Pandemic Planning and Preparedness Guidelines for the United Nations System AN OVERVIEW

Pandemic Planning and Preparedness Guidelines for the United Nations System

AN OVERVIEW

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Contents

• Pandemic Basics

• UN System Strategy

• UN Planning Objectives

• UN Contingency Planning Process

• Timeline & Outputs

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Three Kinds of Influenza

• Bird virus - different from human influenza virus• Spreads from birds to birds • Can sometimes infect humans • Can sometimes mutate into human virus

• Human viral respiratory infection• Self-limiting, but can be serious & fatal in elderly &

very young ~ 500,000 deaths globally each yr.• Occurs seasonally• Routine vaccination available

• Global outbreak of new human influenza (different from seasonal and avian influenza)

• Rare but recurrent event (every 10-42 years). Associated with increased morbidity & mortality. Last 3 pandemics in last 100 yrs – 1968 (3m deaths), 1957 (2m deaths and 1918 (50m deaths)

• Past 3 pandemics - avian viruses became a human virus

Seasonal Influenza“The Flu”

Avian Influenza“Bird Flu”

Pandemic Influenza“A Pandemic”

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Pandemic Influenza Prerequisites

A new influenza virus emerges to which the general population has little/no immunity

The new virus must be able to replicate in humans and cause disease

The new virus must be efficiently transmitted from one human to another

NOT TO DATE

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Threat of H5N1 Human Influenza

?

Inter-pandemic Period Pandemic Alert Period Pandemic Period

• Circulating in wild birds and poultry since 2003

• Highly contagious / deadly among birds

• Spreading from Asia to Europe, Middle East and Africa

H5N1:• Has infected humans in

rare instances - resulting from close exposure to sick birds and/or their droppings

• If H5N1 evolves into a human virus it could cause a human influenza pandemic

• Also possibility that H5N1 never evolves into a human virus

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We are now at WHO Pandemic Phase 3

Inter-pandemic period

Phase 1 No new influenza virus detected in humans. If a new influenza virus presents in animals, the risk of human infection is considered to be low

Phase 2 No human infections, but a circulating animal influenza virus poses a risk to humans

Pandemic alert period

Phase 3 Human infection(s) with a new virus, but no (or very infrequent) human-to-human spread.

Phase 4 Small human-to-human cluster(s) - less than 25 people, lasting less than 2 weeks, highly localized - virus is not well adapted to humans

Phase 5 Larger human-to-human cluster(s) - between 25-50 people, lasting from 2-4 weeks, still localized but virus increasingly better adapted to humans

Pandemic period

Phase 6 Significantly increased and sustained transmission in general population

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Scenarios - 3 Broad MODELS

Time

Imp

act

Does avian virus become efficiently transmissible from human to human?

Does human influenza virus immediately spread rapidly with high caseloads and increasing mortality?

Yes

MODEL 3 - Rapid Onset / Widespread impactLittle time for preparation, response is reactive and defensive

Yes

MODEL 2 - Slow Onset / Moderate & Localized ImpactSlowly acquires human infectiousness. Depending on the evolution of virus it may be contained after its emergence. May also develop into a pandemic

MODEL 1 – Extended WHO Phase 3 / Continued Outbreaks of Avian Influenza

Impact on livelihoods due to culling of birdsNo

No

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Broad Risks of a Pandemic

• Food and income loss from poultry deaths/ culling & decreased economic activity

• High illness & potentially higher death rates• Overstretched health facilities• Disproportionate impact on vulnerable

• Increased demand for governance & security• Higher public anxiety• Reduced capacity due to illness & death

• Deterioration of coping & support mechanisms• Interruption in public services• Quarantine policies

• Trade & commerce disruptions• Degraded labour force• Interruption of regular supply systems

Livelihoods

Social & Humanitarian Needs

Governance & Security

Human Health

Economic Systems

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Contents

• Pandemic Basics





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UN System Strategy

HOW TO ADDRESS THE PANDEMIC THREAT

Preparation to Minimise Pandemic Impact

Engage Stakeholders to:

• Improve virus surveillance• Prevent outbreaks• Contain the disease

• Prevent human infection through public awareness of:- virus transmission- hygiene- poultry keeping

• Respond to livelihood shocks & increased vulnerability

• Mobilize required behavioral changes• Prepare for containment response

Diminish Pandemic Likelihood

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UN System Strategy

HOW TO ADDRESS THE PANDEMIC THREAT

Diminish Pandemic Likelihood

Plan with Stakeholders to:

• Contain human influenza outbreaks

• Mitigate health & socio-economic impacts

Preparation to Minimise Pandemic Impact

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Contents

• Pandemic Basics





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UN Objectives

“Survive Well to Serve Well”

Minimize a pandemic’s impact on Staff Health & Safety

In order to maintain and sustain Operational Capacity

In order to support National Preparedness and Response

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Planning Context

Time:

Uncertainties

• Where or when?

• How long it will last?

• Severity?

• Reach?Impact:

Plans must be:

• Robust • Flexible

to address range of scenarios

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UN Roles & Responsibilities

• UNRC brings together - UNCT, Partners, NGOs & Donors

• UN Agencies address own operational and programme prioritisation while supporting national & UN contingency plans

• UNCT & Agency contingency plans should have common elements for staff health, safety, HR, communication etc

• Provide support for country to country coordination

• Work closely with regional bodies to ensure plans are aligned

• An SG-appointed UN System Influenza Coordinator aligns & harmonizes programmes of UN agencies, development banks, private sector and engagement of donor community

Country Team

Global Level

Regional Level

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Contents

• Pandemic Basics


• Objectives & Planning Context



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UN Contingency Planning Process

National Pandemic Response Plans and Actions

What are risks to staff, operational continuity and operating environment?

Which risks should be planned and prepared for?

How might selected contingencies affect staff, operational continuity and operating environment?

Prepare and share plans

Plan rehearsal, updating as necessary, new factors?

Hazard/Risk Analysis

Contingency Prioritization

Scenario- Building

Agency Plan

UNCTPlan

PreparednessActions & PlanMaintenance

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Hazard/Risk Analysis

• Appoint a pandemic influenza coordinator

• Identify risks affecting staff health and safety, program and operational continuity

• List hazards/risks and implications - who it could impact and how it could impact them

- Identify vulnerable populations- Consider effects of prevention, containment and

mitigation measures - Include factors from national pandemic plan - Align UN System with National Plan & non-UN

partners

Action Information sources

• Section 7

• Section 7.2, Box 4. Critical Risk Analysis Guide

Hazard/RiskAnalysis

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Contingency Prioritization

Prioritise:- Risks (which threaten UN System Objectives?)

- Programmes & operational activities (which should be continued?)

- Prevention, containment & mitigation measures- Building national capacity- Contingency addressing threats to staff health &

safety

• Conduct a joint sectoral analysis of gaps and national priorities


• Section 8


ContingencyPrioritization

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Scenario Building

Develop the hazard, risk and contingency analysis into detailed scenarios

- Extend 3 Scenario MODELS

- Identify key driving forces: existing insecurity, poverty, rights issues, food insecurity strengths/ weaknesses of govts, movement restrictions etc.

- Produce a set of planning assumptions to be used as bases of plan

- Consult with national authorities and key non-UN partners


• Section 9

• Section 3, Box 1. Representation of three MODEL frameworks


Scenario Building

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Preparing and Sharing Plans

• Produce detailed Plans that address:- each of the 3 MODELS - hazard/risks- UN System objectives

• Focus Plans on prevention, containment, mitigation actions and continuation of essential services

• Incorporate key elements of Agency plans & harmonize with national plans

• Work with Agencies to determine staff critical to perform priority operations & functions during a pandemic & ensure they are trained


• Section 10

• Annex E - Checklist

• Annex F - Template

Agency Plan

UNCT

“Triggers” for start of particular response actions should be clearly linked to WHO Pandemic Phase Levels

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Preparedness Actions & Maintenance

• Test plans through simulations and rehearsals in conjunction with national plan and other stakeholders

• Procure health items as described in Medical Contingency Plan

• Train and sensitise staff

• Pre-position other supplies for operational continuity

• Regularly review preparedness status

• Monitor progress


• Section 11

• Medical Services Guidelines

• Annex A - Abridged Medical Services Staff Contingency Plan

PreparednessActions & PlanMaintenance

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Contents

• Pandemic Basics


• Objectives & Planning Context

• UN Planning Process


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Timeline & Output

Stage 2 -Operationalise

Stage 1 - Finalise Plan & Determine Resources

Before 30 May 2006

• Finalisation of UN Contingency Plan at Country Team level

• The country team, regional offices and headquarters to determine resources required to both maintain operations and establish new programmes - Must include human, material & financial resources

Before 15 June 2006

• Plans operationalised as per preparedness actions

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What is in the Guidelines?

THE MAIN BODY of the Pandemic Planning and Preparedness Guidelines provide broad scenarios and key pointers to UNCT members when creating or updating harmonized UNCT pandemic plans with agency plans

ANNEX A: UN Medical Services Staff Contingency Plan

ANNEX B: Pandemic Influenza Safety and Security Guidelines

ANNEX C: UN HR Network Administrative Guidelines

ANNEX D: Psychosocial Contingency Plan

ANNEX E: Pandemic Influenza Contingency Planning & Preparedness Checklist

ANNEX F: Contingency Plan Template

ANNEX G: UN System Country Level Roles

ANNEX H: Glossary

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Where can I find more information?

• The World Health Organization provides good information about avian influenza and the possibility of a pandemic: – http://www.who.int/csr/disease/avian_influenza/en/

• The Food and Agriculture Organization provides additional information, including on food safety issues:– http://www.fao.org/AG/AGAInfo/subjects/en/health/diseases-

cards/special_avian.html• A website has been created for UN system staff and

their families:– http://avianinfluenza.staffinfo.un.int

• There is a contingency planning toolbox on the UNSIC site– http://www.undg.org/content.cfm?id=1611

Documents

Pandemic Planning and Preparedness Guidelines for the United Nations System AN OVERVIEW