like to express their gratitude to the authorities of Pakistan for
their support in the preparation and conduction of the eventand more particularly to- Dr Malik Muhammad Safi, Director Programs, Ministry of National Health Services, Regulation &Coordination- Dr Qurban Ali, Animal Husbandry Commissioner, Chief Veterinary Officer, Ministry of National Food
Security and Research- The WHO country office, with a special thanks to Dr Mohammad Assai Ardakani, WHOrepresentative a.i. in Pakistan and Dr Farah Sabih whose commitment and support at all stages of the
preparation has been an invaluable support.
This workshop was funded by the European Commission's Directorate-General for International
Cooperation and Development, as one of the component of the project “IFS/2014/350-752 One Health
Project in Pakistan”

TABLE OF CONTENTSTABLE OF CONTENTS ............................................................................................................... 3
ABBREVIATIONS & ACRONYMS ................................................................................................ 4
INTRODUCTION ....................................................................................................................... 5
Background ................................................................................................... 5
Objectives of the workshop and expected outcomes ....................................... 6
Preparatory Work .......................................................................................... 7

REPORT ON THE SESSIONS ....................................................................................................... 8
Opening session ............................................................................................ 8
Session 1: The One Health Concept and National Perspectives ......................... 8
Session 2: Interactions on The Road to One Health ......................................... 8
Session 3: Navigating the Road to One Health – Collaboration Gaps ................. 8
Session 4: Bridges along the Road to One Health .......................................... 10
Session 5: Crossroads – PVS Pathway and IHR MEF reports ............................ 11
Session 6: Road Planning ............................................................................. 12
Session 7: Roadmap – Reaching consensus ................................................... 14
Closing Session ........................................................................................... 14

WORKSHOP OUTPUTS ........................................................................................................... 15
Output 1: Objectives and actions identified per technical areas .................... 15
Output 2: Prioritization results .................................................................... 18
Output 3: Link with the IHR National Action Plan for Pakistan ....................... 19
Output 4: Immediate follow-ups by province / region ................................... 20
Output 5: TORs of the One Health Hub ......................................................... 21
Output 6: Coordination mechanisms ............................................................ 22
Output 7: Key workshop recommendations & way forward ............................ 23

WORKSHOP EVALUATION ...................................................................................................... 24
APPENDIX.............................................................................................................................. 25
Annex 1: Workshop agenda .......................................................................... 25
Annex 2: List of participants ........................................................................ 27

3

ABBREVIATIONS & ACRONYMS
AI
AJK
CCHF
FATA
FAO
FELTP
FP
HQ
IHR
IDSR
IT
JEE
KPK
LIMS
MEF
MNFSR
MNHSRC
NAP
NIH
OIE
PH
PMDC
PVMC
PVS
SOP
TOR
WHO

Avian Influenza
Azad Jammu and Kashmir
Crimean-Congo Hemorrhagic FeverFederally Administered Tribal Areas
Food and Agriculture Organization of the United Nations
Field Epidemiology and Laboratory Training Program
Focal Point
Headquarters
International Health Regulations (2005)
Integrated Disease Surveillance & Response
Information technology
Joint External Evaluation
Khyber Pakhtunkhwa
Laboratory Information Management System
Monitoring and Evaluation Framework
Ministry of National Food Security and Research
Ministry of National Health Services Regulations and Coordination
National Action Plan
National Institute of HealthWorld Organisation for Animal HealthPublic HealthPakistan Medical and Dental Council
Pakistan Veterinary Medical Council
Performance of Veterinary Services
Standard Operating Procedures
Terms of Reference
World Health Organization

4

INTRODUCTIONBACKGROUND
The World Health Organization (WHO) and the World Organisation for Animal Health (OIE) are the two maininternational organizations responsible for proposing references and guidance for the public health and animal
health sectors respectively. WHO and OIE have been active promoters and implementers of an intersectoralcollaborative approach among institutions and systems to prevent, detect, and control diseases among animals
and humans. They have developed various frameworks, tools and guidance material to strengthen capacities at
the national, regional and global levels.
 WHO Member States adopted a legally binding instrument, the International Health Regulations (IHR, 2005),
for the prevention and control of events that may constitute a public health emergency of international concern.
Through these regulations, States Parties are required to develop, strengthen and maintain minimum nationalcore public health capacities to detect, assess, notify and respond to public health threats and as such, should
implement plans of action to develop and ensure that the core capacities required by the IHR are present andfunctioning throughout their territories. Various assessment and monitoring tools have been developed by WHOsuch as the IHR Monitoring and Evaluation Framework (MEF), which includes inter alias the Annual Reporting
Questionnaire for Monitoring Progress and the Joint External Evaluation (JEE) Tool.
 The OIE is the intergovernmental organization responsible for developing standards, guidelines andrecommendations for animal health and zoonoses; these are mainly laid down in the OIE Terrestrial and Aquatic
Animal Codes and Manuals. In order to achieve the sustainable improvement of national Veterinary Services’compliance with those standards, in particular on the quality of Veterinary Services, the OIE has developed the
Performance of Veterinary Services (PVS) Pathway, which is composed of different tools to assist countries toobjectively assess and address the main weaknesses of their Veterinary Services.

These support tools shift away from externally driven, short-term, emergency response type ‘vertical’ approaches
addressing only specific diseases, and contribute to a more sustainable, long term ‘horizontal’ strengthening of5

public and animal health systems. WHO IHR MEF and the OIE PVS Pathway approaches enable countries todetermine strengths and weaknesses in their respective functions and activities, and promote prioritization andpathways for improvement. Furthermore, they propose to engage the countries in a routine monitoring andfollow up mechanism on the overall level of performance and help to determine the needs for compliance withinternationally adopted references or standards.
The use of WHO IHR monitoring tools and OIE PVS Pathway would result in a detailed assessment of the existing
forces and gaps, with better alignment of capacity building approach and strategies at country level between thehuman and animal health sectors. The two organizations propose a format of workshops (the IHR PVS National
bridging Workshops) enabling countries to further explore possible overlapping areas addressed in the OIE andIHR capacity frameworks and develop, where relevant, appropriate bridges to facilitate coordination. A
structured approach using user-friendly material enables the identification of synergies, review of gaps and thedefinition of operational strategies to be used by policy makers for concerted corrective measures and strategic
investments in national action plans for improved health security.
In Pakistan,- a PVS Evaluation was conducted in November-December 2014 and- a JEE mission was organized in April-May 2016.

OBJECTIVES OF THE WORKSHOP AND EXPECTED OUTCOMES
The main objectives of the National IHR-PVS bridging workshop are to provide an opportunity to human andanimal health services to share their views on the current level of coordination between the two sectors, jointly
review the gaps identified through respectively the PVS Pathway and the IHR MEF (including the JEE), and buildon these results to jointly develop strategic actions to strengthen their preparedness for and control of zoonotic
diseases.
The workshop aims were:

to increase awareness and understanding of WHO’s IHR MEF and of OIE’s PVS Pathway;to discuss the outcomes of IHR and PVS Pathway country assessments and identify ways to use theoutputs;

to facilitate the intersectoral coordination through improved understanding of respective roles andmandates;

to facilitate the identification of possible synergies through facilitated discussion on technical expertise,data, best practices, and resources;

to provide comprehensive and realistic information from international organizations in order to identify
tools to facilitate the institutionalization of coordination mechanisms and intersectoral cooperation
including in terms of funding, aligning national priorities and strategies.

The agenda of the Workshop is available at Annex 1. It was attended by over 70 national participants (Annex 2),
with approximately one half from the Ministry of National Health Services Regulations and Coordination and theother half from the Ministry of National Food Security & Research with representatives from the Federal and each
Provincial / Regional level attending the three-day discussions. Representatives of the environmental sector, legal
sector, media and health development partners were also present.

6

PREPARATORY WORKThe agenda of the workshop was developed in close collaboration between the WHO and the OIE based on theexperience acquired during similar workshops held in Azerbaijan, Thailand and Costa Rica, with inputs from
representatives of the MNHSRC and MNFSR. The agenda and technical inputs for the different sessions were
finalized during on-site pre-workshop meetings.

7

REPORT ON THE SESSIONS
The workshop uses an interactive methodology and a structured approach with user-friendly material, casestudies, videos and facilitation tools. Sessions were structured in a step-by-step process as follows:

OPENING SESSION
The opening ceremony was attended by high level national representatives, namely Dr Assad Hafeez - Director
General and Dr Malik M Safi - Director Programs, MNHSRC; Dr Khurshid Ahmad – representing the Chief
Veterinary Officer/ Animal Husbandry Commissioner, MNFSR and Dr Yusuf Zafar - Chairman Pakistan Agricultural
Research Council. Also participating in the opening ceremony were Dr Mohammad Assai, WHO Representative inPakistan, Dr Muhammad Afzal, representing FAO, Dr John Woodford – PVS experts, representing the OIE and Dr
Stephane de La Rocque, head of the One Health Team in the department “Country Health Emergency
Preparedness and IHR”, WHO HQ.

SESSION 1: THE ONE HEALTH CONCEPT AND NATIONAL PERSPECTIVES
A documentary video introduced the One Health Concept, its history, rationale and purpose and how it became
an international paradigm. The video also introduced the workshop in the global and national context byproviding high level background information on the collaboration between WHO, OIE and FAO.
Both MNHSRC and MNFSR then provided comprehensive presentations on their respective structure andexperiences in responding to One Health related challenges. The workshop approach and methodology wereexplained and participants had the opportunity to introduce themselves.

SESSION 2: INTERACTIONS ON THE ROAD TO ONE HEALTH
Through a documentary video, the second session provided participants with concrete worldwide examples ofintersectoral collaboration in addressing health issues at the human-animal interface. The session concluded witha plenary discussion on experience sharing regarding past intersectoral collaborations in preventing or managing
zoonotic disease outbreaks.

SESSION 3: NAVIGATING THE ROAD TO ONE HEALTH – COLLABORATION GAPS
Participants were divided into 8 working groups of mixed participants from both sectors (MNHSRC and MNFSR)
and from different levels (Federal, Provincial, Regional). Groups were provided with one of four case study
scenarios based on diseases relevant to the Pakistan context; Avian influenza, Brucellosis, Crimea Congo
Hemorrhagic Fever (CCHF) and rabies (Table 1), developed in collaboration with MNHSRC and MNFSR
representatives.

8

Table 1: Scenarios used for the different case studies
Rabies – A stray dog which was known to have bitten two cows and was behaving aggressively towards members of
the public and was reported to have bitten some children in the same neighborhood was shot dead by Police in theoutskirts of Rawalpindi two days ago. The carcass of the dog was destroyed before the Veterinary authorities were able
to take the head of the dog for confirmation of diagnosis.

CCHF – One week prior to the Eid-ul Azha celebrations six butchery workers from the District of Zhob (Balochistan) who
had been involved in the routine slaughter of sheep died having developed acute haemorrhagic symptoms. Anotherperson from the same butchery was admitted to hospital in Quetta and was diagnosed as having contracted CCHF.

Brucellosis – During the last month three cows all belonging to a small-holder dairy farmer in Kasur District (Punjab)
aborted. At the time of the first two abortions the farmer did not bother to report the problem to his local veterinary
officer as his farm was too far away from the District Veterinary Office. However, the third abortion took place a day
before market day and he happened to be in town, where he met the District vet and he mentioned that 3 of his cows
had recently aborted their calves. The veterinarian quickly went to the farm and carried out a Milk Ring Test on thethree animals which had aborted and found them all to be positive for Brucellosis.

Avian Influenza – Two persons were admitted at the Faisalabad Allied Hospital with pneumonia. Laboratory testing by
RT-PCR resulted positive for H7N9 subtype of avian influenza. One of the patients is a semi-commercial broiler producer
who sells his birds three times a week at the local live bird market. The other patient reported having visited the same
market 7 days prior to disease onset and having bought four quails.

Using experience from previous outbreaks of zoonotic diseases, the groups discussed on how they would haverealistically managed these events, and evaluated the level of collaboration between the veterinary and the
public health services for 16 key technical areas: coordination, investigation, surveillance, communication, etc.
(Table 2). These activities/areas of collaboration were represented by color-coded technical area cards: green for“good collaboration”, yellow for “some collaboration”, and red for “collaboration needing improvement” (Figure
1).

Figure 1: Results obtained from one of the groups working on the Avian Influenza scenario. The level of the 16 key technicalareas for collaboration has been assessed with 3 green, 10 yellow and 3 red cards.

During an ensuing plenary session, each group provided feedback on their work. Table 2 summarizes the resultsfrom the 8 working groups.

9Table 2: Summary of results obtained from the Session 3 working group exercise:Technical area (cards)
Coordination at high Level
Coordination at local Level
Coordination at technical Level
Legislation / Regulation
Finance
Emergency funding
Communication w/ media
Communication w/ stakeholders
Field investigation
Response
Risk assessment
Joint surveillanceLab
Education and training
Human resources
Logistics

Rabies (1)Rabies (2)Brucellosis (1) Brucellosis (2)CCHF (1)

CCHF (2)Influenza (1) Influenza (2)For each disease, the performance of the collaboration between the human health and the animal health sectors is color-coded: green for “goodcollaboration”, yellow for “some collaboration”, and red for “collaboration needing improvement”.

SESSION 4: BRIDGES ALONG THE ROAD TO ONE HEALTH
Documentary videos introduced the international legal frameworks followed by human health (IHR 2005) andanimal health (OIE standards) as well as the tools available to assess the country’s capacities: the annual reportingand JEE tools for public health services and OIE PVS Pathway for veterinary services. The differences andconnections between these tools were explained. A large matrix (IHR-PVS matrix), cross-connecting the indicatorsof the IHR MEF (in rows) and the indicators of the PVS Evaluation (in columns) was set-up and introduced to theparticipants (Figure 2).
Through an interactive approach, working groups were invited to plot their technical area cards onto the matrix
by matching them to their corresponding indicators. A plenary analysis of the outcome showed clear gap clusters
and illustrated that most gaps were not disease-specific but systemic.

Figure 2: Mapping of the technical area cards on the IHR-PVS matrix and plenary discussion

The main gaps (clusters) identified were associated with the following capacities:
 Coordination
 Field investigation and response Surveillance and laboratory
 Communication
 Human resources and training

10

SESSION 5: CROSSROADS – PVS PATHWAY AND IHR MEF REPORTS
New working groups with representation from all previous groups were organized for each of the five priority
technical areas (Figure 3).

Figure 3: Generic graph describing the organization of working groups for Session 3 (left) and Session 5-6 (right).

The matrix was used to link the identified gaps to their relevant indicators in the IHR MEF and in the PVS Pathway.
Each working group then opened the assessment reports (annual reporting, JEE, PVS Evaluation) and extracted
the main findings and recommendations relevant to their technical area (Figure 4). To facilitate the process, theparticipants were suggested to use the WHO-OIE Handbook for the assessment of capacities at the human-animal
interface1 in which the linkage between the indicators of the IHR MEF and the PVS Pathway are highlighted.

Figure 4: Results obtained for the technical group focusing on Surveillance and Laboratory. The reporting panel is split into
two columns (public health and animal health), orange and green post-its summarize respectively the gaps and therecommendations described in the assessment reports.

1

http://www.who.int/ihr/publications/9789241511889/en/

11

SESSION 6: ROAD PLANNING
Using the same working groups as for the previous session, participants were asked to identify, for each technicalarea, three joint objectives to improve their collaboration. For each objective, they filled Action Cards, detailingthe activities, their dates of expected implementation, the focal points responsible, the required support as wellas measurable indicators (Figure 5).

Figure 5: Identification of joint objectives and activities to improve collaboration between the sectors for surveillance.

The feasibility and cost of each action were evaluated using blue and red stickers respectively and a semiquantitative scale (1 to 3). The session ended with a World Café exercise: each group nominated a rapporteur
whose duty was to summarize their outputs to the other groups. Each group rotated between the different
boards to contribute and provide feedback on all technical areas. At the end of the cycle, each group returned totheir original board and the rapporteur summarized the feedback and changes or additions suggested by theother participants (Figure 6).

Figure 6: World café exercise: the group on Communication is providing feedback to the rapporteur of the group working on
Investigation/Response.

The following paragraphs summarize the results of the discussions of all working groups, which are fully detailedin Output 1.

Technical area: Coordination
The development of effective intersectoral coordination mechanisms was recognized as a critical need and a key
objective. This could be reached in part by the identification of focal points at all levels, with defined terms ofreference (TOR), the development of standard operating procedures (SOPs) for coordination between the sectors
and the implementation of effective information sharing mechanisms. Regular intersectoral coordination
meetings should be held at the different levels and joint simulation exercises conducted on a yearly basis.

12

Technical area: Human resources and training
Three main actions were identified to fill the gaps in terms of human resource and training:- the establishment of a National Institute for Infectious and Zoonotic Diseases (after a feasibility study);- the training and capacity building of animal and human health professionals, including para-medics and paravets, through frequent on service and refresher trainings; and- a need-based revision of the curricula at national level by the Pakistan Medical and Dental Council (PMDC)
and the Pakistan Veterinary Medical Council (PVMC).

Technical area: Investigation and response
A key priority identified was the establishment of real-time intersectoral disease surveillance and response
mechanisms, using One Health coordination units located at all levels with dedicated and trained staff from publichealth, animal health and environmental Ministries.
The development of multi-sectoral contingency plans for zoonotic diseases, clarifying the lines of command, theroles and the responsibilities in all sectors was also identified as a critical need.
The development of a joint IT system for the identification of outbreaks in both human or animal populations andthe need to ensure availability and allocation of resources for investigation and response (following a needs
assessment) were also discussed.

Technical area: Surveillance and laboratory
The main objectives identified to strengthen the intersectoral coordination for surveillance and laboratory related
activities included the establishment of a One Health Hub at Federal, Provincial and District level; theestablishment and strengthening of a joint laboratory network with a harmonized LIMS (Laboratory information
management system); and the implementation of a cross-sectoral IDSR (Integrated Disease Surveillance &Reporting) mechanism, following a preliminary pilot study at District level.

Technical area: Communication
For communication actions, the highest priority was set for the development of a functional mechanism for joint
communication, with dedicated units established at all levels, and identification of clear mechanisms for
information sharing within and across sectors. The need for capacity building of communication staff throughregular trainings and simulation exercises to enable mass communication in a harmonized and effective way was
also recognized.

13

SESSION 7: ROADMAP – REACHING CONSENSUS
Prioritization
Participants were asked to connect via computers or smartphones to a web application (Figure 7) to prioritize thepreviously defined objectives by assessing their level of priority from ‘very low’ to ‘very high’. Fifty nine (59)participants voted (29 from ‘animal health’, 26 from ‘public health’, 1 from ‘environment’, 1 from ‘legal’, 1 from‘communication’ and 1 from ‘other’) and the final results are detailed in Output 2.

Figure 7: Voting web-application for prioritization of objectives (left) and extract of voting results (right).

Linkage with the IHR National Action Plan for Pakistan
A presentation followed by a plenary discussion showed how the prioritized actions could be linked to the IHRNational Action Plan (IHR-NAP) and how outcomes of the workshop and particularly the identified actions could
directly feed into it and contribute to reaching its objectives (Output 3).

After meeting actions
A final province wise group session was organized to discuss the next steps and the implementation of identified
One Health action. Groups were asked the following questions:- As a follow up of this meeting what will be the immediate action to improve the coordination for One Health?
-What should be the main points of a post workshop press release?
Results are documented in Output 4.

CLOSING SESSION
The closing session started by a presentation of the terms of reference for a One Health Hub (Output 5) as well as
coordination mechanisms for surveillance and information sharing, coordinated response and overall risk
mitigation (Output 6). Key workshop recommendations were also presented (Output 7).
The workshop ended with statements from MNHSRC and MNFSR indicating that both sectors took ownership of
the outcomes of the workshop. They also ensured joint engagement in addressing the gaps identified forcollaboration at the human-animal interface. Both the WHO and the OIE (represented by PVS expert John
Woodford) reiterated their full commitment to support the country in improving this collaboration.
All the material used during the workshop, including movies, presentations, documents of references, resultsfrom the working groups and pictures were copied on a memory stick distributed to all participants. In addition, ashort movie of the workshop is accessible at the following link:
https://drive.google.com/file/d/0B_FQSk1UzlipbUNtWkFCajQybFk/view

14

WORKSHOP OUTPUTSOUTPUT 1: OBJECTIVES AND ACTIONS IDENTIFIED PER TECHNICAL AREAS
ActionDate ofachievement

Feasibility(1-3 scale)Cost(1-3 scale)

Responsibility

Required support

Indicators

Coordination
Objective 1: Develop effective intersectoral coordination mechanisms
1.1. Identification and notification of FPs
and coordination taskforce with defined
TORs at all levels in all sectors

December 2017

1.2. Develop SOPs for coordination
between the different sectors

June 2018

1.3. Conduct regular intersectoral
coordination meetings

December 2017

1.4. Conduct advocacy and awarenessraising activities for the strengthening ofmultisectoral coordination

Continuous

1.5. Develop effective intersectoral
information sharing mechanisms

Continuous

1.6. Conduct regular multisectoral
simulation exercises at all levels

Yearly1.7. Promulgate legislation at provincial
and federal level for coordination

December 2018

1.8. Ensure sustainable allocation andavailability of financial resources toimplement the action plan

Continuous

1.9. Monitoring and evaluation of
coordination

Continuous

MoH and all allied departments
and ministries

Political, technical, retainingof notified and skilled person-FPs notified-TORs defined-Taskforce notified+

Lead by MoH, approved bytaskforce

Technical, Financial-SOPs approved by taskforce andimplemented in relevant sectors++++

MoH and all allied departments
and ministries

Financial-Number of quarterly meetings-Number of emergency meetings

IHR/One Health taskforce

Financial++++-Meeting minutes-Session reports-Advocacy material developed

++

+++

M&E Cell

IT linkages

Joint reporting

++

+++

MoH and all allied departments
and ministries

Financial, Logistics, Mobility-Simulation exercise reports++

FPs of relevant departments andtaskforce

Technical from experts andlaw department-Legislation passed by assembly-Regulations notified and implemented

All ministries and departments++++

Political commitment,
technical-Allocation of required funds-Availability of required funds-Timely release of funds

+++

+++

M&E Cell

IT linkages

Joint reporting

MNFSR

Financial, Technical, Political
will-Consultant hired-PC-1 approved-PC-1 executed

CEO of National Institute of
Infectious and Zoonotic Diseases

Financial, HR, Experts ofWHO, OIE and GOP-Human resources trained

+++

+

++

Human resources and training
Objective 2: Establishment of National Institute for Infectious and Zoonotic Diseases
2.1. Conduct a feasibility study

December 2018

2.2. Develop PC-1

++

+++

2.3. Approval and execution
Objective 3: Capacity building of Animal and Human health professionals
3.1. Training of trainers
3.2. On service / refresher trainings

June 2018++++

3.3. Trainings of para-meds / para-vets

15

Objective 4: Need based revision and implementation of curricula at National level
4.1. Joint meeting of PMDC and PVMC forreview of need based curricula

Continuous

HEC++

4.2. Implementation under the umbrella of
HEC+

Subject specialists /academicians-Training needs assessed-Need-based curricula developed

Political commitment-TORs developed-Identification of labs, offices and space

Investigation and Response
Objective 5: Establish real time integrated disease surveillance & response mechanisms based on One Health approach
5.1. Establish a one health coordination
unit at all levels (federal, provincial,
district)

December 20175.2. Placement of dedicated staff frompublic health, veterinary andenvironmental Ministries at all levels (rapid
response units)

December 2017++5.3. Capacity building at all levels

++

++

+++

+

+++

-MNFSR and MNHSRC-Provincial Health and Livestock
departments-Notified people from all levels-Contact list

Objective 6: Development of multi-sectoral contingency plans for zoonotic diseases
6.1. Clarify line of command and control inboth public health and veterinary healthsectors

December 20176.2. Identify alert thresholds for escalation

December 20176.3. Development of IT system ofidentification of outbreaks for both sectors

June 2018

6.4. Clarify roles and responsibilities for
emergencies

December 2017

+++

+

++

++

++

+

++

+

Physical spaces and staff-Line of command clarified in case of
emergencies-Identified staff at all levels

Staff time

-Alert thresholds defined-Provincial disease surveillance &response unit

IT support, Financial-System developed-Number of alerts generated-Reports produced

Human resources

Objective 7: Ensure availability and allocation of resources for investigation and response
7.1. Development of joint training basedon competenceJune 2018

7.2. Need assessment and mapping ofexisting resources

December 2017

++

++

++

+

++

+++

+++

++

+++

+

One Health Coordinator

Training coordination,
Finances-Training package developed-Training delivered

Technical, Academia support-Need assessment done at all levels

Ministries / Departments

Technical, trainings, IT
support, Financial-Functional LIMS
-Number of trainings and participants-OH Dashboard functional-Recruited staff

Relevant Ministries/Departments

Technical, Financial,
Recruitment, Trainings-Number of trainings-Number of participants-Recruited staff

Ministries / Departments

Technical-List of gaps identified-SWOT conducted

Surveillance and Laboratory
Objective 8: Establish and strengthen laboratory network
8.1. Develop harmonized LIMS and LINK
with One Health Dashboard at Provincial
and Federal Levels

June 2019

8.2. Capacity building (Lab and field)

Continuous

8.3. Need assessment in both sectors

December 201716

Objective 9: Develop and implement a cross-sector IDSR (Infectious Disease Surveillance & Reporting) mechanism
9.1. Establishment of One Health Hub atFederal/Provincial/District Level Link
EPINET-LABNET

2020

9.2. Pilot testing of IDSR at District Level

Ministries / Departments

Technical, Financial, IT-Functional OH Hub+++Ministries / Departments

Technical, Financial-Pilot test conducted+++

Ministries / Departments

Technical, Financial-Joint list of notifiable diseases notified

Ministries / Departments

Technical, Financial

+++

++

-Number of awareness sessions
conducted-Number of trainings conducted-Trained participants

Ministries / Departments

Technical, Financial, Political
Commitment-Number of meetings/awareness sessions

Ministries / Departments

Technical, Financial-Reviewed Act-Approved Act

National/Provincial concerned
Departments

Financial, Infrastructure-TORs developed-Official notification of focal points-Physical presence of com. units in
respective departments

Focal points for communication

Financial, Technical-Communication plan available

National/Provincial taskforce +concerned department

Financial, Politicalcommitment, IT support-Number of meetings/awareness sessions-Reports

Focal points DSRU / DIOs

Financial, Technical, IT
support-Data analysis report-Periodic disease warning alerts

National, Provincial focal points+ CEP unit

Financial, Technical-CEP established-Training reports and attendance-M&E reports

Communication FPs, social
mobilizers

Financial, Technical-3rd party evaluation reports-Media advertisements+++

December 2018+

9.3. Develop joint list of notifiable diseases

December 2017

9.4. Raise awareness of stakeholders andbuild capacity of field staff

Continuous

Objective 10: Develop and implement legal framework for disease surveillance, prevention and control
10.1. Advocacy of policy makers and otherstakeholders

December 201710.2. Review draft 2010 PH Act and otherlaws/act, amend as needed and adopt

2021

+++

+

+

++

Communication
Objective 11: Develop a functional mechanism for joint communication
11.1. Establish a communication unit at alllevelsJune 201711.2. Develop a mechanism for information
sharing/communication

June 201711.3. Advocate for PVS/IHR
communication across all sectors of One
Health2017-2021

Objective 12: Capacity building of communication staff
12.1. Develop a standardized mechanism
2017-2019
for early warning system and disease alerts
12.2. Conduct simulation exercises forreporting2017-2020

+

+++

+++

++

+++

++

++

++

+++

++

+++

+++

Objective 13: Implement effective mass communication
13.1. Raise public awareness throughelectronic, print and social media

2017-2020

Feasibility: Low +, Moderate ++, Highly feasible +++Cost: Low +, Moderate ++, Very costly +++17

OUTPUT 2: PRIORITIZATION RESULTS
Priority
ratingObjective
Objective 1: Develop effective intersectoral coordination mechanisms

3.5

Objective 5: Establish real time integrated disease surveillance & response mechanisms based on One Health approach
Objective 8: Establish and strengthen laboratory network
Objective 9: Develop and implement a cross-sector IDSR (Infectious Disease Surveillance & Reporting) mechanism

3.4
3.3

Objective 3: Capacity building of Animal and Human health professionals
Objective 10: Develop and implement legal framework for disease surveillance, prevention and control

3.2

Objective 7: Ensure availability and allocation of resources for investigation and response
Objective 6: Development of multi-sectoral contingency plans for zoonotic diseases

3.1

Objective 11: Develop a functional mechanism for joint communication

3.0

Objective 4: Need based revision and implementation of curricula at National level

2.9

Objective 13: Implement effective mass communication

2.8

Objective 2: Establishment of National Institute for Infectious and Zoonotic Diseases
Objective 12: Capacity building of communication staff

2.7

The priority rating is the average rating obtained from the 59 voters, using the following semi-quantitative scale:
Priority Level
Very Low
Low
ModerateHigh
Very High

Score
0
1
2
3
4

Results show that while the development of effective intersectoral coordination mechanisms was selected as the most important objective, the range of priority levels
between the various objectives was relatively narrow (2.7 - 3.5), indicating that participants focused on objectives that are all somewhat important.

18

OUTPUT 3: LINK WITH THE IHR NATIONAL ACTION PLAN FOR PAKISTAN
The last draft of the IHR-NAP is structured objectives in 3 levels:

Level 1 - PRIORITIESLevel 2 - OBJECTIVES

Level 3 - ACTIVITIES, further informed by internal & external resources, timeline, estimated cost, responsibility, required funds etc.

ExamplePRIORITY 4: ZOONOTIC DISEASESOBJECTIVE 1: Developing and implementing necessary legal instruments and coordination mechanisms to adopt a One Health approach fordisease management)

zoonotic

Activity 4.1: Development & endorsement of National Zoonoses Framework at all levels supported by appropriate legislation
Activity 4.2: Establish One Health hub/dashboard with defined ToRs and operational mechanism in collaboration with provinces…
The actions discussed by the working groups during the workshop detail some of the activities mentioned in the IHR-NAP when coordination between sectors is involved.
The table below indicates the correspondence between the Activities in the IHR-NAP and the actions discussed, both identified by their reference numbers.
Actions discussed during the IHR-PVS National Bridging Workshop (ID include combination of the 2 lines below)
1.
1

Activities
in theIHR-NAP

2.
2

3

4

5

6

7

8

9

1

3.
2

3

1

4.
2

3

1

5.
2

1

6.
2

3

1

7.
2

3

4

1

8.
2

1

9.
2

3

1

10.
2

4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9
4.10
4.11
4.12
4.13
4.14

Not in the IHR-NAP

19

3

4

1

11.
2

1

12.
2

3

1

13.
2

1

OUTPUT 4: IMMEDIATE FOLLOW-UPS BY PROVINCE / REGION
As a follow up of this meeting, what will you do tomorrow when back in your office to improve the coordination for One Health?
1. One Health hub is being established, We (both Health &Livestock sector) will acquaint with One health Platform TORs shared by NIH.
2. Arrange intra & inter-sectoral meetings to develop coordination mechanisms.
FEDERAL
3. Both sectors (NIH & NARC/NVL) will share already existing LIMS software and work together to develop harmonized LIMS for further actions.
1. Sensitize colleagues about IHR-PVS, its importance & implementation.
2. Report immediately any problem relating to public health to all concerned quarters.
3. Publish the editorials relating to IHR-PVS to educate the masses.
PUNJAB
4. Review and amendment of disease outbreak response protocols.
5. Contact sharing between different departments of One Health.
1. Notification of Task Force.
2. Plan for Coordination meetings.
FATA
3. Gap analysis pertaining to One Health.
4. Meetings for development of mechanisms, TORs, SOPs.
1. To write a letter DHO/Dy. Director Livestock regarding coordination under One Health.
2. Data sharing at district and provincial level.
3. Fortnightly meetings at district and divisional level.
BALOCHISTAN
4. Monthly meetings at provincial level.
5. Press release at district and divisional level regarding minutes of meetings
6. Strengthening of already existing isolation ward in FJCH Quetta.
1. Will arrange a meeting with colleagues to share the objectives & outcomes of One Health.
2. Report to higher authorities.
SINDH
3. Future scheduling/Planning.
1. Public Health will lead provincial IHR
2. Meetings will be called to discuss the issues related to One Health approach and actions will be recommended.
KHYBER
3. The proposal will be presented to provincial IHR task force for future actions.
PAKHTUNKHWA
4. Focal persons at provincial & district level will be notified.
5. A mechanism for periodical review will be developed.
1. To request notification of focal point for One health (lead by Health department)
2. Coordination of all stakeholders from public health, animal health, environment, food and agriculture and schedule meetings for all
stakeholders.
GILGIT-BALTISTAN
3. Develop a provincial action plan in line with the national action plan.
4. Notification of district focal points led by health.
5. Dissemination of provincial action plan to district level and to all stakeholders.
1. We will have a meeting with concerned people of health department to define a program on how to work together in the future, especially for
AZAD JAMMU &the upcoming event of EID QURBAN to minimize the chances of CCHF outbreak in our region.
KASHMIR
2. Follow up of IHR Task Force.

20

OUTPUT 5: TORS OF THE ONE HEALTH HUB

I. Provide a platform of coordination to share and discuss information, experiences andfindings of zoonotic diseases and to devise future strategies.
II. Serve as an informational resource for emerging & re-emerging zoonotic diseases,
environmental factors such as climate and disasters, and latest news, including professional
opinions on particular topics.
III. Coordinate through Technical Experts Advisory Group (TEAG) for planning
implementation and strategize to handle zoonotic diseases of national and international
concern.
IV. Strengthen a network for communication between stakeholders and professionals andstreamline the information regarding any zoonotic event.
V. Play a coordinating role during outbreak investigations and develop liaison between
human, animal and environment health sectors & partners to detect and respond to eventsof zoonotic origin.
VI. Issue alerts, advisories and suggestions on zoonotic disease events.
VII. Provide technical support to provincial human & animal health management teams todevelop and implement provincial preparedness and response plans for zoonotic
interventions.
VIII. Conduct advocacy and awareness campaigns, joint studies and implementation of One
Health concept.
IX. Provide Support to the training of provincial and district One Health teams.

21

OUTPUT 6: COORDINATION MECHANISMS
Surveillance and information sharing
Step 1: Identify contacts for surveillance and information sharing in both sectors
Step 2: Identify events and incidents where information sharing is required
Step 3: Determine the roles and responsibilities of each sector
Step 4: Evaluate and revise the protocol where necessary
Coordinated response
Step1: Identify the events, scenarios and locations where coordinated responses are required
Step 2: Identify activities to be coordinated in these events, scenarios and locations
Step 3: Clarify each sector’s roles and responsibilities in these events, scenarios and locations
Step 4: Evaluate progress and revise the protocol where necessary
Risk reduction
Step 1: Identify high-risk areas, populations at risk, practices and behaviors
Step 2: Identify measures to reduce risks
Step 3: Determine roles and responsibilities for risk reduction measures
Step 4: Evaluate and revise the plan for risk reduction interventions/activities where
necessary

22

OUTPUT 7: KEY WORKSHOP RECOMMENDATIONS & WAY FORWARD

Key Workshop Recommendations
1. The workshop recognized the need for institutionalization of joint coordination mechanisms for
One Health with defined roles and responsibilities and operating procedures between humanhealth and veterinary sectors at all levels;
2. There is need for strengthening technical collaboration between both human health andveterinary sectors for:i.
Integrated disease surveillanceii.
Response including laboratory network
iii.
Communication (regular and risk communication)iv.
Human Resource development including capacity building/ training
3. We expect that the recommendations will contribute to the implementation of IHR throughsupporting the IHR MEF, IHR NAP and the PVS Pathway (Gap Analysis).

Way Forward
1. Establishment of One Health Hub with inclusion of human health, veterinary, agriculture andenvironment sectors with finalization and endorsement of ToRs;
2. Nomination of focal points for One Health at the Federal and Provincial/ Regional levels fromhealth and veterinary sectors;
3. Share workshop recommendations with the health and veterinary departments at the provincial
and regional levels to allocate necessary resources for implementation;
4. Capacity building of the nominated focal persons to take forward the approach of One Health intheir provinces/ regions;
5. Ensure implementation of the recommendations/ next steps defined by the provincial andregional working groups; and,6. Introduction of joint periodic reviews at all levels.

23

WORKSHOP EVALUATION
Many participants pointed out that this workshop marked the first time that MNHSRC and MLDD had
liaised in such a collaborative exploration of a better One Health strategy, and the participants agreed
that they now felt well-placed to explore joint strategies to address, within the next year, many of the
major gaps identified.
An evaluation questionnaire was completed by 74 participants in order to collect feedback on therelevance of such workshops. The vast majority of the national participants to the workshops rated
the workshop highly, being for the most part “fully satisfied”, or otherwise “satisfied” with both thecontent and the format of the workshop (Table 3). In addition, when asked about the level ofimpact of the workshop, 91% and 85% of participants answered ‘high impact’ or ‘very highimpact’ on their technical knowledge and on the work of their department/unit respectively.
Table 3: Results of the overall assessment of the event by participants (74 respondents)

Overall assessmentof the event

Participants 'satisfied' Average ratingor 'fully satisfied'(/4)

Content

96%

3.4

Structure / Format

92%

3.3

Organization

95%

3.6

"This was the first time that so many representatives from both sectors sat together and worked on
how to improve their collaboration. It was very motivational""This innovative approach creates a very conducive environment for these important discussions""The workshop was very well structured and very interactive. It was great to gather so many
stakeholders and a lot was achieved"

24

APPENDIXANNEX 1: WORKSHOP AGENDA
Day 1: 09 May 20170830-0900

Registration of participants

Opening Session

0900-1030

Recitation of Holy Quran
Opening Remarks
 DG Health MNHSRC
 Chief Veterinary Officer/ Animal Husbandry
Commissioner MNFSR
 Chairman Pakistan Agricultural Research Council
 Remarks from HQ WHO
 WHO Representative Pakistan

Dr Assad Hafeez
Dr Khurshid Ahmad
Dr Yusuf Zafar
Dr Stephane de La Rocque
Dr Muhammad Assai

Session 1: Workshop Objectives and National Perspectives
Introduction of participants

1030-1230

1230-1400

The OIE - WHO collaboration and vision
Tea BreakCoordination Mechanisms & One Health challenges under
IHR& PVS Pathway
 Human Health Perspective
 Veterinary Health Perspective
 Workshop approach and methodology
Lunch BreakMovie

Dr Malik M Safi
Dr M Azeem Khan
Dr Guillaume Belot

Session 2: The Road to One Health
1400-1500




Movie: interaction do happen when needed
Plenary discussion (experience sharing)

Dr Malik Safi
Dr Khalid Naeem

Session 3: Navigating the Road to One Health (Working Groups)
1500 1730


Presentation of the working group exercise
Working groups: Case study (working groups by
disease)WHO HQ
Facilitators

Day 2: 10 May 2017
0900-0915

Feedback from day 1

0915-1015

 Restitution of working groups Plenary discussion
Coffee break1015-1045

Dr Jamil Ansari
Dr Stéphane De La Rocque
Working groups
Dr Najam Baig

Session 4: Bridges along the road to One Health1045-1300
1300-1400



Lunch

Presentation of the tools (1/2) (IHR MEF including JEE,PVS Pathway)
Mapping gaps on a IHR/PVS matrix
Plenary Discussion

Movie
Dr Stephane De La Rocque& Dr Salman

25Session 5: Crossroads - IHR MEF, JEE and PVS Pathway reports

1400-1630



Presentation of the tools (2/2) (Handbook)

Movie



Presentation of the working group exercise

Dr Guillaume Belot

Working groups: Extract main results from the PVS andIHR reports (including JEE), in relation to gaps
identified on the matrix and discuss operational options(groups organized by technical topic)

All Facilitators

Day 3: 11 May 2017
0900-0915

Feedback from day 2

Dr Jamil Ansari
Dr Stéphane De La Rocque

Session 6: Roadmap – Joint objectives and activities

0915- 1200

1200-1300

Presentation of the working group exercise

Dr Guillaume Belot

Working groups: Identification of joint objectives andpractical activities to implement

All Facilitators

World café

All Facilitators

Finalization of the objectives/activities for each technicalarea

All Facilitators

Lunch

Session 7: Roadmap - Reaching consensus


1300-1500


1500-1530

Assessment of priority level for each activity andprioritization
Linkages with the National Action Plan for Health
Security
Working group exercise by Province

Dr Guillaume Belot
Dr Stéphane De La Rocque
All Facilitators

Coffee break

Closing Session
1530-1550

Sharing of Draft TORs for One Health Hub

1550-1610

Final plenary discussion: Key workshop recommendations

1610-1630

Closing Remarks
Vote of Thanks

Dr Najam Baig/ Dr
Mumtaz Khan
Dr Malik Safi
Director Programs
Dr Johar Ali Member ASD
PARC
Dr Mukhtar Ahmed ED
NIH
Dr Khurshid Ahmad Rep
AHC/CVO26

ANNEX 2: LIST OF PARTICIPANTSMINISTRY OF NATIONAL HEALTH SERVICESREGULATIONS AND COORDINATIONDr Assad Hafeez
Director General – MNHSRC
az10@hotmail.com
Dr Malik Muhammad Safi
Director, Programs / HPSIU: IHR-GHSA
dr_msafi@hotmail.com

Dr Tahir Yaqoob
WTO Quality Lab
University of Veterinary & Animal Sciences
tahiryaqub@uvas.edu.pk
Dr Aamir Ghafoor Bajwa
Director University of Veterinary & Animal
Sciences
aamir.ghafoor@uvas.eud.pk

Dr Qurban Ali
Animal Husbandry Commissioner
M/o National Food Security & Researchdrqurban@yahoo.com

Dr Muhammad Iqbal
Director Veterinary Research Institutefmdiqbal@outlook.com

Dr Khalid Naeem Khawaja
Consultant Microbiologist/ One Health Expert
naeem1955@gmail.com

Dr Mashkoor Mohsin
Assistant Professor - University of Agriculture
mashkoormohsin@uaf.edu.pk

Dr Muhammad Salman
National IHR Focal Person - NIH
salman14m@gmail.com

Dr Shafia Tehsin Gul
Assistant Professor - University of Agriculture
drshafia66@yahoo.com

PROVINCIAL DEPARTMENTS

Dr Masood Akhtar
Dean - Faculty of Veterinary Sciences
Bahauddin Zakria University
veterinary@bzu.edu.pk

PUNJABDr Bashir Ahmed
Director CDC/Public Healthrahmadbashir@gmail.com
Dr Aun Raza
Senior Instructor - SKMC Hospitalaunraza@skm.org.pk
Dr Anjum RazzaqueInstitute of Public Healthanjrazzq@gmail.com
Dr Masood Rabbani
Director Department of Microbiology
Faculty of Veterinary Sciences
University of Veterinary & Animal Sciences
mrabbani@uvas.edu.pk
Dr Abdur Rehman Afzal
Microbiologist
abrehman2044@gmail.com

SINDH
Dr Muhammad Saleem Memon
Additional Director (PH)Director General Health Services
memondoctor@hotmail.com
Dr Mubeen Ahmed
Provincial Coordinator (DHIS)
Directorate General Health Services
mobin.memon@yahoo.com
Dr Amir Bux
Microbiologist - Peoples University of Medical
Sciences Hospital Shaheed Benazirabad
dramirbuxdetho65@gmail.com
Dr Ali Akber Soomro
DG Livestock, Hyderabad
dglivestocksindh@gmail.com

27

Dr Parkash Deewani
Senior Research Officer - Veterinary Research &Diagnosis Sindh - Central Veterinary DiagnosticLab
dewani_cvdl@yahoo.com

BALOCHISTANDr Moomal Bughio
Research Officer - Poultry Research Institutemoomal-bughio@yahoo.com

Dr Muneer Kasi
Program Coordinator - Quetta

Dr Manzoor Asif Pathan
Disease Investigation Lab
Animal Livestock Production Complex
mangoorasifpathan@yahoo.com
Dr Nazeer Hussain Kalhoro
Director - Sindh Poultry & Vaccine Centre
Animal/Livestock Production Complex
drnazeerhussain@hotmail.com
Dr Rumina Hasan
Consultant Microbiologist - AKU
rumina.hasan@aku.edu

KHYBER PAKHTUNKHWA
Dr Shaheen Afridi
Director Public Health
IHR Focal Person
shaheenafridi@gmail.com
Dr Mirza Ali Khan
Director General - L&DD FATA
drmirza62@yahoo.com
Dr Syed Asad Aali Shah
Deputy Epidemiologist IHR Focal Person
D.I. Lab, L&DD Peshawar, KPKaa.shah@yahoo.com

Dr Kalsoom Bibi
Veterinary Officer - L&DD Peshawar, KPK
kalsoom.2847@gmail.com

Dr. Masood Qadir Nousherwani
DGHS, Quetta
dghs_balochistan@yahoo.com

Dr. Ghulam Sarwar Pirkani
Consultant Microbiologist, BMCH Quetta
pirkani77@gmail.com
Dr Saima Iram
Pathologist / Focal Person Lab
drsaima@yahoo.com
Dr Tariq Kiani
Director - CASVAB, Animal Sciences Complex
tariqkianiraja@hotmail.com
Dr Bahawal Haq
Divisional Officer - L&DD
buhaqzhob@gmail.com
Dr Aitabar Khan
Deputy Director/ IHR Focal Person - L&DD
aitabark03@gmail.com

FATA
Dr Anisa Afridi
IHR Focal Person
anisaafridi@yahoo.com
Dr Malik Ayaz Wazir
Director - L&DD FATA
ayaz1961@hotmail.com
Dr Zia ud Din
Deputy Director / IHR Focal Person
L & DD FATA
zia6577@yahoo.com
AZAD JAMMU & KASHMIRDr Matloob Hussain Raja
Animal Husbandry Department AJK28

Dr Shafqat Mehmood
IHR Focal Person
Animal Husbandry Department AJK
shafqatm521@gmail.com

Dr Nadeem Younas
Shifa International Hospital
neem.y2010@gmail.com

Dr Adnan Rasheed Malik
Deputy Director Planning
adnan_riasi@hotmail.com

Dr Ejaz Khan
Consultant Pediatrician
Hospitalejazkhan99@hotmail.com

Dr Nabila Latif
VO (H) - L&DD AJKnabilalatif46@gmail.com

Dr Shazia Nazeer
Directorate of L&DD Rawalpindi
drshanaz74@gmail.com

Dr Mumtaz Ahmed
AIMS
mumtazahmad8166@gmail.com

Dr Madeeha Shams
Intern at FELTP
madeeha.shams@gmail.com

Syed Naeem ur Rehman
FELTP
drnadeemsyed999@gmail.com

Ms Sidra Manzoor
Intern at NIH
gondalsidra@yahoo.com

GILGITDr Nadia Noreen
Directorate General of Health Establishment
nadia.jamil3@gmail.com

Dr Rasheed Ahmed
DOH - Gilgit
rashadahmad.dr@gmail.com
Dr. Hafizullah
Focal Person IHR
hafeezdhsgb@gmail.com
Dr. Ejaz ud Din
Pathologist / Focal Person Labs
ejazmalkal@gmail.com
Dr Zaeem Zia
DOH -Gilgit
zaeemzia983@gmail.com

Shifa

International

Dr Mamoona Tahir
PH England
momoona.tahir@phe.gov.uk
Dr Rafay
PH England
rafay.aku.epibio@gmmail.com
Dr Tamkeen Ghafoor
FELTP Pakistan
ghafoor.tamkeen@gmail.com
Dr Farooq Azam
TRF & Representing DFID
farooq.azam@trfpakistan.org

ISLAMABAD & RAWALPINDI
Dr Brig Aamer Ikram
CMH Peshawar
mahin1@yahoo.com
Dr Rana Jawad Asghar
Resident Advisor, FELTP Pakistan
bvv9@cdc.gov

Dr Muhammad Tayyab
IHR Coordiantor, MNHSRC
drtayyab3@gmail.com
Dr Uzam Bashir
Senior Virologist, NIH
uzmaaamir73@yahoo.com

29

Dr Faheem Tahir
Chief, PHLD, NIH
faheemtahir2000@gmail.com

Dr Adnan Saeed
Scientific Officer, NVL
adnan.saeed92@gmail.com

Dr Jamil Ansari
Chief, FEDSD, NIH
jam62aa@gmail.com

Dr Naila Siddique
SSO/PL, NRLPD, ASI, NARC
naila.nrlpd@gmail.com

Dr Mumtaz Ali
Medical Officer FEDSD / NIH
drmomi74@gmail.com

Dr M. Athar Abbas
SSO, NRLPD, ASI, NARC
matharabbas@hotmail.com

Dr Najamullah Baig
SSO, NIH, Islamabadnajamullah@yahoo.com
Dr Moin Iqbal
Epidemiologist, NIH
drmoiniqbal@gmail.com
Dr Urooj Aqeel
FEDSD / NIH
uroojdouhile@hotmail.com
Dr Farooq Tahir
PRI, Rawalpindi
drmftahir@gmail.com
Dr Khurshid Ahmed
PSO, NVL
khurshid5@hotmail.com
Dr Zahida Fatima
Deputy Director (AH), ASD, PARC
zahidavet@yahoo.com
Dr Aman Ullah
SSO, AHP, ASI, NARC
amanvet@gmail.com
Dr Hamid Irshad
SSO, AHP, ASI, NARC
hamidirshad@hotmail.com

WHO & OIEDr Mohammad Assai
WHO Representative Pakistan a.i
assaim@who.int
Dr. Stéphane de La Rocque
Technical Advisor - WHO HQ
delarocques@who.int
Dr. Guillaume Belot
Technical Officer - WHO HQ
belotg@who.int
Dr. John Woodford
Representative OIE
jdwoodford@gmail.com
Dr Michael Lukwiya
Cluster Leadlukwiyam@who.int
Dr Farah Sabih
National Professional Officer GHI
sabihf@who.int
Ms Zouyya Ashar
Team Assistant:asharz@who.int

Dr M. Javed Arshad
SSO, NVL
mjnvl786@gmail.com
Dr Akbar Ali
Scientific Officer - NRLPD, ASI, NARC
drakbaralimalik@gmail.com

30