Advancing Pandemic Preparedness through APSED III

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Kelley Powell
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1 Advancing Pandemic Preparedness through APSED III Masaya Kato Programme Area Manager Country Health Emergency Preparedness and the IHR (CPI) WHO Health Emergencies Programme (WHE) WHO Western Pacific Regional Office Meeting of the Bi-regional Technical Advisory Group on the Asia Pacific Strategy for Emerging Diseases and

Influenza Pandemic 1918 Estimated attributable excess mortality 20-50

(Oct-Nov 1918) associated with particularly high mortality Young adults

2 Influenza Pandemic 1918 Estimated attributable excess mortality million (up to 100 million) Case fatality rate 2-3 % The second wave (Oct-Nov 1918) associated with particularly high mortality Young adults affected most; high mortality in pregnant women Severity compounded by the First World War 22 2

Are we ready for the next pandemic? The world is ill-prepared to respond to a severe influenza pandemic or to any similarly global, sustained and threatening public health emergency.

3 Are we ready for the next pandemic? The world is ill-prepared to respond to a severe influenza pandemic or to any similarly global, sustained and threatening public health emergency. Report of the Review Committee on the Functioning of the IHR(2005) and on Pandemic Influenza (H1N1) 2009 We are simply not prepared to deal with a global epidemic. Bill Gates OpEd, The New York Times, 2015

4 Advancing Pandemic Preparedness Meeting to Advance National Pandemic Preparedness in the Three Mekong Countries, Siem Riep, Cambodia, April 2018

Two Tier Approach Whole-of- Society Approach Risk-based Approach for Flexible Response Meeting to Advance 19-21 National

5 Two Tier Approach Whole-of- Society Approach Risk-based Approach for Flexible Response Meeting to Advance National June Pandemic 2018 Preparedness New Delhi, in India the Three Mekong Countries April 2018 Siem Reap, Cambodia 22/ 5

6 Two-Tier Approach for Public Health Emergency Preparedness Actions specific to events Based on routine activities Coordinating with wider health systems

Two-Tier Approach First Tier - Emergency Planning Response plan Overall public health emergency response plan, complemented by: o hazard-specific plan o heath care facility plans and business

7 Two-Tier Approach First Tier - Emergency Planning Response plan Overall public health emergency response plan, complemented by: o hazard-specific plan o heath care facility plans and business continuity plans for essential services Test through exercises and update as needed Legislation where needed Coordinated process for planning Coordination mechanism with relevant stakeholders

8 Two Tier Approach Emergency Planning Framework for Action Surveillance, risk assessment and response Laboratory Public health intervention including points of entry measures Command and coordination Health care system response including clinical management Risk communications

9 Two-Tier Approach for Public Health Emergency Preparedness Hazard specific Generic (All Hazard)

10 Two Tier Approach System Readiness Hazard specific Generic (All Hazard) EOC IMS IHR NFP Coordination Financing Surveillance, Risk assessment, Response Laboratory Network Infection Prevention & Control Risk Communication

11 Two Tier Approach System Readiness Pandemic Influenza Dengue Vaccine Preventable Diseases Hazard specific Natural Disasters Generic (All Hazard) EOC IMS IHR NFP Coordination Financing Surveillance, Risk assessment, Response Laboratory Network Infection Prevention & Control Risk Communication

12 Two Tier Approach System Readiness Pandemic Influenza Vaccines Anti-virals Hazard specific Nonpharmaceutical Interventions Generic (All Hazard) EOC IMS IHR NFP Coordination Financing Surveillance, Risk assessment, Response Laboratory Network Infection Prevention & Control Risk Communication

Pandemic Influenza Vaccination Producing a vaccine for a new strain of pandemic influenza will take approximately 5 6 months; global production capacity will be limited.

13 Pandemic Influenza Vaccination Producing a vaccine for a new strain of pandemic influenza will take approximately 5 6 months; global production capacity will be limited. System readiness critical: Capacity to produce or procure pandemic influenza vaccine during a pandemic Priority groups for vaccination under different pandemic scenarios (e.g. essential workers, high-risk populations) - ethical consideration. A deployment and vaccination plan, based on existing routine immunization capacities. Regulatory pathways to expedite the importation, marketing authorization and licensing. Communication and information management. Robust seasonal influenza vaccination programmes as pandemic preparedness

14 Japan-ASEF Stockpile Project Antivirals and PPEs

15 Engaging Whole-of-Government, Whole-of-Society Meeting to Advance National Pandemic Preparedness in the Three Mekong Countries April 2018 Siem Reap, Cambodia 22/ 1

16 Whole-of-Society Coordination - Models A. Primarily Health Sector B. Health Sector convening other sectors C. Multi-sectoral coordinating body, with health sector, playing vital roles Meeting to Advance National Pandemic Preparedness in the Three Mekong Countries April 2018 Siem Reap, Cambodia 1

17 Roles of Communities in Pandemic Response 22 June

18 Flexible response based on severity Source: Pandemic Influenza Risk Management, WHO 2017 A need for flexible response guided by national risk and severity assessment

Risk Assessment for Decision using Multiple

multiple sources of available information Informs

19 Risk Assessment for Decision using Multiple Sources of Information Pandemic Influenza Severity Assessment (PISA) Assesses the severity of an influenza epidemic or pandemic based on multiple sources of available information Informs national and global risk assessments for decision to guide response

20 Key Messages It is unpredictable when the next pandemic occurs. Once it occurs, consequences could be significant. Despite considerable progress, further investment is critical to advance pandemic preparedness, building upon core capacities developed through implementing APSED over the decade. Pandemic preparedness requires response planning, while strengthening of system readiness to implement the plan. Engagement of whole-of-society in pandemic preparedness and response requires dedicated planning for coordination and communication.

21 Thank you!

22 Goal of Rapid Containment Shift the peak Gain the time for preparing to sustain the essential social function Implementing Rapid Containment measures 22

Pandemic Influenza Preparedness and Response

24 th Meeting of Ministers of Health Dhaka, Bangladesh, 20-21 August 2006 SEA/HMM/Meet.24/4(b) 10 July 2006 Pandemic Influenza Preparedness and Response Regional situation: Human cases and outbreaks of