International Partnership on Avian and Pandemic Influenza

1. International Partnership on Avian and Pandemic Influenza Senior Officials' Meeting October 2005

2. History

3. Past Influenza Pandemics 1847 42yrs 1889 29yrs 1918 39yrs 1957 11yrs 1968 1850 1900 30 – 40yearscycle 1950 No Pandemic for > 35 years 2000

4. Mortality during the pandemic of 1918-19 A/H1N1 – Spanish influenza • 3 epidemic waves in close succession • March 1918, Sept 1918, Feb 1919 • Est 40 million deaths world-wide,

5. Geographic spread: 1918-19 06/18 ? 04/18 03/18 06/18 05/18 ? 01/19 06/18 C.W. Potter, Textbook of Influenza, 1998

6. Geographic spread: 1957-58 06/57 06/57 06/57 02/57 08/57 04/57 07/57 05/57 07/57 C.W. Potter, Textbook of Influenza, 1998

7. 1 The Challenge • Senior officials are being asked to • Cope with present realities • Prepare for an uncertain future • Be ready for major disruption • A very difficult challenge

8. 1 The Challenge • Senior officials are being asked to • Cope with present realities • An avian influenza epidemic • Prepare for an uncertain future • A human influenza pandemic • Be ready for major disruption • Reaction to the pandemic • A challenge that affects all – not just agriculture and health

9. 2 Elements of the task • Technical: Essential Interventions selected on the basis of need; making them available where and when required • Institutional: People, Systems, Management and Resources; working well enough to deliver interventions • Political: Decision making bodies engaged: ensuring resources are available and checking progress; keeping up the pressure, unblocking and facilitating

10. Today we focus on the Political Issues…

11. What is an influenza Pandemic….(Pan…..Demos)

12. A global epidemic of influenza resulting from • the emergence of an influenza A virus with a sub-type different from strains circulating among humans in recent years • a high proportion of susceptible people in the community • high person-to-person transmissibility of the new virus, with accompanying human disease

13. What do we know…. • Pandemic influenza will happen (at some point) • It is more likely now than three years ago • It could be mild • It could be severe • It could be extremely severe • It affects younger age groups than "normal" influenza

14. What do we know - Two • It could come once or in waves • It will probably come quickly • Work forces will be badly affected • Maybe infectious before symptoms appear • There are infections with no symptoms • Early Isolation less useful of SARS

15. What do we know - Three • An effective vaccine will take several months to develop • There will probably be few anti-viral medicines available and the emergence of resistance is possible

16. What do we know - Four • Influenza is infectious – but not as highly infectious as measles • Not everyone will be infected • There are ways of reducing the numbers affected • If an infectious and damaging virus emerges, containment of people may be justified • Need for epidemiological information

17. 4 The current reality

18. An outbreak of Highly Pathogenic Avian Influenza caused by Virus H5N1

20. 5 Potential for limiting the pandemic

21. Potential for limiting would depend several factors • The relative strength of acute medical and public health infrastructure, especially surveillance and response capacity • The size of the outbreak when it is first recognized and rate of increase of new cases? • The geographical location (mobility of populations, whether the site is an international hub for trade or travel)? • Whether containment and control measures are effective?

22. 6 Strategy

23. Strategy • Prevent – or, at least, delay – the human pandemic • Control avian influenza at source • Vaccinate poultry • Detect Cull infected bird flocks • Limit human-bird interaction • Prepare – be ready and quick to act • Surveillance, Alert and Action: • Capacity to detect suspect clusters of human influenza • Confirmation • Rapid containment • Respond – Reduce illness, Keep services going • Systems • Triggers and rapid implementation

24. Preparedness : • Being Ready to Intervene • Mass treatment with pre-positioned antiviral drugs • ‘Broad’ public health measures (restriction of movements, quarantine) • Protection for front line personnel • A narrow window of opportunity • Need to act within days • Extensive technical and logistic support is necessary • A local issue with immediate global significance

25. 7 Keys, Needs and Challenges faced by Governments

26. Six Keys • Communicate for action: single message • Commit to results • Encourage functioning networks • Insist on "Joined-up" working • Ensure needed resources are made available • Adopt and use international technical standards and expertise (key roles of FAO, WHO, OIE)

27. Six Needs • Shared goals, agreed strategy • Partnership that works: government .. ... community groups, private sector, professional bodies, civil society • Early information, shared as required • Capacity to shift focus when necessary • Well functioning technical support system • Concerted international backing

28. Six Challenges • Avian Influenza in wild birds • Potential value of antiviral medicines • Vaccine development and availability • Support for poorer countries • Protecting the vulnerable • Safeguarding front-line personnel

30. Final Thoughts • Analyse data, share experiences • Adapt in response to changing needs • Keep essential services going (food, water, transport, heat, electricity etc) • When in doubt, Communicate • … it can be done , so let's do it