| Title:
|
Pandemic influenza preparedness in the AsiaPacific region |
| Abstract:
|
Concerns are mounting that the threat of another influenza pandemic will become a reality and that the epicentre of the outbreak could be the AsiaPacific region. We assessed the documents that some AsiaPacific countries have published as part of preparedness planning for an outbreak of influenza in people. Regional approaches were polarised. Thailand China and Vietnam had set out a strategic vision to strengthen future capacity in preparedness planning. By contrast Hong Kong Australia and New Zealand took a strategic approach aimed mainly at harnessing available resources or preparing for the deployment of resources such as stockpiled antiviral agents and vaccines. The plans of Hong Kong Australia and New Zealand compared favourably with the best European plans. The plans of resource-poor countries addressed some issues that were largely neglected by most European plans. Other countries (including those that do not yet have plans) could benefit from analysis of the strengths and weaknesses of the plans drawn up by countries in the region and in Europe. |
| Published:
|
2006-08-22 |
| Journal:
|
Lancet |
| DOI:
|
10.1016/s0140-6736(06)69209-x |
| DOI_URL:
|
http://doi.org/10.1016/s0140-6736(06)69209-x |
| Author Name:
|
Coker Richard |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/coker_richard |
| Author Name:
|
Mounier Jack Sandra |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/mounier_jack_sandra |
| sha:
|
195ecdcecbe81a07fe38b3aa4ef2a8c37bc3e9e8 |
| license:
|
no-cc |
| license_url:
|
[no creative commons license associated] |
| source_x:
|
Elsevier; Medline; PMC |
| source_x_url:
|
https://www.elsevier.com/https://www.medline.com/https://www.ncbi.nlm.nih.gov/pubmed/ |
| pubmed_id:
|
16950366 |
| pubmed_id_url:
|
https://www.ncbi.nlm.nih.gov/pubmed/16950366 |
| pmcid:
|
PMC7123339 |
| pmcid_url:
|
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123339 |
| url:
|
https://www.ncbi.nlm.nih.gov/pubmed/16950366/
https://www.sciencedirect.com/science/article/pii/S014067360669209X
https://api.elsevier.com/content/article/pii/S014067360669209X |
| has_full_text:
|
TRUE |
| Keywords Extracted from Text Content:
|
people
Asia-Pacifi c
US$
wet-market poultry
ASEAN
health-system
human
ort
patients
F Hoff mann-La Roche
poultry
phase-by-phase
avian infl uenza
animals
community-eg
Food
Laos
Asia-Pacifi c countries
Asia-Pacifi c
bird handlers
civil-response sectors
funds
aff
Vietnam-had
H5N1
H5N1 virus
human infections-pandemic
c
birds.
humans
Cambodia,
Guidance
that-national
joint
UK |
| Extracted Text Content in Record:
|
First 5000 Characters:Concerns are mounting that the threat of another infl uenza pandemic will become a reality and that the epicentre of the outbreak could be the Asia-Pacifi c region. We assessed the documents that some Asia-Pacifi c countries have published as part of preparedness planning for an outbreak of infl uenza in people. Regional approaches were polarised. Thailand, China, and Vietnam had set out a strategic vision to strengthen future capacity in preparedness planning. By contrast, Hong Kong, Australia, and New Zealand took a strategic approach aimed mainly at harnessing available resources or preparing for the deployment of resources such as stockpiled antiviral agents and vaccines. The plans of Hong Kong, Australia, and New Zealand compared favourably with the best European plans. The plans of resource-poor countries addressed some issues that were largely neglected by most European plans. Other countries (including those that do not yet have plans) could benefi t from analysis of the strengths and weaknesses of the plans drawn up by countries in the region and in Europe.
The World Health Organization (WHO) has emphasised the importance of the Asia-Pacifi c region as a potential epicentre of emerging diseases such as severe acute respiratory syndrome (SARS) and avian infl uenza. During the past three decades, 30 new infectious agents have been detected in this region. 1 Since 2003, a total of 49 countries and one special administrative region (Hong Kong) have had outbreaks of the H5N1 subtype of infl uenza A in birds. 2 The H5N1 virus will continue to pose an important public-health threat in the short term. 2 More than 80% of the reported deaths from H5N1 have taken place in southeast Asia.
In a resolution issued in April, 2005, 3 WHO expressed concern about the general inadequacy of global preparedness for pandemic infl uenza. WHO's global infl uenza preparedness plan, which was launched in 1999, was updated in 2005. The plan outlines components that countries should include in their national preparedness plans to ensure an eff ective response. 4 In 2005, WHO published a checklist to facilitate preparedness planning. 5 The aims of such planning were to reduce transmission; decrease the incidence of new cases, hospital admissions, and deaths; maintain essential services; and reduce the socioeconomic consequences of a pandemic. 5 In our own assessment of European national preparedness plans 6 we concluded that although Europe was broadly well prepared, important gaps, weaknesses, and inconsistencies remained. We identifi ed a need for operational planning, in particular, to be strengthened. We also suggested that although European countries had explicitly expressed their interest in cooperating with international institutions such as the European Centre for Disease Control and WHO, regional cooperation between countries was inadequate. Here, we have analysed pandemic infl uenza plans from selected countries in the Asia-Pacifi c region, emphasising specifi c concerns about preparedness in this region.
Using a data-extraction method developed from WHO's checklist for infl uenza epidemic preparedness, 4,5 we aimed to assess the national infl uenza preparedness plans of eight countries (Australia, Cambodia, China [and Hong Kong], Indonesia, Laos, New Zealand, Thailand, and Vietnam) (table). However, we could not obtain copies of any national preparedness plans for Cambodia, Laos, or Indonesia. We included plans that were published between Jan 1, 2002 and Feb 28, 2006. The six plans were reviewed according to seven themes: planning and coordination; surveillance; public-health inter ventions; health-system response; maintenance of essential services; communication; and putting plans into action. 18 Some countries-Thailand, China, and, to a lesser degree, Vietnam-had set out a strategic vision to strengthen future capacity in preparedness planning. Others, including Hong Kong, Australia and New Zealand, *China has issued several documents addressing preparedness, planning, and contingency implementation: Preparedness and contingency planning for infl uenza pandemic; Emergency planning for human infections-pandemic outbreak of avian infl uenza; Guidance for diagnosis, treatment, prevention and control of infections of avian infl uenza; National emergency planning for animal pandemic outbreak; National emergency planning for highly pathogenic avian infl uenza; Contingency implementation plan for the prevention and control on highly pathogenic avian infl uenza in autumn and winter in 2005; and Contingency working procedure of prevention and control on pathogenic avian infl uenza in autumn and winter in 2005. 8 Table: Country pandemic infl uenza plans took a strategic approach similar to that of most European plans. These strategic plans focused on management of currently available resources and preparation for the deployment of resources such as stockpiled antiviral agents and vaccines. The polarisation of approaches in t |
| Keywords Extracted from PMC Text:
|
poultry
health-system
Cambodia,
H5N1
criticised.23
Gaps
planning.5
countries.•Several
region.1
birds.2
bird
epidemic.•Several
plans).•Most
US$
Europe
joint
plans6
H5N1 virus
stage.24
prophylactics.•Most
ASEAN
resources.•Several
international).•Most
wet-market poultry
vaccination.•Most
funds
scenario.•Several
phase-by-phase
Laos
human
challenge,19
humans
Food
patients
plans.11 |
| Extracted PMC Text Content in Record:
|
First 5000 Characters:The World Health Organization (WHO) has emphasised the importance of the Asia–Pacific region as a potential epicentre of emerging diseases such as severe acute respiratory syndrome (SARS) and avian influenza. During the past three decades, 30 new infectious agents have been detected in this region.1 Since 2003, a total of 49 countries and one special administrative region (Hong Kong) have had outbreaks of the H5N1 subtype of influenza A in birds.2 The H5N1 virus will continue to pose an important public-health threat in the short term.2 More than 80% of the reported deaths from H5N1 have taken place in southeast Asia.
In a resolution issued in April, 2005,3 WHO expressed concern about the general inadequacy of global preparedness for pandemic influenza. WHO's global influenza preparedness plan, which was launched in 1999, was updated in 2005. The plan outlines components that countries should include in their national preparedness plans to ensure an effective response.4 In 2005, WHO published a checklist to facilitate preparedness planning.5 The aims of such planning were to reduce transmission; decrease the incidence of new cases, hospital admissions, and deaths; maintain essential services; and reduce the socioeconomic consequences of a pandemic.5
In our own assessment of European national preparedness plans6 we concluded that although Europe was broadly well prepared, important gaps, weaknesses, and inconsistencies remained. We identified a need for operational planning, in particular, to be strengthened. We also suggested that although European countries had explicitly expressed their interest in cooperating with international institutions such as the European Centre for Disease Control and WHO, regional cooperation between countries was inadequate. Here, we have analysed pandemic influenza plans from selected countries in the Asia–Pacific region, emphasising specific concerns about preparedness in this region.
Using a data-extraction method developed from WHO's checklist for influenza epidemic preparedness,4, 5 we aimed to assess the national influenza preparedness plans of eight countries (Australia, Cambodia, China [and Hong Kong], Indonesia, Laos, New Zealand, Thailand, and Vietnam) (table
). However, we could not obtain copies of any national preparedness plans for Cambodia, Laos, or Indonesia. We included plans that were published between Jan 1, 2002 and Feb 28, 2006. The six plans were reviewed according to seven themes: planning and coordination; surveillance; public-health interventions; health-system response; maintenance of essential services; communication; and putting plans into action.18
Some countries—Thailand, China, and, to a lesser degree, Vietnam—had set out a strategic vision to strengthen future capacity in preparedness planning. Others, including Hong Kong, Australia and New Zealand, took a strategic approach similar to that of most European plans. These strategic plans focused on management of currently available resources and preparation for the deployment of resources such as stockpiled antiviral agents and vaccines. The polarisation of approaches in the region contrasts with the uniform approach taken by countries in Europe. The plans of Hong Kong, Australia, and New Zealand compared very favourably in terms of completeness and quality with the best European plans. However, as in Europe, all of the plans contained some gaps. The plans of lower-income countries in the region addressed several issues that were largely neglected by most European plans. The potential therefore exists for countries (including those which are still formulating their plans) to draw on the strengths of preparedness plans developed by other countries. The panel
summarises some strengths, weaknesses, and gaps in the preparedness plans of these selected Asia–Pacific countries. For brevity, differences between countries and areas of coherence are presented by comparing planned public-health interventions.PanelFeatures of Asia–Pacific influenza preparedness plans
Strengths of plans
•All recognised the effect of a potential influenza pandemic and gave political support to preparedness planning.•All linked surveillance and response measures for animals and humans, including specific measures targeted at bird handlers•All incorporated wide multisector cooperation, involving major stakeholders from health, animal, and civil-response sectors.•All proposed measures for early containment, on the basis that an original outbreak within their country was a likely scenario.•Several recognised the need for surveillance to be strengthened, and for laboratory capacity in the region to be reinforced. They contained provisions for developing financial and organisational support.•All discussed use of various social distancing measures, including travel restrictions (both internal and international).•Most outlined strategies for organisation of the response from health services, relying mainly on specialised units. Severa |
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