Together, we are accelerating progress toward global health security.

The 7-1-7 target is not going to address everything required for epidemic preparedness. Rather, the 7-1-7 target promotes early and effective action during outbreaks and rapid quality improvement for detection and response systems.  

There are four main uses of the 7-1-7 target: 

• Performance improvement: Delays and bottlenecks are easily identified and quantified, and remedial actions are taken to drive rapid improvement; 
• Prioritization for action and financing: Data on real-world system performance informs prioritization of available and needed financing (complementing the JEE and SPAR); 
• Communications and advocacy: When presented with clear data based on simple metrics, political leaders and donors can easily visualize resource and policy needs—and see how their investments are making an impact; 
• Accountability and reporting: Evaluating performance against simple metrics simplifies monitoring and improves transparency in reporting, making it easier to demonstrate the impact of interventions. 

A toolkit for using 7-1-7 is available in English, French, Portuguese and Spanish.  

Timeliness has been increasingly recognized as an important factor in improving system performance for early detection and response to public health emergencies.

The 7-1-7 target is aligned with the WHO’s Thirteenth General Programme of Work and Triple Billion target for Health Emergencies Protection, which created a new global metric for the timely detection, notification and response to public health threats.

It also contributes to the achievement of Sustainable Development Goal 3, specifically target 3.3, which aims to end epidemics of communicable diseases and strengthen country capacity for early warning, risk reduction and management of national and global health risks.

The Pandemic Fund, which provides grant financing for projects that seek to strengthen pandemic prevention, preparedness and response functions, also included the 7-1-7 Approach in its results framework.   

The 7-1-7 target offers a complementary approach and proposes a simplified way of assessing how well health security systems detect and respond to disease outbreaks in real-world conditions and real time. It helps countries gather reliable data for immediate decision-making to improve overall co-ordination and performance and prioritize their use of existing resources and future funding needs.

More than a decade has passed since the revised International Health Regulations (2005) (IHR) were established to ensure global security and help countries build the capacities needed to detect and respond to public health emergencies.  Still, as the global experience with COVID-19 made clear, too many countries were not adequately prepared for a pandemic, even when they seemed prepared on paper.    

Capacity assessments are often abstract, time-consuming and resource intensive. Reviewing real-world performance using 7-1-7 takes just a few hours and delivers immediately actionable data. It’s a quick but comprehensive evaluation of how well detection and response systems are working, using a systems approach focused on quickly identifying bottlenecks and enablers to timely performance. Detection and response systems can then be rapidly improved, using real-world data on performance to prioritize activities and resources where they’re needed most.  

In many settings, effective implementation of National Action Plans for Health Security (NAPHS)—a planning process for implementing core capacities in the IHR (2005)—has been handicapped by lack of prioritization. Integrating the 7-1-7 approach into the NAPHS process identifies focal areas for performance improvement and helps define a more feasible number and order of priorities per IHR technical area for both implementation and funding. 

The 7-1-7 approach complements existing preparedness assessments under the IHR, including the State Parties Self-Assessment Annual Reporting (SPAR) and Joint External Evaluation (JEE) tools, by evaluating the efficacy of outbreak detection and early response systems under the pressure of real-world conditions. It enhances After-Action Reviews (and Inter-Action Reviews) by providing clear performance targets and a simple way to check performance from the very start of a public health event—not months after the fact.  It can also support monitoring and evaluation of the performance of surveillance systems and strategies for integrated disease surveillance and response.  

The 7-1-7 approach is designed to rapidly identify bottlenecks in early detection and response systems and help governments define solutions to address them. These solutions may be inexpensive and quick to implement—such as workflow and coordination improvements—or long-term systems investments that should be prioritized in national planning efforts including NAPHS operational and strategic plans. 

In some countries using the 7-1-7 approach, funding for early responses has been identified as a bottleneck. 7-1-7 performance data can be used to advocate for solutions to the lack of resources for early response, such as setting up a revolving fund for access to emergency funding (which has been shown to be effective in decreasing early response time). 

In Uganda, health officials have used data from the 7-1-7 approach (in combination with data from other components of the IHR Monitoring and Evaluation Framework) to inform prioritization of activities in the national operational plan to improve epidemic preparedness. Using the 7-1-7 approach, officials recognized that lack of community awareness had resulted in delayed detection of certain priority diseases, such as anthrax and viral haemorrhagic fever.  The 2023 Annual Operational Plan prioritizes development and distribution of community educational materials for these specific diseases. 

A toolkit for using 7-1-7 is available in English, French, Portuguese and Spanish.  

Using the 7-1-7 approach is not resource-intensive. For most countries, the first steps are to meet with high-level decision-makers and conduct workshops to introduce the 7-1-7 approach in detail to stakeholders including those working in the areas of coordination, data collection, performance improvement, national planning, and communications and advocacy. Many successful workshops have included retrospective reviews of recent outbreak responses using the 7-1-7 approach—a useful way of demonstrating the value-add of the 7-1-7 target.   

Start-up activities include initial staff training; adjustments to data collection and monitoring systems to include timeliness data; and identification of a meeting where stakeholders can convene to review 7-1-7 performance after identification of an outbreak, discuss bottlenecks and take remedial actions to improve the response. Most pilot countries have also employed a dedicated staff-person to support the first year of implementation, with responsibilities including developing an implementation plan, updating guidance, convening stakeholders, and consolidating 7-1-7 performance data. Once these initial steps have been completed, the workload decreases, and ongoing 7-1-7 implementation may not require full-time dedicated staff. 

A toolkit for using 7-1-7 is available in English, French, Portuguese and Spanish.  

The 7-1-7 approach has been piloted in Brazil, several counties in the U.S, four African countries (Ethiopia, Liberia, Nigeria, Uganda), and is in early stages in another three African countries.  

Funds for three of the pilot projects were donated by the Bill & Melinda Gates Foundation, with other funding provided by Resolve to Save Lives.  

Preliminary findings have shown that the 7-1-7 target is feasible across high, middle and low-income countries and improves health security system performance. Using the 7-1-7 approach helps identify problems and bottlenecks that have been missed in other evaluations, many of which can be rectified in real time for little or no cost.   

To date, the most common bottleneck identified in the outbreak detection stage has been low levels of awareness/clinical suspicion by frontline health workers, followed by delays in laboratory confirmation. Other common bottlenecks include failure to report events to relevant authorities, lack of access to the resources needed for initiation of a rapid response, and low supply of medicines, vaccines and personal protective equipment. 

The 7-1-7 Alliance is a country-led partnership that will accelerate and support achievement of the 7-1-7 target and help countries meet their obligations under the International Health Regulations (2005). It is open to national, regional and local governments, public health and research institutions, multilateral agencies, civil society organizations, and donors and foundations. 

Its main activities will include: 

• Providing ongoing technical assistance for performance improvement; 

• Offering small grants to establish 7-1-7 in daily workflows and to build needed capacities as identified through functional assessments by countries and localities;  
• Engaging partners in communities of practice and regional learning networks to strengthen implementation, disseminate lessons learned and further refine the 7-1-7 approach; 
• Developing resources and creating an online hub with guidance, tools and training materials to support implementation; 
• Establishing a common monitoring and evaluation agenda to improve planning and implementation processes and inform donor funding priorities.   

A secretariat for the 7-1-7 Alliance will be hosted by Resolve to Save Lives (RTSL) for an initial five-year period. The Alliance will also benefit from the strategic advice of a Technical Steering Group composed of country representatives, multilateral partners and technical experts. 

The 7-1-7 Alliance has begun to formally welcome partners and will begin to accept new grant applications later this year.  In the interim, we’ll be hosting webinars, sharing lessons learned from pilots and consulting with partners on Alliance principles.  

To stay informed as the 7-1-7 Alliance evolves, please sign up for our email distribution list.

For help adopting 7-1-7 today, email us at contact@717alliance.org.