Strategies for strengthening surveillance and NIC capacities in the WHO European Region

Transcription

1 Strategies for strengthening surveillance and NIC capacities in the WHO European Region 3rd Meeting with National Influenza Centres (NIC) on Strengthening the WHO Global Influenza Surveillance Network (GISN) 30 November, Hammamet, Tunisia Caroline S. Brown, Programme Manager a.i. And Dmitriy Pereyaslov, virologist Influenza and Other Respiratory Pathogens Team, WHO Regional Office for Europe Influenza & Other Respiratory Pathogens Contribute to the reduction in morbidity and mortality due to influenza and other respiratory pathogens in the Region Capacity building of epidemiological and lab components go hand in hand Page 1 of 11

2 Strategies to enhance surveillance of influenza in the Region Advocate with Member States to support influenza surveillance and vaccination programmes Assist Member States to implement/enhance sentinel surveillance (ARI/ILI/SARI) Coordinate surveillance in the Region with ECDC by: Providing a Regional Platform with single-data entry for ECDC, Regional and global platforms EuroFlu bulletin Coordinate activities with CDC and other partners Regional surveillance and data flows EU/EEA Tessy (ECDC) Member States (surveillance unit/nic) Epi and vir data Simultaneous automatic transfer EuroFlu Non-EU/EEA Simultaneous automatic transfer FLU-ID (epi data) Semi-automatic transfer FluNet (vir data) Global updates Page 2 of 11

3 EuroFlu bulletin in Russian and English New in 2010 % positive sentinel detections Page 3 of 11

4 New in 2010 SARI graphs in the background Development of associated tools and guidance WHO EURO Regional surveillance guidance Sentinel site training package and monitoring checklist Detailed survey of surveillance systems in the Region Information exchange through EuroFlu mailing lists Page 4 of 11

5 Regional surveillance guidance data/assets/pdf_file/0020/90443/e92738.pdf Meetings and missions Annual meetings (2009, 2010, 2011 jointly with ECDC) Forum for Member States to determine priorities Country missions on surveillance (focus on lab and SARI) Page 5 of 11

6 NIC in the WHO European Region: Current status 40/50 NIC Maintain NIC status Improve influenza laboratory capacities On/site assessment, laboratory assessment tool NIC ToR Ship viruses to WHO CC Informs on potential public health threats Obtain WHO Recognition (all by 2013?) Participate in EuroFlu, WHO EQAP Regional QCA Complies with basic standards of laboratory quality Perform base tasks routinely (storage of specimens, virus detection (PCR), virus isolation Page 6 of 11

7 WHO recognition How to become a WHOrecognized National Influenza Centre: Guidance on the process for influenza laboratories in the WHO European Region data/assets /pdf_file/0007/126457/e94432.pdf NIC-Laboratory Assessment tool: WHO NIC checklist combined with laboratory quality standards Red: Below 50%, requires significant improvement Yellow: Between 50 and 85%, some improvement is necessary Green: Above 85%, the laboratory is in good standing Page 7 of 11

8 Implementation of this process Process piloted in Malta, July 2010 Document will be shared with EuroFlu network and with Member States Maintenance of NIC status: yearly letter to MoH to keep NIC on the agenda, thanking for participation in EuroFlu/GISN Providing support to NIC in collaboration with WHO CC NIMR Training of NIC staff at WHO CC supported by WHO EURO Supporting shipment of specimens and viruses Training in IS shipment by WHO EURO (certified) Offer to all NIC during 2011 Annual Meeting Supporting exchange of information and data between WHOCC and NIC Page 8 of 11

9 Training According to needs identified by EQA, during Annual Meetings/missions/upon request On-site, groups trainings, influenza techniques, biosafety, lab quality, shipment Provided in collaboration with WHOCC NIMR, subregional labs (Vector, Cantacuzino), NIC (Denmark) Support WHO EQAP and Regional QCA WHO EQAP: number of labs participating over the years 35 Panel 1 (80% 10/10) 59 Panel 8 (95% 10/10) Discuss follow up and certificates of performance Regional QCA in coordination with ECDC/CNRL Virus isolation QCA 2008, 53 labs 2010/11 virus isolation and AV testing QCA (54 and ~30 labs respectively) Compare results Discuss performance indicators with the network Page 9 of 11

10 Provide reagents and other supplies Coordinating provision of CDC kits (PCR and WHO reagents kit for HI) Providing lab supplies during outbreaks/pandemic Main strengths Building on a long-term network (EISS) Many NIC with excellent capacities and some providing support to other laboratories through training, missions, information. WHO CC with strong commitment to provide support to NIC in the Region in coordination with WHO EURO Contribution of ECDC/CNRL activities to capacity building Page 10 of 11

11 Main challenges Keeping influenza on the agenda after a mild pandemic Financial crisis Sustainability of surveillance systems in some countries (dedicated budget lines) Some labs do not yet practice base tasks routinely Shipment problems affecting virus sharing/eqa panels/reagents (customs, legislation, lack of trained personnel) Need for a sustainable training and EQA programme that is funded and coordinated with partners Limited resources to assist development of enhanced capacity (sequencing, AV testing, research?) Acknowledgements The NIC/Member States Our partners The WHO EURO EuroFlu team in Copenhagen: Caroline Brown (programme manager/virologist) cbr@euro.who.int Joshua Mott (epidemiologist) jmo@euro.who.int Pernille Jorgensen (epidemiologist) pjo@euro.who.int Dmitriy Pereyaslov (laboratory specialist) pdm@euro.who.int In the Netherlands Temporary Advisers to WHO: Liana Martiryosan (epidemiologist) l.martiryosan@nivel.nl Tamara Meerhoff (epidemiologist) t.meerhoff@elg.umcn.nl Page 11 of 11