“A taste of crisis”: a massive simulation exercise helps countries to prepare for and better respond to extreme weather

As the climate crisis wreaks more havoc across Europe and central Asia year after year, WHO Member States are urgently seeking to strengthen their readiness for a range of emergencies, both individually and in collaboration with each other. It was within this context that the annual Joint Assessment and Detection of Events (JADE) exercise - the WHO European Region's biggest simulation exercise, designed to mimic real-world public health emergencies - was carried out. Converging online and in Copenhagen on 19-21 November, participants from 46 of the 53 Member States of the WHO European Region faced the scenario of a fictional flood, with public health consequences.

As 2024 was declared the hottest year on record both in Europe and globally, this year's JADE focus on extreme weather was requested directly by Member States, reflecting countries' efforts to prime and adapt their preparedness and alert systems. The exercise drew upon real-life examples and best practices from various parts of the Region, providing genuine value and templates for future action.

Flood preparedness in Armenia

In May 2024, heavy rains caused unexpectedly severe flooding in Armenia, as rivers burst their banks, leading to many deaths and evacuations. Several bridges collapsed and some transportation links had to be closed. Fortunately, the country's health infrastructure was not badly affected. "The floods were a very challenging time," says Mesrop Hazroyan, Director of Vanadzor Medical Centre. "There were casualties, and this was the main facility in the region responsible for treating them. We also used mobile teams deploying from here to reach people in the remote flood-affected areas."

Responding to the growing threat of extreme weather, among other health hazards, WHO/Europe, together with the WHO Country Office in Armenia, has been supporting the Ministry of Health to reinforce national preparedness capacity by introducing chief physicians, senior nurses, and specialists in critical hospital systems to the Hospital Safety Index (HSI) tool. The tool is helpful in assessing the safety of hospitals and determining their capacity to function in an emergency.

HSI assessments were conducted in hospitals across Armenia, and results are being compiled and analysed to support decision-making about short- and medium-term interventions to strengthen hospital safety and capacity.

Raising the alert on potential cross-border health threats

As the National Focal Point (NFP) for the International Health Regulations (IHR) for Armenia, Dr Nune Bakunts, Deputy Director-General at the National Centre for Disease Control, is responsible for ensuring communication on potential health-impacting events both within the country and externally with WHO and other Member States.

"Extreme weather events, high temperatures, storms and floods cause disruption to health systems, water and sanitation infrastructure, and supply chains, and may cause outbreaks of infectious diseases. These kinds of events do not stop at borders; they can move, spread and affect the territory of more than one country," she says.

She is not surprised that WHO Member States are increasingly requesting support to prepare for extreme weather events.

"Climate change is increasing the scale, frequency and intensity of extreme weather events, such as heatwaves, wildfires and floods. The sooner you raise the alert about an extreme event, the more time you have to prepare and protect the people, thus preventing or mitigating humanitarian emergencies and health impact."

Portugal responds to wildfires

In September 2024, wildfires ripped through central and northern Portugal, burning over 900 square kilometres of land, killing 9 people and affecting up to 11 300 others, according to Copernicus, the European Union's Earth observation system. These were some of the worst blazes the country had seen since the 2017 Pedrogão Grande wildfires. As wildfires affect Portugal every summer, the country has developed complex alert and response systems.

"Extreme weather is one of the priority risks identified in Portugal among environmental hazards," says Paula Vasconcelos from the Support Unit of the National Health Authority in Portugal/Public Health Emergency Operations Centre. "It's monitored by the health sector, the civil protection sector and the environmental sector, within a specific collaborative Seasonal Health Surveillance and Response Programme."

She continues, "There is a systematic way to activate a response if needed, according to the alert level, in line with the national and subnational plans adopted. At local level, this involves local health services and public health units and municipalities, among other partners."

Noting the importance of a whole-of-society approach, the Portuguese programme may also involve the veterinary sector, due to the eventual impact of wildfires on livestock, as well as other sectors such as the transportation sector. To protect citizens from the threat of wildfires, Portugal also provides extreme weather alerts through every mobile network nationwide.

"Portugal has experienced extreme weather events, and it has used the experience to improve systems and procedures, to ensure monitoring, assessment and response, and to readjust processes, using the best tools to disseminate information."

Taking stock of strengths and weaknesses

JADE is designed to test and enhance communication between IHR NFPs and WHO IHR Regional Contact Points. Although IHR NFPs are more used to raising alerts on infectious diseases, most agreed that the scenario focusing on extreme weather event was highly relevant.

"Countries in Europe share mountains, rivers, and roads," says Vasconcelos. "These are favourable conditions for cross-border environmental threats affecting more than one country."

She cites a turnover in human resources, and the need to update protocols and tools as reasons to regularly test and refresh alert and preparedness systems.

In Armenia, Nune Bakunts concurs, "We need working and effective alert systems and preparedness mechanisms that are in line with the current situation and requirements, and have a ready and trained personnel," she says. "Testing and other assessments help us to identify our weaknesses and gaps in order to improve capacities and response systems."

"Simulations such as JADE give us a taste of crisis," says Paula. "They offer the participants a chance to stop their routine activities and take stock of their strengths and weaknesses. They force them to think about the procedures, the mandate, the functions and the tasks required to deal with and act on information that they receive, simulating reality."

"Climate change is not a distant threat - it's our current reality, demanding bold and immediate action," says Antonio Parenti, Director for Public Health, Cancer and Human Security at the European Commission's Directorate-General for Health and Food Safety (DG SANTE). "Simulation exercises like JADE strengthen our resilience and enhance our collective ability to protect the European Region from the worst impacts of climate emergencies, safeguarding our future."

JADE 2024, held on 19-21 November, was led by the WHO Country Health Emergency Preparedness and IHR team at WHO/Europe, in close collaboration with the European Centre for Disease Prevention and Control, DG SANTE, and the National Institute for Public Health and the Environment of the Kingdom of the Netherlands. The event was funded by the European Union.

Countries working jointly on combating climate change and its impacts on health is one of the commitments in the groundbreaking Budapest Declaration that emerged from the Seventh Ministerial Conference on Environment and Health in 2023. Preparedness for extreme weather is also an important part of Preparedness 2.0, the Region's newly adopted Strategy and action plan for emergency preparedness, response and resilience. The plan has been developed by Member States with support from WHO/Europe. WHO/Europe partners with Member States in tackling the challenges of extreme weather via the WHO Regional Office for Europe in Copenhagen, Denmark, and the WHO European Centre for Environment and Health in Bonn, Germany.

Public link

Please use the above public link if you want to share this noodl on another website.