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PAHO Strategic and Operational Plan for Responding to Pandemic Influenza


... PAHO activities for to influenza pandemic preparedness and response Implementation of the International Health ... International Health Regulation ... – PowerPoint PPT presentation

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Title: PAHO Strategic and Operational Plan for Responding to Pandemic Influenza

PAHO Strategic and Operational Plan for
Responding to Pandemic Influenza
San José, Costa Rica Central America. December
14-16, 2005
  • I had a little bird
  • Its name was Enza
  • I opened the window
  • And in-flew-enza

from a lullaby popular in USA during the early XX
Influenza global Implications
  • The newly adopted International Health Regulation
    (IHR-2005) lists human influenza caused by a
    new subtype among the 4 diseases that need to be
    notified to WHO
  • The emergence and widespread circulation of a new
    highly pathogenic avian influenza A (H5N1) strain
    in Asia
  • This virus has the capacity to infect humans
    creating an opportunity to the occurrence of a
    new pandemic

Task Force on Epidemic Alert Response
  • PAHO Director established an inter-programmatic
    and multidisciplinary Task Force on Epidemic
    Alert and Response
  • Advise, Enable, Coordinate, and Monitor
  • PAHO activities for to influenza pandemic
    preparedness and response
  • Implementation of the International Health
    Regulations in the Region
  • Responsible for drafting the PAHO Strategic and
    Operational Plan for responding to pandemic

Strategic Operational Plan for Responding to
Pandemic Influenza
  • Objectives
  • To direct PAHO Technical Cooperation activities
    to prepare the Region for an influenza pandemic
  • To assist countries in their Development of
    National influenza pandemic preparedness plans
  • To assist countries in the implementation of
    supporting actions which are needed for the
    effective response to a pandemic

Considerations for Development Strategic and
Operational Plan
  • Directives given by PAHO and WHOs Governing
  • The phase-specific approach set forth by the WHO
    strategic plan
  • WHO Global influenza Preparedness plan
  • WHO checklist for influenza pandemic preparedness
  • Other WHO documents
  • Countries existing NIPPPs
  • The newly adopted International Health
    Regulations (IHR-2005)
  • Ongoing Technical Cooperation

Impact of an Influenza Pandemic
  • Unparalleled tolls of illness and death expected.
  • Air travel could hasten viral spread and decrease
    available time for preparing interventions.
  • Health care systems could be rapidly
    overburdened, economies strained, and social
    order disrupted.
  • But it should be possible minimize the
    consequences by having prepared for the challenge
    in advance.
  • Essential to preparedness planning is to estimate
    likely impact of the next pandemic, including
    associated morbidity and mortality burden health
    services surge capacity, and social economic

Economic Impact of Selected Infectious Diseases
Pandemic Preparedness
  • Development of National Influenza Pandemic
    Preparedness Plans are urgently needed.
  • Mandated by the 56th World Health Assembly and
    the 44th Pan American Health Organization
    Directing Council Resolutions
  • Guidelines
  • WHO Global Influenza Preparedness Plan
  • WHO Checklist for influenza Pandemic Preparedness
  • WHO Strategic Action Plan for Pandemic Influenza
  • Consider worst-case scenarios
  • No vaccines and antivirals drugs

Pandemic Preparedness Planning
  • Complicated by the unpredictability of the time
    of inception and severity a pandemic influenza
  • Public health authorities recognize risk and
    impact of pandemic
  • Development of plan not always a priority
  • Competes with other public health issues
  • Many countries lack the human resources to
    dedicate time and effort to something that is not
    yet real
  • WHO has revised guidelines to assist countries in
    the development of pandemic preparedness plans
    PAHO has translated and disseminated them in the

Development of National Influenza Pandemic
Preparedness Plans (NIPPPS)
  • New International Health Regulations (IHR-2005)
    recommends that countries develop their necessary
    core capacities to detect and respond to diseases
    like influenza
  • Pandemic preparedness should be built on existing
    processes and programs and cannot be disconnected
    from routine and current activities
  • Plan should seek to integrate National and local
    activities involved in the response to a pandemic

Implementation of NIPPS
  • Activities in pandemic preparedness plan should
    be subject to constant revision
  • Simulation exercises need to happen at different
  • including facility and local jurisdictions
  • enable the testing of contingency plans for
    patient care to deal with surges and delivery of
    services where there are problems of access
  • Importance of organizing national debriefings on
  • when outbreak with pandemic potential occurs
  • conduct periodic reviews of the plan to include
    new evidence and technical developments

WHO Pandemic Phases
  • Pandemic Alert Period
  • Phase 3. Human infection with the new subtype but
    no human-to-human transmission
  • Phase 4. Small clusters with limited human-to-
    human transmission.
  • Phase 5. Larger clusters but human to human
    transmission still localized 
  • Interpandemic Period
  • Phase 1. No new human influenza subtype. Low risk
    of infection of circulating animal influenza
  • Phase 2. No new human influenza subtype.
    Circulating new animal influenza virus poses risk
    to humans
  • Pandemic Period
  • - Phase 6. Pandemic increased and sustained
    transmission in general population 

Phase-specific Approach and Objectives
  • Phase pre-pandemic
  • Promote the development of National Influenza
    Pandemic Preparedness Plans
  • Strengthen the early warning system
  • Support countries in making available pandemic
    vaccine antivirals
  • Plan for health-care services and infection
  • Reduce opportunities for human infection
  • Implement a communication strategy and raise
    awareness to encourage pandemic planning
  • Estimate potential impact of an influenza
    pandemic and assess additional information gaps
    to guide policy-making
  • Build partnerships and strategic alliances
  • Phase emergence of pandemic virus
  • Contain or delay early spread of the virus
  • Phase pandemic declared spreading
  • Reduce morbidity, mortality, and social
    disruption through a coordinated response
  • Quantify and monitor pandemic impact and

ER 7.1 Potential health impact of pandemic
estimated, including economic impact to guide
  • Indicator
  • Studies estimating Regional morbidity, mortality,
    and economic impact due to pandemic influenza
  • Framework for country level estimation of health
    and economic impact of influenza pandemic
    developed, validated and disseminated to the 21
    countries of Latin America and CAREC.
  • Key activities
  • Develop and validate tools for country level
    estimation of health and economic impact of
    influenza pandemic.
  • Conduct modelling studies of pandemic virus
    emergence considering possible pathways for viral
  • Conduct modeling studies to estimate burden of an
    influenza pandemic.
  • Conduct modeling studies to assess economic
    impact of an influenza pandemic.
  • Translate, adapt, and distribute the following
    WHO publications, pending publication
  • Generic protocol for population-based
    surveillance to estimate the disease burden of
    influenza and other ARI from vaccine preventable
    or potentially preventable agents

Next Steps
  • Development of a budget timeline for
    implementation of activities detailed in Plan
  • Widen consultation on the Plan
  • Resource mobilization started
  • Capacity building of country-level resources,
    early 2006
  • Development of National Influenza Pandemic
    Preparedness Plans with PAHO support early 2006
  • Consultation meeting on the implementation of Non
    Pharmaceutical Public Health Measures during a
    pandemic period. April 2006

Final Remarks CE137/5
  • We urge all Ministries of Health of the Region
    not only to support but also take the lead in the
    development implementation of National
    Influenza Pandemic Preparedness Plans.
  • The Development of the Plan should include other
    partners beyond the Health Sector, including the
    private sector.
  • PAHO will cooperate and support Member States in
    the mobilization of necessary technical
    financial resources for the achievement of this
  • PAHO will coordinate with partners to support
    countries in the development and implementation
    of the National Pandemic Plans

  • The role of public health is, whenever possible,
    to prevent epidemics, not to primarily describe
  • Thomas R Frieden

No vale ver después. Lo importante es ver antes
?y estar preparados José Martí