Introduction:
Points of Entry (PoEs)—including ports, airports, and ground crossings—are vital for international travel and trade. The International Health Regulations (IHR, 2005) aim to prevent, protect against, control, and respond to the international spread of diseases while minimizing interference with travel and trade.

Methods:
This study conducts a secondary analysis of data from the IHR monitoring and evaluation framework in the EMR utilizing publicly available WHO data¹ and country mission reports conducted during the COVID-19 pandemic.

Results:
PoE capacities in the EMR are among the lowest globally, with significant variability across countries. The region designated 247 PoEs for IHR implementation: 90 airports, 104 ports, and 53 ground crossings. In 2023, the average PoE capacity in the EMR was 62%, down from 68% in 2022. Routine capacity averaged 64%, while public health emergency response capacity averaged 58%, and capacity for risk-based international travel measures averaged 65%. Ports had an average capacity of 68%, with 72% for routine capacities and 65% for emergency capacities. Additionally, 17 countries reported that they have authorized ports to issue ship certificates (120 ports). All designated ports reported having identified competent public health authorities. 76% of designated ports reported having Public Health Emergency Contingency Plans (PHECP), and 90% vector surveillance and control programs. COVID-19 pandemic exposed limited PoE preparedness, amongst others limitations in PHECP implementation, functional testing of plans and multi-sectoral coordination. COVID-19 also posed challenges for international shipping, interrupted supply chain and impacted the health of seafarers².

Conclusions:
The maritime sector was heavily impacted during COVID-19, affecting global supply chains and seafarer health. There is a critical need for member states to equip ports with necessary resources and capacities for all-hazard preparedness, including infectious diseases. Investments are required to enhance coordination, and operational capacities for rapid response. Lessons learned emphasize the need for innovative, multisectoral coordination in preparedness and response at ports to address global health security needs.