A year without precedent globally, 2020 has brought short and long-term social and economic disruptions whilst COVID-19 infections and deaths soared around the world. The rapid spread and impact of the pandemic have propelled public health core capacities described in the 2005 International Health Regulations (IHR) into the international spotlight.
These capacities for emergency preparedness and response include - but are not limited to - coordination, surveillance, laboratory services, provision of essential health services, risk communication and guidance for monitoring points of entry.
At the request of the Government of Bangladesh (GoB), the World Health Organization (WHO) facilitated a COVID-19 Intra Action Review (IAR) last week to analyze the on-going response in Cox’s Bazar, share lessons learnt and agree on next steps to further improve and strengthen the continued response to the pandemic. 
Since the onset of the coronavirus pandemic, life has changed in the Cox’s Bazar refugee camps. The disruption of services impacted everyone, everywhere, but especially Rohingya women and girls. WHO Bangladesh/Tatiana Almeida
Lessons learnt, sharing of experiences and actions of one country can help others. This knowledge might guide countries to more rapidly and effectively detect cases, prevent new infections from becoming clusters, and clusters from turning into community transmission. One way to achieve that is by regularly conducting intra-action reviews to ensure continual learning on best approaches to control this new virus and revise countries’ response strategies as needed.
“The COVID-19 Intra Action Review conducted last week in Cox’s Bazar was an opportunity to review the functional capacities of public health and the emergency response in Cox’s Bazar and helped identify remaining gaps and challenges that should be mitigated and addressed in an adjusted manner. The Health Sector partners who attended the meeting represent some of the key actors in Cox’s Bazar collaborative effort throughout the COVID-19 pandemic. The meaningful discussions we had during the IAR will help shape the response in 2021 and strengthen the health sector”, says Health Sector Coordinator, Dr Egmond Evers.
The Intra Action Review took place on 1st February 2021 having been attended by thirteen (13) Health Sector and Humanitarian partners in Cox’s Bazar. WHO Bangladesh/Tatiana Almeida
During the one-day long Intra Action Review meeting, partners navigated through each of the pillars which have guided - and continue to guide - the emergency response in Cox’s Bazar comprising: coordination, risk communication, surveillance, district laboratory, infection prevention and control, clinical case management, essential health services, monsoon and cyclone preparedness, operational support and points of entry.
“I would like to highlight the good synergies and intersectional collaboration in setting up of the severe acute respiratory infection isolation and treatment centres (SARI-ITCs), in accordance with the UN Coherence principles. The technical support provided early on in the response, and months before the first COVID-19 case was detected in the camps, was a remarkable collaborative effort and achievement. We were ready to prevent, respond to and mitigate the impact of the pandemic before local transmission started,” says UNICEF Bangladesh Health Specialist Dr. Yulia Widiati.
In 2020, health partners contributed to uphold health service quality in Cox’s Bazar complex setting through the establishment 14 Severe Acute Respiratory Infection (SARI) Isolation and Treatment Centres (ITCs) across the Rohingya refugee camps with a capacity of nearly 1200 beds. Initiated and coordinated by WHO, these facilities ensured effective, timely and specialized treatment and isolation of COVID-19 patients from both refugee and host communities.
“The online forums created to enhance adequate clinical case management have fostered peer to peer support and knowledge exchange which were key to ensure service quality in the Cox’s Bazar context”, states IOM COVID-19 Health Coordinator, Dr Marsela Nyawara. “On another note, I feel that there is room for improvement in the provision of essential health services in terms of respectful communication with Rohingya patients and in making sure they fully understand their health condition and the importance of treatment”, she adds.
IOM COVID-19 Health Coordinator in Cox’s Bazar, Dr Marsela Nyawara, sharing her views at the Intra Action Review meeting. WHO Bangladesh/Tatiana Almeida
WHO Health Sector Coordinator Dr Egmond Evers (left), and WHO Head of Sub-Office, Dr Kai von Harbou (right), facilitating the Intra Action Review meeting held in Cox’s Bazar. WHO Bangladesh/Tatiana Almeida
“WHO Cox’s Bazar will share key findings and recommendations at the upcoming Strategic Advisory Group (SAG) meeting in Cox’s Bazar, as well as with relevant actors at national, regional and global levels for further information and to guide decision-making for immediate improvements of the response, including for the strategic and operational planning. After a year of online meetings and intense hard work at all fronts, it was important to bring together Cox’s Bazar key partners and stakeholders and delve into opportunities to improve”, concludes WHO Head of Sub-Office, Dr Kai von Harbou.
In 2021, as the lead agency of the Health Sector, WHO will continue supporting to the Government of Bangladesh (GoB) in the response to COVID-19 and the Rohingya humanitarian crisis in general with the aim to effectively control the outbreak through new interventions like vaccines and therapeutics (as they become available) while maintaining and further strengthening measures already deployed and support continued utilization of essential health services with quality service delivery.