IHR and Asia Pacific Strategy for Emerging Diseases Health Security and Emergencies (DSE)
Global distribution of relative risk of an Emerging Infectious Disease Event Maps are derived for EID events caused by a, zoonotic pathogens from wildlife, b, zoonotic pathogens from non-wildlife, c, drug-resistant pathogens and d, vectorborne pathogens. The relative risk is calculated from regression coefficients and variable values, categorized by standard deviations from the mean and mapped on a linear scale from green (lower values) to red (higher values). 2 2
Regional Event Based Surveillance (WPRO, July 2008 June 2010) Reported events 2008 2009 n=206 2009 2010 n=218 Infectious diseases 142 (69%) 174 (80%) Animal events 35 (17%) 26 (12%) Chemical 13 ( 6%) 9 ( 4%) Disaster and others 16 ( 8%) 9 ( 4%) Information source of initial reports 2008 2009 n=206 2009 2010 n=218 Media reports 147 (71%) 162 (74%) Reported by country offices 50 (24%) 36 (17%) Official websites + others 9 ( 5%) 20 (9%) 3
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Continued Global Spread of H1N1 Apr - Dec 2009 5
Infectious disease travel fast but Faster spread of virus High expectations by general population for immediate information, transparency, long term (cost) effectiveness, safety.. 6
Economic Impact of EID $40bn $50bn SARS China, Hong Kong, Singapore, Canada $30-50bn Estimated Cost $30bn $20bn Foot & Mouth UK $25 30bn $10bn BSE UK, $10-13bn Foot & Mouth Taiwan, $5-8bn Classical Swine Fever, Netherlands $2.3bn HPAI, Italy $400m Nipah, Malaysia $350-400m BSE Japan $1.5bn BSE Canada $1.5bn Avian Flu, NL $500m Avian Flu Asia, $5 10bn BSE U.S., $3.5bn 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Figures are WHO estimates Western Pacific and Regional are presented Office (WPRO) as relative size. 7
International Health Regulations An internationally agreed instrument for global public health security Represent the joint commitment for shared responsibilities and collective defence against disease spread Legally binding for the world s countries and WHO that have agreed to play by the same rules to secure international health. The IHR (2005) entered into force on 15 June 2007 8
Broader scope of IHR (2005) Disease under IHR (2005) an illness or medical condition, irrespective of origin or source, that presents or could present significant harm to humans All events All events that may constitute a public health emergency of international concern (PHEIC) 9
National IHR Focal Point The national centre for communications with WHO on a 24/7 basis NOT an individual person Legally required functions Sending to WHO urgent communications Disseminating information to and consolidating inputs from relevant governmental sectors/institutes/agencies Expected tasks risk assessment, coordinated response etc. Gov. sectors NIFP WHO Accessible at all time (24/7) 10
APSED Approach to Address Capacity General EID Pandemic Preparedness IHR Public Health Emergencies of International Concern Asia Pacific Strategy for Emerging Diseases (APSED) Bi-Regional Workplan Surveillance & Response Laboratory Zoonoses Collaboration Infection Control Risk Communication 11
AREA 1: Surveillance & Response A simple framework for Member States to develop a robust surveillance and response system that includes: Event-based surveillance (EBS) Indicator-based surveillance (IBS) Rapid response capacity (RRC) 12
AREA 3: Zoonoses ASPED Approach to address zoonoses focuses on establishing and maintaining functional coordination mechanism between animal and human health sectors that facilitate: sharing of surveillance sharing coordinated response risk reduction efforts operational research 13
AREA 5: Risk Communication Three components: Operational communication Outbreak communication Communication for behavior change 14
APSED Achievements Median (days) 20 18 16 14 12 10 2003 2004 2005 2006 2007 2008 2009 Year Time from onset to official reporting for H5 human infection 100 90 80 70 60 50 40 30 20 10 0 2007 2008 2009 Percentage of countries with minimum surveillance capacity 15
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Process of Developing APSED (2010) Country Consultations Discussion Papers Bi-Regional Consultation on APSED and Beyond 24-27 May 2010 Draft APSED (2010) Independent Review 5 th TAG Meeting 6-9 July 2010 RCM (Oct 2010) 17
Process of Developing APSED (2010) Voice/Outcomes of Country and Regional Consultations Results of APSED (2005) Common Indicators Assessments APSED (2010) Lessons learned from Pandemic preparedness & response 18
Structure of APSED (2010) 19
Expanded Scope: 8 Focus Areas APSED (2010) APSED (2005) 1. Surveillance and Response 2. Laboratory 3. Zoonoses 4. Infection Control 5. Risk Communication 1. Surveillance, Risk Assessment and Response 2. Laboratory 3. Zoonoses 4. Infection Prevention and Control 5. Risk Communication 6. Public Health Emergency Preparedness 7. Regional Preparedness, Alert and Response 8. Monitoring and Evaluation 20
FOCUS AREA 6: Public Health Emergency Preparedness APSED (2010) 1. Surveillance, Risk Assessment and Response 2. Laboratory 3. Zoonoses 4. Infection Prevention and Control 5. Risk Communication 6. Public Health Emergency Preparedness 7. Regional Preparedness, Alert and Response 8. Monitoring and Evaluation Comprehensive plans and wellprepared systems can reduce the negative health, social and economic impacts of public health emergencies Key components Public health emergency planning National IHR Focal Point functions Points of entry preparedness Response logistics Clinical case management 21
FOCUS AREA 7: Regional Preparedness, Alert & Response APSED (2010) 1. Surveillance, Risk Assessment and Response 2. Laboratory 3. Zoonoses 4. Infection Prevention and Control 5. Risk Communication 6. Public Health Emergency Preparedness 7. Regional Preparedness, Alert and Response 8. Monitoring and Evaluation Enduring regional system and cooperation is critical in protecting against emerging diseases. Because borders pose no barrier to infectious diseases, strong systems that interact effectively are needed in every country Key components Regional surveillance and risk assessment Regional information sharing system Regional preparedness and response 22
Conclusion Asia Pacific Region is the epicentre for emerging infectious disease Capacity to detect and respond had increased significantly through APSED (2005) implementation but still more lies ahead Member States in the region decided to go further five years with APSED (2010). Surveillance remains one of the key areas of work under APSED (2010) APSED (2010) plans to explore the possibility to establish linkage with other sector including group deals with deliberate release of Biological, Chemical and Radiological/Nuclear Agents, if appropriate 23
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