Pandemic Preparedness Planning

Transcription

1 Fachgespräch: Schutzziele im gesundheitlichen Bevölkerungsschutz und Gesundheitsziele BMI, Bonn, 25. Januar 2013 Pandemic Preparedness Planning Handlungserfordernisse bezogen auf Pandemie und MANI aus Sicht der WHO Tim Nguyen, Technical Officer World Health Organization, Geneva 2003$ SARS Re'emergence$ $of$h5n1$$ Pandemic$(H1N1)$2009$ April$2009'August$2010$ Pandemic Preparedness Guidelines (1999): 3 phases IHR revision Includes all Public Health Emergencies of International Concern (PHEIC) (2005) PP guide (2005): 6 phases PP guide (2009): 6 phases Report$of$$ the$ihr$ $pandemic$$ review$$ CommiEee$ (May$2011)$ 2

2 Preparedness before the pandemic (H1N1)2009! WHO Pandemic preparedness guidelines issued in 1999 and updated in 2005 and early 2009! National preparedness Plan for response : more than 70% of Member States with a pandemic preparedness plan Stockpiles: a number of countries with antiviral and vaccines stockpile and/or dormant contract with manufacturers Regulations: emergency licensing for specific products 3 Preparedness efforts before 2009! Study* : 142 preparedness plans available analysed! Assessment indicators (88): Planning and coordination (22), Situation monitoring and assessment (11), Prevention and containment (26), Health system response (16) Communication (13).! From 3 to 609 pages with a median length of 43 pages! Published mainly in 2005 and 2006 (70%)! Pharmaceutical interventions 110 plans (92%) describe the use of antiviral drugs Vaccine use was considered by 108 Member States (91%) 4

3 5 Before the pandemic Pandemic phases Phases: Tool for planning Description of the risk / spread Phase 4 for rapid containment operations 50% of the country plans (60/119) linked national activities to WHO phases 6

4 Pandemic (H1N1) 2009: 2 dimensions Pandemic)Phases) Phase)1-3) Phase)4) Phase$5$ Phase$6$ Risk Geographic)spread) of)virus/cases)at) global)level) Severity)Assessment) Severe) Moderate)) Mild) Impact)of)the) pandemic) at)country)level) 7 Use of phases during the pandemic Tool for response Public announcement of phases to describe the evolution of the event Trigger for national actions Purchase agreement, infection control, etc. Communication "Phase 6" seen as a signal of a severe pandemic 8

5 Value of preparedness! The preparedness efforts done before the 2009 pandemic facilitated communication between countries and coordination at regional level. E.g. Virus sequence made publicly available on 25 April 2009 RT-PCR kits available on 2 May 2009! Increased capacity at country level on outbreak detection and response under the International Health Regulations enabled better sharing of information and reduced the risk of inappropriate decisions on border control measures. 9 Conclusion$of$the$IHR$pandemic$review$ commieee$ Report to the 64 th WHA May 2011 Conclusion 3 The world is ill-prepared to respond to a severe influenza pandemic or to any similarly global, sustained and threatening public health emergency... 10

6 Revision of the pandemic preparedness guidance! WHO approach: Multi-sectoral, all hazards emergency preparedness! Opportunities Better health outcomes for people at risk of emergencies Increased capacity to manage health risks from all hazards Effective prevention, preparedness, response, recovery Resilience of communities and health systems! Expected outcomes More sustainability More inclusive approach Economy of scale! Overarching policy framework: Emergency risk management framework Rationale: Areas in common for emergencies: planning, communication, stockpiling, Hazard specific areas: e.g. pandemic severity, pandemic phases,.. 11 Proposed Purpose of the HERM Framework! Guidance on the key capacities for a comprehensive all hazards HERM system! Roles of local, national, regional, and global stakeholders, including Ministries of Health and WHO in HERM! Common voice for the health sector to advocate for and strengthen health aspects of national and international ERM policies and frameworks 12

7 Proposed 6 Essential Components of Health Emergency Risk Management 1. Policies and Resource Management 2. Planning and Coordination 3. Health and Related Services 4. Information and Knowledge Management 5. Health Infrastructure and Logistics 6. Community ERM Capacities 13 Proposed Essential Components of HERM 1. Policies and Resource Management Policies, strategies and legislation Capacity development strategies Financing Human Resources Management Monitoring, evaluation and reporting 2. Planning and Coordination Coordination mechanisms ERM units in MOH Prevention and mitigation planning and coordination Response planning and coordination Recovery planning and coordination Business continuity management Exercises and simulations 14

8 Proposed Essential Components of HERM 3. Health and Related Services An array of health related services are central to health emergency risk management, in terms of prevention, preparedness, response and recovery from emergencies Supported by: policy and resource management, planning and coordination mechanisms, information knowledge management and logistics 4. Information and Knowledge Management Risk assessments Early warning and Surveillance Research for ERM Knowledge management technical guidance and support Information management Public communications 15 Proposed Essential Components of HERM 5. Health Infrastructure and Logistics Logistics, supplies Safer, prepared/functional health facilities 6. Community ERM Capacities Local capacities assess, reduce risks, respond and recover Training and support should be provided for the community based health workforce Community action and self-reliance 16

9 Join our list serve: THANK YOU 17 Implementation of the HERM Framework Key steps: 1. Assess current capacities in managing health risks of the country 2. Conduct a risk assessment to identify and analyse the risks of emergencies 3. Identify strengths and areas for capacity development as per the assessment of risks at the community and country level 4. Integration of actions into capacity development strategies 18

10 Pandemic phases revision! Elements to take into account International Health Regulation (2005/2007) Pandemic Influenza Preparedness framework (PIP), endorsed in May 2011 (need to declare a pandemic to activate the SMTA2 agreements) Experience from the (H1N1) 2009 pandemic: rapid spread, variability of impact, interpretation of pandemic phases by the media and the public and use of phases at national level. National pandemic preparedness plans and feed back from countries 19 Pandemic Preparedness: Strong focus on H5N1 Number of countries number of PP plans accessed / analyzed % PP plans analyzed focusing on H5N1 African Region (63%) / 29 93% Region of the Americas (69%) / 20 55% Eastern Mediterranean region (57%) / 10 80% European Region (81%) / 32 19% South East Asia Region (100%) / 10 90% Western Pacific Region (63%) / 18 50% 20