EC/ECDC/WHO Uppsala Presentation by David Nabarro UN System Influenza Coordinator May 15 th 2006.

EC/ECDC/WHOUppsala

Presentation by David Nabarro

UN System Influenza Coordinator

May 15th 2006

PREPARING FOR PANDEMICS

• Building a Movement of Actors

• Being Alert to Pandemic Potential

• Working for Pandemic Prevention

• Readying for Pandemic Response– The H5N1 Wake-Up Call : Urgency and

Focus

• Our Common Cause

• An International effort for the Global Good

1 BUILDING A MOVEMENT OF ACTORS WITH COMMON CAUSE

• Strategic Focus: Science Base• Acting Locally, Nationally, Regionally, Globally• Involving Political Leaders, Government Services,

Professional Bodies, Civil Society• Engaging key figures, institutions, systems,

technical networks for the long term• Sustaining and institutionalizing focus on health

security• Mobilizing funds…..

2 BEING ALERT TO PANDEMIC POTENTIAL

– Local outbreaks: Global Impact (SARS - <1000 dead, $50 billion economic loss).

– Significant loss of life: High absenteeism– IMF analysis: significant temporary impact

• Disrupted supplies (markets closed, access reduced, unreliable utilities, shortages of cash, telecom outages

• Reduced demand (affecting travel and leisure, restaurant and food industry)

– Threats to Rule of law, Security, Continuity of Governance

• H5N1 in Birds ……

3 WORKING FOR PANDEMIC PREVENTION

H5N1 OUTBREAKS IN BIRDS: CHRONOLOGY 1996 TO DATE

1996 to 2003June 2004December 2004June 2005December 2005March 2006

ChinaChinaSouth KoreaSouth Korea

IndonesiaIndonesia

VietnamVietnam

ThailandThailand CambodiaCambodia

JapanJapan

LaosLaos

MalaysiaMalaysia

KazakhstanKazakhstan

RussiaRussia

MongoliaMongolia

TurkeyTurkey

UkraineUkraine

RomaniaRomania

CroatiaCroatia

BulgariaBulgaria

AzerbaijanAzerbaijan

IraqIraq IranIran

NigerNiger

NigeriaNigeria

EgyptEgypt

FranceFranceSwitzerlandSwitzerland

GermanyGermanyItalyItaly

AustriaAustriaBosnia HerzegovinaBosnia Herzegovina

SlovakiaSlovakiaSerbia MontenegroSerbia Montenegro

HungaryHungary

SloveniaSlovenia

GreeceGreece PakistanPakistan

IndiaIndia

2000 miles2000 miles3000 miles3000 miles4000 miles4000 miles5000 miles5000 miles6000 miles6000 miles7000 miles7000 miles

Distance from Hong KongDistance from Hong Kong

Map compiled by WFP Emergency Preparedness and Response Branch (ODAP) 06.03.06

• H5N1 in Birds – An Epizootic moving rapidly across the

world: sporadic human cases and the potential to cause a pandemic

– More than 30 countries reporting H5N1 since January 2006;

– 15 countries in the preceding 2.5 years

• 70% of new infections will come from the animal kingdom

3 WORKING FOR PANDEMIC PREVENTION

Three Pandemic Scenarios

Time

Imp

act

MODEL 3 - Rapid Onset / Widespread impactLittle time for preparation, response is reactive and defensive

MODEL 2 - Slow Onset / Moderate & Localized ImpactSlowly acquires infectivityContainment may be successful Limited pandemic

MODEL 1 - Extended Pandemic Phase 3 / Continued Outbreaks of Avian Influenza

Impact on livelihoods due to culling of birds

4 BEING READY FOR PANDEMIC RESPONSE

Human Survival and Health

Human Survival and Health

Rule of Law and Governance

Rule of Law and Governance

Vulnerable Livelihoods

Vulnerable Livelihoods

Financial Systems And Trade

Financial Systems And Trade

• High illness & potentially higher death rates• Overstretched health facilities• Impact on persons with chronic disease

• Increased demand for governance & security• Higher public anxiety, reduced capacity• Potential exploitation

• Diminished coping & support mechanisms• Shortage of basic necessities• Vulnerabilities – & needs - of Contained Groups

• Trade & commerce disruptions• Reduced availability of cash • Interruption of logistics

Basic Services and Utilities

Basic Services and Utilities

• Absenteeism affecting manufacture and services Interruption of Electricity and Water Supplies

• Telecommunications overload

5 AGREED STRATEGY (November 2005)

1.Stop influenza in animals through stamping out the disease at the place where the infection starts

2.Prevent emergence of pandemic by limiting human exposure;

• if pandemic does start, contain it quickly;

• if containment is not possible, mitigate pandemic consequences.

IN PURSUIT OF THE STRATEGY

• Integrated National Influenza Plans

• Multiple Actors Engaged

• Financial Assistance Pledged (Jan 2006)

• Urgent Programmes Initiated

• National Plans Appraised

• External support for Implementation

• Emphasis on Coordination: Harmony, Synergy, Unity

BEST PRACTICE 05 - 06

• Sound, evidence-based national strategy and plan • Focus on immediate (under one year) and medium

term (up to 5 years) • Primary focus to animal health (including veterinary

services and livestock sectors), • Emphasise effective systems for public health • Inter-sectoral approaches to pandemic preparedness. • Fully-costed operational plan• Implementation and management arrangements• Regular reviews of relevance and utility• Transparent analyses of achievements

MAKING BEST PRACTICE HAPPEN 1. POLITICAL LEADERSHIP FOCUSING ON TOUGH ISSUES2. THE WHOLE OF GOVERNMENT INVOLVED, MORE THAN

HEALTH AND AGRICULTURE …PRIVATE AND VOLUNTARY SECTORS TOO

3. MASS MEDIA CAMPAIGNS TO PROMOTE HEALTHY ACTIONS AND PANDEMIC READINESS

4. MANAGEMENT SYSTEMS: FUNDS AND STANDARD PROCEDURES DISTRIBUTED, KEY PEOPLE MADE RESPONSIBLE AND ACCOUNTABLE – AT NATIONAL AND LOCAL LEVELS

5. INCENTIVES AND COMPENSATION SCHEMES TO REDUCE VULNERABILITY AND SUSTAIN LIVELIHOODS

6. REGULAR REVIEWS OF PROGRESS BY ALL STAKEHOLDERS, ANALYZING PROGRESS, TRACKING FUNDS, AND MODIFYING PROGRAMME DIRECTION

7. EXTERNAL COMMUNITY WORKING TOGETHER IN SUPPORT OF NATIONAL ACTION

6 INTERNATIONAL ACTION• Risks posed by avian Influenza and potential pandemic

– Sharing information on threats to livelihoods, to continuity of services, to health; joint response to uncertainty

• Information and Support for Behaviour Change– Encouraging an international movement for reduction of pandemic

risks: a joint approach reflecting best practice• Technical support for better Animal Health

– Inter-country support for surveillance, incentives, prompt reporting, responsiveness, bio-security, strategic vaccination and recovery

• Technical support for Pandemic Containment– Inter-country support for public health systems: surveillance,

information, containment; access to vital supplies• Continuity and well-being during Pandemic

– Intergovernmental mechanisms to sustain health outcomes, equity, continuity, and recovery

• Applying science to animal and human influenza– International epidemiological initiatives; Development of Vaccines

and Diagnostics

ASKING QUESTIONS OF OURSELVES….

• Are we working together, as a team– making the weak links strong, wherever they may

be?– Being ready to raise our game - at a moments

notice?– Moving as one, holding our shape, keeping fluid,

whatever the challenges we face?– At ease with uncertainty about what will happen but

determined to get the right result?