Commonwealth Health Ministers Pre WHA Meeting Geneva

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Commonwealth Health Ministers Pre WHA Meeting
Geneva

• Presentation by David Nabarro
• UN System Influenza Coordinator
• May 21st 2006

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H5N1 OUTBREAKS IN BIRDS CHRONOLOGY 1996 TO DATE
January 04 to December 04
January 04 to December 05
January 04 to May 06
1996 to 2003
Map compiled by WFP Emergency Preparedness and
Response Branch (ODAP) 17.05.06
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WORKING FOR PANDEMIC PREVENTION

• H5N1 in Birds
• An Epizootic moving rapidly across the world
  sporadic human cases and the potential to cause a
  pandemic
• More than 30 countries reporting H5N1 since
  January 2006
• 15 countries in the preceding 2.5 years
• 70 of new infections will come from the animal
  kingdom

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THREE PANDEMIC SCENARIOS
MODEL 3 - Rapid Onset / Widespread impact Little
time for preparation, response is reactive and
defensive
MODEL 2 - Slow Onset / Moderate Localized
Impact Slowly acquires infectivity Containment
may be successful Limited pandemic
Impact
MODEL 1 - Extended Pandemic Phase 3 / Continued
Outbreaks of Avian Influenza Impact on
livelihoods due to culling of birds
Time
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BEING READY FOR PANDEMIC RESPONSE
Human Survival and Health

• High illness potentially higher death rates
• Overstretched health facilities
• Impact on persons with chronic disease

• Absenteeism affecting manufacture and services
  Interruption of Electricity and Water Supplies
• Telecommunications overload

Basic Services and Utilities

• Increased demand for governance security
• Higher public anxiety, reduced capacity
• Potential exploitation

Rule of Law and Governance

• Diminished coping support mechanisms
• Shortage of basic necessities
• Vulnerabilities needs - of Contained Groups

Vulnerable Livelihoods

• Trade commerce disruptions
• Reduced availability of cash
• Interruption of logistics

Financial Systems And Trade
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COMMON CAUSE AGREED STRATEGY (Nov 2005)

• Stop influenza in animals through stamping out
  the disease at the place where the infection
  starts
• Prevent emergence of pandemic by limiting human
  exposure
• if pandemic does start, contain it quickly
• if containment is not possible, mitigate pandemic
  consequences.

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IN PURSUIT OF THE STRATEGY

• Integrated National Influenza Plans
• Multiple Actors Engaged
• Financial Assistance Pledged (Jan 2006)
• Urgent Programmes Initiated
• National Plans Appraised
• External support for Implementation
• Emphasis on Coordination Harmony, Synergy, Unity

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• MAKING BEST PRACTICE HAPPEN
• Political leadership focusing on tough issues
• The whole of government involved, more than
  health and agriculture private and voluntary
  sectors too
• Mass media campaigns to promote healthy actions
  and pandemic readiness
• Management systems funds and standard
  procedures distributed, key people made
  responsible and accountable at national and
  local levels regular reviews of progress by all
  stakeholders, analyzing progress, tracking funds,
  and modifying programme direction
• Incentives and compensation schemes to reduce
  vulnerability and sustain livelihoods
• External assistance community working together in
  support of national action WHO, FAO etc

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CONCERTED INTERNATIONAL EFFORT

• Communications Messages and Media to Support
  Behaviour Change
• Animal Health Best practice to it in different
  contexts (special focus on Strategic Vaccination)
  
• Human Pandemic Containment Best practice, agreed
  protocols and stockpiles
• Continuity during pandemic Intergovernmental
  mechanisms to sustain health outcomes, equity,
  governance, economy, and recovery
• Focused scientific initiatives epidemiology,
  virology and social science Development of
  Vaccines and Diagnostics
• Flexible Finance available rapidly, where
  needed, for governments, civil society, UN system

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CHALLENGES OF SUSTAINING A FOCUS ON
PANDEMIC(When we have so many other things to do)

• Are we all working together, as a global team
• Moving as one, holding our shape, keeping fluid,
  whatever the challenges we face?
• Making the weak links strong, wherever they may
  be?
• Being ready to raise our game - at a moments
  notice?
• At ease with uncertainty about what will happen
  but determined to get the right result?
• Sustaining momentum when our colleagues question
  whether it really is necessary?

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DISCUSSION POINTS

• Getting the message right Problems of reduction
  in poultry consumption
• Why is there A to H and not H to H
• Problem of Beijing funding being focused on
  Africa? How to mobilize it?
• Need for more grants, not credits
• Oseltamivir how efficacious is it? What is its
  role?
• Need for good information (Jamaica and PNG)
• How to help small Pacific island nations

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david.nabarro_at_undp.orgwww.influenza.undg.org