Should an outbreak of severe pandemic influenza occur in West Africa, most countries in the region would be armed with plans that look good on paper but are untested and underfunded, according to health experts.
“Only a few African countries have started to get ready for the potential disruptions a severe influenza pandemic would cause society,” Liviu Vedrasco, West Africa's pandemic readiness adviser for the UN Office for the Coordination of Humanitarian Affairs (OCHA), told IRIN.
The World Health Organization (WHO) has confirmed 94,500 cases of H1N1/09 worldwide with 429 deaths as of 7 July. Of these cases, 140 are in Africa, which has not recorded an H1N1/09 death.
Most African governments have developed plans to respond to a severe influenza outbreak, Michel Yao, WHO’s West Africa emergency focal point, told IRIN. But countries now need to implement these plans by training public service staff to set up pandemic influenza surveillance systems and identify vulnerable groups, among other actions.
Cape Verde, Gambia, Ghana and Nigeria have gone further than sub-Saharan neighbours by integrating pandemic flu response plans into their wider disaster preparedness procedures, according to OCHA.
In Nigeria, the ministries of information and agriculture are working with the Health Ministry to outline their joint response, said the Health Ministry’s epidemiology director, Abdul Nasidi.
“We have established a command centre. We are also trying to expand our pandemic response plan…and we are working with the federal government to import more stocks of Tamiflu [a flu-inhibiting drug] to cover at least 10 to 20 percent of the population,” he told IRIN.
|Confirmed H1N1/09 infections in Africa as of 23 June 2009|
In the Senegalese capital Dakar, a pre-existing infectious diseases committee is now meeting weekly to plan the country’s response, Awabadhily Bathily, epidemiology adviser at the Health Ministry, told IRIN. While only health staff attended before the latest flu outbreak, the interior and livestock ministers are now participating, she said.
National plans need to integrate flu preparedness into wider emergency response plans, outline how each sector would respond – from defence forces to health clinics and address special needs for vulnerable groups, said OCHA.
But some of the systems Senegal's Health Ministry has set up are not operational – including an H1N1/09 telephone hotline that plays music instead of providing information.
Space limitations in the national H1N1/09 focal point hospital prevent patients’ isolation, which the US Centers for Disease Control and Prevention (CDC) recommends for flu victims at the early stage of an outbreak.
WHO raised the level of influenza pandemic alert to the highest alert phase 6 on 11 June to capture the virus’s global spread.
The current strain has been only moderately severe to date, but when the northern hemisphere’s flu season begins in October, OCHA fears more dangerous strains could develop.
A severe outbreak could disrupt world financial markets; cause public services including health facilities and schools to collapse; shut down borders; and disrupt law and order, OCHA has warned.
“Pandemic influenza should be on the national security agenda of countries," Vedrasco said. "Parliaments should be discussing it and should allocate sufficient resources to address response needs. This is not just a health issue; it is a whole-of-society problem.”
WHO is supporting six laboratories in Africa – in Algeria, Côte d’Ivoire, Senegal, two in Nigeria and South Africa – to test and treat H1N1/09, helping countries set up surveillance systems, assisting governments to create national response plans and sending limited stocks of Tamiflu to countries worldwide.
Preparing for a flu outbreak may not seem urgent, said Vedrasco, but to “see it that way is to miss an opportunity.”
“Through preparing for a severe influenza pandemic, governments could…improve prevention control and response capacities for other infectious diseases and disasters… History brings opportunities every now and then, and some of these have the potential to foster long-term change.”