Dr. Sok Touch, Country Coordinator (Chair 2008-2009)

Guilin, PR China

27 February 2009

Progress in ImplementingMBDS Plan of Action during 2008 and

Plans for 2009: Report to Executive Board

6 countries

MBDS Partners

Rest of the World

Reporting of Progress is Based onSeven MBDS Core Strategies

(1) XB cooperation and information exchange

(2) Animal-human interface (zoonoses)(7) Policy research

(6) Risk communications

(2) Community-based surveillance

(3) HR development - epidemiology

(4) ICT capacity

(5) Laboratory capacity

Info sharing

Advantages of Standardized Reporting

Standardized reporting by XB site coordinators, Standardized reporting by XB site coordinators, CC’s and Strategy Coordinators would CC’s and Strategy Coordinators would provide more reliable and comparable information across countries and strategies, for MBDS countries and their development partners

Reports summarized here came from well organized and presented (but not standardized) country reports

Discussion on February 26 suggested that MBDS members would prefer standardized reporting of progress

(1) Overall Progress on XB Strategy

Orientation and establishment of new XB sites nearly on schedule for 2008 and into 2009

Counterparts generally know each others’ contact information and exchange information regularly

XB sites meet at least annually; meetings are already scheduled for 2009

Most XB sites report joint outbreak investigation or exercise past year; more exercises planned for 2009

Supervisory visits to XB sites reported only by Lao PDR (who conducted them 1-2 times per site)

(1) Maintain & Expand XB Sites (Lao PDR lead)XB Site (#, location)XB Site (#, location) Statu

sYear

2003-2007

1 Savannakhet (LAO) - Mukdaharn (THAI)Savannakhet (LAO) - Mukdaharn (THAI) ● 20032 Savannakhet (LAO) - Quang Tri (VIET) ● 20033 Champasak (LAO) - Stung Treng (CAMB) ● 20034 Luang Namtha (LAO) - Mengla (CHI-Y) ● 2003

2008-2009

5 Bo Kaeo (LAO) - Chiang Rai (THAI) ● 20086 Sakaeo (THAI) - Banteay Mean Chey (CAMB) Ө 20087 Takaeo (CAMB) - An Giang (VIET) ● 20088 Kampot (CAMB) - Kien Giang (VIET) ● 20089 Lai Chau (VIET) - Luchun (CHI-Y) O 200810 Chiang Rai (THAI) - Tachilake (MYAN) O 200811 Champasak (LAO) - Ubon Ratchathani (THAI) ● 200912 Borikhamxay (LAO) - Ha Tinh (VIET) O 200913 Vientiane (LAO) - Nongkhai (THAI) O 200914 Mae Sot (THAI) - Myawaddy (MYAN) O 2009

(1) Example of Standardized Reporting: (1) Example of Standardized Reporting: Progress report on XB sites – Lao: 2008Progress report on XB sites – Lao: 2008

XB SitesXB Sites Status Start

11 22 33 44 55 66 77

XB A-H HR ICT Lab RC Rsch

11Savannakhet (LAO) - Mukdaharn (THAI)

●2003

LaoLao ●●● ●●●●● ●●● ●O●●● ●●● OO O

ThaThaOOO OOOOO OOO OOOOO OOO OO O

22Savannakhet Savannakhet (LAO) - Quang Tri (LAO) - Quang Tri (VIET)(VIET)

●2003

LaoLao ●●● ●●●●● ●●O ●O●●● ●●● OO O

VNVNOOO OOOOO OOO OOOOO OOO OO O

33Champasak (LAO) - Stung Treng (CAMB)

●2003

LaoLao ●●● ●●●O● OOO ●●●●● ●●O O● ●

CbCbOOO OOOOO OOO OOOOO OOO OO O

44Luang Namtha (LAO)-Mengla (CHI-Y)

●2003

LaoLao ●●● ●●●●● ●O● ●OOOO O●● OO O

ChiChiOOO OOOOO OOO OOOOO OOO OO O

55Bo Kaeo (LAO) - Chiang Rai (THAI)

●2008

LaoLao ●●● ●●●●● OO● ●OO●● ●●O OO O

ThaTha OOO OOOOO OOO OOOOO OOO OO O

1111Champasak (Lao)-Ubon Ratchathani (Thai)

●2009

LaoLao ●●● ●●●●● OO● ●●●●● ●●O OO O

ThaTha OOO OOOOO OOO OOOOO OOO OO O

IHR (2005) as organizing framework Most provincial level counterparts in human and animal

health sectors have each others’ contact information Mechanism for collaboration across sectors (human,

animal, others) established or in progress, including formal MOUs & joint action plans

Priority zoonoses established in several countries Regular meetings and/or sharing information across

sectors established or in development Annual joint investigations &/or exercises conducted or

planned for animal or human disease outbreaks Village health workers trained and/or functioning for

surveillance (e.g., Vietnam, Cambodia)

(2) Animal-Human Health Interface and (2) Animal-Human Health Interface and Community Surveillance Community Surveillance (Vietnam lead)(Vietnam lead)

Systematic development of Country Work Plans – group process, needs/gap analysis in each country, guidance & country visits by strategy coordinator Dec 2008-Feb 2009

Most countries sent > 1 staff member for short epi course in Thailand (June 2008) and > 1 for longer term FETP training; plan to continue this in 2009

Trainees include senior central level (long term) and provincial or district level (short term)

Some countries have established short and/or longer-term epidemiology training in country (Vietnam, Myanmar) and others plan to do so (e.g., Cambodia)

(3) Human Resource Development – Epidemiology (Thailand lead)

(4) Strengthening ICT Capacity (Cambodia lead)

National forum (Phnom Penh August 2008)National forum (Phnom Penh August 2008)

InSTEDD supporting Cambodia as first pilot site – InSTEDD supporting Cambodia as first pilot site – central and provincial levels: field visits, training, central and provincial levels: field visits, training, current & new technologies, technical assistance, current & new technologies, technical assistance, pilot exercise, stakeholder interviews, use simple pilot exercise, stakeholder interviews, use simple ICT to support RRTsICT to support RRTs

Some countries routinely using electronic Some countries routinely using electronic notification (e.g., Lao PDR), others are in earlier notification (e.g., Lao PDR), others are in earlier stages of ICT planning/developmentstages of ICT planning/development

Most countries involved in GIS training & retrainingMost countries involved in GIS training & retraining

Most countries will participate in InSTEDD forum in Most countries will participate in InSTEDD forum in Mukdahan (April 2-3, 2009), then will develop their Mukdahan (April 2-3, 2009), then will develop their ICT plans ICT plans

(5) Strengthening Laboratory Capacity (5) Strengthening Laboratory Capacity (China lead)(China lead)

Strategy leader’s roadmap– Identify core diseases (August 2008)– Develop lab assessment questionnaire (Oct 2008)– Conduct field assessments in each country (ongoing)– Prepare final report (March 2009)– Identify gaps, develop common lab development plan

Countries awaiting final report from assessments in order to develop their plans and begin implementation

Some lab staff at central and provincial levels have been trained for RRTs (Lao PDR)

(6) Strengthening Risk Communications (6) Strengthening Risk Communications (Myanmar lead)(Myanmar lead)

Strategy coordinator: Strategy coordinator: – Emphasized the importance of planning for RCEmphasized the importance of planning for RC

– Described range of “public” audiences and need to tailor Described range of “public” audiences and need to tailor RC channels and messages to their contextRC channels and messages to their context

– Laid out steps to organize and implement this strategy Laid out steps to organize and implement this strategy across countriesacross countries

– Requested collaboration/help from development partners Requested collaboration/help from development partners

Most countries have not yet made progress on this Most countries have not yet made progress on this strategystrategy– However, Thailand conducted provincial level PHEIC However, Thailand conducted provincial level PHEIC

exercise of AI June 2008)exercise of AI June 2008)

(7) Conduct and Apply Policy Research (No specified lead)

Several countries reported policy research Several countries reported policy research completed, underway or plannedcompleted, underway or planned

– Thailand: Number of epidemiologists required to conduct Thailand: Number of epidemiologists required to conduct surveillance, investigate outbreaks & implement control surveillance, investigate outbreaks & implement control measures (underway)measures (underway)

– Vietnam: Situation analysis of new XB sites, future study Vietnam: Situation analysis of new XB sites, future study on 1-2 selected zoonoses (KAP, epidemiology and on 1-2 selected zoonoses (KAP, epidemiology and transmission characteristics – planned for May-June 2009)transmission characteristics – planned for May-June 2009)

– Lao PDR: KAP survey on AI prevention and control in 10 Lao PDR: KAP survey on AI prevention and control in 10 border sites (completed), study on malaria infection in border sites (completed), study on malaria infection in border village (Vietnam border area- completed), pilot border village (Vietnam border area- completed), pilot study to develop AI-free villages (planned)study to develop AI-free villages (planned)

– Myanmar: Conduct situation analysis at XB sites, identify Myanmar: Conduct situation analysis at XB sites, identify gaps, and plan to resolve them (planned), pending- study gaps, and plan to resolve them (planned), pending- study on 1 selected zoonosison 1 selected zoonosis

Summary of 2008 implementationSummary of 2008 implementation

Collectively, progress across countries is Collectively, progress across countries is impressive impressive

Implementation is largely on schedule, with some Implementation is largely on schedule, with some strategies and countries further advanced in their strategies and countries further advanced in their implementation and some lagging a bit behindimplementation and some lagging a bit behind

XB sites and countries can probably learn from one XB sites and countries can probably learn from one another’s experiences another’s experiences MBDS should identify MBDS should identify ways to facilitate this to greater extentways to facilitate this to greater extent

At current pace, progress in 2009 will likely be At current pace, progress in 2009 will likely be substantial across all MBDS countries and substantial across all MBDS countries and strategiesstrategies

Plans for next 6-12 months:Continue Progress Across All Countries & Strategies

1. XB: Establish 2008 and 2009 sites, maintain existing sites, monitor progress

2. Animal-human health interface: Agreements, communications, exercises, research

3. HRD – epidemiology: Complete Country Work Plans and implement

4. ICT – Extend beyond Cambodia pilot beginning with InSTEDD-sponsored April workshop in Mukdahan

Plans for next 6-12 months:Continue Progress Across All Countries & Strategies

(continued)

5. Lab – Complete assessment process and report, develop common lab capacity development plan (begin procurements and training?)

6. Risk communications – potential assistance from development partner to be identified to collaborate with strategy leader and MBDS countries

7. Policy research – Conduct studies already planned, identify policy questions to be addressed through new studies, disseminate results, apply results

Some Ideas Raised on February 26 (1 of 2)

“All countries have to implement all strategies to ensure regional security.”

More standardized presentations (e.g., using M&E forms, PPT template) for progress reporting by country and by strategy are desirable for future meetings– EB and development partners want to see “the whole picture”

Use MBDS newsletter and website to disseminate information on progress, outcomes of joint activities, lessons learned, results of policy research, etc.

Some Ideas Raised on February 26 (2 of 2)

Consider policy research areas: (1) which part of health system addressed by MBDS (central/provincial/district/local), (2) help reconcile multiple development partners with overlapping programs in countries and the region (e.g., ASEAN+3, GFATM, etc.)

Consider creating a user-friendly “clearinghouse” as a repository for all MBDS programmatic information – Knowledge Management

Thank you Thank you very much very much

for your kind for your kind attentionattention