Countries lagging in flu pandemic plans, UN warns

Most Asia-Pacific nations are making progress on avian flu control, but are lagging in plans to tackle the social and economic fallout of a human flu pandemic, a senior UN influenza specialist has warned.

"In general, the situation is that countries are getting much more on top of the bird flu," senior UN System Influenza Coordinator (UNSIC), David Nabarro, told IRIN in Bangkok. "I'm impressed with progress, but I am saying a lot more needs to be done, particularly on multi-sectoral pandemic preparedness."

UNSIC in the Asia-Pacific, collaborating with the Asian Disaster Preparedness Centre and the Kenan Institute Asia, has released its first compilation of simulation exercises conducted by countries to prepare for a human influenza pandemic.

In the book, countries such as Indonesia, Vietnam and China detail and assess their simulations, which range from table-top discussions to full-scale exercises; in one 2006 Australian simulation, 800 participants from domestic government agencies responded to a pandemic originating in a fictional Southeast Asian nation.

The simulations were aimed at testing a range of areas, from cooperation between government agencies to the efficiency of standard procedures and the feasibility of existing pandemic preparedness plans.

Although governments have built experience through simulations, Nabarro writes in the book that many plans worldwide have yet to show how essential services will continue in a pandemic, where there may be high work absenteeism. There is also insufficient preparation for wider social, economic and political consequences.


Photo: Brennon Jones/IRIN

"I'm impressed with progress, but I am saying a lot more needs to be done, particularly on multi-sectoral pandemic preparedness."

David Nabarro, senior UN System Influenza Coordinator (UNSIC), told IRIN in Bangkok.


"The planning for pandemics that has been done by most countries and organisations during the last two years has concentrated on health service planning - making sure that the hospitals are equipped to keep working, making sure that the medical staff have some understanding of what they are expected to do," Nabarro told IRIN.

"Yet … our experience is that a pandemic will do much more than affect the health system, it will affect essential services, it will affect the operation of government and transport and all other aspects of society."

The book, Simulation exercises on influenza pandemic responses in the Asia-Pacific region, will be distributed to governments at the Sixth International Ministerial Conference on Avian and Pandemic Influenza from 24 October this year in Egypt. 

The book is also available online.

Pandemic fears

Since the re-emergence of the highly pathogenic H5N1 influenza virus in poultry in 2003, 387 cases of human avian flu have been recorded, of whom 245 died, according to September 2008 figures from the World Health Organization.

Health experts fear the H5N1 virus will mutate into a form that can be easily transmitted between humans, leading to a flu pandemic.

Nabarro said the book was aimed at encouraging the testing of pandemic preparedness through simulations - the most effective form of preparation.

While governments have the political will to include pandemic preparedness in their disaster planning, it "sort of comes quite low down the priority list" for busy government officials, who may also need to think beyond a pandemic's immediate health crisis, he said.


Photo: FAO
In an effort to raise awareness, the Cambodian government has taken the battle against bird flu to the community level

"The instinctive impression, for example, in the mind of a senior government figure when pandemic preparedness comes up in discussion is to say, 'Really, that's the ministry of health's job, isn't it?'" he said.

While the book has a few exercise examples that move beyond the health sector to involve countries' finance and tourism sectors, there are "not enough", Nabarro said.

"If a government is preparing for a pandemic, for the continuity during a pandemic, it will only really appreciate some of these broader consequences if it undertakes a simulation," he said.

"If you don't plan for the broader social, economic and political consequences of a pandemic, if you don't do what we call multi-sectoral preparedness planning, then you are missing out on the overall preparation that's necessary."

ey/bj/mw