Download Pandemic

Outline of Workshop in FUKUOKA
on pandemic preparedness and
response in the region
CSR/WPRO
The 3rd Meeting of Nation al Influenza Centre
in the Western Pacific and South East Asia Regions
19 August 2009
BEIJING, CHINA
Outline of the presentation
1. Overview of “Workshop on the revised WHOGuidance on pandemic influenza preparedness
and response” in Fukuoka
2. Pandemic preparedness and response in the
region to the current situation
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Fukuoka Workshop: Overview
•
Objectives
– Review progress of pandemic preparedness in the Region
– Introduce the ‘Revised WHO guidance on pandemic influenza
preparedness and response’
– Identify future steps to update Member States’ pandemic
preparedness plans
•
Structure
– 3-5 March 2009 (3½ days)
– More than 70 participants/observers from 14 Member States of the
WHO Western Pacific Region.
– Six plenary sessions and two group discussions with poster
presentation.
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Pandemic Preparedness Progress
•
Significant progress made by each Member State
– Significant increase in level of understanding of pandemic influenza
preparedness
•
All Member States have developed a national
pandemic preparedness and response plan
–
•
Focus of the plan and involvement of stakeholders differs between
countries
Most Member States have conducted exercises to
validate their plans
–
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Many parties involved in plan development and exercises
Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Areas for Improvement
•
Integrating pandemic response into emergency management
processes
•
Developing (more) operational plans that include rapid
containment, including local level plans
•
Strengthening risk communication
•
Incorporating the “whole of society” approach in pandemic
preparedness planning
•
Establishing or strengthening comprehensive influenza
surveillance systems
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Recommendations:
Timing and Scope of Plans (I)
•
All Member States should consider revising their national
plans in consideration of updated WHO guidance
– Member States are encouraged to revise their plans by June 2010.
•
The "whole of society approach” should be incorporated in
the updated plans
– Member States should identify and define the roles and responsibilities
of central and local level authorities.
– Advocacy for high level support is needed. The Ministry of Health
should take the technical lead on this effort.
– Communication strategies for community involvement in pandemic
preparedness should be developed by each Member State.
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Recommendations:
Timing and Scope of Plans (ll)
•
A multi-sector rapid containment plan should be developed
and integrated into the national plan
–
–
•
National emergency management should be activated for rapid
containment
Rapid containment guideline can also be used to help countries take
action to stop the spread of the disease from the first national cases –
even when the global rapid containment may no longer be feasible
Surveillance for pandemic influenza is needed and should be
included in the national plan
–
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The national pandemic preparedness process should facilitate the
strengthening of a comprehensive national influenza surveillance
system
Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Recommendations:
Testing Plans and Monitoring Progress
•
Exercises should be conducted regularly to test and
validate national plans
•
Each Member State should assess their pandemic
preparedness annually with the ‘WHO WPRO and
CDC Joint Assessment Tool for Pandemic
Preparedness’
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Recommendations:
WHO Support
•
Provide technical support for plan revision as requested by
Member States
•
Convene forums
– Rapid containment for health and emergency management officials
– How to advocate for a multi-sector approach to Member States
•
Continue to assist with conduct of pandemic preparedness
and rapid containment exercises
– AND disseminate exercise program information and lessons learned
•
Assist with assessing comprehensive influenza surveillance,
including pandemic influenza surveillance capacity
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Outline of the presentation
1. Overview of “Workshop on the revised WHOGuidance on pandemic influenza preparedness
and response” in Fukuoka
2. Pandemic preparedness and response in the
region to the current situation
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Stage-Wise Intervention
Different public health strategy
and interventions are required at
the different stages of response
Pandemic Response
Rapid
Containment
Averting Pandemic Influenza
Inter Pandemic
(1 -3)
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Pandemic Alert
(4)
Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Pandemic
(5-6)
A Two-Tiered Approach to Pandemic
Preparedness
Influenza
Pandemic
specific
Core capacity
building;
APSED Work
plan
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Background
•
“WHO WPRO and CDC Joint Assessment Tool for
Pandemic Preparedness” (May – June 2009)
•
Sent to WPRO Member States and territories (via
Country Office if present)
•
Results analysed in 2 groups
– Group A (Countries and territories with CO presence)
– Group B (Countries and territories without CO presence)
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Data Analysis
•
Questions scored from 0 – 3
–
–
–
–
0 = no capacity
3 = advanced capacity
Moving from one level of capability to the next demonstrates
improvement in public health functions
Score ≥ 2 considered ‘good’
•
Median values used to calculate the level of capability in
APSED program area, for each stage of intervention
•
Proportion of countries at capability level ≥ 2 calculated
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Group A: Trends Summary
Group A (2008)
100%
90%
Gains
• Significant improvement (38%) in
2008
% responses ≥ 2
80%
70%
60%
50%
40%
•
30%
20%
Surveillance and Response and
Infection Control in all 3
intervention stages
Improvements in Risk
Communication
10%
0%
Group A (2009)
Surveillance and
Response
100%
90%
Laboratory
Risk Communication
Infection Control
Zoonosis
Averting Pandemic Influenza
APSED Priority Area
2009
Rapid Containment
Pandemic Response
% responses ≥ 2
80%
Areas for Improvement
• Infection Control capacity
•
70%
60%
•
50%
40%
30%
20%
10%
|
16 Surveillance
and
0%
Response
(increased, but still low)
Zoonosis capacity (no
improvement)
Risk Communication –
particularly in Rapid
Containment and Pandemic
Response intervention stages
Communicable Disease Surveillance & Response (CSR)
Risk Communication Infection Control
Zoonosis
WHO Western Pacific Regional Office (WPRO)
Laboratory
Averting Pandemic Influenza
Group B: Trends Summary
Group B (2008)
2009
100%
90%
2008
•
80%
% responses ≥ 2
Gains
70%
60%
•
50%
40%
30%
20%
10%
Group B (2009)
0%
Surveillance and
Response
Laboratory
% responses ≥ 2
70%
60%
50%
40%
30%
20%
10%
|
18 Surveillance
and
0%
Response
Infection Control
Zoonosis
2008
APSED Priority Area
2009
80%
Risk Communication
Averting Pandemic Influenza
100%
90%
Improvements in Surveillance
and Response
Significant increase in
Laboratory capacity at
Pandemic Response stage
(32%)
Rapid Containment
Pandemic Response
Areas for Improvement
•
Capacities in Pandemic
Response intervention stage
(lowest or equal lowest in all
areas)
• Risk Communication during
Averting Pandemic Influenza
stage (decreased by 13%)
Communicable Disease Surveillance & Response (CSR)
Laboratory
Risk Communication
Infection Control
Zoonosis
WHO Western Pacific Regional
Office (WPRO)
Averting Pandemic Influenza
Assessment Recommendations
•
WHO to continue technical support to Member
States in strengthening preparations for pandemic
response
– Shift from Containment to Mitigation strategies
– Adjust to local context and risk assessment
•
Assess pandemic preparedness and response
capabilities before June 2010
– Evaluation of progress or achievement of these goals
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Pandemic Response: Stages of Spread
Sporadic Cases
Clustering
(limited communitylevel transmission)
Community level outbreak
(sustained transmission)
Pandemic level spread
(extensive transmission)
How can we reduce preventable deaths close
to the level of a developed country?
Death
Early stage of USA
Japan
Severe
Mild
E.g. Mexico
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
E.g. USA
Shift from Containment to Mitigation
Sporadic Cases
Clustering
(limited communitylevel transmission)
Community level
outbreak
Pandemic level
spread
(sustained transmission)
(extensive transmission)
CONTAINMENT
To stop or delay the spread of the
virus by detecting cases and taking
vigorous actions, such as contact
tracing, treatment and/or quarantine
of contacts
To slow the spread of the virus in the
community and minimize transmission to
vulnerable populations
To ensure healthcare for those who need
it most
To minimise social disruption and other
negative consequences
MITIGATION
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
Framework for Action
SURVEILLANCE
Laboratory
PARTNERS
COMMUNICATION
COMMAND
HEALTH SECTOR
HEALTH CARE
RESPONSE
How to minimize
preventable deaths
PUBLIC HEALTH
INTERVENTIONS
INDIVIDUAL LEVEL
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How to slow down
transmission
Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)
SOCIETAL LEVEL
Conclusions and Next Steps
•
Continue strengthening core capacities through
implementation of the APSED workplan
– Will provide the basis to prepare and respond to an influenza
pandemic, as well as other infectious diseases
•
Accelerate pandemic preparedness and response
by prioritizing key areas to be strengthened
– Pandemic H1N1 2009 response
– Key areas outlined in the Framework of Action for response;
Command, Surveillance, Health Care Response, Public Health
Interventions and Communication
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Communicable Disease Surveillance & Response (CSR)
WHO Western Pacific Regional Office (WPRO)