Cross border preparedness and response: Key health issues and challenges

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1 Cross border preparedness and response: Key health issues and challenges Prince Mahidol Award Conference Bangkok, Thailand February 1, 2013 Prof. Mahmudur Rahman, PhD Director Ins/tute of Epidemiology, Disease Control and Research Na/onal Influenza Center

2 The cross borders of Bangladesh 3 interna/onal airports 2 sea ports Shares 11 land ports with India & 1 with Myanmar Legally 1.2 million people cross the border annually Bangladesh shares 4000 km land border with India and Myanmar A route for legal and illegal trade of livestock, food items, medicines and drugs among neighboring countries

3 Cross Border Health Risks Trade Legal and illegal Cross- border movements of people Legal and illegal Since 1990, global trade has grown six- fold and the number of people travelling by air has increased 17- fold More than 2 million people cross borders each day and travel /mes are shorter than the incuba/on periods of many diseases Increasingly, a country's foreign policy may be linked to cross- border health risks

4 Scope of rapid spread of infec/ous diseases Proximity of Border ci/es Large trade of goods and commodi/es Viral adapta/on and ecological shiws as a result of climate change Animal trading on Bangladesh border Close contact of Human- Animal Poor living condi/ons of the refugees

5 Cross border infec/ous diseases InfecDons in humans PoliomyeliDs Nipah Leishmaniasis Anthrax Malaria Chikungunya Dengue Avian influenza Rabies Bovine TB Salmonella infec/ons Brucellosis Transboundary animal diseases Foot and mouth disease PPR New castle disease

6 Cross Border Concerns Lack of systema/c iden/fica/on of cross border health issues No surveillance system to assess the border popula/on as a geographic unit The surveillance case defini/ons of cross border diseases among Bangladesh, India and Myanmar may be different No mechanism to exchange border surveillance data

7 Ways forward Systema/c assessment to iden/fy cross border concerns Strengthening Interna/onal Health Regula/on (2005) to enhance disease detec/on, response and repor/ng Interna/onal Health Regula/on (IHR) Forma/on of regional networks to improve communica/on and collabora/on across borders and across sectors Mul/- country border infec/ous disease surveillance

8 Thank You

9 InternaDonal Health RegulaDon (IHR) IHR (2005) is the only legal framework for sharing urgent epidemiological information on trans-boundary spread of infectious diseases There is a strong synergy between cross-border collaboration and IHR (2005)

10 What is IHR 2005 IHR is about preventing the international spread of diseases IHR seeks that all Member States be able to timely detect, assess, notify and report events and respond to public health risks and Public Health Emergency of International Concern (PHEIC)

11 What do the IHR call for? Strengthened national capacity for surveillance and control, including in travel and transport Prevention, alert and response to public health emergencies of international concern Rights, obligations and procedures, and progress monitoring Global partnership and international collaboration

12 Core CapaciDes under IHR Na/onal legisla/on, policy and financing 2. Coordina/on and Na/onal Focal Point (NFP) communica/ons 3. Surveillance 4. Response 5. Preparedness 6. Risk communica/on 7. Human resources 8. Laboratory

13 Core CapaciDes under IHR 2005 cont 9. Designated Ports, Airports & Ground Crossings Dealing Poten,al Hazards of : 10. Biological events - Infec/ous - Zoonosis - Food safety 11. Chemical events 12. Radio nuclear events

14 SEAR Countries Average Attribute Scores

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16 5 Priority AcDons for States 1. Establish a func/oning Na/onal IHR Focal Point 2. Ensure adherence to repor/ng requirements and verifica/on of public health events 3. Adjust administra/ve and legisla/ve arrangements (including cer/ficates) 4. Assess core capaci/es (gap analysis) surveillance and response designated points of entry 5. Develop na/onal plan and mobilize resources necessary to guarantee compliance with the provisions set in the IHR (2005) Ways forward