Download Meeting of the Global Outbreak Alert and Response Network

Meeting of the
Global Outbreak Alert and
Response Network (GOARN) Partners
from the Western Pacific Region
19 - 20 October, 2009
Beijing, China
( $ ' World Health
~ Organization
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Western Pacific Region
WPR/2009/DCC/08/CSR
English only
Report Series Number: RS/2009/GE/26 (CHN)
REPORT
EETING OF THE GLOBAL OUTBREAK ALERT AND RESPONSE NETWORK (GOARN)
PARTNERS FROM THE WESTERN PACIFIC REGION
Convened by
THE WORLD HEALTH ORGANIZATION
AND THE CHINESE CENTER FOR DISEASE CONTROL AND PREVENTION
Not for sale
Printed and distributed by:
World Health Organization
Western Pacific Regional Office
Manila, Philippines
December 2009
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NOTE
The views expressed in this report are those of the participants and temporary advisers at the Meeting
of the Global Outbreak Alert nnd Response Network (GOARN) Partners from the Western Pacific
Region and do not necessarily reflect the policies of WHO.
This report was published by the Western Pacific Regional Office for the participants at the Meeting of
the Global Outbreak Alert and Response Network (GOARN) Partners from the Western Pacific Region
held in Beijing, China, from 19 to 20 October 2009.
TABLE OF CONTENTS
1. BACKGROUND
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2. INTRODUCTION
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3. THE GLOBAL AND REGIONAL PERSPECTIVE
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4. GOARN MISSIONS AND FIELD EXPERIENCE
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5. EXPERIENCES FROM THE FIELD: CHINA'S NATIONAL AND
INTERNATIONAL RESPONSES
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ANNEXES
ANNEX 1
PROGRAMME OF ACTIVITIES
ANNEX 2
LIST OF PARTICIPANTS
ANNEX 3 LIST OF CURRENT GOARN PARTNERS IN THE WESTERN
PACIFIC REGION
ANNEX 4
WPRO OFFICES IN THE WESTERN PACIFIC REGION
ANNEX 5
LIST OF RECOMMENDED PRINT AND ONLINE RESOURCES
Keywords:
Disease outbreaks - prevention and control I Communicable diseases, Emerging prevention and control I Technical cooperation I Natural disasters I Disaster
preparedness
1. Background
The Global Outbreak Alert and Response Network (GOARN) is an international grouping of
technical institutions that collaborates on the common goal of international outbreak response. The
network provides teclmical advice and operational support for the control of cliseilsr: o11thrr:ilk"s
worldwide. It has a large and active membership in the Western Pacific Region with over 40 partner
institutions. In the last two years, there has been a concerted effort, as part of the Asia Pacific Strategy
for Emerging Diseases (APSED), to strengthen the network and encourage greater participation from a
wide range of technical institutions in the Region.
A meeting of the GOARN partners in the Western Pacific Region originally was scheduled for
14 to 15 May 2009 in Beijing, China. But the outbreak of the pandemic influenza A (H1N1) 2009
forced the meeting to be rescheduled to 19 to 20 October 2009. The Beijing meeting was hosted by the
Western Pacific Region in partnership with the Chinese Center for Disease Control and Prevention
(Chinese CDC).
The 2009 GOARN meeting was the third organized by the Western Pacific Region and brought
together more than 100 participants from existing and potential GOARN partner institutions from 12
countries. Also in attendance were the GOARN Secretariat, WHO regional staff and observers from
various academic institutions and regional bodies with an interest in GOARN activities.
The meeting opened with an introductory and background address by incoming China WHO CountiJ
Representative Dr Michael O'Leary. Dr Liang Wannian, Deputy Director General of the Health Response
Office of the Chinese Ministry of Health, and Dr Yang Weizhong, Deputy Director General of the Chinese
CDC, followed with welcoming remarks. Amy Cawthorne of the Western Pacific Regional Office then
briefly reviewed the objectives and outcomes expected for the conference, which included:
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to enroll partner institutions in the Region with a particular focus on technical institutions in
China; and
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to draw on the experiences and lessons learnt from recent international responses to disease
outbreaks through the GOARN mechanism, including the outbreak of severe acute respiratory
syndrome (SARS) in 2002 and 2003, the 2004 Indonesian tsunami, the 2008 Wenchuan
earthquake in China and the H1N1 outbreak of2009.
Dato Dr Tee Ah Sian began the morning session with an overview of the APSED and the
establishment of GOARN in the Region. Her points set the tone for a lively series of technical
presentations and plenary discussions during the two-day event. The complete agenda is available in
Annex 1. This report summarizes the main themes, action points and recommendations that emerged
from the meeting. It should be used as a reference for current and prospective GOARN partners to
better understand GOARN's mission and procedures in response to new, emerging and recognized
epidemiological outbreaks, natural disasters and other regional and global occurrences.
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2. Introduction
The Western Pacific Region has witnessed the detection of more than 30 new infectious agents
in the past three decades, including SARS, avian influenza A (H5Nl), Nipah virus and drug-resistant
malaria. With a population approaching 3.5 billion people, the presence of emerging diseases and their
impact on health and economic growth has been underscored by a rash of high-profile epidemiological
outbreaks, including the 2009 HlNl pandemic that threatens millions worldwide. The importance of
formulating a well-prepared and strong public health system to combat these diseases is a clear priority
for the Region.
GOARN was formed in April 2000 at a meeting in Geneva, Switzerland, and brought together
64 technical institutions with expertise in epidemic surveillance and response. Participants identified
the need for a global network, building on new and existing partnerships, to deal with the global threats
of epidemic-prone and emerging diseases. The network provides an operational framework to link this
expertise and skills to keep the international community constantly alert to the threat of outbreaks and
ready to respond. A steering committee of network partners also was established to guide its evolution.
GOARN is central to global health security because it:
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combats the international spread of disease outbreaks;
ensures that the right technical assistance reaches affected states rapidly; and
contributes to long-term epidemic preparedness and capacity-building.
Since April 2000, GOARN has been bringing agreed standards to international epidemic
response through the formulation of Guiding Principles for International Outbreak Alert and Response
and operational protocols to standardize epidemiological, laboratory, clinical management, research,
communications, logistics support, security, evacuation and communications systems.
The current roster of participating partners is 150. GOARN has been active in many global
crises in the past nine years, both in Asia and worldwide. They include Ebola and other viral
haemorrhagic fever outbreaks in parts of Africa, SARS, avian influenza A (H5Nl) and A (HlNl)
outbreaks that involved many of the 150 partners. A priority has been to establish consensus and
assign protocols for key administrative, managerial and implementing strategies.
WHO and the Chinese CDC hosted the 2009 GOARN meeting for the Western Pacific Region
from 19 to 20 October 2009 in Beijing, China. The meeting of current and potential GOARN partners
included more than 100 participants from 10 countries, including programme planning, staffmg and
logistical support from the Western Pacific Regional Office in Manila, the WHO Office in Beijing and
WHO Headquarters.
China has five GOARN partners, and its experiences in recent global events (the Indonesian
tsunami and international health crises) have enhanced its preparedness level both at home and abroad.
One of the focuses of the meeting was to document China's recent field activities and to report on
further efforts to strengthen its protocols and programmes and integrate them with GOARN's.
The meeting opened with an introductory and background address by incoming WHO China Country
Representative Dr Michael O'Leary, who spoke about the importance of GOARN in stemming
epidemiological outbreaks worldwide, especially in the Asian theatre. He addressed the need to expand
GOARN's partners and welcomed his copanelists from China and thanked the China CDC, the Western
Pacific Regional Office, WHO staff from Geneva and the local WHO staff for their support and assistance in
the planning and logistics for the meeting.
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Dr Liang W annian, Deputy Director General of the Health Response Office of the Chinese Ministry
of Health, and Dr Yang Weizhong, Deputy Director General of the China CDC, welcomed the participants to
China and offered their support for a successful event.
Amy Cawthorne of the Western Pacific Regional Office briefly reviewed the objectives and expected
outcomes of the conference, which included:
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to enroll partner institutions in the Region with a particular focus on technical institutions in
China; and
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to draw on the experiences and lessons learned from recent international responses to disease
outbreaks through the GOARN mechanism, including the SARS outbreak in 2002 and 2003,
the 2004 Indonesian tsunami, the 2008 Wenchuan earthquake in China and the HlNl outbreak
of2009.
The APSED was a steering document established in 2005 that mandated that GOARN work
with partner institutions to:
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reduce the risk of emerging diseases;
strengthen the early detection of outbreaks of emerging diseases;
enhance the early response to emerging diseases;
build preparedness for emerging diseases; and
establish sustainable technical collaboration with current and prospective new partners within
the Western Pacific Region.
The 2009 meeting of GOARN from the Western Pacific Region was launched with these
directives in mind. The two~day programme included presentations from local and international groups
and extensive cultural programmes and off-site events.
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3. The Global and Regional Perspective
This session was moderated by Data' Dr Tee Ah Sian, Director of the Combating
Communicable Disease Unit at the Western Pacific. Re:eional Office , and Dr Feng Zijian, Director of
the Chinese CDC Office for Disease Control and Emergency Response. The session was organized as
an introduction to GOARN and its accomplishments and activities since 2000. It also emphasized
communicable disease surveillance response (CSR) activities and promotion in the Western Pacific
Region and China's experiences with CSR activities in this area.
Dr Tee opened the session with a brief historical review of GOARN growth in the Western
Pacific Region, introducing the International Health Regulations (2005), also lmown as the IHR (2005),
as the legally binding document for WHO's efforts to combat the spread of infectious disease at the
local, regional and global levels. Created in 2005, the IHR called for all countries to establish the core
capacities for surveillance and response no later than June 2012 while stressing the following objectives
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strengthened national capacity for surveillance and response;
strengthened international systems for prevention, alerts and response to international public
health emergencies; and
global partnerships, international collaboration and collective actions.
Also in 2005, the APSED mandated a biregional strategy (with the WHO South-East Asia
Regional Office) for strengthening capacity for communicable disease surveillance and response in the
Region. The goal of the APSED was "to improve health detection in the Asia Pacific Region through
productive partnerships for preparedness planning, prevention, prompt detection, characterization, and
the containment and control of emerging infectious diseases" by directing countries to create a fiveyear, five-step programme to achieve minimum capacity requirements by 2010. The five capacity
areas are surveillance and response, laboratory, zoonosis, infection control and risk communication.
Adhering to IHR (2005) and the APSED protocols, GOARN is committed to:
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enhancing technical capacities;
establishing disease surveillance and response;
strengthening laboratory networks;
building collaboration for systems development, and;
expanding collaboration on research among countries, intergovernmental organizations,
nongovernmental organizations (NGOs), public-private enterprises and academic and research
institutions.
Recent GOARN deployments in the Region were noted, as were their missions and procedures.
The major conclusions drawn about missions were that the emphasis should be on strengthening
regional response capacity and the need to maintain a high level of regional and international
deployment capabilities. In addition, with regard to regional, scenario-driven training, it was
concluded that the involvement of country participants had improved training experiences and outcomes
the sustained participation of partners needed to continue training and that the importance of investing
in a pool of facilitators was a necessity.
Dr Tee closed her presentation by suggesting key steps to enhance GOARN activities in the
Region: (a) regional meetings for continuing discussions and implementing activities; (b) fmalizing
GOARN training strategy and training materials; (c) building on international involvement of GOARN
partners in the Region; (d) sustained engagement of field epidemiology training programmes (FETPs);
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and (e) continued contingency planning and preparedness to deploy and engage GOARN partners for
Pandemic HlNl 2009.
Mr Patrick Drury, Project Manager for Alert and Response Operations for WHO's Pandemic
Alert and Response Unit, gave an overview of WHO's establishment of a global strategic partnership.
He reviewed WHO's global regional organizations and its involvement in combating infectious diseases
from polio to measles to AIDS to, more recently, H5Nl, SARS and HlNl. Mr Drury highlighted
event management systems, disease surveillance, analysis and response as key components to
WHO/GOARN response planning.
He described GOARN's primary aims of assisting countries with disease control efforts,
ensuring rapid appropriate technical support to affected populations, investigating and characterizing
events, assessing risks of rapidly emerging epidemic threats and supporting national outbreak
preparedness by ensuring that responses contribute to sustained containment of epidemic threats. He
then proposed "a radical new approach to all public health threats", involving:
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identifying outbreaks of potential international public health concern;
verifying rumours with the affected country;
coordinating international risk assessment;
communicating public health information; and
providing direct technical and operational assistance to the affected country.
In terms of building GOARN, several factors were cited. The mechanisms for outbreak
response training, outbreak field logistics, field operations and operations were listed. The overall
outcome of building the network would be:
access to resources, information exchange and sharing of best practices and technology
transfer;
reducing vulnerability, strengthening resilience and providing redundancy;
alleviating costs by improving the use and mobilization of resources and providing surge
capacity; and
strengthening transparency and credibility, enhancing dialogue and building trust.
It was made clear that no single institution has all of the capacity to address the complex and
diverse array of epidemiological events affecting many of the world's regions. Different situations
required different response methods- bilateral, multilateral, United Nations-coordinated. A brief
review of emerging infectious diseases operations was listed. WHO mechanisms that led to declaring
the HlNl outbreak a global pandemic also were recounted. The need to assist countries with HlNl
prevention and control efforts, including direct technical assistance and field support, also were
reviewed.
Currently, GOARN has nearly 200 technical institutions, partners and networks. Internally, it
has an operational support team (OST), a steering committee (SCOM) for guidance overseeing
planning and technical working groups and subcommittees established to focus on specific projects and
issues.
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Mr Drury described GOARN's partners' priorities as:
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equitable and appropriate participation in field missions;
early alerts and requests for assistance;
estahlishing clear terms of referenr.e: for inte:rnfltion<1l missions;
composing clear terms of reference for experts;
rapid, transparent, consistent decision-making;
professional administration and contracting; and
dependable field logistics and consistent operational support.
In closing, Mr Drury stressed three focal points for the organization: (1) devising field
information management systems for assessing and directing operations; (2) using the GOARN
Steering Committee to evaluate and define guiding principles and standard operating procedures (SOPs)
and operational communications protocols; and (3) coordination of training.
Dr Chin-Kei Lee, a medical epidemiologist and the CSR Team Leader with WHO China,
spoke about GOARN's growth in China, including its early stages of cooperation with the Ministry of
Health and the China CDC. The CDC has more than 3500 field offices in China's 23 provinces, five
autonomous regions, four municipalities and two special administrative regions (Hong Kong and
Macao).
With an abundance of staffmg, funding and improved management and growing interactions
with overseas agencies, China appears ready to assist other nations with their own epidemiological
incidents. There is evidence for this because of China's support and participation in the aftermath of
relief efforts following the 2004 Indonesian tsunami and its internal experiences with disease
surveillance, prevention and control after the 2008 Wenchuan earthquake.
Dr Lee said GOARN's early and continuous growth in China has been mutually beneficial to
China and other countries. Both GOARN and China are discussing ways to advance their relationship.
Communication and exchange was demonstrated by the creation of a joint China CDC/WHO video link
and other collaboration. Expanding the relationship beyond infectious disease seems a certainty for the
future.
Dr Yang Wiezhong, Deputy Director General of the China CDC, provided an overview of the
Chinese health care network, an organizational review of the Chinese CDC and described Chinese
infectious disease surveillance, alerts and the response mechanism for such events. The emergence of
the SARS epidemic in 2002 and 2003 alerted the Chinese government to overhaul and expand its CSR
activities, which had several recognizable deficiencies when the first of several epidemiological events
began to surface early in the last decade. The strategic framework is as follows:
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establishing clear targets for the prevention and control of top priority infectious diseases
(AIDS, tuberculosis, schistosomiasis and hepatitis B virus (HBV));
improving early warning capacity, case management, investigation and intervention for
intensified monitoring of infectious diseases (plague, cholera, SARS, H5Nl, A (HlNl);
expanded vaccination programmes for diseases such as measles, polio, diphtheria, tetanus,
mumps, rubella, and other important infectious diseases such as hepatitis Band A, Japanese
encephalitis (JE), haemorrhagic fever with renal syndrome, leptospirosis and anthrax; and
improving the capacity for detecting, identifying, investigating, control and preparedness of
emerging infectious diseases such as SARS, H5Nl and HlNl.
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Dr Yang reported that China has introduced multisource information collecting or surveillance
systems for disease monitoring and decision-making, including the notifiable infectious disease
reporting system, the event-based surveillance system, the enhanced infectious disease surveillance
system, the infectious disease-related vector surveillance system and the sentinel surveillance system.
For example, the country has expanded its influenza surveillance network to 556 sentinel hospitals 1 411
laboratories covering all 31 provinces, autonomous regions and municipalities since June 2009 for
monitoring the disease trends including influenza strains.
The current notifiable infectious disease reporting system is Internet-based and covers
all 39 notifiable infectious diseases monitored by hospitals and clinics. With more than 68 000 users,
the system covers 100% of CDC satellite units, 97% of county and higher level hospitals and more
than 80% of township hospitals. Compared with the old system, the new system has the following
advantages:
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improved the timeliness of reports;
improved the completeness and accuracy of surveillance data;
improved the ability of early outbreak detection; and
improved the ability of emerging diseases detection according to the indicator cases, such as
pneumonia, with unknown pathogens.
But the system still faced formidable challenges, including: (a) strengthening the evaluation of
the surveillance system; (b) improving the analysis and interpretation of surveillance data; (c) using
new methodology and techniques to facilitate information use and decision-making; (d) improving the
capability of detecting and identifying other emerging infections; and (e) strengthening laboratory
surveillance.
For the enhanced infectious disease surveillance system, encompassing more than 800 sentinel
sites, covering 25 diseases such as cholera, plague, JE, shistosomiasis, leptospirosis, malaria, rabies,
brucellosis, anthrax and Yersinia enterocolitica, has given the Chinese CDC the ability to get in-depth
data about disease epidemiology, the immunity level in the population, pathogen variance and drug
resistance.
These experiences allowed China to expand scientific and research development (such as rapid
test kits for influenza), strengthening international collaboration (timely information exchanges with
WHO and the Centers for Disease Control in the United States of America) and expanding its
stockpiles of diagnostic reagents, antivirals and medical equipment.
The last segment of the presentation focused on H 1N 1's emergence in China and the country's
efforts to control the epidemic, which has affected more than 46 000 Chinese to date. Also noted were
efforts to mitigate the pandemic, which included expanding scientific and research development such as
creating and distributing rapid test kits for influenza network labs, enhanced international collaboration
and improving preparedness.
With the flu season fast approaching, he announced a number of measures aimed at reducing
the spread and prevalence of H1N1, which were to include enhancing capacity in surveillance and
investigation, launching vaccine distribution and immunization counseling, guiding efforts to control
outbreaks in clinical settings, directing medical facilities in preparing infection prevention and control
tasks, providing technical guidelines about consulting services for home care patients and establishing
public prevention guidelines, information dissemination and communication.
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4. GOARN Missions and Field Experience
Dr Poh-lian Lim, a senior consulting physician with the Communicable Diseases Division of
the Singapore Ministry of Health, and Dr Kan Biao, Deputy Director of the Chinese CDC's National
Tnstitute for \.ommunicahle Disease Control anci Prf.vf.ntion, ('.haired this session, focusing on recent
GOARN missions. The session reflected a range of international responses and the mechanisms in
place regionally and globally to address current and emerging outbreaks such as H1N1, hanta and viral
haemorrhagic fevers such as Ebola and recent missions primarily in Asia and Africa.
Miss Cawthorne of the Western Pacific Regional Office gave an overview of GOARN field
missions during the past decade to show the different variations, large and small, in GOARN
mobilizations in response to epidemiological outbreaks. Her report indicated that during the period
2000-2007, GOARN participated in more than 100 mobilizations in more than 60 countries, including:
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avian influenza (31 mobilizations);
viral haemorrhagic fevers (22 mobilizations);
meningococcal disease (13 mobilizations);
SARS (10 mobilizations);
yellow fever (eight mobilizations); and
natural disasters (six mobilizations).
Each mission required expertise in social mobilization and health education, case management
and funerals, media communications and press briefmgs, coordination, logistics and security,
surveillance, epidemiology and laboratory research. Eight case studies were used to show the varying
degrees of responses. These included an Ebola outbreak in Uganda (2000), which involved 500 local
and national personnel, 120 international staff, 22 institutions and four isolation facilities over the three
affected zones; an Ebola outbreak in Congo (2002); and the post-tsunami CSR activities in Aceh,
Indonesia (2005).
Other major events noted were dengue fever and myocarditis outbreaks in Sri Lanka (2005);
disease surveillance following the 2008 Wenchuan earthquake in China (2008); the H1N1 virus in
Malaysia (2009); a cholera and shigelloses outbreak in Papua New Guinea (2009); and an outbreak of
Vibrio vulnificus cases in New Caledonia (2009).
Each of these events required a different level of response, of specialization and mobilization of
staff, equipment and other resources. To further illustrate this, in 2006, GOARN's avian influenza
response involved 30 missions that required 120 experts. Though each had similar terms of references,
the field experiences were different in many cases. But overall, each event faced the same challenges
of preparedness, infection control, surveillance system, diagnostic capacities, animal-human interface
and social mobilization/risk communication.
In her review, Miss Cawthorne stressed that for most GOARN responses:
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the role of team members was impossible to standardize;
responsibilities sometimes were defmed poorly;
the need for flexibility and adaptability were a necessity;
a high level of technical skills and excellent communication (language) skills were essential in
many instances; and
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a clear understanding of the playing field, including personnel and staffing requirements,
national and local in-country partners, including NGOs and even local political and social
leaders, is crucial to success.
Mr Drury of WHO Headquarters narrated a session on the role of craft networks in addressing
the challenieS of viral haemorrhagic fevers (VHFs) and other emerging diseases worldwicie. He spoke
on behalf of Dr Pierre Formenty of the CDS/CSR Department at WHO HQ who created the
presentation but was unable to attend the meeting. The session focused primarily on GOARN's success
and efforts in creating effective mechanisms for epidemic response to VHFs, including a Marburg
outbreak in Rwanda (2005) and Ebola outbreaks in Uganda (2001) and Congo (2003), Rift Valley
Fever in Sudan (2007) as well as pandemic A (HlNl) 2009, SARS, avian influenza and other agents.
As part of WHO's Global Alert and Response Programme, Dr Formenty's presentation focused
on the need for:
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technical partnerships and networks to support international health security;
real-time information management and communications: field data and situational reports and
other data for decision-making;
joint risk analysis and decision support;
operational and technical planning; and
coordination of response activities.
An Emerging Diseases and Dangerous Pathogens Laboratory Network (EDPLN) comprised of
laboratory outbreak response, assay and reagent development, technology transfer and training,
international communication and applied research was recommended as a means of providing:
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A forum for real-time communication immediately following an outbreak alert and the sharing
of technical advice on effective diagnostics and applied research platforms requirements.
Scientific and technical decisions for deployment of effective scalable and deployable
laboratory capabilities and coordination with clinical response teams and other stakeholders to
improve patient management and outbreak control.
Research and development on diagnostics, applications for field use and the appropriate
transfer of technology to regional networks and countries in threatened regions.
A safe collaborative environment and framework for sharing of knowledge and scientific
expertise on laboratory science and tools for EDPs and disease ecology.
Opportunities for participation in GOARN field responses.
The need for clinical networking and supporting technical networking also was emphasized to
identify new and emerging diseases, clinical management, infection prevention and· control,
communications, humanitarian considerations and aetiological/laboratory network.
Dr Formenty also called for the creation of a Global Infection Prevention and Control Network
that would provide infection, prevention and control (IPC) recommendations on the prevention and/or
containment of virus transmission. Its essential components would be data collection and management,
including detailed records of the clinical course, clinical observation and differential diagnosis, clinical
pathways, appropriate infection control practices, team management and training and quality assurance
and improvement.
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The stated objectives of the presentation were:
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Establishing a global IPC network that would provide IPC recommendations on prevention
and/or containment of transmission.
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Assisting GOARN field responses through training and identifying experts for field deployment.
Supporting sustainable IPC preparedness in health care through advice on basic IPC
infrastructure and other technical advice.
Helping to disseminate WHO IPC policies and materials and lessons learned from crisis
r~spnns~
The presentation concluded with measures for improving GOARN's role in identifying,
preventing and controlling epidemics such as creating a mechanism for rapid communications, efficient
identification and evaluation of data and enhanced training of laboratory workers for disease diagnosis.
Also emphasized was the need for ensuring global strategic protocols for emerging infectious diseases,
on allowing countries more rapid access to the GOARN services and resources and turning knowledge
into action with regard to communicable disease surveillance, prevention and control.
Professor Janusz T. Paweska, of the South African National Institute for Communicable
Diseases, spoke about recent arenavirus outbreaks in Africa - Guinea, Liberia, Sierre Leone and
Nigeria, among others. He cited "old world" viruses (Lassa, Mobala, Mopeia, Ippy) and "new
world" viruses and the need for balancing public health intervention in the field and scientific research
developments to identify, prevent and contain such diseases.
Dr Paweska cited a recent event of arenavirus and other zoonotic agents in Johannesburg,
South Africa (2008), a Marburg outbreak in Rwanda (2005) and in Uganda (2001) and Congo (2003).
The South Africa case proved particularly noteworthy. A new species of arenavirus named the Lujo
virus was identified - the first in more than 40 years, with patients showing viral haemorrhagic fever
symptoms. The first case had originated near Lusaka, Zambia, and spread to Johannesburg, South
Africa, after the original patient was transported to a hospital there.
Test results conducted by epidemiologists at Columbia University in New York and the Centers
for Disease Control in Atlanta identified the virus. Ultimately, four of the five patients died, including
two of three infected health workers who most likely were infected through contaminated materials and
a South African businessman who traveled from Johannesburg to Rio de Janeiro, Brazil, and
subsequently succumbed to the disease.
The outbreak of the first new case of an "old world" arenavirus was limited to these five
individuals. The source of the Lujo virus, as it is now called, has yet to be determined. GOARN
partners continue to support the involved countries in various facets of the outbreak investigation,
including laboratory diagnosis, investigations, active cases and follow-up with contacts.
Dr Amadou Alpha Sail, a noted epidemiologist with the Institute Pasteur Dakar, spoke about
yellow fever risk assessment, citing 200 000 infections and 30 000 deaths annually in unvaccinated
populations. While 90% of cases occur in Africa, some questioned the inevitability of diseases such as
yellow fever reaching countries such as China and other largely, unaffected regions of the world and
measures - vaccination and vector controls -- in place to reduce this possibility.
The 17D vaccine, developed in the 1930s, has provided protection for more than 10 years, and
more than 500 million doses are administered annually. However, in most instances, countries with a
prevalence of endemic yellow fever lieport a vaccination rate of merely 50% of the population. But a
2006 programme by WHO and the Global Alliance for Vaccines and Immunization (GAVI) has
targeted 12 West African nations for enhanced yellow fever vaccination programmes. Because the
disease is widespread in several monkey populations endemic to the region, vaccination is regarded as
the best means of controlling yellow fever.
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Dr Sall cited no increased risk of yellow fever in recent studies conducted in Africa, stressing
the importance of standardization of protocols and guidelines for controlling the disease. He reported
about countries combating yellow fever, including the Central African Republic, which has a relatively
low rate of infection because of a high vaccination rate of more than 90% of its population.
An evaluation of efforts by the Central African Republic at assessing the prevalence of the
disease in the mosquito populations (32 species of mosquitoes were tested) and among several monkey
species (66 animals were tested) also was provided. In addition, a survey was conducted with more
than 1800 people to determine their knowledge and infection rate of the disease.
From this research data, Dr Sail reported the following preliminary conclusions and
recommendations:
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no increased risk of yellow fever activity was found and improvements in yellow fever
surveillance were evident;
a continued risk for yellow fever emergence as well as spread to other regions remained a
possibility;
detailed analysis by region and zones on progress was necessary;
the study might be transferable to travelers from nonendemic regions;
samples can be used for evaluation of other vector-borne diseases;
protocols are being written and being made generic for other regions of the world and Africa;
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technical guidelines are being written from lessons learned.
Dr Li Qun, Deputy Director of the Office for Disease Control and Emergency Response for
the China CDC, reported on the Chinese response to the May 2008 Wenchuan earthquake that killed
more than 85 000 people and displaced another 15 million. Dr Li gave a comprehensive, statistical
review of China's response, which included direct medical services and disease surveillance and
prevention and control mechanisms used by the CDC and other Chinese health agencies. The CDC
examined its activities in the emergency phase (the first 72 hours after the earthquake) and the
reconstruction phase, which is continuing.
In the immediate aftermath (the first 72 hours) of the earthquake, more than 35 000 medical
workers were sent to treat nearly 70 000 wounded and 15 000 seriously injured people, the Ministry of
Health deployed an additional 3900 antiepidemic staff and 644 epidemic-prevention vehicles to combat
potential communicable diseases from water- and food-borne contaminants. Among the activities
undertaken was the surveillance for diseases such as cholera, typhoid, hepatitis A, tuberculosis, vectorborne agents, zoonotic viruses and vaccine-preventable infectious diseases.
About 9200 medical staff were mobilized and 2500 immunization sites were established to
combat vaccine-preventable diseases (VCDs). Children with no precise immunization histories were a
high priority. The rapid restoration of the disease surveillance and reporting system was made possible
through a mobile phone system, which employed 560 devices from 368 communicable diseasereporting stations in the affected areas.
The cumulative actions of medical, public health and disease prevention and control efforts
included the deployment of more than 6600 medical teams which resulted in a 43% decrease in the
number of focal infectious disease and a 38% decrease in mortality rates for those diseases in the
comparable period between 2005 and 2007. Consequently, in the earthquake-affected areas:
•
no large-scale communicable disease outbreaks occurred;
- 12-
•
•
•
a significant reduction in epidemic risk factors was achieved;
the removal of environmental hazards in the 21 earthquake-affected counties was near 100%;
and
a near 100% restoration of the reporting system for infectious diseases in the affected areas
had been achieved.
The overwhelming message was that the Chinese government learned much from this disaster
and preparations and systems are in place for future events of this kind. In addition, there is an
increasing willingness of China to lend its support to international responses to natural and
epidemiological events.
- 13-
5. Experiences from the Field: China's National and International Responses
The session was moderated by Mr Drury and
Dr Li Dexin, Director of the National Institute for Viral Disease Control and Prevention at the Chinese
CDC. This session focused on China's recent epidemiological response efforts at home and ahroad.
'
Dr Liu Qiyong, Director of the Department of Vector Biology and Control at the Chinese
CDC's National Institute for Communicable Disease Control and Prevention, gave a brief review of
China's recent experiences with vector-borne disease (VBD) control and response and Chinese
government efforts at sustainable management of disease vectors. In China, emphasis is on local
mechanisms for dealing with emerging diseases in everyday and disaster scenarios. Dr Liu's
presentation shows· China's recent international response mobilizations to contain vector-borne diseases
such as dengue fever, JE and malaria in tsunami-affected areas of Sri Lanka (2004-2005), with
Chikungunya Fever in Mauritius (2006) and multiple VBD-disease control and management efforts
following the Wenchuan earthquake.
Among the items stressed was the need to apply appropriate vector control strategies at
different periods, to perfect the vector control system according to the disease growth situation in
consideration of factors such as resources and staffing, materials and fmance and risk assessment of
VBDs as the key basis for wise and effective vector control, especially in emergency response. Among
the major topics of concern were:
emerging vectors and VBDs under climate change;
risk assessment and alert on vector and VBDs;
rapid and accurate identification of disease vectors;
sustainable development and application of pesticides;
vector surveillance and control in emergencies;
vector surveillance and management in big events; and
strategic framework for sustainable management of disease vectors.
Dr Liu cited the establishment of the National Vector Surveillance Network in 2007 as a major
achievement in Chinese efforts to establish an effective mechanism for controlling and responding to
vector-borne agents. The current network is comprised of 43 cities in 19 provinces of China. In
closing, Dr Liu said that through global communications networks and cooperation, the China CDC
would promote the development of vector control, the sharing of technical information and the
communication of new achievements and new products and thereby contribute significantly to the
realization of sustainable vector control.
As part of its effort to show China's expanded participation in international relief efforts,
Dr Ji Rang, director of the Biological Contamination and the Monitoring Laboratory at the National
Institute of Nutrition and Food Safety at the Chinese CDC, spoke about China's participation in the
international response to the 2004 Indonesian tsunami which killed more than 160 000 people and
displaced more than 500 000. China dispatched four medical teams and more than 160 personnel to
Aceh, Indonesia.
In addition to the medical and pharmaceutical services these teams provided, they also
conducted health assessments of drinking water, nutrition, waste disposal and the distribution of
supplies in refugee camps, which contributed to the prevention of potential communicable diseases. In
its largest international aid operation, the Chinese teams provided significant clinical services while
collaborating with relevant local and international organizations and navigated various logistical
concerns such as staff management and health, safety and security concerns.
- 14-
Dr Tony Stewart of the Burnet Institute of Melbourne, Australia, discussed the institute's
activities and participation in GOARN. Located in eight countries in Asia, the Pacific and Africa and
with an international medical staff of 160 people, the institute links laboratory research and public
health to the aim of reducing the impact of serious infectious diseases such as HIV, hepatitis, malaria,
tuberculosis, avian influenza, cancers such as breast, ovarian and prostate, and inflammatory diseases
such as rheumatoid arthritis and lupus. Its range of expertise includes virology, immunology,
diagnostics development, epidemiology, mother and child health/community paediatrics,
communications/information, educational and communication materials development, education and
training and health systems strengthening.
As a GOARN member since 2005, the institute is partnered with several United Nations
agencies, regional bodies and NGOs at the regional, country and local levels. It also promotes
education and training via public and international health doctoral programs with Monash University
and the University of Melbourne in Australia and in public health short courses available to the staff of
private and nonprofit organizations. Its participation in GOARN has included staff training at WHO
HQ, presentations and assistance at previous GOARN meetings, training simulations (Geneva, the
Philippines, Australia) and deployment to GOARN activities following the Indonesian tsunami and a
cholera outbreak in Zimbabwe in December 2008.
In conclusion, Dr Stewart offered benefits that GOARN membership gave to partner
institutions (staff training, preparedness for international and transborder events), stressed the
importance of establishing agreements on participation, such as staffmg, fmancing and time
commitments and showed how the institute's experiences with GOARN serves as a model for other
current and participating members in areas such as:
•
•
•
•
assisting with the implementation of country and regional training;
participation in regional exercises;
active involvement in the steering committee; and
identifying other institutions that may join GOARN.
Miss Cawthorne of the Western Pacific Regional Office and Dr Feng Zijian, Director of the
Office of Disease Control and Emergence Response at the Chinese CDC, gave the closing remarks,
thanking the participants and encouraging their continued support and participation in GOARN
activities worldwide. Participants also were invited to attend the next GOARN conference, scheduled
for March 2010 in Siem Reap, Cambodia.
ANNEX 1
PROGRAMME OF ACTMTIES
Day 1 -Monday, 19 October 2()(}9
Opening session
Opening Remarks
- Dr Michael 0 'Leary, WR/China
Welcome Remarks
- Dr Liang Wannian, DDG, Health Response Office, China MoH
-Dr Yang Weizhong, DDG, Chinese CDC
Introduction: Meeting Objectives and Outcomes
-Amy Cawthorne
Section 1 - GOARN Overview: The Global and Regional Perspective
Chair: Dato' Dr Tee Ah Sian and Dr Feng Zijian
APSED and the Development of GOARN in the Region
- Dato' Dr Tee Ah Sian, DCC, WHO/WPRO
Global Alert and Response
- Dr Mike Ryan, Director, EPRICDS, WHO/HQ
GOARN: Development of a Global Strategic Partnership
- Mr Pat Drury
Question and Discussion Period
GOARN: Development in China
- Dr Chin-Kei Lee
Overview of the Infectious Disease Surveillance, Alert
And Response System in China
- Dr Yang Weizhong
Question and Discussion Period
Section 2 - GOARN Missions and Experiences from the Field
Chair: Dr Poh-lian Lim and Dr Klm Biao
GOARN Field Missions: An Overview
- Amy Cawthorne
Within GOARN, The Role of Craft Networks in Addressing
The Challenge of VHFs and Other Emerging Diseases
- Mr Pat Drury on Behalf of Dr Pierre Formenty
Arena Virus Outbreaks: GOARN Partners Involvement in the
Identification of a New Virus
Professor Janusz T. Paweska
•
Annex 1
Question and Discussion Period
Yellow Fever Risk Assessment Mission
- Dr Amadou Alpha Sall
Response to the May 2008 Wenchuan Earthquake (China)
DrLiQun
Question and Discussion Period
Day 2 - Tuesday, 20 October 2009
Section 3 - Experiences from the field: China Is national
and international responses
Chair: Dr Mike Ryan and Dr Li Dexin
Experiences of Participating in an International Response to Vector-Borne
Disease Occurences
- Dr Liu Qiyong
Experiences of Chinese CDC Is Participation in the Tsunami
Indonesia, 2006
Response in
- DrliRong
Question and Discussion Period
institutional Motivations, Benefits and Costs for Involvement in
WHO Field Missions
- Dr Tony Stewart
Question and Discussion Period
Conclusions and Recommendations
Closing Remarks
Amy Cawthorne, WPRO
Dr Feng Zijian, Director, DCERO/Chinese CDC
Field Trips:
Great Wall Tour
Tour and Dinner at the New Campus of the Chinese Center for Disease
Control and Prevention hosted by Dr Wang Yu, Director General of the
Chinese CDC
ANNEX2
PROVISIONAL LIST OF PARTICIPANTS, TEMPORARY ADVISERS,
OBSERVERS AND SECRETARIAT
1. PARTICIPANTS
CAMBODIA
Dr Sirenda:VONG, Institut Pasteur du Cambodge
5, Monivong Blvd., P.O. Box 983, Phnom Penh
Tel. no. : (855) 1280 2982; Fax no. : (855) 2372 5606
Mobile : (855) 12 333 650
E-mail : [email protected]
CHINA
Dr MAO Suling, Vice Director
Sichuan Provincial CDC, No. 6 Zhongxue Road, Chengdu
Tel. no. : 028-85582913; Mobile : 028-85582320
E-mai~ [email protected]
Dr MAERDANG Abudureheman, Deputy Director
CDC of Xinjiang Uyghur Autonomous Region
380 Jianguan Yijie Street, Urumqi, Xinjiang 830002
Tel. no. : 0991-2615505; Fax no. : 0991-2625962
E-mail: [email protected]
Dr LAN Hong, Head, Office dealing with emergency cases
Gangsu Provincial CDC, 230 Donggangxi Avenue
Room 703, Lanzhou, Gansu 730000
Tel. no. : 0931-8265913; Fax no. : 0931-8272156
E-mail : [email protected]
Dr LI Zhaoyi, Section Chief
Guizhou Provincial CDC, Bageyan Street
- Guizhou Province, Guiyang City
Tel. no. : 0851-6822632; Fax no. : 0851-6816162
Mobile : 135-95107118
E-mail : [email protected] .en
Dr YUE Jianning, QingHai Provincial CDC
66 Ba Yi Road, Xi Ning, QingHai 81007
Tel. no. : 0971-8801358; Fax no. : 0971-8801318
E-mail: [email protected]
Dr LI Li, Endemic Diseases Control and Prevention
CDC of Ningxia Hui Autonomous Region
470, Shengli Street, Xingging District, Yinchuan, Ningxia
Tel. no. : 0951-4087302; Fax no. : 0951-4077307
E-mail: [email protected]
Annex 2
CHINA (cont'd.)
Dr BAI Xuetao, Institute for Environment Hygiene and
Health Related Product Safety, Chinese CDC, Beijing
Tel. no. : 010-67754147; Fax no. : 010-67719392
E-mail: [email protected]
Dr CAO Bin, Chaoyang Hospital, Chaoyang, Beijing
Tel. no. : 13911318339
Dr CAO Minghua, Anhui Provincial CDC, Anhui
Tel. no. : 0551-2863087; Fax no. : 0551-2860524
E-mail : [email protected]
Dr CAO Wuchun, Military CDC, Beijing
Tel. no. : 010-66948501; Fax no. : 010-63815259
Dr CHEN Biyun, Hunan Provincial CDC, Hunan
Tel. no. : 0731-4305970; Fax no. : 0731-4305853
E-mail: [email protected]
Dr CHEN Fengxin, Ditan Hospital, Beijing
Tel. no. : 010-84322172; Fax no. : 010-84397205
Dr CHEN Haomin, Henan Provincial CDC, Henan
Tel. no. : 0371-68089089; Fax no. : 0371-68089008
E-mail : [email protected]
Dr CHEN Weishi, Guangdong Provincial CDC, Guangdong
Tel. no. : 020-89101322; Fax no. : 020-89101322
E-mail
[email protected]
Dr CHEN Zhiping, Zhejiang Provincial CDC, Zhejiang
Tel. no. : 0571-87115006; Fax no. : 0571-87115000
E-mail: [email protected]
Dr DENGYing, Beijing CDC, Beijing
Tel. no. : 010~64407019; Fax no. : 010-64407019
Dr DING Fan, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Tel. no. : 010-83167453
E-mail: [email protected]
Dr FENG Lin, Office for International Cooperation
Chinese CDC, Beijing
Tel. no. : 010-83159113; Fax no. : 010-83159113
E-mail: [email protected]
Annex 2
CHINA (cont'd.)
Dr GUO Weidong, Inner Mongolia CDC, Inner Mongolia
Tel. no. c: 0471-6984920; Fax no. : 0471-6984920
E-mail: [email protected]
Dr HAN Hongwei, Institute for Nutrition and Food Safety
Chinese CDC, Beijing
Tel. no. : 010-67791292; Fax no. : 010-67711813
Dr HAN JiXiu, Division of International Organization
Department of International Cooperation
Ministry of Health, Beijing
Dr HE Yi, Shanghai CDC, Shanghai
Tel. no. : 021-62758710; Fax no. : 021-62192593
E-mail: [email protected]
Dr HONG Rongtao, Fujian Provincial CDC, Fujian
Tel. no. : 0591-~7528254; Fax no. : 0571-87607324
E-mail : [email protected]
Dr HUANG Liuyu, Military CDC, Beijing
Tel. no. :c010-66948~07; Fax no. : 010-66948307
E-mail: [email protected]
Dr JIN Huarui, Inner Mongolia CDC, Inner Mongolia
Tel. no. : 0471-5984920; Fax no. : 0471-5984902
Dr JIN Ronghua, You' an Hospital, Beijing
Tel. no. : 139-0137-4552
Dr KAN Biao, Institute for Communicable Disease Control
and Prev~ntion, Chinese CDC, Beijing
Tel. no. : 010-61739458; Fax no. : 010-61739458
E-mail: [email protected]
Dr LI Dexin, Institute for Viral Disease Control and
Prevention, Chinese CDC, Beijing
Tel. no. : 010-63572877; Fax no. : 010-63572877
Dr LI Qi, Hebei Provincial CDC, Hebei
Tel. no~ : 0311-86573358; Fax no. : 0311-86573358
Dr LI Shizhu~ National Institute of Parasitic Disease
Chines~ CDC, Shanghai
Tel. no. : 021-6474-6458; Fax no. : 021-6474-6458
E-mail : [email protected]
Dr LI Xinwu, Institute for Environment Hygiene and
Health Related Product Safety, Chinese CDC, Beijing
Tel. no. : 010-8777-9905; Fax no. : 010-6771-9392
E-mail : [email protected]
Annex 2
CHINA (cont'd.)
Dr LIANG Wannian, Deputy Director-General
Office of Health Emergency Response
Ministry of Health, Beijing
Tel. no. : 010-6879-2576
E-mail : [email protected] .en
Dr LIANG Xiaofeng, Director
National Immunization Programme
Chinese CDC, Beijing
Tel. no. : 010-63176737; Fax no. : 010-63171724
E-mail: [email protected]
Dr LIU Bo, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Tel. no. : 010-8316-7453
E-mail: [email protected]
Dr LIU Xiaoqing, Jiangxi Provincial CDC, Jiangxi
Tel. no. : 0791-8183872; Fax no. : 0791-8319800
E-mail
[email protected]
Dr LU Guiyang, Hubei Provincial CDC, Hubei
Tel. no. : 027-87652061;-Fax no. : 027-87652076
E-mail: [email protected]
Dr LU Shan, Institute for Communicable Disease Control
and Prevention, Chinese CDC, Beijing
Tel. no. : 010-61739466; Fax no. : 010-61739466
E-mail: [email protected]
Dr MA Huilai, CFETP Office, Chinese CDC, Beijing
Tel. no. : 010-83133202; Fax no. : 010-83133202
E-mail : [email protected]
Dr MENG Hong, Heilongjiang Provincial CDC, Heilongjiang
Tel. no. : 0451-55153609; Fax no. : 0451-55153609
E-mail: [email protected]
Dr NI Daxin, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing_
Tel. no. : 010-63177356; Fax no. : 010-63177356
£:.mail: [email protected]
Dr QIANG Zhengfu, Director
Office for International Cooperation, Chinese CDC, Beijing
Tel. no. : 010-83160720; Fax no. : 010-83160720
E-mail: [email protected]
Annex 2
ClllNA (cont'd.)
Dr QIN Mingfang, Yunnan Provincial CDC, Yunnan
Tel. no. : 0811-3610500; Fax no. : 0871-3611102
E-mail: [email protected]
Dr SHEN Zhuang, Beijing CDC, Beijing
Mobile : 13901185153; Fax no. : 010-644U'/U1Y
Dr SID Guoqing, CFETP Office, Chinese CDC, Beijing
Tel. no. : 010-83171510; Fax no. : 010-83171510
E-mail: [email protected]
Dr SID Ping, Jiangsu Provincial CDC, Nanjing
Tel. no. : 025-8375-9408
E-mail : [email protected]
Dr SU Qiru, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Tel. no. : 010-83153724; Fax no. : 010-83153724
E-mail : [email protected]
Dr SUN Hui, Office for Disease Control and Emergency
Response, Cpinese CDC, Beijing
Tel. no. : 010-83163341; Fax no. : 010-63047378
E-mail: [email protected]
Dr SUN Jun, Chongqing CDC, Chongqing
Tel. no. : 023-68805196; Fax no. : 023-68805196
E-mail: [email protected]
Dr SUN Junling, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Tel. no. : 010'-6302-5413
Dr TU Wenxiao, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Fax no. : 010-83153724
E-mail: [email protected]
I
Dr WANG Jian, General Office, Chinese CDC, Beijing
Tel. no. : 010~83164617; Fax no. : 010-63170894
E-mail: [email protected]
Dr WANG Rui, Office of Disease Control and Emergency
Response, Chinese CDC, Beijing
Tel. no. : 010-6317-7356
E-mail: Wangri7224@163. com
Dr WANG Shiwen, Institute for Viral Disease Control and
Prevention, Chinese CDC, Beijing
Tel. no. : 010-8354-6229
Annex 2
CHINA (cont'd.)
Dr WANG Yu, Director-General
Chinese CDC, Beijing
Tel. no. : 010-63033502
E-mail: [email protected]
Dr WANG Zijun, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Tel. no. : 010-63045571; Fax no. : 010-63047378
E-mail: [email protected]
Dr XIONG Weiyi, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Tel. no. : 010-63177356; Fax no. : 010-63177356
E-mail: [email protected]
Dr XU Bianli, Henan Provincial CDC, Henan
Tel. no. : 0371-68089291; Fax no. : 0371-68089008
E-mail : [email protected]
Dr XU Xuqin, Zhejiang Provincial CDC, Zhejiang
Tel. no. : 0571-87115140; Fax no. : 0571-87115147
E-mail: [email protected]
Dr XU Zb.en, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Tel. no. : 010-83167453; Fax ·no. : 010-63152572
E-mail : [email protected]
Dr YANG Jinye, CDC of Guangxi Zhuang Autonomous
Region, Guangxi .
Tel. no. : 0771-2518833; Fax no. : 0771-2518768
Dr YAO Wenqing, Liaoning Provincial CDC, Liaoning
Tel. no. : 024-23388236; Fax no. : 024-23373123
Dr YI Jianrong, Guangdong Provincial CDC, Guangdong
Tel. no. : 020-84466336; Fax no. : 020-84466336
E-mail : [email protected]
Dr YIN Zundong, Center of Nationallmm.unization Program
Chinese CDC, Beijing
Tel. no. : 010-8315~9521
E-mail: [email protected]
Dr ZENG Zhaochang, Hainan Provincial CDC, Hainan
Tel. no. : 0898-6533 3245; Fax no. : 0898:..6533 3245
E-mail: [email protected]
Annex 2
ClllNA (cont'd.)
Dr ZHANG Jiemin, Shanxi Provincial CDC, Shanxi
Mobile: !3903513179; Fax no. : 0351-7553026
Dr ZHANG Qian, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Tel. no. : 010-83133671; Fax no. : 010-K:lU:;671
E-mail : [email protected]
Dr ZHANG Weidong, Office for Disease Control and
Emergency Response, Chinese CDC, Beijing
Tel. no. : 010-63132075; Fax no. : 010-63132075
E-mail: [email protected]
Dr ZHANG Weimin, Institute for Nutrition and Food Safety
Chinese CDC, Beijing
Tel. no. : 010-67791292; Fax no. : 010-67711813
Dr ZHANG Wensheng, Tianjin CDC, Tianjin
Tel. no. : 022-24333432; Fax no. : 022-24333433
E-mail : [email protected]
Dr ZHANG Yanping, Institute for Viral Disease Control and
Prevention, Chinese CDC, Beijing
Tel. no. : 010-83546729; Fax no. : 010-83559952
E-mail : [email protected]
Dr ZHENG Liping, Office for International Cooperation
Chinese CDC, Beijing
Tel. no. : 010-63022960; Fax no. : 010-63022960
E-mail : [email protected]
Dr XU Min, Office of Health Emergency Response
Ministry of Health, Beijing
Tel. ·no. : 010-6879-2976
E-mail : [email protected] .en
Dr ZHOU Hang, Office for Disease Control and Emergency
Response, Chinese CDC, Beijing
Te~. no. : 010-83163341; Fax no. : 010-63047378
E-mail: [email protected]
JAPAN
Dr Kouichi MORITA, Professor and Head
Department of Virology, Institute of Tropical Medicine
Nagasaki UniversitY,, 1-12-4 Sakamoto-machi
Nagasaki 852,..8523
Tel. no. : (81 95) 819 7827; Fax no. : (81 95) 819 7830
E-mail : [email protected]
Annex 2
JAPAN (cont'd.)
Dr Kazuhiro KAKIMOTO, Technical Official and
Communicable Disease Control Advisor
Bureau of International Cooperation, International Medical
Center of Japan, 1-12-1, Toyama, Shinjuku City, Tokyo
Tel. no. : (81 3) 3202 7181; Fax no. : (81 3) 3205 7860
E-mail : [email protected]
Dr Nobuhik:o OKABE, Director
Infectious Disease Surveillance Center, National Institute
of Infectious Diseases, 1-23-1 Toyama, Shinjuku
Tokyo 162-8640
Tel. no. : (81 3) 5285 1111 Ext. 2501
Fax no. : (81 3) 5285 1129
E-mail : [email protected]
Dr Toru CHOSA, Senior Consultant of Internal Medicine
Kyushu Industry Health Foundation, St. Mary Hospital
Nagata Bldg 4F, Chuou-Maehi 32-24
Kurume-Shi, Fukuoka 830-8583
Tel. no. : (81 9) 4235 8195; Fax no. : (81 9) 4238 7063
E-mail : [email protected]
NEW CALEDONIA
Dr Justus BENZLER., Communicable Disease Surveillance
Specialist, Secretariat of the Pacific Community
BP D5, NC 98848, Noumea Cedex
Tel. no. : (687) 26 20 00 Ext. 232; Fax no. : (687) 26 38 18
E-mail : [email protected]
PHILIPPINES
Dr Vito ROQUE Jr., Medical Specialist IV
Public Health Surveillance and Informatics Division
N ational1 Epidemiology Center, First Floor, Building 9
Department of Health, San Lazaro Compound, Tayuman St.
Sta. Cruz, Manila 1003
Tel no. : (632) 251 4203; Fax no. : (632) 743 8301
E-mail: [email protected]
2. TEMPORARY ADVISERS
Professor John S. MACKENZIE, Australian Biosecurity CRC
Curtin University of Technology, GPO Box U1987
Perth, W A6845
Tel no. : (613) 9822 6223; Mobile : (614) 3987 5697
Fax no. : (618) 9266 1650
E-mail : J [email protected]
Annex 2
TEMPORARY ADVISERS (cont'd.)
Dr Anthony PauLSTEWART, Medical Epidemiologist
Emerging Infectious Diseases, The Macfarlane Burnet
Institute, for Medical Research & Public Health Ltd., Centre
for Internati9nal Health, GPO Box 2284, Melbourne, Victoria
Tel no. : (614) 1429 8627; Fax no. : (613) 9787 8210
E-mail : tonys(g)bumet.edu.au
Dr Poh Lian LIM, Senior Consultant Physician
Department of Infectious Diseases, Tan Tack Seng Hospital
Communicable Diseases Division, Ministry of Health
11 Jalan Tan Tack Seng, Singapore 308433
Tel no. : (658) 126 3253; Fax no. : (656) 252 4056
E-mail : [email protected]; [email protected]
Dr Amadou Alpha SALL, lnstitut Pasteur de Dakar
Unite des Arbovirus et Virus de fievres hemorragiques
36, Avenue Pasteur, BP 220, Dakar, Senegal
Tel. no. : (221) 338399223 (fixe); (221) 775700303 (portable)
Fax no. : (221) 338399210
E-mail : [email protected]
Professor Janusz T. PAWESKA, Head Special Pathogens
Unit, National Institute for Communicable Diseases
of the National Health Laboratory Service, Private Bag X4
Sandringham-Johannesburg, 2131 Modderfontein Road 1
Gauteng, South Africa
.
Tel. no. : (2711) 386 6382 I 6336; Fax no. : (2711) 882 3741
E-mail : [email protected]
Dr YANG Weizhong, Deputy Director-General
China Center for Disease Control and Prevention
#27 Nanwei Road, Xuanwu District, Beijing
Tel. no. : 010-8315288; Fax no. : 010-8315288
E-mail : [email protected]
Dr LI Qun, Deputy Director
Office for Disease Control and Emergency Response
China Center for Disease Control and Prevention
#27 Nanwei Road, Xuanwu District, Beijing
Tel. no.·: 010-63045571; Fax no. : 010-63047378
E-mail: [email protected]
Dr LIU Qiyong, Assistant Director and Research Fellow
Institute for Communicable Disease Control and Prevention
China C~nter for Disease Control and Prevention
#5, Liuzi, Changping District, Beijing
Tel. no. : 010-61731296; Fax no.: 010-61731296
E-mail : [email protected]
Annex 2
TEMPORARY ADVISERS (cont'd.)
Dr ll Rong, Director of Biological Contamination and
Monitoring Laboratory, Institute for Nutrition and Food
Safety, China Center for Disease Control and Prevention
#7 Panjiayuan, Chaoyang District, Beijing
Tel. no. : 010-67799342; Fax no. : 010-67799342
E-mail : [email protected]
Dr FENG Zijian, Director for Office for Disease Control and
Emergency Response, China Center for Disease Control and
Prevention, 27 Nanwei Road, Xuanwu District, Beijing
Tel. no. : 010-63131219; Fax no. : d10-63131219
E-mail: [email protected] or; [email protected]
3. OBSERVERS/REPRESENTATIVES
AUSTRALIAN AGENCY
FOR INTERNATIONAL
DEVELOPMENT (AUSAID)
EMBASSY OF CANADA
Dr Linna CAl, Senior Policy Officer (Health)
Development Cooperation, Australian Embassy
21 Dongzhimen , Wai Dajie, Beijing 100600
Tel. no. : (86 10) 5140 4404; Fax no. : (86 10) 5140 4199
E-mail : [email protected] .au
Dr Felix Ll, Minister Counsellor (Health)
19 Dongzhimenwai Dajie, Chaoyang District, Beijing
Tel. no. : (86 10) 5139 4058; Fax no. : (86 10) 5139 4454
E-mail : [email protected]
4. SECRETARIAT
WHOIWPRO
Dato' Dr TEE Ah Sian, Director
Combating Communicable Diseases, World Health
Organization,-Regional Office for the Western Pacific
P.O. Box 2932, 1000 Manila
Tel. no. : (632) 528 9701; Fax no. : (632) 521 1036
E-mail : teeas@wpro. who.int
Ms Amy CAWTHORNE, Epidemiologist
Communicable Dis_ease Surveillance and Response
World Health Organization, Regional Office for the Western
Pacific, P.O. Box 2932, 1000 Manila Tel. no. : (632) 528 9917; Fax no. : (632) 528 1036
E-mail : cawthornea@wpro. who.in
Annex 2
WHOIWPRO (cont'd.)
Ms Janet MINA, Administrative Assistant
Communicable Disease Surveillance and Response
World Health Organization, Regional Office for the Western
Pacific, P.O. Box 2932, 1000 Manila
Tel. no. : (632) 528 9729; Fax no. : (632) 521 1036
.E-ma11 : mmaJ@wpro. who.int
WHO/HQ
Mr Patrick DRURY, Project Manager
Alert and Response Operations (ARO)
Department of Epidemic and Pandemic Alert and Response
World Health Organization, Geneva
Tel. no. : (41 22) 791 3692; Fax : (41 22) 791 1397
E-mail: [email protected]
Ms Sameera SURI, Communications Officer
Global Outbreak Alert and Response Network
World Health Organization, Geneva
Tel. no. : (41 22) 791 1058; Fax no. : (41 22) 791 1397
E-mail : [email protected]
WHO/CHN
Dr Michael O'Leary, WHO Representative in China
World Health Organization, 401, Dongwai Diplomatic Office
Building, 23, Dongzhimenwai Dajie
Chaoyang District, Beijing 1000600
Tel. no. : (8610) 6532 7189 Ext. 81210
Fax no. : (8610) 6532 2359
E-mail: [email protected]
Dr Chin-Kei LEE, Medical Epidemiologist
Communicable Disease Surveillance and Response
World Health Organization, 401, Dongwai Diplomatic Office
Building, 23, Dongzhimenwai Dajie
. Chaoyang District, Beijing 1000600
Tel. no. : (8610) 6532 7189 Ext. 81249
Fax no. : (8610) 6532 2359
E-mail : LeeC@wpro. who.int
Mr ZHANG Xiaodong, National Programme Officer (NPO)
Communicable Disease Surveillance and Response
World Bealth Organization, 401, Dongwai Diplomatic Office
Building, 23, Dongzhimenwai Dajie
Chaoyang District, Beijing 1000600
Tel. no. : (8610) 6532 7189 Ext. 81244
Fax no. : (8610) 6532 2359
E-mail : zhangxia@wpro. who.int
Annex 2
WHO/CHN (cont'd.)
Ms WU Sheng, Secretary
Communicable Disease Surveillance and Response
World Health Organization, 401, Dongwai Diplomatic Office
Building, 23, Dongzhimenwai Dajie
Chaoyang District, Beijing 1000600
Tel. no. : (8610) 6532 7189 Ext. 81245
Fax no. : (8610) 6532 2359
E-mail : [email protected]
Ms SUN Yue, Secretary
Communicable Disease Surveillance and _Response
World Health Organization, 401, Dongwai Diplomatic Office
Building, 23, Dongzhimenwai Dajie
Chaoyang District, Beijing 1000600
Tel. no. : (8610) 6532 7189 Ext.- 81291
Fax no. : (8610) 6532 2359
E-mail : sunyu@wpro. who.int
5. CONSULTANT
Mr Chris TERRY, President
T & T Publishing Associates, Fangcaodi Xijie 6, Di Yang
Gong Yu 6071, Chaoyangqu District, Beijing 100020
Mobile : (86) 13 43 951 0432
E-mail : [email protected]; SKYPE: christo1922
ANNEX3
Listing of GOARN Partners in the Western Pacific Region
As of October 2009, forty (40) GOARN Partners are currently active in countries within the
Western Pacific Region. The listings of organizations by country is as follows:
Australia
Victorian Infectious Diseases Reference Laboratory (VIDRL)
http://www. vidrl.org.au/
National Centre for Epidemiology and Population Health (NCEPH),
The Australian National University (ANU)
http:/ /nceph.anu.edu.au/
Westrnead Hospital
http: I /www. cidm. info/
Burnet Institute for Medical Research and Public Health
http://www. burnet.edu.au
Australian Biosecurity Cooperative Research Centre (CRC),
Curtin University
http:/ /wwwl.abcrc.org.au/
Office of Health Protection, Department of Health and Ageing (DOHA)
[email protected]
·
Australian Infection Control Association (AICA)
http://www .aica.org.au
PathWest Laboratory Medicine W A
http://www. pathwest. com. au
Cambodia
Institute Pasteur (IP)
http :www. pasteur. fr
China
Centre for Health Protection (CHP), Department of Health
http://www.chp.gov.hk
Chinese Center for Disease Control and Prevention, (Chinese CDC)
http://www.chinacdc.cn
Centre for Disease Control and Prevention of Guangdong Province
http://www .cdcp.org.cn
The Chinese University of Hong Kong
http://www.cuhk.edu.hk/med/mic/index.html
University of Hong Kong
http://jmsc.hku.hk/2009/10/the-jmsc-public-health-programrne/
Annex 3
Japan
Association of Medical Doctors of Asia (AMDA)
narazu@amda. or .jp
Center for Infectious Diseases, Nara Medical University
[email protected]
Department of Public Health, Osaka City University Faculty of Medicine
http://www .med.osaka-cu.ac.jp/kouei
Department of Virology, Tohoku University, School of Medicine
[email protected]
Hokkaido University
http://www .hq~dai.ac.jplbureau/e/index-e.html
Institute of Tropical Medicine, Nagasaki Upiversity
http://www .nagasaki-u.ac.jp/index_en.html
International Medical Center of Japan
http://www.imcj.go.jp
...
Kurume University
[email protected]
National Institute of Infectious Diseases (NIID)
http://www .nih.go.jp/niid/index-e.html
Osaka University
http://www .biken.osaka-u.ac.jp/
Our Lady of Snow Medical Juridical Corporation St. Mary's Hospital
[email protected] .jp
School of Medicine, Niigata University
[email protected]
Korea
Korea Centres for Disease Control and Prevention (KCDC)
http://www .english.mohw .go.kr
Malaysia
Institute of Health & Community Medicine (IHCM)
Universiti Malaysia Sarawak
http://www. unimas.my /researchlihcm/index.html
Institute of Public Health, National Institute of Health, Malaysia
http://www .iku.gov .my
New Caledonia
Secretariat of the Pacific Community (SPC)
http: I lwww. spc. int
Annex 3
New Zealand
Institute of Environmental Science and Research Limited (ESR)
http://www .esc.cri.nz
Papua New Guinea
Papua New Guinea Institute of Medical Research (PNG TMR)
http://www. pngimr. org. pg/
Philippines
National Epidemiology Center, Department of Health, Ministry of Healtj
[email protected]
Singapore
Ministry of Health, Singapore
http://www.moh.gov.sg/
National University of Singapore (NUS)
http://www.nus.edu.sg/
Regional Emerging Diseases Intervention (REDI) Center
http://www.redi.org.sg
Singapore General Hospital
[email protected]
Tan Tack Seng Hospital
http://www.ttsh.com.sg
ANNEX4
Listing of WHO Offices in the Western Pacific Region
As of October 2009, WHO has offices in the following countries in the Western Pacific Region:
American Samoa
New Caledonia
Australia
New Zealand
Brunei Darussalam
Niue
Cambodia
China
The Commonwealth of the North Mariana
Islands
Cook Islands
Palau
Fiji
Papua New Guinea
French Polynesia
The Philippines
Guam
Pitcairn Islands
Hong Kong
Samoa
Japan
Singapore
The Republic of Korea
Solomon Islands
The Lao People ' s Democratic Republic
Tokelau
Macao
Tonga
Malaysia
Tuvalu
The Marshall Islands
Vanuatu
The Federated States of Micronesia
VietNam
Mongolia
Nauru
Wallis and Futuna
To view contact information for any of these offices, visit the WPRO website at:
www .wpro. who.int
ANNEX5
KEY PUBLICATIONS AND RESOURCES
Publications
Asia Pacific Strategy for Emerging Diseases. World Health Organization (2005)
Meeting Report: Meeting of t!Je Global Outbreak Alert and Response Network (GOARN)
Partners from the Western Pacific Region, Melbourne, Australia. World Health
Organization- Western Pacific Region (July 2008)
Meeting Report: Meeting of the Global Outbreak Alert and Response Network (GOARN)
Partners from the Western Pacific Region, Melbourne, Sendai, Japan. World Health
Organization- Western Pacific Region (July 2007)
Regional Committee Report on the 5f!h World Healtl1 Assembly Regulations WHA58.3.
Revisions of the International Health Regulations. May 2005. World Health Organization.
(July 2005).
WHO International Standard Terminologies 011 Traditional Medkine in the Western Pacific
Region. WHO-Western Pacific Region. (2007)
The Work of WHO in the Western Pacific Region, July 2008- June 2009: Regional
Director's Report. WHO Western Pacific Region. (2009).
Websites
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www.euro.who.int
www.searo.who.int
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