Centre for Health Protection: Strengthening Health Protection in Hong Kong

3. Background • In May 2003, the Chief Executive announced that the Government had begun to study the establishment of a CDC – like organisation in Hong Kong • SARS Expert Committee’s Report released in Oct 2003 recommended the establishment of a Centre for Health Protection (CHP)

5. Health Protection • Health protection is about the measures that public health authorities and others take to protect the population from communicable diseases and other public health hazards • (Report of the SARS Expert Committee2003 )

6. What differences will CHP make?

7. International and Mainland authorities Community DH Hospital Authority/ Private hospitals and practitioners Universities Existing Interface Gaps

8. Science Legislation Surveillance Programme Development Risk Management Effective Health Protection System Source: Health Protection for the 21st Century, Health Canada

9. Review of mandate Promotion of standards SCOPING Assessment of potential building blocks of health protection • SCIENCE • Support of a • network of • laboratories • Laboratory • enhancement • Science-based • practice • SURVEILLANCE • Strengthening of • epidemiology as the • core competency • Enhanced • surveillance • EMERGENCY RESPONSE • Multi-disciplinary • emergency response • Centralisation of field • epidemiology services • Strengthening of • risk communication • LEGISLATION • Review of legislation in • communicable disease • control • PROGRAMMME • DEVELOPMENT • Set up specialised • health protection • programmes • INTERNATIONAL COLLABORATION • Coordination in Pearl River Region • Networking with international partners • RESEARCH SUPPORT • Incorporation of applied • research • EXPERTISE DEVELOPMENT • Reorganisation of public health training • Strengthening of fieldepidemiology as the core business • for investigation, analysis and rapid response capability

10. Organisation of CHP Director of Health Controller, CHP SURVEILLANCE & EPIDEMIOLOGY BRANCH INFECTION CONTROL BRANCH PUBLIC HEALTH LABORATORY SERVICES PUBLIC HEALTH SERVICES EMERGENCY RESPONSE AND INFORMATION BRANCH PROGRAMME MANAGEMENT & PROFESSIONAL DEVELOPMENT BRANCH

11. New functional elements • Epidemiology Unit • CD Surveillance Unit • Emergency Response and Information Branch • Programme Management and Professional Development Branch • Infection Control Branch • Health Protection Programmes for targeted diseases Existing services to be incorporated • Regional Offices • Disease Prevention and Control Division • Central Health Education Unit • TB & Chest Service • Social Hygiene Service • Special Preventive Programme • Pathology Service

12. Risk Communication • Standardisation of Infection • Control Practice • Population Based • Programmes • Health Education • Programmes • Epidemic Intelligence • Communicable Disease • Notification • Training • Attachment Programmes International & Mainland authorities Community CHP • Communicable Disease • Information System • Health Protection • Programmes for • targeted diseases • Infection Control • Multi-disciplinary • Emergency Response • Professional • Development • Multi-disciplinary • Emergency Response • Appointed Collaboration • Centres • Health Protection • Programmes for • targeted diseases Universities Hospital Authority / Private Hospitals & Practitioners

13. Strengths of CHP Three Rs: • Real-time surveillance • Rapid intervention & resolution • Risk communication

14. Functional Branches

15. Surveillance & Epidemiology Branch FUNCTIONS • Use contemporary IT programmes and infrastructures to collect, collate, analyse and disseminate surveillance data on notifiable diseases and other communicable diseases • Establish a central communicable disease information system • Manage & respond to communicable disease outbreaks and develop control measures • Mastermind a surveillance system for GD-HK-Macao and focus on the situation of communicable diseases in PRDR FACILITIES • Epidemiology Unit and its Outbreak Teams • Data Management Centre • Communicable Disease Surveillance Unit

16. Priority issues • Enhance comprehensiveness and sensitivity of disease surveillance • E-Notification platforms for physician reporting • Centralised notification system for receiving reports of institutional outbreaks • Emerging infections surveillance network • Expanded surveillance network: local and international

17. Priority issues • Strengthen Epidemiology and surge capacities • Epidemiology as core public health training • Set up structured Epidemiology Training Programme for specialist development • Exchange programmes and training for dealing with emerging pathogens • Training for supporting professionals and public health partners

18. Infection Control Branch FUNCTIONS • Develop, promulgate and evaluate best practices in infection control at health care and non-health care settings • Coordinate, facilitate and support training in infection control for all levels of health care workers • Support epidemiological investigation of nosocomial infections in hospital • Conduct surveillance on infection hazards in health care and non-health care setting • Set up epidemiology and infection control units in five major public hospitals FACILITIES • Simulation Room • Epidemiology and Infection Control Units

19. Branch Head Senior Microbiologist Specialist in ID Senior Epidemiologist Advisory Office Technical Support Division Clinical Consultation & Investigation Division Surveillance & Research Division Training programmes Expert Committees

20. CHP Infection Control Branch Advisory Office Expert Panel on Infection Control Training & technical support Recommendations Coordinating body Training programmes Infection control committee Infection control committee Infection control committee hospital-based Epidemiology and Iinfection Control Units Interface in Infection Control Practices

21. TMH PWH PMH PMH QEH QMH Epidemiology and Infection Control Unit

22. Emergency Response & Information Branch FUNCTIONS • Overall corporate planning • Co-ordinate emergency response on a community/territory-wide basis • Contingency planning • Overall risk communication strategy • Update information system needs • Facilitate the development of preventive strategy and cross-sector logistic support • Develop contingency plans and arrange drills FACILITIES • Emergency Response Centre

25. Crisis Communication Lifecycle Precrisis Initial Maintenance Resolution Evaluation • Be prepared. • Foster alliance. • Develop consensus recommendations. • Test message. • Acknowledge the event with empathy. • Explain and inform the public in simplest forms, about the risks. • Establish agency/ spokes-person credibility. • Provide emergency courses if action (including how/ where to get more information). • Commit to stakeholders and public to continued communication. • Help public more accurately understand its own risks. • Provide background and encompassing information to those who need it. • Gain understanding and support for response and recovery plans. • Listen to stakeholder and audience feedback, and correct misinformation. • Explain emergency recommendations. • Empower risk/ benefit decision-making. • Improve appropriate public response in future similar emergencies through education. • Honestly examine problems and mishaps, and then reinforce what worked in the recovery and response efforts. • Persuade the public to support public policy and resource allocation to the problem. • Promote the activities and capabilities of the agency (corporate identity reinforced- internally, too) • Evaluate communication plan performance. • Document lessons learned. • Determine specific actions to improve crisis systems or the crisis plan. (Source: Crisis, Emergency & Risk Communication, CDC)

26. Public Health Services FUNCTIONS • Support the control of communicable diseases in the community (TB, HIV, STI) • Contribute to the surveillance of communicable diseases in Hong Kong • Provide specialised clinical services • Provide communicable disease treatment services • Consist of TB and Chest Service, Social Hygiene Service and Special Preventive Programme FACILITIES • Specialist Clinics • Public Health Units

27. Priority issues • To evaluate and improve the notification and reporting systems for STI, TB and HIV/AIDS • To explore the role of information technology on surveillance and intersectoral coordination in relation to the above diseases • To facilitate the training and interchange of expertise between the public health stream and the clinical stream

29. Public Health Laboratory Services FUNCTIONS • Provide pathology service for communicable disease surveillance and control • Provide laboratory support for outbreak investigations • Develop infection control standards in laboratory settings • Train microbiologists and infection control professionals for laboratory services • Collaboration with laboratories in HA, AFCD, Govt Lab, local universities and overseas agencies FACILITIES • Public Health Laboratory Centre

30. Priority issues • To introduce new laboratories to improve investigative capacity, including the laboratories for antimicrobial resistance surveillance, molecular virology, etc. • To develop and evaluate new test and optimize current tests for earlier laboratory confirmation of SARS CoV and shorten turn around time

31. Priority issues • To strengthen the networking and coordination with local universities, HA and other health care institutions on laboratory research and support of communicable diseases control • To enhance training for medical, scientific and technical staff

34. Programme Management & Professional Development Branch FUNCTIONS • Coordinate and organise training activities for medical and nursing professionals of CHP, HA and other institutions • Liaise with local and international institutions to arrange attachment and exchange programmes • Carry out and coordinate research, including research projects in collaboration with universities, HA and other government departments • Manage health protection programmes • Coordinate with various advisory committees • Undertake health promotion activities FACILITIES • Library, IT facilities • Training Office • Research Office

35. Health Protection Programmes

36. Health Protection Programmesfor targeted diseases/ health hazards Three Dimensions • Multidisciplinary approach and intersectoral participation • Prevention – intervention continuum • Sustainable development

37. Advisory Committee Controller, CHP S & E ER & I PHLS PHS IC Expert members CHP Core Group for HP Programme A Programme lead CHP Scientific Committee for HP Programme B Programme lead Expert members Hospital X University P HP Programme organisation

38. Implementation Milestones

39. Dec 2003 – Jan 2004 • Consultations with stakeholders on the establishment of CHP

40. Mid 2004 • To establish CHP under a transitional stage • Appointment of Controller, CHP • Establishment of the Surveillance & Epidemiology Branch & Infection Control Branch • Enhancement of Multi-disciplinary Emergency Response Mechanism • Endorsement of Manpower Enrichment / Redeployment Plan

41. 2005 • All functional elements of CHP to operate smoothly, including • Implementation of CD information system (by phases) • Implementation of manpower plan • CHP IT platform in place (e.g. e-notification system, case notification system)

42. Thank You