Application of the Emergency Response Framework by a WHO country office during an acute-onset emergency

In November 2023, a 6.4-magnitude earthquake struck western Nepal, its most powerful since 2015, causing severe destruction in the Jajarkot, Rukum, and Salyan districts. The disaster left 154 dead, thousands homeless, and over 75 health facilities non-functional. In response to government's request for support, World Health Organization (WHO) Nepal applied the Emergency Response Framework (ERF) 2.0 to structure its operations, demonstrating how a WHO country office could operationalize ERF protocols during an acute-onset emergency. Through the activation of a whole-of-office incident management team (IMT), including an active field-level presence, WHO Nepal met key ERF performance standards such as staff safety, rapid situation analysis, and coordinated action. This experience addresses the limited documentation on the practical application of the ERF at the country level and offers insights into the preconditions necessary for its effective use in real-world emergencies. Following the Jajarkot response, the WHO country office institutionalized ERF-recommended practices across operational units, creating a model that was successfully replicated during the 2024 floods and landslides affecting three provinces. This experience underlines the idea that, while the ERF provides a strong structural foundation for emergency response, its effective implementation hinges on institutional readiness, specifically a capacitated and trained workforce, functional coordination mechanisms, and established operational infrastructures. WHO Nepal's response demonstrates how structured frameworks like the ERF can enhance preparedness and enable scalable, flexible responses in disaster-prone settings, offering a replicable approach for other WHO country offices and partners working in similar contexts.