Risk Wise

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responsible for the health aspects of pandemic preparedness and

response, has prepared guidance for its member states, the UN system

and non-governmental organizations (NGOs). These kinds of initia-

tives help ensure that key personnel are informed and prepared, and

will ultimately help save lives in a pandemic.

It is also clear that the broader humanitarian community will have

a critical role to play, as academic research suggests that upwards of 95

per cent of deaths due to a pandemic will occur in developing coun-

tries, and that vulnerable populations there will suffer most. In light

of this, 23 organizations involved in the delivery of humanitarian aid

– including the Red Cross/Red Crescent Movement, international

NGOs and UN agencies – signed a declaration on 29 October 2007,

pledging to work together to get ready to respond to the consequences

of an influenza pandemic on vulnerable populations. Two subsequent

inter-agency simulation exercises were held in 2008, helping organi-

zations identify gaps and inconsistencies in their respective pandemic

plans; further joint activities are planned in 2009.

At the 2008 Sharm El Sheikh International Ministerial Conference

– the sixth in a series of intergovernmental meetings on avian and

pandemic influenza since 2005 – more than 120 countries and 26

international and regional organizations collectively reaffirmed their

determination to continue efforts for multi-sectoral, multi-level and

multi-country pandemic preparedness.

It has been recognized that emerging infectious diseases are signif-

icantly correlated with socio-economic, environmental and ecological

factors, and thus in turn require coherent and connected approaches

to prevention and control across many sectors, including animal and

human health and wildlife. This coordination and collaboration under-

lies the principle of ‘One World, One Health’ developed by the Wildlife

Conservation Society in 2004 and a strategic framework launched in

2008 by WHO, FAO, OIE, UNICEF, UNSIC and the

World Bank, which have the aim of achieving better

prevention of, preparation for and response to the health,

social, economic and political impacts of infectious

diseases emerging at the animal-human-ecosystem inter-

face.

The successful use of the ‘One World, One Health’

concept in planning and implementation of programmes

will contribute significantly to the overall goal of protect-

ing the world from emerging infectious diseases of animal

origin. Strengthening of laboratory, epidemiologic and

public health response capacities (part of the One World,

One Health concept) will in turn increase the ability of

countries to identify and respond to pandemic influenza.

Conclusion: vigilance is vital,

complacency dangerous

Over the last several years, substantial and significant

progress has been made in pandemic preparedness

worldwide. The number of countries that have devel-

oped a pandemic preparedness plan has steadily

increased, and more countries have conducted simula-

tion exercises of their plans. Nevertheless, many plans

remain unendorsed at the highest political level and

lessons from simulations are not being included in plan

revisions, indicating that many plans are neither legally

nor logistically feasible.

It is imperative that all countries and international orga-

nizations continue to devote resources to be better

prepared to save lives and minimize socio-economic

disruption in a pandemic. It is now important to consol-

idate achievements in pandemic planning, and make

plans operational by further advocating, endorsing,

testing and systematically reviewing plans with lessons

learned. National authorities need to ensure that logisti-

cal and legislative provisions are made for effective

non-pharmaceutical measures including (at a minimum)

isolation of cases, quarantine of close contacts of cases

and social distancing, and that pharmaceutical control

strategies, such as use of anti-viral drugs for treatment

and prevention of infection in certain groups, and

vaccines, are implementable as far as possible. Since

successful pandemic preparedness increases the resilience

of national institutions in the face of other emergencies,

national authorities should strive to integrate pandemic

planning into national disaster management structures

so as to increase its sustainability and broaden its bene-

fits. It is also essential that national pandemic

preparedness efforts be undertaken jointly by all stake-

holders – including representatives of public sector

bodies, private entities, civil society and Red Cross or Red

Crescent societies, media organizations and faith groups.

No country or region should prepare for pandemic in

isolation – hence the absolute need for nations to work

within the context of intergovernmental agreements and

means for joint working at regional and global levels.

We must avoid being complacent given that a

pandemic is such a major threat to the security of the

human race. We have an opportunity to be ready now,

and we cannot afford to miss it.

Participants at the tabletop simulation exercise held on 23 October 2008 under the

auspices of the One UN System in Kigali, Rwanda

Image: UNSIC