Dr. Sok Touch, Country Coordinator (Chair ) Guilin, PR China 27 February 2009 Progress in Implementing MBDS Plan of Action during 2008 and Plans for 2009: Report to Executive Board

6 countries MBDS Partners Rest of the World Reporting of Progress is Based on Seven MBDS Core Strategies (1) XB cooperation and information exchange (2) Animal-human interface (zoonoses) (7) Policy research (6) Risk communications (2) Community- based surveillance (3) HR development - epidemiology (4) ICT capacity (5) Laboratory capacity Info sharing

Advantages of Standardized Reporting Standardized reporting by XB site coordinators, CC’s and Strategy Coordinators would provide more reliable and comparable information across countries and strategies, for MBDS countries and their development partners Standardized reporting by XB site coordinators, CC’s and Strategy Coordinators would provide more reliable and comparable information across countries and strategies, for MBDS countries and their development partners Reports summarized here came from well organized and presented (but not standardized) country reports Reports summarized here came from well organized and presented (but not standardized) country reports Discussion on February 26 suggested that MBDS members would prefer standardized reporting of progress Discussion on February 26 suggested that MBDS members would prefer standardized reporting of progress

(1) Overall Progress on XB Strategy Orientation and establishment of new XB sites nearly on schedule for 2008 and into 2009 Orientation and establishment of new XB sites nearly on schedule for 2008 and into 2009 Counterparts generally know each others’ contact information and exchange information regularly Counterparts generally know each others’ contact information and exchange information regularly XB sites meet at least annually; meetings are already scheduled for 2009 XB sites meet at least annually; meetings are already scheduled for 2009 Most XB sites report joint outbreak investigation or exercise past year; more exercises planned for 2009 Most XB sites report joint outbreak investigation or exercise past year; more exercises planned for 2009 Supervisory visits to XB sites reported only by Lao PDR (who conducted them 1-2 times per site) Supervisory visits to XB sites reported only by Lao PDR (who conducted them 1-2 times per site)

(1) Maintain & Expand XB Sites (Lao PDR lead) XB Site (#, location) StatusYear Savannakhet (LAO) - Mukdaharn (THAI) ● Savannakhet (LAO) - Quang Tri (VIET) ● Champasak (LAO) - Stung Treng (CAMB) ● Luang Namtha (LAO) - Mengla (CHI-Y) ● Bo Kaeo (LAO) - Chiang Rai (THAI) ● Sakaeo (THAI) - Banteay Mean Chey (CAMB) Ө Takaeo (CAMB) - An Giang (VIET) ● Kampot (CAMB) - Kien Giang (VIET) ● Lai Chau (VIET) - Luchun (CHI-Y) O Chiang Rai (THAI) - Tachilake (MYAN) O Champasak (LAO) - Ubon Ratchathani (THAI) ● Borikhamxay (LAO) - Ha Tinh (VIET) O Vientiane (LAO) - Nongkhai (THAI) O Mae Sot (THAI) - Myawaddy (MYAN) O 2009

(1) Example of Standardized Reporting: Progress report on XB sites – Lao: 2008 XB Sites Status Start XBA-HHRICTLabRCRsch 1 Savannakhet (LAO) - Mukdaharn (THAI) ● 2003 Lao ●●●●●●●●●●● ● O ●●● ●●● OOO Tha OOOOOOOOOOOOOOOOOOOOOO 2 Savannakhet (LAO) - Quang Tri (VIET) ● 2003 Lao ●●●●●●●● ●● O ● O ●●● ●●● OOO VN OOOOOOOOOOOOOOOOOOOOOO 3 Champasak (LAO) - Stung Treng (CAMB) ● 2003 Lao ●●● ●●● O ● OOO ●●●●● ●● OO●O● ● Cb OOOOOOOOOOOOOOOOOOOOOO 4 Luang Namtha (LAO)-Mengla (CHI-Y) ● 2003 Lao ●●●●●●●● ●O●●O●● OOOOO ●● OOO Chi OOOOOOOOOOOOOOOOOOOOOO 5 Bo Kaeo (LAO) - Chiang Rai (THAI) ● 2008 Lao ●●●●●●●● OO ●● OO ●●●● OOOO Tha OOOOOOOOOOOOOOOOOOOOOO 11 Champasak (Lao)- Ubon Ratchathani (Thai) ● 2009 Lao ●●●●●●●● OO ● ●●●●● ●● OOOO Tha OOOOOOOOOOOOOOOOOOOOOO

IHR (2005) as organizing framework Most provincial level counterparts in human and animal health sectors have each others’ contact information Mechanism for collaboration across sectors (human, animal, others) established or in progress, including formal MOUs & joint action plans Priority zoonoses established in several countries Regular meetings and/or sharing information across sectors established or in development Annual joint investigations &/or exercises conducted or planned for animal or human disease outbreaks Village health workers trained and/or functioning for surveillance (e.g., Vietnam, Cambodia) (2) Animal-Human Health Interface and Community Surveillance (Vietnam lead)

Systematic development of Country Work Plans – group process, needs/gap analysis in each country, guidance & country visits by strategy coordinator Dec 2008-Feb 2009 Systematic development of Country Work Plans – group process, needs/gap analysis in each country, guidance & country visits by strategy coordinator Dec 2008-Feb 2009 Most countries sent > 1 staff member for short epi course in Thailand (June 2008) and > 1 for longer term FETP training; plan to continue this in 2009 Most countries sent > 1 staff member for short epi course in Thailand (June 2008) and > 1 for longer term FETP training; plan to continue this in 2009 Trainees include senior central level (long term) and provincial or district level (short term) Trainees include senior central level (long term) and provincial or district level (short term) Some countries have established short and/or longer-term epidemiology training in country (Vietnam, Myanmar) and others plan to do so (e.g., Cambodia) Some countries have established short and/or longer-term epidemiology training in country (Vietnam, Myanmar) and others plan to do so (e.g., Cambodia) (3) Human Resource Development – Epidemiology (Thailand lead)

(4) Strengthening ICT Capacity (Cambodia lead) National forum (Phnom Penh August 2008) National forum (Phnom Penh August 2008) InSTEDD supporting Cambodia as first pilot site – central and provincial levels: field visits, training, current & new technologies, technical assistance, pilot exercise, stakeholder interviews, use simple ICT to support RRTs InSTEDD supporting Cambodia as first pilot site – central and provincial levels: field visits, training, current & new technologies, technical assistance, pilot exercise, stakeholder interviews, use simple ICT to support RRTs Some countries routinely using electronic notification (e.g., Lao PDR), others are in earlier stages of ICT planning/development Some countries routinely using electronic notification (e.g., Lao PDR), others are in earlier stages of ICT planning/development Most countries involved in GIS training & retraining Most countries involved in GIS training & retraining Most countries will participate in InSTEDD forum in Mukdahan (April 2-3, 2009), then will develop their ICT plans Most countries will participate in InSTEDD forum in Mukdahan (April 2-3, 2009), then will develop their ICT plans

(5) Strengthening Laboratory Capacity (China lead) Strategy leader’s roadmap Strategy leader’s roadmap –Identify core diseases (August 2008) –Develop lab assessment questionnaire (Oct 2008) –Conduct field assessments in each country (ongoing) –Prepare final report (March 2009) –Identify gaps, develop common lab development plan Countries awaiting final report from assessments in order to develop their plans and begin implementation Countries awaiting final report from assessments in order to develop their plans and begin implementation Some lab staff at central and provincial levels have been trained for RRTs (Lao PDR) Some lab staff at central and provincial levels have been trained for RRTs (Lao PDR)

(6) Strengthening Risk Communications (Myanmar lead) Strategy coordinator: Strategy coordinator: –Emphasized the importance of planning for RC –Described range of “public” audiences and need to tailor RC channels and messages to their context –Laid out steps to organize and implement this strategy across countries –Requested collaboration/help from development partners Most countries have not yet made progress on this strategy Most countries have not yet made progress on this strategy –However, Thailand conducted provincial level PHEIC exercise of AI June 2008)

(7) Conduct and Apply Policy Research (No specified lead) Several countries reported policy research completed, underway or planned Several countries reported policy research completed, underway or planned –Thailand: Number of epidemiologists required to conduct surveillance, investigate outbreaks & implement control measures (underway) –Vietnam: Situation analysis of new XB sites, future study on 1-2 selected zoonoses (KAP, epidemiology and transmission characteristics – planned for May-June 2009) –Lao PDR: KAP survey on AI prevention and control in 10 border sites (completed), study on malaria infection in border village (Vietnam border area- completed), pilot study to develop AI-free villages (planned) –Myanmar: Conduct situation analysis at XB sites, identify gaps, and plan to resolve them (planned), pending- study on 1 selected zoonosis

Summary of 2008 implementation Collectively, progress across countries is impressive Collectively, progress across countries is impressive Implementation is largely on schedule, with some strategies and countries further advanced in their implementation and some lagging a bit behind Implementation is largely on schedule, with some strategies and countries further advanced in their implementation and some lagging a bit behind XB sites and countries can probably learn from one another’s experiences  MBDS should identify ways to facilitate this to greater extent XB sites and countries can probably learn from one another’s experiences  MBDS should identify ways to facilitate this to greater extent At current pace, progress in 2009 will likely be substantial across all MBDS countries and strategies At current pace, progress in 2009 will likely be substantial across all MBDS countries and strategies

Plans for next 6-12 months: Continue Progress Across All Countries & Strategies 1.XB: Establish 2008 and 2009 sites, maintain existing sites, monitor progress 2.Animal-human health interface: Agreements, communications, exercises, research 3.HRD – epidemiology: Complete Country Work Plans and implement 4.ICT – Extend beyond Cambodia pilot beginning with InSTEDD-sponsored April workshop in Mukdahan

Plans for next 6-12 months: Continue Progress Across All Countries & Strategies (continued) 5.Lab – Complete assessment process and report, develop common lab capacity development plan (begin procurements and training?) 6.Risk communications – potential assistance from development partner to be identified to collaborate with strategy leader and MBDS countries 7.Policy research – Conduct studies already planned, identify policy questions to be addressed through new studies, disseminate results, apply results

Some Ideas Raised on February 26 (1 of 2) “All countries have to implement all strategies to ensure regional security.” “All countries have to implement all strategies to ensure regional security.” More standardized presentations (e.g., using M&E forms, PPT template) for progress reporting by country and by strategy are desirable for future meetings– EB and development partners want to see “the whole picture” More standardized presentations (e.g., using M&E forms, PPT template) for progress reporting by country and by strategy are desirable for future meetings– EB and development partners want to see “the whole picture” Use MBDS newsletter and website to disseminate information on progress, outcomes of joint activities, lessons learned, results of policy research, etc. Use MBDS newsletter and website to disseminate information on progress, outcomes of joint activities, lessons learned, results of policy research, etc.

Some Ideas Raised on February 26 (2 of 2) Consider policy research areas: (1) which part of health system addressed by MBDS (central/provincial/district/local), (2) help reconcile multiple development partners with overlapping programs in countries and the region (e.g., ASEAN+3, GFATM, etc.) Consider policy research areas: (1) which part of health system addressed by MBDS (central/provincial/district/local), (2) help reconcile multiple development partners with overlapping programs in countries and the region (e.g., ASEAN+3, GFATM, etc.) Consider creating a user-friendly “clearinghouse” as a repository for all MBDS programmatic information – Knowledge Management Consider creating a user-friendly “clearinghouse” as a repository for all MBDS programmatic information – Knowledge Management

Thank you very much for your kind attention