The World Health Organization (WHO) has developed and supported numerous initiatives to build capacity and awareness about health emergency and disaster risk management (Health EDRM). These include establishing the Health EDRM Research Network (Health EDRM RN) in 2018 and the publication of the Health EDRM Framework in 2019. These initiatives recognize that research is vital to generating the evidence to inform decision making and research that is integral to disaster preparedness, response and recovery will be vital to delivering the aspirations associated with caring, coping and overcoming in an increasingly challenging world.

To strengthen the capacity for conduct and use of research, resources were developed by the WHO Guidance on Research Methods for Health EDRM.

This first WHO textbook on Health EDRM research methods was published in 2021 and updated in 2022 with a chapter on Health EDRM research in the context of COVID-19. The 44 chapters offer practical advice about how to plan, conduct and report on a variety of quantitative and qualitative studies that can inform questions about policies and programs for health-related emergencies and disasters across different settings and level of resources. Case studies of direct relevance to Health EDRM provide real-life examples of research methods and how they have modified policies.

More than 160 authors in 30 countries contributed to the guidance, which is relevant to researchers, would-be researchers, policy makers and practitioners. It should help improve the quality of Health EDRM research; the quality of policy, practice and guidance supported by the evidence generated; and research capacity, collaboration and engagement among researchers, the research community, policy-makers, practitioners and other stakeholders.

The Guidance is being supplemented by additional resources, including audio podcasts, slideshows, video presentations and webinars, and the content as a whole will be discussed in this presentation.

The COVID-19 pandemic has underlined the international priority to systemically operationalise resilience in the face of increasing prevalence of complex and cascading hazards. This concept paper identifies the components of a resilient society, establishing the usefulness and usability of the application of ‘resilience’, and proposes the characteristics used by a resilient system.

Through the review of case-based examples and previously published concept papers, this paper underwent a concept analysis to understand and qualify the characteristics of a resilient community. Through extensive research and critical analysis of disaster risk responses both effective and not, the authors condensed the literature to identify the key components of a resilient society.

To respond to this evolving landscape of disaster risk, community and governmental responses should be collaborative in order to be successful and sustainable to increase resilience across communities, societies and networks. To unpick the complexity of how communities and governments might promote resilience effectively, we explore whether community and social capital are useful resources to create and sustain resilient approaches to disaster risk reduction and management. We consider that by exploring how social capital links, bridges and bonds actors within a system are qualitative key facets of a resilient community. A resilient system is the product of trust and collaboration between asset-based networks of bonded and bridged communities and risk and support-based networks of bonded and bridged organizations.

By evaluating the usefulness and usability of the concept, we consider that a resilient system is an iterative learning process, asset based, trusting across power and resource gradients and is best built before or even if essential during a crisis. Noting that resilience is a dynamic process which requires integrated collaboration and continual adjustment to develop a sustainable framework, we consider that social characteristics of a resilient system are useful, useable and should be used.

As populations worldwide are experiencing more frequent and intense weather and climate extremes, many professionals of the WADEM community are at the frontline of managing compounding and cascading impacts on physical and mental health. Vulnerable, isolated, and marginalized people are the most affected by climate and weather threats. The elderly and children faced 3.7 billion more life-threatening heatwave days in 2021 than annually in 1986-2005 increasing the need for emergency care on a large scale.

The World Health Organization (WHO) and World Meteorological Organization (WMO), together with partners from health agencies, climate services, academia and other sectors are collaborating to accelerate the use of climate, weather and environmental science and services for better health protection. A selection of key resources and tools will be highlighted that can be used by the WADEM community to better understand, anticipate, and manage health risks from extreme weather and climate.

Participants will learn about the new WHO-WMO ClimaHealth Portal, a global knowledge and action hub with huge potential for facilitating learning and action to better protect health from climate risks. Tools and resources include the Global Heat Health Information Network (GHHIN) Checklist and Technical Brief for improved heatwave preparedness and response in the context of COVID-19, and a new WHO Guidance Document on Measuring the Climate Resilience of Health Systems providing a framework and indicators for assessing and protecting health systems from climate threats.

As extreme weather intensifies, integrated climate-informed services for the health sector including multi-hazard early warning systems and action plans, as well as strengthened partnerships between the health community and hydrometeorological services are indispensable to further restrict adverse health impacts. Accelerating the uptake and upscale of existing tools and resources is urgently needed to meet the increasing health and societal challenges caused by climate change and weather extremes.

WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (Health EDRM RN) is a global expert network, launched in 2018, aiming to strengthen the scientific evidence for managing health risks associated with all types of emergencies and disasters, and to foster global collaboration among academia, government officials and other stakeholders. The Health EDRM RN’s activities are in line with WHO Health EDRM Framework, which support Sendai Framework for Disaster Risk Reduction 2015-2030.

Health EDRM RN’s strategic direction is discussed and advised by its Core Group that consists of focal points of WHO HQ responsible unit, all six Regional Offices, WHO Center for Health Development (Secretariat), RN co-chairs, and key external stakeholders. Based on the strategic direction, the Secretariat facilitates global, regional, and local collaborative activities with the RN participants and partners. As of 2022, over 250 global experts participate in the network.

Following the results of the Core Group Meeting in 2019, 2020 and 2021, multiple activities and results were generated including the identification of five Health EDRM key research areas. WHO Guidance on Research Methods for Health EDRM developed in collaboration with over 150 global experts, initiation of the project to establish WHO Health EDRM Knowledge Hub for developing WHO Health EDRM Research Agenda and aligning with UNDRR research agenda on thematic areas including developing a special supplement on mid-term review of Sendai Framework implementation in health. The 2022 Core Group Meeting, held on October 27, 2022, agreed to promote knowledge dissemination and implementation research for better outputs for regions and countries.

WHO Health EDRM RN will continue its unique function as the platform of global experts and stakeholders to produce, disseminate, and apply knowledge. Participation and engagement by more and broader experts are expected.

In order to promote useful and usable scientific evidence for health emergency and disaster risk management (Health EDRM), the World Health Organization (WHO) Health EDRM Knowledge Hub has been established as part of the WHO Thematic Platform for Health EDRM research network (Health EDRM RN). The Knowledge Hub aims to extend scientific knowledge; strengthen evidence-based practice in the management of health risks in emergencies and disasters; create and develop a competent network in the Health EDRM community; and integrate research, policy and practice.

To begin with, the Knowledge Hub has five interconnected research themes: (1) health data management; (2) psychosocial support; (3) health needs of sub-populations; (4) health workforce development; and (5) research methods. Systematic literature reviews and expert consultations have assessed current research under each theme and identified potential knowledge gaps. The work of the Knowledge Hub is advised by members of the Health EDRM RN and staff in WHO regional offices.

The WHO Health EDRM Knowledge Hub will be a platform for providing and exchanging up-to-date evidence. This will include information on validated methods for managing health data and identifying health needs in specific subpopulations. The Knowledge Hub will raise awareness of psychosocial support, health workforce development and research before, during and after disasters. It is targeted to policy-makers, researchers, practitioners and the broader community with the aim of accelerating evidence-informed policy and programs. This will support implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030, the WHO Health EDRM Framework, and other related global, regional and national agendas.

This paper introduces this new initiative and describes its objectives, design, and implementation. Additionally, it provides an overview of the Knowledge Hub and invites session participants to provide insights into their current needs and to make recommendations for improvement.

The mental health consequences of health emergencies and disasters have the potential to be sustained and severe. In recognition, the 2018 Kobe Expert Meeting on Health Emergency and Disaster Risk Management (Health EDRM), prioritized mental health as one of the key research areas of Health EDRM, to be addressed in a multi-country research project supported by WHO (Kayano et.al., 2019). As climate change, growing urbanization, population density and viral transmission generate increasingly severe hazards, attention to mental health will be critical.

The Asia Pacific Disaster Mental Health Network was established in 2020 to foster advancements in mental health research and policy in the region. Building connections between researchers, practitioners and policy makers, the Network includes broad representation from interdisciplinary scholars and organizations across eight Asian and Pacific nations. A research agenda was designed in early meetings, and collaborative research projects were established.

The Network has supported the development of innovative disaster mental health research investigating community engagement in recovery, psychosocial interventions, and evaluation frameworks. A recent multilingual systematic review of more than 200 longitudinal studies identified the long-term trajectories of post-traumatic stress symptoms, depression and anxiety following disasters and pandemics (Newnham et al., 2022). Synthesized evidence of risks related to age, gender and disaster type were determined to inform intervention targets.

The Asia Pacific Disaster Mental Health Network established a platform for scholarly connection, intervention planning and knowledge dissemination. This presentation will provide an overview of the Network’s activities, and research highlights that have identified targeted points for policy and practice.

The 'all hazards' approach that the Sendai Framework on Disaster Risk Reduction calls for ‘to strengthen technical and scientific capacity to capitalize on and consolidate existing knowledge and to develop and apply methodologies and models to assess disaster risks, vulnerabilities and exposure to all hazards;’ (paragraph 24 j)’ needed clarification.

Following extensive scientific consultation, the United Nations Office for Disaster Risk Reduction (UNDRR) and the International Science Council (ISC) published in 2020 the UNDRR/ISC Hazard definition and classification review. This was followed by the UNDRR/ISC Hazard Information Profiles: Supplement to UNDRR-ISC Hazard Definition & Classification Review–Technical Report (2021). This Supplement consists of a description of each of the 302 hazard information profiles (HIPs), which was developed using a consultative process by scientists and experts across the globe.

The UNDRR/ISC Hazard Information Profiles (HIPs) provide a common set of hazard definitions and other information relevant to informing the strategies and actions of governments and stakeholders, and for managing the risks associated with hazards. They can be used whenever and wherever for assessment, planning, and action related to hazards. As such, they relate to the design, implementation, and monitoring of disaster risk reduction and risk-informed investments at all levels.

The science-based structure of the HIPs serves to avoid confusion and duplication in the classification of hazards. It also promotes up-to-date information derived from the ‘data revolution, rigorous accountability mechanisms and renewed global partnerships’. The HIPs support the implementation of not only the Sendai Framework for Disaster Risk Reduction 2015-2030, but also the Sustainable Development Goals of Agenda 2030, the Paris Agreement and International Health Regulations (2005). In 2022 an International Science Council Policy Brief was published describing the use of UNDRR/ISC HIPs to manage risk and implement the Sendai framework for disaster risk reduction.

We summarize what we assess as the past year's most important findings within climate change research: limits to adaptation, vulnerability hotspots, new threats coming from the climate–health nexus, climate (im)mobility and security, sustainable practices for land use and finance, losses and damages, inclusive societal climate decisions and ways to overcome structural barriers to accelerate mitigation and limit global warming to below 2°C.

We synthesize 10 topics within climate research where there have been significant advances or emerging scientific consensus since January 2021. The selection of these insights was based on input from an international open call with broad disciplinary scope. Findings concern: (1) new aspects of soft and hard limits to adaptation; (2) the emergence of regional vulnerability hotspots from climate impacts and human vulnerability; (3) new threats on the climate–health horizon – some involving plants and animals; (4) climate (im)mobility and the need for anticipatory action; (5) security and climate; (6) sustainable land management as a prerequisite to land-based solutions; (7) sustainable finance practices in the private sector and the need for political guidance; (8) the urgent planetary imperative for addressing losses and damages; (9) inclusive societal choices for climate-resilient development and (10) how to overcome barriers to accelerate mitigation and limit global warming to below 2°C.

Science has evidence on barriers to mitigation and how to overcome them to avoid limits to adaptation across multiple fields.

Disasters may have major impacts to mental health and to the utilization of mental health services (MHS). Moreover, these effects may be worsened by the preclusion of access to basic services following the event. The aim of this study is to evaluate the utilization of public MHS by the population that suffered water supply interruption following the Mariana Dam Failure in Brazil, 2015.

We conducted an Interrupted Time Series analyzing secondary health data from the municipalities that faced water supply interruption, comparing it to data from the other municipalities of Minas Gerais state.

We found a higher immediate (RR: 1.78; 95% CI: 1.25–2.53) and gradual (RR: 1.05; 95% CI: 1.03–1.06) change in the rate of mental health visits (MHV) in the affected population following the event, whereas there was an immediate fall (RR: 0.41; 95% CI: 0.29–0.59) followed by a higher gradual increase (RR: 1.04; 95% CI: 1.02–1.06) in the rate of hospital admissions (HA) in the affected population.

The results suggest that there was an increase in the utilization of public MHS by the population that suffered water supply interruption following the disaster.

As the incidence of cancer and the frequency of extreme weather events rise, disaster mitigation is becoming increasingly relevant to oncology care.

To investigate the effect of natural disasters on cancer care and the associated health effects on patients with cancer through the means of a systematic review.

Between database inception and November 12, 2016, Embase, ScienceDirect, MEDLINE, Scopus, PsycINFO, Web of Science, and CINAHL were searched for articles. Those identifying the effect of natural disasters on oncology services, or the associated health implications for patients with cancer, were included. Only articles published in English were included. Data extraction was done by two authors independently and then verified by all authors. The effects of disaster events on oncology services, survival outcomes, and psychological issues were assessed.

Natural disasters cause substantial interruption to the provision of oncology care. Of the 4,593 studies identified, only 85 articles met all the eligibility criteria. Damage to infrastructure, communication systems, medication, and medical record losses substantially disrupt oncology care. The effect of extreme weather events on survival outcomes is limited to only a small number of studies, often with inadequate follow-up periods.

To the best the authors’ knowledge, this is the first systematic review to assess the existing evidence base on the health effects of natural disaster events on cancer care. Disaster planning must begin to take into consideration patients with cancer.

Both India and Nepal are prone to a wide range of natural and man-made disasters. Almost 85% of India’s area is vulnerable to one or more hazards, and more than 80% of the total population of Nepal is at risk of natural hazards. In terms of the number of people affected in reported disastrous events, India is in the top 10 and Nepal is in the top 20 globally. Over the last two decades, India and Nepal have taken steps to establish their respective National Disaster Management organizations, which provide essential disaster responses. However, key gaps still remain in trained clinical capacity for managing impacts from various disasters. Our review of the region has shown that large parts of the population suffer injuries, diseases, disabilities, psychosocial, and other health-related problems from disasters.

Develop disaster medicine clinical capacity to reduce morbidities and mortalities from disasters.

Independent published data and work undertaken by the lead author in various disasters in India and Nepal since 1993 formed the basis of establishing the Faculty of Disaster Medicine for South Asia. The Faculty of Disaster Medicine - India and Nepal (FDMIN) was launched from Pune in March 2015. This initiative is supported by the National Association of Primary Care (UK), Public Health England, Faculty of Pre-hospital Care of Royal College of Surgeons - Edinburgh and CRIMEDIM (Novara) - Italy.

FDMIN has international expert advisors and has outlined 16 modules training curriculum for health care professionals. FDMIN currently has partnerships for teaching disaster medicine program with 3 medical universities and 12 major health care providers. Six pilot training programmes have been conducted in Pune, Delhi, Chennai, and Kochin. Work is underway to submit an application to the Indian regulatory bodies for approval to establish a post-graduate diploma and Master’s for Disaster Medicine.

In catastrophic events, a key to reducing health risks is to maintain functioning of local health facilities. However, little research has been conducted on what types and levels of care are the most likely to be affected by catastrophic events.

The Great East Japan Earthquake Disaster (GEJED) was one of a few “megadisasters” that have occurred in an industrialized society. This research aimed to develop an analytical framework for the holistic understanding of hospital damage due to the disaster.

Hospital damage data in Miyagi Prefecture at the time of the GEJED were collected retrospectively. Due to the low response rate of questionnaire-based surveillance (7.7%), publications of the national and local governments, medical associations, other nonprofit organizations, and home web pages of hospitals were used, as well as literature and news sources. The data included information on building damage, electricity and water supply, and functional status after the earthquake. Geographical data for hospitals, coastline, local boundaries, and the inundated areas, as well as population size and seismic intensity were collected from public databases. Logistic regression was conducted to identify the risk factors for hospitals ceasing inpatient and outpatient services. The impact was displayed on maps to show the geographical distribution of damage.

Data for 143 out of 147 hospitals in Miyagi Prefecture (97%) were obtained. Building damage was significantly associated with closure of both inpatient and outpatient wards. Hospitals offering tertiary care were more resistant to damage than those offering primary care, while those with a higher proportion of psychiatric care beds were more likely to cease functioning, even after controlling for hospital size, seismic intensity, and distance from the coastline.

Implementation of building regulations is vital for all health care facilities, irrespective of function. Additionally, securing electricity and water supplies is vital for hospitals at risk for similar events in the future. Improved data sharing on hospital viability in a future event is essential for disaster preparedness.

OchiS, NakagawaA, LewisJ, HodgsonS, MurrayV. The Great East Japan Earthquake Disaster: Distribution of Hospital Damage in Miyagi Prefecture. Prehosp Disaster Med. 2014;29(3):1-8.

Lactate measurement has been used to identify critical medical illness and initiate early treatment strategies. The prehospital environment offers an opportunity for very early identification of critical illness and commencement of care.

The investigators hypothesized that point-of-care lactate measurement in the prehospital aeromedical environment would: (1) identify medical patients with high mortality; (2) influence fluid, transfusion, and intubation; and (3) increase early central venous catheter (CVC) placement.

Critically ill, medical, nontrauma patients who were transported from September 2007 through February 2009 by University of Massachusetts (UMass) Memorial LifeFlight, a university-based emergency medical helicopter service, were eligible for enrollment. Patients were prospectively randomized to receive a fingerstick whole-blood lactate measurement on an alternate-day schedule. Flight crews were not blinded to results. Flight crews were asked to inform the receiving attending physician of the results. The primary endpoint was the ability of a high, prehospital lactate value [> 4 millimoles per liter (mmol/L)] to identify mortality. Secondary endpoints included differences in post-transport fluid, transfusion, and intubation, and decrease in time to central venous catheter (CVC) placement. Categorical variables were compared between groups by Fisher's Exact Test, and continuous variables were compared by t-test.

Patients (N = 59) were well matched for age, gender, and acuity. In the lactate cohort (n = 20), mean lactate was 7 mmol/L [Standard error of the mean, SEM = 1]. Initial analysis revealed that prehospital lactate levels of ≥4 mmol/L did show a trend toward higher mortality with an odds ratio of 2.1 (95% CI, 0.3-13.8). Secondary endpoints did not show a statistically significant change in management between the lactate and non lactate groups. There was a trend toward decreased time to post-transport CVC in the non lactate faction.

Prehospital aeromedical point-of-care lactate measurement levels ≥4 mmol/L may help stratify mortality. Further investigation is needed, as this is a small, limited study. The initial analysis did not find a significant change in post-transport management.

MullenM, CerriG, MurrayR, TalbotA, SanseverinoA, McCahillP, MangoldsV, VolturoJ, DarlingC, RestucciaM. Use of Point-of-Care Lactate in the Prehospital Aeromedical Environment. Prehosp Disaster Med. 2014;29(1):1-4.