Download logo
Government representatives from Egypt, Libya, Sudan and Tunisia — major countries on migratory routes in North Africa — convened in Cairo from 18–20 August for a 3-day table-top simulation exercise (SimEx) organized by the World Health Organization (WHO) and the International Organization for Migration (IOM).
The 4 countries share porous borders. Displaced people often face overcrowding, inadequate shelter, poor sanitation and limited access to timely, quality health care services. These conditions create public health risks for migrants, refugees and host communities. When health care services are not accessible to all, it fuels inequity and undermines health security.
The SimEx brought together delegates from Ministries of Health, Interior and Transport to test preparedness for cross-border population movements in line with the International Health Regulations (IHR 2005). Focused on ensuring access to health services for refugees, migrants and other people on the move while reinforcing national health security, it involved interactive and practical exercises on stakeholder coordination for public health event prevention, detection and response, aiming to improve compliance with IHR 2005, enhance communication between sectors and identify gaps to strengthen cross-border public health management, including access to health care services.
At the conclusion of the exercise, the multisectoral government representatives recommended standardizing public health procedures across borders to promote consistency and coordination. They called for sustainable dialogue and follow-up exercises to refine and scale-up bilateral and regional cross-border collaboration mechanisms and for formal collaboration frameworks and legal agreements between neighbouring countries to be established, building on mechanisms already in place.
Participants underscored the importance of strengthening technical capacity at national and cross-border levels, including real-time cross-border collaboration and communication during active outbreaks, and managing population movement and joint public health risks in line with the IHR 2005.
On the first day, on the sidelines of the SimEx, WHO, the Italian Embassy in Egypt and IOM co-hosted a reception to brief on WHO and IOM projects supporting migrant health. At the event, Dr Mohamed Jama, Senior Adviser to the WHO Regional Director for the Eastern Mediterranean, stressed: “We bring together the governments of Egypt, Libya, Sudan and Tunisia alongside our partners because the challenges we face are shared – and so too must be our response. Together, we can help alleviate the suffering of people on the move by providing essential, dignified health care to millions in transit who are escaping conflicts and instability across our Region.”
Justin MacDermott, IOM Deputy Regional Director for Operations, added: “Migrants are too often exposed to undignified conditions that erode well-being, resilience and human dignity. We must act now to expand lifesaving services, strengthen health systems and protect vulnerable migrants and host communities.”
The Eastern Mediterranean Region comprises 22 countries and territories, from which nearly 50% of the estimated 45 million refugees and asylum seekers in 2024 originated. An estimated 33% of them remain in the Region.
Speaking to participants and partners, the Italian Embassy in Cairo emphasised Italy’s strong support for inclusive health care, saying: “Health is not a privilege but a foundational right, a human right. Our approach combines political will with strong humanistic efforts to support stability, equity and resilience, particularly in the face of global challenges and the constant challenge to the multilateral rules-based order.”
The table-top simulation exercise is part of a broader joint regional initiative by WHO and IOM to strengthen cross-border health security in North Africa, supported by the Italian Ministry of Foreign Affairs and in collaboration with Africa CDC. Two previous workshops in Tunisia brought together Algeria, Libya and Tunisia to design a regional workplan for improving border health preparedness and coordination. This SimEx scaled up the scope and expanded the geographic coverage.
The simulation exercise marks a crucial milestone in advancing regional health security in North Africa, where migration and mobility are defining features of public health dynamics. By strengthening preparedness and coordination, governments in the Region reaffirmed their commitment to protecting the health of migrants, refugees, host communities and all populations at risk.
Distributed by APO Group on behalf of World Health Organization – Regional Office for the Eastern Mediterranean.