Response to drought generated public health emergencies (focusing on AWD outbreak) through provision of essential medicines and medical and laboratory supplies. The AWD outbreak response continued in 2017 in Afar, Amhara, Oromia, SNNP, Tigray and Somali regions. The rapid increase in the number of cases (mid April 2017) to more than 4000/week triggered significant mobilization of resources by the FMOH/PHEM and partners for treatment and the control of the outbreak. Although it has been brought under control in the most heavily affected Somali Region the AWD outbreak continues to spread, and will continue to spread unless current levels of response and control efforts are maintained. Drought-induced degradation of health determinants such as access to safe drinking water, wide-spread food insecurity with general poor nutrition and increasing SAM incidence, along with cross-border movements, internal displacement, on the back drop of an overburdened local health system increased the risk of further spread of AWD as well as other types of outbreaks with potential surge in Aug and Sept.

The response and control of an outbreak requires multi-disciplinary and multi-sectorial measures to address the underlying causes and interrupt the community spread, coordination and command, and logistics to support all operations. Along with the presence of qualified staff, laboratory support for guiding the response and availability of medicines for timely treatment of cases is essential to save lives. Appropriate treatment of cases will also promote the interruption of community transmission of the causative agent. This proposal will support procurement of essential medicines, laboratory supplies and other equipment and logistics to support the ongoing response mobilized by the FMOH and partners. 

The medicines and medical supplies necessary for continuation of the response to the AWD outbreak but also for treatment of increasing number of endemic communicable diseases that threatens to reach epidemic levels especially among the most vulnerable drought affected communities such as IDPs and remote communities will be procured. Laboratory supplies, from sampling material, rapid diagnostic tests to reagents for confirmation of cases ensures that the treatment is the most appropriate and in accordance with national guidelines. 

To fill in urgent gaps reported mainly from Somali, Tigray and Amhara regions, part of the supplies will be procured locally (using WHO standards for quality requirements) to speed the process the bidding has been initiated based of the most urgent gaps identified by RHBs and WHO led incident command centers (ICC). 

The remaining requirements for the next 6 months (to avoid beginning of the year shortages) have been coordinated with FMOH and RHBs based on the projected potential number of cases and the risk for other outbreaks. Two tranches of international procurement (WHO catalog standard kits) one faster from the WHO logistic hub in Dubai and second from suppliers identified through bidding at the beginning of the year by the WHO HQ. It includes full kits for establishment of medium CTC tented centers, cholera kits for referral CTC and Cholera medicine kits to support existing CTC, CTU and Oral Rehydration Points (community level). Interagency Emergency health kits (IEHKs basic) for treatment of communicable diseases in emergency settings as IDPs for immediate response to increased number of cases. WHO will ensure the in-country transport until the regions.  The transport within regions will be provide by UNOPs to the end beneficiaries (HF and Treatment centers) in Somali region, and for the other regions RHBs and WHO. Procurement and distribution of all planned supplies will be finalized by the end of November. The requested project period is 7 month to allow time for clearance of all encumbrances (financial report), and reporting of distributions and utilization of supplies. 

The distribution of supplies will be readjusted with the partners through the cluster, ICC and technical working groups based on the epidemiological situation development and real needs.