FAO/WHO/USAID development of integrated desktop simulation exercises on

avian influenza in animal and human populations for Eurasia

Dr. Katinka de Balogh

Overview

๏ Emergency preparedness and simulation exercises

๏ The Armenia pilot desktop simulation exercise

๏ The Albania desktop simulation exercise

๏ Upcoming simulation exercises (Azerbaijan, regional)

๏ Lessons Learned

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Overall Aim of FAO/WHO/USAID project

๏ Enhanced preparedness and capacity of countries to face outbreaks of HPAI and other zoonotic diseases in animal and human populations

๏ Integration of animal and human health components of contingency plans

๏ Improved communication, coordination and chain of command between the different sectors involved.

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Preparedness planning

๏ political commitment for preparedness planning๏ funding made available๏ persons identified to write the plan or provide

inputs

๏ Plan adapted to the prevailing reality considering:- legislation- structures and mechanisms- chain of command- emergency resources- contingency plans/SOPs- capacity building needs, etc

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Preparedness planning

Evaluating preparedness through simulations:

- tabletop

- field

- combined tabletop and field

- computer

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Country free of HPAI

HPAI cases in humans

HPAI outbreaksin animals

(domestic/wildlife)

Preparedness planning

Control activities

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Preparedness Planning

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Start-up of the FAO/WHO/USAID project

๏ contracting the Health Protection Agency (UK)exercise teamhttp://www.hpa.org.uk

๏ Feb. 2007 Rome meeting at FAO with WHO, USAID, HPA, resource persons, Armenia delegates to develop 1st pilot exercise for Armenia

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The tabletop exercise

->define clearly the aim of the exercise

-> realistic scenario

-> participants carefully selected

(stakeholders)

-> available contingency plan available?

-> ‘lessons learned’ to adapt exercise

integrated simulation exercise for avian influenza in

animal and human populations

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The pandemic phases

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Pre-event

๏ mission to country to host exercise (lead organisation)

๏ status of plans

๏ interest of MoA and MoH

๏ identify potential participants

๏ official letter

๏ determine dates

๏ focal points, scenario writer(s) ( training in UK)

๏ possible venue

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Selecting the venue

๏ The main room:- space- carpet- electricity connections- round tables- event control table- observer tables- registration table (outside)-equipment

๏ coffee and tea, snacks ad libitum in room

๏ catering/lunch, reception

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Selecting the venue

๏ translation facilities

- simultaneous

- for documentation

๏ computer

๏ printing, copying facilities

๏ projections

๏ microphones (mobile)

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Past exercises

๏ one day (Armenia)

๏ two days (Albania, Azerbaijan)

๏ number of participants: max. 50 (+observers) 8-10 persons/round-table

๏ Ministry level, technical and local authorities

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Session set ups

๏ plenary sessions (simultaneous translation)

๏ working group sessions (whispering translation for observers)

๏ special programme for observers

๏ simulated press releases and press conference

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Exercise Agenda

0830 Arrival and registration (including refreshments)

0900 Welcome IntroductionExercise Briefing

1030

1200

Session 1 – Day 1Players work in groups (at tables)Plenary feedback

1230 Lunch

131513201515

Session 2 – Day 10Players work in groups (at tables)Plenary feedback

1530 Session 3 – Day 50Players work in groups (at tables)

1630 Plenary feedback & Player Hot Debrief

1700 Depart

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Exercise Structure Armenia

Inter Ministerial Task Force (incl. other Ministries)

Local Commission(incl. Community Level)

Expert Group

Rapid Response Team

Observers

GROUPS:

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The methodology

Scenarios

Session 1: first outbreak of HPAI in animals suspected

Session 2: outbreaks in animals confirmed first human cases,

Session 3: human fatalities due to H5N1

Session 4: situation gets under control, rehabilitation phase

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Scenarios and Injects

Create situations; provide specific instructions or data; keeps the scenario on track

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Answer sheets

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Injects – Answer Sheets

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Lessons learned

Armenia

๏ one day

๏ homogenous groups

๏ low interaction between groups

๏ observers got some injects

๏ facilitators briefed

๏ follow-up meeting

Albania

๏ two days

๏ mixed groups

๏ mock press conference

๏ neigbouring countries as observers (special programme provided)

๏facilitators trained

๏ action plan followed by donor meeting

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Some lessons learned

- buy in of country

- involvement of different sectors

- language (translations)

- new working methods/interactive

- need for good organisation and facilitation- time-limit, what is achievable?

- how to enhance discussions between groups

- importance of a very good event control team

- clear follow-up after the simulation

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Follow-up in country after exercise

๏ Presentation of Exercise report

๏ Identified needs discussed in country

๏ Elaboration of Action plan in country

๏ Presented to donors for funding

๏ Improvement of country preparedness

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Upcoming activities

๏ national exercise in Azerbaijan (1-2 July 2008)

๏ development of regional simulation exercise (fall 2008)

๏ regional exercise for the Balkan countries (end 2008/early 2009)

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Regional exercise

Issues to be addressed:

- cross border communication and cooperation

- outbreak communication

- cross border movement (control)

- harmonization of procedures (eg.compensation)

- how to deal with outbreak in border area

- - etc

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emergency preparedness is a continuous process

desktop simulation exercise is a useful tool to assess the contingency plan and communication mechanisms

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Thank you for your attention!

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Questions?

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