Background In May 2003, the Chief Executive announced

that the Government had begun to study the establishment of a CDC – like organisation in Hong Kong

SARS Expert Committee’s Report released in Oct 2003 recommended the establishment of a Centre for Health Protection (CHP)

Health Protection

Health protection is about the measures that public health authorities and others take to protect the population from communicable diseases and other public health hazards

(Report of the SARS Expert Committee 2003 )

What differences will CHP make?

International and

Mainlandauthorities

Hospital Authority/

Private hospitalsand

practitioners

Community

Universities

DH

Existing Interface Gaps

Legislation Surveillance

Science

Effective Health

ProtectionSystem

RiskManagement

Programme Development

Source:Health Protectionfor the 21st Century,Health Canada

SCOPING

Assessment of potential building blocks of health protection

SCIENCE

• Support of a network of laboratories

• Laboratory enhancement

• Science-based practice

SURVEILLANCE

• Strengthening of epidemiology as the core competency

• Enhanced surveillance

EMERGENCY RESPONSE

• Multi-disciplinary emergency response• Centralisation of field epidemiology services• Strengthening of risk communication

LEGISLATION

• Review of legislation in communicable disease control

PROGRAMMMEDEVELOPMENT

• Set up specialised health protection programmes

Centre for Health Protection Public HealthLaboratory Services

Surveillance & Epidemiology

Branch

Emergency Response ＆InformationBranch

Public Health

Services

Infection Control Branch

Programme Management and Professional Development Branch

EXPERTISE DEVELOPMENT

• Reorganisation of public health training• Strengthening of field epidemiology as the core business for investigation, analysis and rapid response capability

RESEARCH SUPPORT

• Incorporation of applied research

INTERNATIONAL COLLABORATION

• Coordination in Pearl River Region• Networking with international partners

Review of mandate

Promotion of standards

Organisation of CHP

EMERGENCY RESPONSE ANDINFORMATION

BRANCH

SURVEILLANCE & EPIDEMIOLOGY

BRANCH

PUBLIC HEALTHLABORATORY

SERVICES

PUBLIC HEALTH SERVICES

INFECTIONCONTROL BRANCH

Controller, CHP

PROGRAMME MANAGEMENT & PROFESSIONAL DEVELOPMENT BRANCH

Director of Health

New functional elements

Epidemiology Unit

CD Surveillance Unit

Emergency Response and Information Branch

Programme Management and Professional Development Branch

Infection Control Branch

Health Protection Programmes for targeted diseases

New functional elements

Epidemiology Unit

CD Surveillance Unit

Emergency Response and Information Branch

Programme Management and Professional Development Branch

Infection Control Branch

Health Protection Programmes for targeted diseases

Existing servicesto be incorporated

Regional Offices

Disease Prevention and Control Division

Central Health Education Unit

TB & Chest Service

Social Hygiene Service

Special Preventive Programme Pathology Service

Existing servicesto be incorporated

Regional Offices

Disease Prevention and Control Division

Central Health Education Unit

TB & Chest Service

Social Hygiene Service

Special Preventive Programme Pathology Service

HospitalAuthority /

PrivateHospitals & Practitioners

• Epidemic Intelligence• Communicable Disease

Notification• Training

• Attachment Programmes

• Communicable Disease Information System• Health Protection

Programmes fortargeted diseases •Infection Control

• Multi-disciplinary Emergency Response

• Risk Communication• Standardisation of Infection

Control Practice • Population Based

Programmes• Health Education

Programmes

• Professional Development

• Multi-disciplinary Emergency Response

• Appointed Collaboration Centres

• Health Protection Programmes for

targeted diseases

CHP

International & Mainland

authorities

Universities

Community

Strengths of CHP

Three Rs:

Real-time surveillance

Rapid intervention & resolution

Risk communication

Functional Branches

Surveillance &

Epidemiology Branch

FUNCTIONS Use contemporary IT programmes

and infrastructures to collect, collate, analyse and disseminate surveillance data on notifiable diseases and other communicable diseases

Establish a central communicable disease information system

Manage & respond to communicable disease outbreaks and develop control measures

Mastermind a surveillance system for GD-HK-Macao and focus on the situation of communicable diseases in PRDR

FUNCTIONS Use contemporary IT programmes

and infrastructures to collect, collate, analyse and disseminate surveillance data on notifiable diseases and other communicable diseases

Establish a central communicable disease information system

Manage & respond to communicable disease outbreaks and develop control measures

Mastermind a surveillance system for GD-HK-Macao and focus on the situation of communicable diseases in PRDR

FACILITIES

Epidemiology Unit and its Outbreak Teams

Data Management Centre

Communicable Disease Surveillance Unit

Priority issues Enhance comprehensiveness and

sensitivity of disease surveillance E-Notification platforms for physician reporting Centralised notification system for receiving

reports of institutional outbreaks Emerging infections surveillance network Expanded surveillance network: local and

international

Priority issues Strengthen Epidemiology and surge

capacities Epidemiology as core public health training Set up structured Epidemiology Training

Programme for specialist development Exchange programmes and training for dealing

with emerging pathogens Training for supporting professionals and public

health partners

Infection ControlBranch

FUNCTIONS Develop, promulgate and evaluate

best practices in infection control at health care and non-health care settings

Coordinate, facilitate and support training in infection control for all levels of health care workers

Support epidemiological investigation of nosocomial infections in hospital

Conduct surveillance on infection hazards in health care and non-health care setting

Set up epidemiology and infection control units in five major public hospitals

FUNCTIONS Develop, promulgate and evaluate

best practices in infection control at health care and non-health care settings

Coordinate, facilitate and support training in infection control for all levels of health care workers

Support epidemiological investigation of nosocomial infections in hospital

Conduct surveillance on infection hazards in health care and non-health care setting

Set up epidemiology and infection control units in five major public hospitals

FACILITIES

Simulation Room Epidemiology and

Infection Control Units

Expert Committees

Technical SupportDivision

Clinical Consultation & Investigation Division

Branch Head

Advisory Office

Senior Microbiologist Senior Epidemiologist Specialist in ID

Surveillance & Research Division

Training programmes

Interface in Infection Control Practices

Expert Panel on Infection Control

CHP Infection Control Branch

Recommendations

Training programme

s

Training & technical support

Advisory Office

hospital-based Epidemiology and Iinfection Control Units

Coordinating body

Infection control committee

Infection control committeeInfection control committee

QMH

QEH

PWH

TMH

PMHPMH

Epidemiology and Infection Control Unit

Emergency Response & Information

Branch

FUNCTIONS Overall corporate planning Co-ordinate emergency response on a

community/territory-wide basis Contingency planning Overall risk communication strategy Update information system needs Facilitate the development of preventive

strategy and cross-sector logistic support

Develop contingency plans and arrange drills

FUNCTIONS Overall corporate planning Co-ordinate emergency response on a

community/territory-wide basis Contingency planning Overall risk communication strategy Update information system needs Facilitate the development of preventive

strategy and cross-sector logistic support

Develop contingency plans and arrange drills

FACILITIES

Emergency Response Centre

Crisis Communication Lifecycle

Precrisis Initial Maintenance Resolution Evaluation

•Be prepared.

•Foster alliance.

•Develop consensus recommendations.

•Test message.

•Acknowledge the event with empathy.

•Explain and inform the public in simplest forms, about the risks.

•Establish agency/ spokes-person credibility.

•Provide emergency courses if action (including how/ where to get more information).

•Commit to stakeholders and public to continued communication.

•Help public more accurately understand its own risks.

•Provide background and encompassing information to those who need it.

•Gain understanding and support for response and recovery plans.

•Listen to stakeholder and audience feedback, and correct misinformation.

•Explain emergency recommendations.

•Empower risk/ benefit decision-making.

•Improve appropriate public response in future similar emergencies through education.

•Honestly examine problems and mishaps, and then reinforce what worked in the recovery and response efforts.

•Persuade the public to support public policy and resource allocation to the problem.

•Promote the activities and capabilities of the agency (corporate identity reinforced- internally, too)

•Evaluate communication plan performance.

•Document lessons learned.

•Determine specific actions to improve crisis systems or the crisis plan.

(Source: Crisis, Emergency & Risk Communication, CDC)

Public Health

Services

FUNCTIONS Support the control of communicable

diseases in the community (TB, HIV, STI)

Contribute to the surveillance of communicable diseases in Hong Kong

Provide specialised clinical services Provide communicable disease

treatment services Consist of TB and Chest Service,

Social Hygiene Service and Special Preventive Programme

FUNCTIONS Support the control of communicable

diseases in the community (TB, HIV, STI)

Contribute to the surveillance of communicable diseases in Hong Kong

Provide specialised clinical services Provide communicable disease

treatment services Consist of TB and Chest Service,

Social Hygiene Service and Special Preventive Programme

FACILITIES

Specialist Clinics Public Health Units

Priority issues To evaluate and improve the notification and

reporting systems for STI, TB and HIV/AIDS

To explore the role of information technology on surveillance and intersectoral coordination in relation to the above diseases

To facilitate the training and interchange of expertise between the public health stream and the clinical stream

Public Health

Laboratory Services

FUNCTIONS Provide pathology service for

communicable disease surveillance and control

Provide laboratory support for outbreak investigations

Develop infection control standards in laboratory settings

Train microbiologists and infection control professionals for laboratory services

Collaboration with laboratories in HA, AFCD, Govt Lab, local universities and overseas agencies

FUNCTIONS Provide pathology service for

communicable disease surveillance and control

Provide laboratory support for outbreak investigations

Develop infection control standards in laboratory settings

Train microbiologists and infection control professionals for laboratory services

Collaboration with laboratories in HA, AFCD, Govt Lab, local universities and overseas agencies

FACILITIES

Public Health Laboratory Centre

Priority issues To introduce new laboratories to improve

investigative capacity, including the laboratories for antimicrobial resistance surveillance, molecular virology, etc.

To develop and evaluate new test and optimize current tests for earlier laboratory confirmation of SARS CoV and shorten turn around time

Priority issues

To strengthen the networking and coordination with local universities, HA and other health care institutions on laboratory research and support of communicable diseases control

To enhance training for medical, scientific and technical staff

Programme Management

& Professional Development

Branch

FUNCTIONS Coordinate and organise training

activities for medical and nursing professionals of CHP, HA and other institutions

Liaise with local and international institutions to arrange attachment and exchange programmes

Carry out and coordinate research, including research projects in collaboration with universities, HA and other government departments

Manage health protection programmes

Coordinate with various advisory committees

Undertake health promotion activities

FUNCTIONS Coordinate and organise training

activities for medical and nursing professionals of CHP, HA and other institutions

Liaise with local and international institutions to arrange attachment and exchange programmes

Carry out and coordinate research, including research projects in collaboration with universities, HA and other government departments

Manage health protection programmes

Coordinate with various advisory committees

Undertake health promotion activities

FACILITIES

Library, IT facilities Training Office Research Office

Health Protection Programmes

Health Protection Programmes for targeted diseases/ health hazards

Three Dimensions

Multidisciplinary approach and intersectoral participation

Prevention – intervention continuum

Sustainable development

S & E ER & I PHLS PHS IC

Controller, CHP

Hospital X University P

CHP Scientific Committee for HP Programme B

CHP Core Group for HP Programme A

Advisory Committee

Expert members

Expert members

Programme lead

Programme lead

HP Programme organisation

Implementation Milestones

Dec 2003 – Jan 2004 Consultations with stakeholders on

the establishment of CHP

Mid 2004 To establish CHP under a transitional

stage Appointment of Controller, CHP Establishment of the Surveillance &

Epidemiology Branch & Infection Control Branch

Enhancement of Multi-disciplinary Emergency Response Mechanism

Endorsement of Manpower Enrichment / Redeployment Plan

2005 All functional elements of CHP to

operate smoothly, including Implementation of CD information

system (by phases) Implementation of manpower plan CHP IT platform in place (e.g. e-

notification system, case notification system)

Thank You