Multi-sectoral aspects of pandemic preparedness and response

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Gertrude Greer
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1 Multi-sectoral aspects of pandemic preparedness and response Best practices, challenges and lessons learned in the EU International Ministerial Conference on Avian & Pandemic Influenza Sharm el Sheikh, 25 October 2008 EU legal framework Article 152 of EC Treaty Commission to assist Member States in coordinating measures among themselves Community network on communicable diseases established in 1998 under Decision 2119/98 two components Early Warning and Response System (EWRS) Surveillance clear legal obligation of Member States under EWRS to early report among themselves and European Commission significant new epidemiological events with potential cross-border impact: key for timely and efficient action example: sudden emergence of new avian influenza subtype in humans clear achievement in view of primary remit of Member States for public health good example of overall benefit and added value of limited transfer of national powers to the Community further implementing decisions under Decision 2119/98 influenza a priority disease to be covered by surveillance case definitions for seasonal and avian influenza to be used for reporting at EU level European Centre for Disease Prevention and Control (ECDC) created in 2004 operational from

2 challenges comparing national preparedness plans and assessing preparedness at national levels: key to better understanding of gaps results of this analysis now available key areas where more work is needed integrated planning across governments and sectors making plans operational at the local level interoperability at the national level stepping up prevention efforts against seasonal influenza extending and directing influenza research ECDC to present more details 3 challenges ethical aspects and dilemmas so far inadequately addressed particularly difficult insufficient time to address them effectively once pandemic occurs countries to discuss them now while there is still time for careful deliberations risk that response efforts in event of pandemic could be seriously hampered by not properly addressing these questions in planning key issues priority access to medical care in view of potential shortage obligations for health-care workers have in view of health risks surveillance and social-distancing measures obligations of countries towards each other publicly-discussed ethical framework essential to maintain public trust promote compliance minimise social disruption and economic loss 4 2

3 best practices development of EU guidance first brainstorming at November 2001 Conference in Brussels first Community preparedness plan adopted in March 2004 Commission Communication of November 2005 on pandemic influenza preparedness and response planning in the European Union further review envisaged in light of ongoing WHO work on review of global plan and the need to boost work on inter-sectoral coordination at EU level 5 best practices plan each pandemic phase objectives role main tasks Member States Commission Community agencies planning and coordination monitoring and assessment prevention and containment health system response communication 6 3

4 best practices International Health Regulations: enormous achievement Community legislation in place to streamline congruent reporting both at EU level and in light of the IHR common IT platform now mutually accessible for both EU MS and WHO to facilitate work communication EU wide network of media officers for influenza now put in place as intermediate step extended to cover a wider range of major communicable diseases major crisis management tools at EU level now put in place further sophisticated training and testing 8 million framework contract just signed to continue activities Common ground exercise of November 2005 good example further exercise planned for 2009 ARGUS inter-sectoral coordination within Commission services inter-service group on health some EU MS re-examined planning priorities prioritise attention to flu pandemic planning 7 best practices Health Security Committee three sections including section on influenza preparedness and response network of national flu coordinators to enhance inter-sectoral coordination at EU level heavy agenda for future work share results of analysis of national preparedness plans and review interoperability close collaboration with ECDC using results of ECDC technical assessment report identify core elements of influenza preparedness, analyse how these core elements can be maintained and monitored in future WHO project on indicators funded under public health programme produced set of indicators to facilitate self-assessment of national preparedness discussion in flu section for approval by HSC plenary carry out workshops addressing policy inconsistencies in the area of influenza preparedness close cooperation among Commission, WHO, and ECDC with EU / EFTA Member States already four joint WHO EURO wide EC/WHO/ECDC workshops + 2 EU workshops sharing best practice and experience paramount excellent tool with high added value to share latest developments 8 4

5 best practices Commission research agenda since 2001 specific influenza research projects with over EUR 65 million EUR 28 million dedicated call for proposals launched in late 2005 Seventh Research Framework Programme (FP7, ) new dedicated activity Emerging Infectious Epidemics pathogenic influenza explicitly mentioned business continuity Key factors assess and identify key risks (Business Impact Analysis) identify your key functions and dependencies establish mitigating procedures, measures and actions to address the key threats identify key inter-dependencies, and local/regional/national planning develop inter-operability within your organisation train the key staff, and their back-ups test and exercise using the plans to familiarise staff with the content and identify necessary changes update, develop and refine the plan as necessary maintain awareness 9 best practices vaccines upcoming Commission initiative for a Council Recommendation on seasonal influenza vaccination increasing seasonal influenza vaccination not only to reduce yearly influenza disease burden in EU citizens but at the same time to increase currently insufficient production capacity for pandemic influenza vaccines seek the commitment of the Member States and the European Commission to reach the vaccination coverage level agreed upon by the World Health Assembly in 2003: 75 % coverage in high risk groups by 2010 national public health institutes asked to contribute to accelerating the production of special pandemic vaccines FLUSECURE: contract for project to develop library of seed stocks for the manufacture of influenza vaccine in place 10 5

lessons learned and conclusions A clear framework is in place for pandemic preparedness within the EU, and all EU Member States have

The present momentum should be maintained in view of the risk of pandemic fatigue.

For non-health sector entities, business continuity may be the starting point within which the threat from a pandemic can be addressed.

6 lessons learned and conclusions A clear framework is in place for pandemic preparedness within the EU, and all EU Member States have developed plans but It may take another two to three years to close the gaps that still exist. The present momentum should be maintained in view of the risk of pandemic fatigue. Priorities for future work are addressing interoperability and strengthening inter-sectorial coordination. For non-health sector entities, business continuity may be the starting point within which the threat from a pandemic can be addressed. 11 European Centre for Disease Prevention and Control Best practices, challenges and lessons learned in the EU Denis Coulombier, HoU for Preparedness and Response, ECDC International Ministerial Conference on Avian & Pandemic Influenza Sharm el Sheikh, 25 October

7 ECDC s role on pandemic influenza preparedness Technical guidance and information - Influenza News Surveillance in a pandemic with EISS and WHO Support to influenza communications for MS EU/EEA surveys of pandemic preparedness Done jointly with WHO Regional Office for Europe and the European Commission 6 month transparent process, including one 4 day visit Tailored agenda ( what do you want to focus on? ) Use of selected external national experts from previous visits Resulting in a joint report Highlighting good practises 13 Good news MS Level There has been massive progress since 2005 Every Member State has a plan and many have advanced further Many innovations and developments at the MS and EU level Several Member States are working at all levels, down to the local level Multi-sectoral approaches 14 7

A few of many European influenza control innovations Communicating with the public and children Cascade training of health care staff Getting businesses to prepare for a pandemic Exercises to help

8 A few of many European influenza control innovations Communicating with the public and children Cascade training of health care staff Getting businesses to prepare for a pandemic Exercises to help get hospitals prepared Communicating with poor rural communities Stimulating multi-sectoral planning going at the local level 15 EU preparedness Five major gaps Huge progress since 2005, but five major gaps in preparedness across EU Local preparedness Intersectoral work Interoperability Research that is more targeted Improving use of seasonal vaccine and developing pandemic vaccine capacity 16 8

9 National pandemic preparedness Where we are now in Europe? Preparedness adequately prepared Practice Multi-sectoral Plans Health only unprepared National Local and front line 17 Thank you

DG SANTE actions under the CBRN Action Plan

DG SANTE actions under the CBRN Action Plan Antonis Lanaras DG SANTE C3 Crisis management and preparedness in health 10 th Meeting of the CoU on Secure, Safe and Resilient Societies CBRNE 8 March 2018,