Simulation exercises are essential for emergency preparedness - putting plans into action, sharpening skills, and revealing critical gaps before a real crisis hits. For countries like Tonga, ranked as the third most vulnerable country to disasters according to the World Climate Risk Index 2021, being prepared is not optional. A functioning Public Health Emergency Operations Centre (PHEOC), equipped with well-trained personnel, is critical for ensuring swift, coordinated and effective response during outbreak of diseases to disasters such as earthquakes or cyclones.
To operationalize this preparedness, Tonga conducted its first simulation exercise and training on the national PHEOC from 7 to 9 May 2025, supported by WHO. This exercise brought together over 31 national and subnational leaders from various sectors to test and apply the principles of public health emergency management in a realistic, scenario-based setting, which followed the arc of a response - including readiness, response and de-escalation. It utilized cutting-edge technology with an interactive plug-and-play simulation.
Beyond applying emergency response skills, the simulation and training also served as an opportunity to strengthen national capacity. Tonga’s workforce is now equipped with this innovative technology to lead similar preparedness exercises across the country, expanding the reach and impact of this initiative. Reiterating the value of this approach, Dr Anup Gurung, WHO Country Liaison Officer in Tonga said: “Members of Tonga’s workforce not only have the knowledge and skills they need to coordinate the next emergency response but also have the technology to upskill others across the country.”
Advancing emergency workforce capacities through a multisectoral lens
The PHEOC simulation was conducted in direct response to gaps identified during the 2022 Intra-Action Review (IAR) to evaluate country's response to COVID-19, and later during 2024 Tonga’s Joint External Evaluation (JEE) – particularly the need to strengthen related emergency workforce capacities.
JEE and IAR are both part of a broader suite of monitoring and evaluation tools under the International Health Regulations (IHR 2005), which provide the essential legal framework guiding nations worldwide, including countries in the Pacific to protect people from future outbreaks and pandemics.
Dr Joseph Takai, Senior Medical Officer, Ministry of Health, Tonga noted: “Since COVID-19, we have used several IHR monitoring and evaluation framework tools to assess our capacities in health emergency preparedness and response. More importantly, during these reviews, we’re able to convene experts from interrelated agencies and sectors thus strengthening communication channels and fostering greater collaboration.”
/teams/regional-emergencies-programme-and-division-of-health-security-and-emergencies-(dse)/emergency-operations-(emo)/tonga-pheoc-training.jpg?sfvrsn=1f8c529b_3 "Tonga PHEOC training")
Members of Tonga's emergency workforce attend the first Public Health Emergency Operations Centre training and simulation exercise in the country
The recent simulation offered an opportunity to operationalize findings from those reviews, test existing plans, and enhance coordination and readiness across sectors thanks to the engagement of the Ministry of Health; Port Authority; Department of the Environment; Ministry of Meteorology, Energy, Information, Disaster Management, Environment, Climate Change and Communications; Ministry of Agriculture Forrest and Food; and Police.
Dr Maya Cherian, Director of Public Health at the Australian National Critical Care and Trauma Response Centre, a partner in developing the global health emergency workforce and sponsor of the training and the simulation exercise shared: “A coordinated multisectoral approach is essential for preparedness, response, and recovery. Through PHEOC simulation training, [participants can] learn from their peers and strengthen their skills and understanding before applying them in a real-world public health preparedness, response, and recovery effort.”
These efforts to advance emergency workforce capacities align with WHO’s Global Health Emergency Corps (GHEC) initiative that strives to strengthen countries’ emergency workforce capacities, foster coordination among surge teams and experts, and enhance collaboration across sectors during an emergency.
WHO is grateful for support from the Gates Foundation and the Australian National Critical Care and Trauma Response Centre's (NCCTRC) Public Health Operations in Emergencies for National Strengthening in the Indo-Pacific (PHOENIX) program, which is funded by the Australian Government Department of Foreign Affairs and Trade (DFAT) Partnerships for a Healthy Region (PHR) initiative, that enables this work.