SPF SANTE PUBLIQUE, SECURITE DE LA CHAINE ALIMENTAIRE ET ENVIRONNEMENT. Dr Luc Tsachoua M.D./M.P.H.

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1 1 Dr Luc Tsachoua M.D./M.P.H.

2 2 Every single day in the world, people are victim of adverse health events caused by chemical, biological, radiological, nuclear and meteorological risks factors Spanish flu 60 million victims Between 2000 and 2012 more than 220 million people had been affected by natural disasters of them were killed. Mass casualty incidents have killed more than 50 million people

3 3 Furthermore these events may be at the origin of social and economic collateral effects. All countries in the world are concerned by these issues; the type of event dependent on the profile of the country. In occidental Europe, those risk factors are mainly represented by : the industrialization of our societies, the increase of traveler flow and goods exchanges, and by the climate conditions (climate change).

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5 5 In Belgium, the Public Health Emergency Preparedness & Response is organized at three scales : Local, National, And International. For each of these scales, the management is based on three spots : Organization, Means, Training.

6 6 Organization Means Training

7 7 ORGANIZATION: NATIONAL LEGAL BASIS MEDICAL AND PSYCHOSOCIAL INTERVENTION PLAN MEANS: EMERGENCY CALL CENTER EMERGENCY MEDICAL SERVICES AND VEHICLES TELECOMMUNICATION TOOLS DISASTER LOGISTIC COURSES EXERCISES WORKSHOP TRAINING: ORGANIZATION: NATIONAL LEGAL BASIS NATIONAL DEDICATED PLANS MEANS: HEALTH WARNING UNIT RAG RMG NATIONAL STOCKPILE NATIONAL REFERENCE HOSPITALS AND LABORATORIES TRAINING: EXERCISES WORKSHOP ORGANIZATION: IHR 2005 EUROPEAN LEGAL BASIS MEANS: NFP FOR IHR WHO GLOBAL OUTBREAK SYSTEM EU NOTIFICATION SYSTEMS B-FAST TRAINING: EXERCISES WORKSHOP LOCAL NATIONAL INTERNATIONAL

8 8 ORGANIZATION: NATIONAL LEGAL BASIS MEDICAL AND PSYCHOSOCIAL INTERVENTION PLAN MEANS: EMERGENCY CALL CENTER EMERGENCY MEDICAL SERVICES AND VEHICLES TELECOMMUNICATION TOOLS DISASTER LOGISTIC TRAINING: COURSES EXERCISES WORKSHOP LOCAL

9 9 ORGANIZATION Law on the civil protection General Framework. Law on the Emergency Medical Help 5 July 1964 modified the 22 february 1998 Organization of the emergency call center (100), of vehicles and of the first care on place. Ghent Doctrine of the 30 march 1991 Dedicated to the organization of Medical teams : Alert threshold, Reflex actions, Sorting, Radio usage. Royal Decree of the 16 february 2006 Generic Organization of Major Crisis Emergency plans

10 10 ORGANIZATION MONO DISCIPLINARY INTERVENTION PLAN (DISCIPLINE 2) MIP Medical Intervention Plan PSIP Psychosocial Intervention Plan SIP Sanitairy Intervention Plan PRIMA Plan Risk & Events

11 11 MEANS 10 EMERGENCY CALL CENTER (100/112) MEDICAL SERVICES AND VEHICLES (AMBULANCE, SMUR, PIT, AMBULANCE HELICOPTER) DISASTER LOGISTIC MATERIAL (INFLATABLE TENT, OXYGEN, STRETCHER AND STOCK OF MEDICATION FOR APPROXIMATELY 100 VICTIMS TELECOMMUNICATION TOOLS FOR FIELD TEAM TETRA TECHNOLOGY (Terrestrial Trunked Radio)

12 ORGANIZATION MEANS ACCIDENT 2. CALL 100/ EMERGENCY CALL CENTRE 4. BELGIAN REGULATION MANUAL 5. SELECT AND SEND MEDICAL RESCUE TEAM GIS (GEOGRAPHIC INFORMATION SYSTEM) 6. MEDICAL VEHICLE ON SPOT 7. STAY AND PLAY 8. FOLLOWING OF THE MISSION AND REAPPRAISAL 9. EMERGENCY MEDICAL SERVICES 10. VEHICLE ANEW AVAILABLE

13 13 TRAINING TYPES : MASTER DEGREE (DISASTER MEDICINE, MANAGEMENT OF MASS CASUALTY INCIDENT) EXERCISES(TABLETOP, FULL SCALE EXERCISES, FUNCTIONAL EXERCISE) WORKSHOP ON DISASTER MANAGEMENT AIM: ENSURE A HIGH LEVEL OF COMPETENCY REINFORCE FEDERAL COORDINATION OF STAKEHOLDERS

14 14 ORGANIZATION: NATIONAL LEGAL BASIS NATIONAL DEDICATED PLANS MEANS: HEALTH WARNING UNIT RAG RMG NATIONAL STOCKPILE NATIONAL REFERENCE HOSPITALS AND LABORATORIES EXERCISES WORKSHOP TRAINING: NATIONAL

15 15 ORGANIZATION Law: The same legal basis as for the local level. NATIONAL DEDICATED PLANS: National Flu plan Heat wave and ozone peak Plan Nuclear Plan Etc.

16 16 MEANS HEALTH WARNING UNIT: FEDERAL PUBLIC SERVICE FOR HEALTH REGIONAL AN COMMUNITY HEALTH SERVICES VARIOUS HEALTH INSTITUTES WIV-ISP: (Scientific Institute of Public Health): Implements policies in response to the legal framework and priorities of Federal Public Service for Health FASFC (Federal Agency for the Safety of the Food Chain):Control and protect the safety and the quality of food FAMHP (Federal Agency for Medicines and Health Products): It is the competent authority for medicines and health products FANC (Federal Agency for Nuclear Control) RIM (Royal Institut of Meteorology) Etc.

17 17 MEANS RAG (RISK ASSESSMENT GROUP): ASSESSMENT OF THE CRISIS AND PROPOSITION OF RESPONSE MEASURES RMG (RISK MANAGEMENT GROUP): FINAL DECISION IN REGARD OF THE CHOICE OF MEASURES TO ADOPT AND THE IMPLEMENTATION OF THEM. CRISIS CENTER: MULTI MINISTERIAL COMPOSITION

18 18 MEANS NATIONAL REFERENCE HOSPITALS AND LABORATORIES NATIONAL STOCKPILE (protective equipment, antidotes and Vaccine) COMMUNICATION TOOLS (websites, Dedicated Call-centre, flyers)

19 19 TRAINING TYPES : WORKSHOP ON PHE MANAGEMENT EXERCISES (TABLETOP, FUNCTIONAL EXERCISE) AIM: REDUCE IMPROVISATION INCREASE COMPETENCY REINFORCE COORDINATION BETWEEN NATIONAL STAKEHOLDERS

20 20 ORGANIZATION: IHR 2005 EUROPEAN LEGAL BASIS MEANS: NFP FOR IHR WHO GLOBAL OUTBREAK SYSTEM EU NOTIFICATION SYSTEMS B-FAST EXERCISES WORKSHOP TRAINING: INTERNATIONAL

21 21 ORGANIZATION IHR OF THE WHO (SINCE JUNE 2007) Binding instrument of international law Entered into force on 15 June 2007 MEMORENDUM OF UNDERSTQNDING FOR THE IMPLEMENTATION OF IHR IN BELGIUM (2006) EUROPEAN DECISION ON SERIOUS CROSS-BORDER THREATS TO HEALTH (DECISION NO 1082/2013/EU) Entered into force on 22 October 2013.

22 22 MEANS NFP FOR IHR WHO GLOBAL OUTBREAK SYSTEM EU NOTIFICATION SYSTEMS : EWRS EARLY WARNING RESPONSE SYSTEM ENSURE A RAPID AND EFFECTIVE RESPONSE BY THE EU TO EVENTS (INCLUDING EMERGENCIES) RELATED TO COMMUNICABLE DISEASES RAS BICHAT: ALERT SYSTEM USED FOR EXCHANGING INFORMATION ON HEALTH THREATS DUE TO DELIBERATE RELEASE OF CHEMICAL, BIOLOGICAL AND RADIO-NUCLEAR AGENTS B-FAST (BELGIAN FIRST AID AND SUPPORT TEAM)

23 23 MEANS

24 24 TRAINING TYPES : INTERNATIONAL WORKSHOP INTERNATIONAL EXERCISES AIM: TRAINING FOR PUBLIC HEALTH PROFESSIONAL, DOCTORS, NURSES, LOGISTIC OFFICERS, PREPARATION TO THE MANAGEMENT OF INTERNATIONAL PUBLIC HEALTH CRISIS.

25 25 Mosquitos in Natoye (2002) Viral Haemorrhagic Fever (among which, one confirmed case of Lassa Fever) (2006) Measles outbreak in Antwerp (2007, 2011) Flu A/H1N1 (2009) Salmonella Stanley infection outbreak (2012) Train accident with leakage of acrylonitrile (2013) Warning on medical devices ( mammary prothesis PIP, pacemaker, Cidex, etc.) Multiple suspect package (no anthrax, nor uranium nor adamite, found)

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27 27 Belgium works on a daily basis to the preparedness of response to unexpected PHE. Our action is based on: a strong legislation, simple and standardized action plans, sufficient human and material resources, all this by paying a particular attention to the training of the actors. These efforts are integrated into an international dynamic (WHO, EU, Int. support team). Belgium is a credible partner on international level of whom the expertise is appreciated.

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