1. Considerations in Developing NPHIs Sue Binder www.ianphi.org

2. What Are NPHIs? INSP Mexico INSP Netherlands RIVM U.S. CDC EHNRI Ethiopia EHNRI China CDC Finland THL Who is next?

3. What Are NPHIs: The Framework Developed in response to the need to have a consistent language for ourselves, donors, and partners about what NPHIs are and what they do Developed in response to the need to have a consistent language for ourselves, donors, and partners about what NPHIs are and what they do IANPHI members worked together to create a consensus document, published 2007 IANPHI members worked together to create a consensus document, published 2007

4. The Framework Includes Background information about NPHIs Background information about NPHIs Definition of an NPHI Definition of an NPHI Core NPHI Attributes and Functions Core NPHI Attributes and Functions Approaches to creating or enhancing an NPHI Approaches to creating or enhancing an NPHI

5. Examples of NPHI Core Attributes National scope of influenceNational scope of influence Focus on major public health problemsFocus on major public health problems Scientific basisScientific basis Linkages – sub-national/Linkages – sub-national/ national/international; government/non- government

6. Examples of NPHI Core Functions Population health assessment Population health assessment Surveillance, problem investigation, & control of threats Surveillance, problem investigation, & control of threats Research Research Prevention programs & health promotion Prevention programs & health promotion Human resources development & management Human resources development & management Emergency preparedness & response Emergency preparedness & response

7. Which Core Functions Does a “Typical” NPHI Do? Many NPHIs become more comprehensive over time, e.g., CDC Many NPHIs become more comprehensive over time, e.g., CDC Often, a crisis is an impetus to increase comprehensiveness Often, a crisis is an impetus to increase comprehensiveness Example: Public Health Agency of Canada created following 2003 SARS outbreaksExample: Public Health Agency of Canada created following 2003 SARS outbreaks Lack of communication between national and sub- national Lack of communication between national and sub- national Large numbers of people quarantined unnecessarily Large numbers of people quarantined unnecessarily Health care system overwhelmed by worried well Health care system overwhelmed by worried well Business and tourist travel stopped Business and tourist travel stopped Subsequently, the Parliament legislated the Public Health Agency of Canada Subsequently, the Parliament legislated the Public Health Agency of Canada

8. IANPHI Long-term Projects Mostly in low-resource countries Mostly in low-resource countries Project can last several years Project can last several years Goal is sustainable increases in NPHI capacity to conduct Core Functions related to pressing problems in the country Goal is sustainable increases in NPHI capacity to conduct Core Functions related to pressing problems in the country

9. IANPHI Long-term Projects (cont’d) We aim to be transformative We aim to be transformative IANPHI funds are limited, but can serve as a catalyst – have a multiplier effect IANPHI funds are limited, but can serve as a catalyst – have a multiplier effect Guinea Bissau: Linkage of formerly disparate groupsGuinea Bissau: Linkage of formerly disparate groups a robust NPHI a robust NPHI Tanzania: Investment in non-communicable disease surveillance and policy work as the Ministry expands its NCD efforts, NIMR is playing an important role in providing a science baseTanzania: Investment in non-communicable disease surveillance and policy work as the Ministry expands its NCD efforts, NIMR is playing an important role in providing a science base

10. Keys to Success of Long-Term Projects A high-level champion in the government A high-level champion in the government NPHI Leadership: Critical for NPHI Leadership: Critical for Aligning staff and programs with the NPHI’s vision and missionAligning staff and programs with the NPHI’s vision and mission Staff buy-in to organizational changeStaff buy-in to organizational change Deal with barriersDeal with barriers Garnering additional resourcesGarnering additional resources Vision for how the IANPHI invest- ments will lead to transformation Vision for how the IANPHI invest- ments will lead to transformation

11. Other IANPHI Support for NPHI Development Technical assistance Technical assistance Strategic planningStrategic planning Meeting with key people (e.g., Ghana)Meeting with key people (e.g., Ghana) Funding of meetings, e.g., for strategic planning Funding of meetings, e.g., for strategic planning Training Training General leadership and management development, e.g., as part of annual meetingsGeneral leadership and management development, e.g., as part of annual meetings Targeted: Address specific needsTargeted: Address specific needs Mentorship program Mentorship program

12. Substantive improvements to public health systems require a national organizational focus – an NPHI. IANPHI looks forward to helping you to develop yours.