1. WHO COLLABORATION | September 13, 2015 1 | WHO Indonesia Collaboration with Animal Health

2. WHO COLLABORATION | September 13, 2015 2 | Current Projects in Zoonosis Strengthening the health system for acute respiratory infections –USAID funding, focus on zoonotic influenza, primarily H5N1 Strengthening the Human Health Surveillance System for Emerging Infectious Diseases Detection and Response –AusAID funding, focus on EIDs Response including zoonoses Implementing the National Strategic Plan for Avian Influenza –EU funding, activities closed in Dec 2011 IDENTIFY –USAID funding via SEARO HPED –EU via SEARO

3. WHO COLLABORATION | September 13, 2015 3 | Strengthening the health system for acute respiratory infections Four components Case Management including oxygen therapy Pandemic preparedness Hospital infection prevention and control Strengthening surveillance –Support for district surveillance officers –Support for EWARS (Early Warning Alert and Response System) –Support for labs including ILI and SARI

4. WHO COLLABORATION | September 13, 2015 4 | Strengthening Surveillance Activities Operational support for DSOs in ten high risk provinces (all of Java, N Sumatra, Lampung, Bali and S Sulawesi Refresher training for DSOs Human – animal interface linking, including “Four Way Linking” project Lab network refresher training and procurement Severe Acute Respiratory Infection (SARI) surveillance at three hospitals in Western Java EWARS technical support, and training and procurement in Central Java

5. WHO COLLABORATION | September 13, 2015 5 | Strengthening the Human Health Surveillance System for Emerging Infectious Diseases Detection and Response Five Components Support for EWARS in three provinces (Maluku, N Maluku, NTT) Strengthening Event Based surveillance through Outbreak Command Post at MoH Support for FETP Support for Outbreak Response Zoonosis control (new component)

6. WHO COLLABORATION | September 13, 2015 6 | Zoonosis Control Builds on previous grant to respond to rabies in Bali, with expected outputs: Trained Human Resources including rapid response team members on integrated zoonotic diseases surveillance available Field investigation reports available on priority zoonotic diseases, especially avian influenza Advocacy and Agreement for Healthy Food Markets program continued in selected provinces Advocacy and Agreement for integrated rabies prevention campaign in high risk provinces

7. WHO COLLABORATION | September 13, 2015 7 | Zoonosis Control Expert recommendations for improved management of priority zoonotic infections Trained human resources at district level in cost effective animal bite case management in selected provinces Trained human resources at district level in effective lepto case management in selected provinces Trained human resources at district level in avian influenza case management in selected provinces

8. WHO COLLABORATION | September 13, 2015 8 | What are WHO collaborating centres? "…an institution designated by the Director-General to form part of an international collaborative network carrying out activities in support of the Organization's programme at all levels.“ Example: Miscellaneous Bacteriology Section, National Institute of Health, MoPH, Thailand as WHO CC for Antimicrobial Resistance Surveillance and Training

9. WHO COLLABORATION | September 13, 2015 9 | Strategic rationale and functions WHO CCs assist the Organization in implementing its mandated work, all activities must be clearly linked to the WHO strategic plans and reflected in the workplans of the technical programmes to which they contribute. Granting WHO CC status to an institution is not a mechanism for recognizing the institution as a centre of excellence. 28 September 2010: Indonesia and WHO agreed to establish a WHO Collaboration Centre on Influenza at the human-animal interface in Indonesia

10. WHO COLLABORATION | September 13, 2015 10 | Focusing on 5 topics 1.Integrated risk assessment for influenza at the human animal interface 2.Avian influenza dynamics at the human-animal interface 3.Virology of A(H5N1) viruses isolated from human and animal populations 4.Risks associated with environmental contamination by avian influenza viruses, including risks from Live Animal Markets. 5.Clinical management of human cases of avian influenza virus H5N1 infection WHO Collaboration Centre on Influenza at the human-animal interface in Indonesia

11. WHO COLLABORATION | September 13, 2015 11 | Four-way linking framework Bringing public health and animal health together

12. WHO COLLABORATION | September 13, 2015 12 | Four-way linking concept EpidemiologicHuman AnimalVirologic

13. WHO COLLABORATION | September 13, 2015 13 | Four-way linking project setup Aim: National ability to conduct effective risk assessment Objective: link epidemiological/ virological information from AH/PH sectors in time & space Assessment missions: look at complete national AH & PH systems from field influenza investigations through analysis of epi and virological data Identify linkages and technical and policy gaps Follow-up: joint training workshop to address gaps identified Leading to Action Plan

14. WHO COLLABORATION | September 13, 2015 14 | Example of a joint AH-PH briefing report Graphs and map of human & veterinary cases by region (incl. clade distribution) Human cases by risk factors & poultry source Chicken outbreaks Analytic study summaries (Epidemiological curves,...) Interpretation of sequence information

15. WHO COLLABORATION | September 13, 2015 15 | Topics 1.Risk Assessment principles 2.Sectoral needs and discrepancies 3.Gaps and solution identification through scenario-based training 4.Development of an action plan National level workshops

16. WHO COLLABORATION | September 13, 2015 16 | Expected outcome for action plans Convene national task force Establish mechanism for joint RA Solve data sharing issues

17. WHO COLLABORATION | September 13, 2015 17 | Terima kasih