Result of gap analysis and framework of action required in coming five months 19-20 August 2009 3 rd Meeting of National Influenza Centres in the Western

Result of gap analysis and framework of action required in

coming five months

19-20 August 2009 3rd Meeting of National Influenza Centres in the

Western Pacific Region

Communicable Disease Surveillance & Response (CSR)WHO Western Pacific Regional Office (WPRO) and South East Asia Regional Office (SEARO)

Why we urgently need to prepare (1)Why we urgently need to prepare (1)

Mortality Distributions and Timing of Waves of Previous Influenza Pandemics

Miller M et al. N Engl J Med 2009;10.1056/NEJMp0903906


Why we need to prepare (2) Different stages of influenza spread to Pandemic

Why we need to prepare (2) Different stages of influenza spread to Pandemic

Sporadic Cases School & Community Outbreaks

Sustained Community Transmission

National (and Global) Spread - Pandemic

JapanEarly NY

Mexico NY

Mild

Severe

Death

How can we reduce the level of preventable

deaths?


Scenario Building – Bicol, Region 5Scenario Building – Bicol, Region 5

Population

Sick

Hospitalisations

Death

0.1%

1,022

20%

2% 9%

0.5%

30%

91,97620,439

5,110

5,109,798 (Aug 07 census)

1,021,960 1,532,939

0.1%

1,533

2% 9%

0.5%

137,96530,659

7,665


Background of Gap Analysis how we conducted and how we interpreted

Background of Gap Analysis how we conducted and how we interpreted

Soon after the first report of influenza A(H1N1), WHO Offices of South East Asia Region and Western Pacific Region initiated the rapid assessment to identify gaps in pandemic preparedness in countries

The rapid assessment was conducted through WHO country offices using modified framework of Asia Pacific Strategy for Emerging Diseases (APSED)

Analysis elaborates the need for urgent action and allows WHO to further develop more focused action framework for coming five months


APSED AND WORKPLAN APSED AND WORKPLAN APSED AND WORKPLAN APSED AND WORKPLAN

IHR (Public Health Emergencies of International Concern)

Asia Pacific Strategy for Emerging Diseases (APSED)

Bi-Regional Workplan

AvianInfluenza

Pandemic preparedness


SURVEILLANCESURVEILLANCE

COMMANDCOMMAND

PUBLIC HEALTH PUBLIC HEALTH INTERVENTIONINTERVENTION

COMMUNICATIONCOMMUNICATIONHEALTH CARE HEALTH CARE

RESPONSERESPONSE

HEALTH SECTORHEALTH SECTOR

SOCIETAL LEVELSOCIETAL LEVELHow to slow downHow to slow downthe transmissionthe transmission

Individual Individual LEVELLEVEL

LaboratoryLaboratory

How to How to minimize minimize

preventablepreventabledeathsdeaths

Partnership


Different stages of influenza spread to Pandemic and required intervention

Different stages of influenza spread to Pandemic and required intervention

Sporadic cases School outbreaks + community

Sustained (extensive) community level

Nation wide (pandemic level)

spread

Health Care Response

Public Health Intervention

Surveillance

Communication


Command and planningCommand and planning

Need to urgently update pandemic preparedness and response plan

Need to reconfirm their line of command, roles and responsibility

Need to conduct training for risk assessment that serves as foundation for public health intervention and health care response

Need to organize planning meeting to facilitate the preparation at sub-national level 1. Both political and technical leaders at local authorities2. Disaster Committee3. Response Team4. Laboratory

Need to improve communication capacity: domestically and internationally (IHR)

Need to improve their Business Continuity Plan


SurveillanceSurveillance

1. Further strengthen central unit capacity to collect and analyse data and communicate with command post

2. Further strengthen influenza like illness surveillance and event based surveillance

3. Develop information collection system such as school absenteeism, if appropriate

4. Develop laboratory diagnostic strategy including surge capacity


Health care response Health care response

1. Need to develop national guidelines on clinical management and infection control

2. Need to organize training: infection control, clinical management

3. Need to facilitate hospital management including infection control in pandemic response

4. Need to establish health care response system at sub-national level


Public Health InterventionsPublic Health Interventions

1. Capacity to conduct risk assessment

2. Need further detail advance planning and SOP

3. Need to develop SOP including communication

4. Need to develop communication material (communication)


CommunicationCommunication

1. Communication strategy and public information materials

2. Trainings for media/public/private sector staff responsible for risk communication

3. Protocols and procedures for risk communication collaborating with multi-agencies for pandemic response


Conclusion Conclusion

WPRO and SEARO conducted rapid gap assessment; country showed gaps in similar areas.

Rapid gap assessment provided the opportunity to develop simple and focused framework of action for coming five months

Every country required accelerated action to prepare for the extensive community level transmission

Time is limited and action needs to be focused

Planning and preparation needed not only at national but also at sub-national level

Documents

Result of gap analysis and framework of action required in coming five months 19-20 August 2009 3 rd Meeting of National Influenza Centres in the Western