1. Regional Health Focus Rome | 27 – 29 June 2007 1 |1 | Health Focus WHO Regional Perspective FAO/ OIE/ WHO Technical Meeting on Highly Pathogenic Avian Influenza and Human H5N1 Infection 27-29 June, 2007, Rome. Paul Gully WHO Global Influenza Programme

2. Regional Health Focus Rome | 27 – 29 June 2007 2 |2 | Overview Only 1 of 6 WHO Regions remains un-affected (Americas) Risk universal, burden of disease is un-equal Epicentre remains in SE Asia Spectrum of regional technical and resource needs Increasing human cases but remains avian virus Main focus of efforts: –Prevention of human cases –Pre-event planning

3. Regional Health Focus Rome | 27 – 29 June 2007 3 |3 | Long and short term focus Major interventions for influenza disease control –Vaccine, Anti-virals –Reliance on the health infrastructure –Social Mitigation At a global level important to pursue strategic goals and policy implementation BUT: –When planning for "worst-case" with health systems at, or beyond, the point of collapse –Pre-event, social mitigation & health system planning and preparedness with an emphasis on primary care and community is paramount –And yet paradoxically the least prepared or planned for

4. Regional Health Focus Rome | 27 – 29 June 2007 4 |4 | Western Pacific Region (WPRO) Emphasis on cross-sectoral involvement at the central level –Construction of national plans –Assessment indicators used by the Asia Pacific Strategy for Emerging Diseases/IHR assessments indicate that this has occurred. Strong activity in the area of exercise development and facilitation –March 2007 PanStop: A pandemic influenza preparedness exercise which was conducted with the Association of South East Asian Nations, the Government of Japan, and WHO. It was designed to test specific aspects of rapid containment and to compliment work carried out on regional antiviral stockpiles. A Global Outbreak Alert and Response Network meeting (April 2007) was convened to strengthen the regional response capacity.

5. Regional Health Focus Rome | 27 – 29 June 2007 5 |5 | South East Asia Region (SEARO) Assessment missions to –evaluate high-risk Member States' capacities to respond to H5N1 outbreaks –provide rapid support to laboratories for diagnosing H5N1 virus infections. Rapid Containment Workshops involving over 10 high-risk countries in the Region. Active involvement with clinicians and leading institutions on the South East Asia Influenza Clinical Research Network –trials to produce human H5N1 treatment regimens Training workshop in outbreak communications –November 2006 with FAO, UNICEF and MoH/MoAs from 16 countries in the Region.

6. Regional Health Focus Rome | 27 – 29 June 2007 6 |6 | Africa Region (AFRO) Sub-regional training course on avian influenza infections in humans organized jointly by WHO headquarters and AFRO (2006, Harare, Zimbabwe) Field testing of training modules in social mobilization and food safety. –Modules developed to be included in standardized WHO H5N1 virus control and preparedness training packages for MoHs.

7. Regional Health Focus Rome | 27 – 29 June 2007 7 |7 | Eastern Mediterranean Region (EMRO) Multiple outbreak and risk assessment missions to evaluate high risk member states' capacities to respond Communications workshop (Cairo, Feb 2007) attended by 30 countries and 30 partner organisations. Three sub regional rapid containment workshops –Egypt, Saudi Arabia and Pakistan Intercountry Pandemic Influenza Technical Decision Makers and Outbreak Communications meetings were held in Egypt and Jordan (February & March 2007).

8. Regional Health Focus Rome | 27 – 29 June 2007 8 |8 | European Region (EURO) Multiple national pandemic preparedness assessments –by WHO-EURO and the European Centre for Disease Control WHO EURO is supporting surveillance and response capacity strengthening (EU funding) Active assistance for national outbreak investigations for Romania, Turkey, Azerbaijan and Ukraine. Two desk-top pandemic simulation exercises conducted in Turkey, a third is planned involving the sub-regional level. The 'Strengthening Capacity to Prevent Avian Flu in Humans in the Russian Federation' project was launched (March 2007) –Training curriculum and teaching materials on avian influenza A(H5N1) preparedness and response in the Russian Federation were developed, adapted and successfully tested.

9. Regional Health Focus Rome | 27 – 29 June 2007 9 |9 | Lessons Learned Pandemic preparedness has largely been successfully pursued at a central level. From the WHO perspective, the scope of preparedness should now be extended to local government, health systems and communities with appropriate funding to develop and disseminate tools.

10. Regional Health Focus Rome | 27 – 29 June 2007 10 | Summary Many affected areas have least robust infrastructure, information and response capacity –in such areas socio-economic aspects of epizootic counter measures can influence patterns of human disease –exchange of experiences should be encouraged Regional needs and preparedness levels vary, resources need to accommodate these differentials Funding streams for regional and country offices are needed to –Continue current work in progress & embark on new regional initiatives to prepare for effects of potentially severe health crisis –While being seen as complimentary to, and not detracting from, other disease programmes Transparent collaboration at all levels will encourage such support

11. Regional Health Focus Rome | 27 – 29 June 2007 11 | Thank you