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Commonwealth Health Ministers’ Pre WHA Meeting Geneva

Commonwealth Health Ministers’ Pre WHA Meeting Geneva. Presentation by David Nabarro UN System Influenza Coordinator May 21 st 2006. H5N1 OUTBREAKS IN BIRDS: CHRONOLOGY 1996 TO DATE. Distance from Hong Kong. 8000 miles. 7000 miles. 6000 miles. 5000 miles. 4000 miles. 3000 miles.

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Commonwealth Health Ministers’ Pre WHA Meeting Geneva

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  1. Commonwealth Health Ministers’ Pre WHA Meeting Geneva Presentation by David Nabarro UN System Influenza Coordinator May 21st 2006

  2. H5N1 OUTBREAKS IN BIRDS: CHRONOLOGY 1996 TO DATE Distance from Hong Kong 8000 miles 7000 miles 6000 miles 5000 miles 4000 miles 3000 miles 2000 miles 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

  3. 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

  4. 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

  5. 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

  6. COMMONCAUSE: 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.

  7. 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

  8. 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

  9. 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

  10. 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?

  11. 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

  12. david.nabarro@undp.orgwww.influenza.undg.org

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