Preparing for and responding to health emergencies in the Eastern Mediterranean Region (EMR) presents major technical, operational and political challenges. Effective response to health and humanitarian emergencies is often constrained by insecurity, disrupted health systems, limited local capacities, bureaucratic impediments, insufficient partners with operational presence and underfunding. The Region, a geographical nexus between East and West, displays some of the world’s high levels of labour migration. In addition to the world’s highest levels of labour migration, the Region is home to leisure tourist sites, religious pilgrimage and trade; providing an ideal environment to facilitate fast spread of infectious disease.

As COVID-19 pandemic has shown, respiratory viruses and diseases such as influenza and coronaviruses are a threat to human development and security. Given the ease with which these viruses can both mutate and transmit, it is essential to enhance real-time surveillance to ensure these high-threat pathogens are detected timely and cannot spread out of control, causing localised outbreaks, cross-border spread and even pandemics. In the case of influenza, for example, the virus mutates quickly enough that scientists must race to update existing vaccines every year to ensure some degree of community protection against newly arising variants. In the EMR, Middle East respiratory syndrome, a coronavirus, has been circulating since 2012, causing localised outbreaks, with the majority of cases reported from Saudi Arabia.3 As of 30 May 2022, more than 21 million SARS-CoV-2 infections and 342 000 associated deaths have been reported from the Region