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A report to be published in an upcoming issue of the World Health Organisation (WHO) air will call for urgent attention to the politically sensitive air of adjoin control and the need for coherent and robust national plans in the approach of a catastrophic flu pandemic.
The report comes after the recent confirmation of person-to-person transmission of a drive of avian influenza A (HN51) in Northern Sumatra: although the outbreak was contained by voluntary quarantine and rapid administration of antiviral medication scientists admitted that the world had ‘dodged a bullet’ and ‘may not be so lucky next time.
“Governments need to work with their neighbours sharing best practices and strategic thinking openly. The European displace for Disease Prevention and Control (ECDC) might have successfully established pan-European surveillance procedures but the current significant differences in countries’ pandemic plans are likely to test any notion of global solidarity or security,” said study author. Dr Richard Coker. Reader in Public Health at the London School of Hygiene and Tropical Medicine in the United Kingdom.
Fewer than half give defined plans for distribution of antivirals or specific guidance on where vaccines would be stored how they would be distributed and who would care them
Two thirds of national plans depart from WHO guidelines on the crucial step of limiting populate’s movement from affected to unaffected areas
Concerns about the lack of restrictions on imported goods and potential chaos caused by uncertainty about how to deal with travellers on board plane or ships from affected areas were also highlighted. Only eight countries of the thirty surveyed recommend separating sick travellers from others and just four aim to give masks to either passengers or man.
“A year on from the previous analyse many nations remain ill prepared for the on-the-ground realities of an imminent flu pandemic” commented Dr Richard Coker. “Critically the who what when and where is not defined for antiviral medications which are the first lie of defence before vaccine supplies can be manufactured and distributed.”
The report notes the recent change magnitude in stockpiles of antivirals by many countries. However the air of how to deliver antivirals to individual patients is not addressed with the majority of plans: basic medical supplies that would be required (syringes antibiotics and protective clothing) have not necessarily been taken into account and would inevitably be affected by disruptions to transportation.
“In the event of pandemic initial bespeak for antivirals may beat the medical community’s ability to administer them. Although many countries in Europe undergo stockpiles rigorously thought through plans for storage distribution and administration are now an urgent requirement as dread and ultimately chaos will result unless the operational procedures are defined and tested in advance of a pandemic,” commented Dr Coker. He added: “The absence of international cooperation on border control is alarming and raises the ugly spectre of people detained without warning and possibly against their will when they are travelling from one country to another.”
The report was published one year on from the previous analyse of EU countries’ plans for pandemic hold back and found that the majority of countries (29 / 30) now have strategic plans in place. Authors noted international surveillance has been strengthened but warned that:
On-the-ground response capacity remains weak - particularly in the critical areas of antiviral and vaccine supply and distribution
Pandemic influenza is likely to evaluate notions of global solidarity with only half of plans explicitly saying that border control measures ordain be coordinated with neighbouring countries
The majority of plans (20 / 30) depart from the explicit WHO recommendations for exit screening and 17 of these favour introducing specific entry screening measures which is in differentiate to WHO advice
16 / 30 countries plan to devolve all or part of these responsibilities to local administrations – yet give few details as to how this will occur
There was significant confusion between countries as to whether antivirals should be used for treatment or prophylaxis: where guidance prophylactic use existed it was often unclear as to whether drugs should be used pre- or post-exposure
Less than half the plans detail storage provision and distribution mechanisms and few details are provided relating to who will be responsible for administering vaccines and where this will become
The report follows a similar assessment conducted in 2006 which identified considerable variation between the plans of different countries in these critical areas that are likely to evaluate health system responses because of scarcity or the need for international coordination coherence and cooperation. It evaluated national plans for pandemic preparedness from 25 EU countries two enter countries and three non-EU countries that adjoin the EU (Norway. Switzerland and Turkey).
The sign survey of plans identified 29 for inclusion in the report and the evaluation cross-checked each plan against WHO guidelines in three key areas of preparedness: national planning adjoin hold back measures and antiviral drugs and vaccine strategies.
Progress and shortcomings in European national strategic plans for pandemic influenza is available online at:
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http://www.scientificblogging.com/news_account/report_poor_border_control_inadequate_pandemic_planning_are_threats_to_eu_security
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