Download Notes and Recommendations 18th Brunei Darussalam – Indonesia

Notes and Recommendations
18 Brunei Darussalam – Indonesia – Malaysia – Singapore – Thailand
(BIMST) Public Health Conference
29 - 30 October 2014
Belitung Island, INDONESIA
Opening session
th
Welcome address by the Host of the meeting [Indonesia]
Dr. Untung Suseno, M.kes, The Secretary General of The Ministry of Health of The
Republic of Indonesia delivered a welcome speech. He thanked Brunei Darussalam for
hosting the 17th Brunei Darussalam – Indonesia - Malaysia – Singapore – Thailand (BIMST)
Public Health conference with the success chairmanship year 2013-2014. He stated that the
world is now facing the public health emergency on the outbreak of Ebola virus diseases.
Further, the ministers of Health of BIMST member countries expressed their strong
commitment at the 12th ASEAN Health Ministers’ Meeting (AHMM) highlighting that ASEAN
countries need to strengthen the regional strategies, policy and capacities.
He highlighted the importance of the theme “Prevention and Control of Emerging
Infectious Diseases in BIMST Countries” to encourage the BIMST members to share the
experiences on response of emerging infectious diseases. Finally, he wished all delegates to
have successful discussion and have a memorable stay in a beautiful Belitung island.
Remarks by Outgoing Chair (Brunei Darussalam)
Dr. Pg Khalifah Pg Ismail, as an outgoing chair, thanked Indonesia for hosting the
conference. He recalled the previous meeting with the theme of “Health Beyond 2015” as
well as the fruitful roundtable discussions on the issues concerning vector borne diseases,
nutritious food in schools, FCTC implementation, tobacco control and ageing. He also
expressed the appreciation that Indonesia has chosen the topic of EID Prevention and
control as the theme for 18th BIMST. He then handed over the chairmanship of BIMST to
Indonesia.
Election of Chairperson, Vice Chairperson and Rapporteur
Indonesia was elected as the Chairperson of the meeting along with Malaysia as the
Vice Chairperson and Thailand as the Rapporteur.
Opening address by the Chair of the meeting (Indonesia)
Dr. Muhammad Subuh, MPPM, Chairperson of the 18th BIMST Public Health
Conference, once again welcomed all delegates. He expressed his appreciation to Brunei
Darussalam for being a successful Chair for the period of 2013-2014 and for hosting of 17th
BIMST. The previous 17th BIMST discussed on various issues including multisectoral
approach to prevent and control of NCDs, maintaining the existing networking, the food safety
standardization and FCTC. He hoped that the theme of “Prevention and Control of Emerging
Infectious Diseases in BIMST Countries”, which the ministers had the commitment in the
previous AHMM, will encourage delegates to share the experience on the best practise of
EID prevention and control and wished that BIMST countries could make a significant
progress towards this ultimate goal. The importance of collaboration within the BIMST was
highlighted with benefits for all members, including the continuous of Post 2015 Health
Development Agenda.
Adoption of Agenda
The agenda of the 18th BIMST Public Health Conference was adopted and
conducted as scheduled.
Review of Recommendations from the 17th BIMST Public Health Conference Meeting
in
Brunei Darussalam
Brunei Darussalam shared the recommendations of the 17th BIMST meeting in
Brunei Darussalam. BIMST Countries acknowledged that the Millennium Development
Goals (MDGs) has been afforded to achieve for people’s wellbeing. Presentations of BIMST
countries mostly highlighted the common regional response on Non-Communicable
Diseases by addressing the underlying determinants of unhealthy lifestyle. Roundtable
Discussion has been displayed in various topics such as vector borne disease control, food
consumed by school children, tobacco control efforts, and ageing society management.
Country’s Perspectives on Prevention and Control of Emerging Infectious Diseases
(EIDs)
1. Brunei Darussalam
Emerging infectious diseases remain a significant public health threat globally and
regionally including in BIMST countries. Brunei Darussalam presented on the background of
infectious diseases surveillance as well as status and updates of infectious diseases of
concern within the country. Dengue and other climate sensitive vector borne diseases
continues to be a significant public health threat together with MERS-CoV and Ebola posing
an increasing threat. In this regard, Brunei Darussalam continues to strengthen its
surveillance and preparedness activities including the endorsement of MERs-CoV and Ebola
Preparedness Plan in response to the current global disease outbreak situation. The issue of
managing infectious diseases highlighted the need for multi-sectoral collaboration nationally,
regionally and globally and ongoing collaboration specifically sharing of information and
experience with other BIMST countries on response to emerging infectious diseases has
proven beneficial.
2. Indonesia
Indonesia has National strategic plan for controlling Influenza A (H5N1) which
effectively decreased cases of the disease in poultry and human continually in overall and
this plan has been used for pandemic preparedness of other EIDs. Implementation of
strategies in EID prevention and control including 9 components i.e. international
collaboration, command and coordination, surveillance, medical response and laboratory,
pharmaceutical intervention, non-pharmaceutical intervention, risk communication, point of
entry, and simulation. For early detection and response, Indonesia has already set up Rapid
Response Team (RRT) and Early Warning Alert and Response System (EWARS) in 31
provinces including appointed hospitals and laboratories as referral health facilities.
Surveillance and other response, moreover, were prepared to an outbreak of the disease
accompanied with specific training programs for related officers. However, there are many
challenges to control infectious diseases including geography, resource capacity, migration
and culture which require collaboration from other sectors engagement.
3. Malaysia
Malaysia presented that threat of EIDs was influenced by climate change, ,
population migration and increasing global interconnectedness. Nipah virus, SARS, H5N1,
avian influenza A (H7N9) and MERS-CoV are the EID of concern in Malaysia. Malaysia
developed National Influenza Pandemic Preparedness Plan (NIPPP) with regards to health
security. There are key components of the preparedness including capacity building,
infrastructure development and surveillance system. In the face of the threat of emerging
diseases all related sectors should be working together towards common goal in order to
address public health security risks.
4. Singapore
The presentation showed the national mechanism for crisis management in
Singapore. The prevention and control of Emerging Infectious Diseases (EIDs) emphasises
on caring for cases, minimising import, containing spread, and mitigating impact for diseases
that cannot be contained. The Disease Outbreak Response System Condition (DORSCON)
Framework for infectious diseases has four alert levels represented by four colors (green=no
disruption, Yellow = minimal disruption, Orange = moderate disruption and Red = major
disruption). In planning for EID outbreaks, Singapore considers six areas namely
surveillance and early detection, preventing spread, clinical management and laboratory
testing, contact tracing, quarantine or phone surveillance, and public communications.
Singapore shared its contingency plan for MERS-CoV compriseing eight areas such as
legislation, risk communication, border control, Contact Tracing and Quarantine.
5. Thailand
Emerging Infectious Diseases (EIDs) occurs every year. More than 70% of EIDs are
zoonosis. The important EIDs in Thailand consist of Avian Influenza, Middle East
Respiratory Syndrome Coronavirus (MERS-CoV), Ebola Virus Disease (EVD) and Multidrugresistant tuberculosis (MDR-TB). Nowadays, Thailand uses a National Emerging Infectious
Diseases Strategic Plans (2013-2016) with 5 strategies for preparedness and response to
EIDs. The National Emerging Infectious Diseases Strategic Plans compose of 8 steering
sub-committee with Deputy prime minister as a chairman. Thailand conducts the preparation
and response to EIDs in form of multisectoral coordination with one health concept such as
Prince Mahidol Award Conference, Asia Partnership for Emerging Infectious Disease
Research (APEIR), Thailand Partnership on Emerging Infectious Disease Research
(TPEIR), and National Health Assembly. In conclusion, efficient command, control and
management are the foundation of successful response to emerging infectious diseases and
public health emergencies.
Roundtable Discussion
1. Brunei Darussalam[National medicine policy]
Brunei Darussalam National Medicine Policy (BDNMP) was launched recently. The
objectives of BDNMP is to ensure the equitable and timely access to safe, effective and
affordable medicines of good quality and promoting the quality use of these medicines with
the aim of optimising health outcomes for all. There are eight elements of BDNMP which
focuses on quality, safety and efficacy of medicines, medicines availability, medicines
affordability, quality use of medicines, human resources development, research and
development, technical cooperation and governance. This policy will remain dynamic and
responsive to evolving global situations and advancement in technology and is a useful tool
for preparedness to address EIDs. Furthermore, all stakeholders are expected to actively
involved in its implementation, monitoring and evaluation.
2. Indonesia [BIMST Pandemic Alert and Preparedness]
In the face of risk for EIDs, Indonesia addressed high risk for EIDs on BIMST
members through the region which should have followed rocketing economic area, supply of
labour, tourism destination, pilgrimage for Umrah and Hajj and point of entries between
countries. Indonesia suggested the surveillance for international travellers should work on
multi sectors approach to be the best fit activities to minimize the impact. Meanwhile, prompt
communication between countries to anticipate potential EIDs importation also plays an
important role. The strategy on strengthening pandemic alert and preparednessis a joint
contingency plan on EID including outbreak simulation engangement multi-sectoral in border
areas within BIMST countries.
3. Malaysia [Global Health Security Agenda]
Malaysia is committed to accelerate progress towards a world safe and secure from
infectious disease threat and to promote global health security as an international priority.
Malaysia which serves as the lead country for GHSA package (Respond 1) whereby
enhancing public health EOCs capacity is the main pillar. Malaysia urges BIMST member
countries to have exchange of visits of EOCs to share best practices, explore
communication link ups and provision of technical assistance to strengthen existing EOCs.
The strategy “Global Health Security Agenda (GHSA)” is based on shared responsibility by
collaborating countries and international organizations with an objective of “Developing an
interconnected global network of Emergency Operation Centers” followed by adopting an
action package on concerned issues. The purpose of its action package is to prevent
(Antimicrobial Resistance, Zoonotic Diseases, National Biosafety and Biosecurity system,
Immunization) detect (Nationwide Laboratory System, Surveillance, Reporting, Workforce)
and respond (EOCs, Multisectoral Respond, Countermeasure and Personnel to health
concerns GHSA steering Group will require high-level political support to ensure that these
objectives remain a priority and the working level support team will provide technical and
administrative support to both of these groups, facilitate information sharing across partners
and encourage replication across regions via single contact point on each BIMST country.
4. Singapore[Leveraging Social Media for Disease Surveillance and Public
Sensing]
During the outbreak of human infection with avian influenza A (H7N9) in China,
Chinese social media, called “Sina weibo”, was used as a complementary tool for reporting
and risk communication. The result of the study found the number of weibo posts on H7N9
increased with the daily number of H7N9 cases reported during the outbreak. Rumours of
cases had started even before official health authorities released the information. . In
addition, reporting of new cases on Weibo was significantly faster than those on the
conventional public health channels; Weibo was on average 1 hours earlier than China
NHFPC reporting, compared to WHO notification which was 1day later than NHFPC
reporting. Using of Weibo during H7N9 outbreak was showed to have several benefits.
Social media could be used as a tool for risk communication, timely reporting of cases,
crowdsourcing of information, , and public sensing for response measures. However, there
are many challenges in using social media such as knowing the right social media platform
to use, veracity of the information, language barrier, , etc.
5. Thailand[Response to pandemic of Ebola Virus]
Ebola virus disease outbreak in the West Africa impacts on every countries in the
world. As a result, World Health Organization (WHO) announced the endemic of Ebola Virus
Disease (EVD) as Public Health Emergency of International Concern (PHEIC). In spite of
low risk of importing EVD in Thailand, the Ministry of Public Health (MOPH) announced EVD
as dangerous communicable disease. MOPH established measures to prevent and control
EVD; composing of surveillance systems among humans and animals, treatment and
infection control at hospitals, laboratory testing and management. In addition, risk
communication to general people, healthcare workers, and travellers visiting in endemic area
is the most important to prevent and control EVD in Thailand.
Recommendations from the 18th BIMST Public Health Conference
We agree to accelerate our cooperation in the prevention and control of EIDs by
strengthening mechanism amongst BIMST countries and put into action, wherever
appropiate the following activities :
1) Exchange of particulars of border health contact point and relevant institutions including
list of health facilities and referal mechanism. .
2) Sharing of Lessons Learnt and best practices on EIDs outbreak prevention and control.
3) Exchange of information on BIMST current regulation and policies on EIDs Prevention
and control
4) Strengthening border agency coordination between relevant BIMST member countries
and utilizing existing platform such as IHR mechanism and relevant ASEAN Health
Clusters Focal Points.
5) Developing Border Contingency Plan for EIDs Preparedness and Response, taking into
consideration their respective Preparedness Plan of each member state
6) Conducting joint Multisectoral Outbreak Simulation in the relevant border areas
Date and Venue of the 19th BIMST Public Health Conference
The 19th BIMST Public Health Conference will be held in Kuala Lumpur Malaysia year 2015