Emergency contingency planning at designated Points of Entry CAPSCA, 2. meeting in Europe Frankfurt, Dr Markus Kirchner Division of Communicable Diseases, Health Security, & Environment WHO Regional Office for Europe The Way Forward: Regional Strategy IHR core capacities 1. Legislation and policy 2. Inter sectoral coordination 3. Surveillance 4. Response 5. Preparedness 6. Risk communication 7. Human resource capacity 8. Laboratory 9. Multi sectoral and environmental hazards (zoonotic, chemical, radiologic, food safety) 10. Points of Entry PoE Preparedness EURO (2012) 1. High level political ownership on IHR implementation process 2. Legislative and regulatory mechanisms 3. Empowerment of National IHR Focal Points 4. Awareness and advocacy efforts beyond the health sector 5. Availability of guidance in local languages 6. Risk Communication 7. Points of Entry 8. Monitoring and Evaluation 1
IHR implementation can impact many ministries, sectors and governmental levels Domestic Areas Affected by IHR (2005) Public health Emergency Management Environment International borders, ports, airports, ground crossings Customs, revenue services Food safety Veterinary Agriculture (including animal health) Radio-nuclear safety and chemical safety Industry Transportation (including dangerous goods) Collection, use and disclosure of health-related information Ministries Affected by IHR (2005) Health Environment Transport Finance Energy Agriculture/Food/Consumer Protection Economy Interior Foreign Affairs Governmental communications services Municipal, sub-national or local offices Managing public health events at PoE Hospitals & facilities Arrangements: - transportation - treatment - isolation - diagnosis PoE Coordinator Arrangements - Quarantine - Conveyance inspection - vector control - disinfection WHO Public health authority: National Surveillance and Response system NFP Infect. Dis.. security Mechanisms: - Event communication - Collaborative investigation - Coordinated response (e.g. examination, disinsection, derating, disinfection, decontamination, contact tracing, etc) Relevant sectors & stakeholders 2
Capacity to apply PHM at designated PoE Overview of designated PoE, 2011 WPRO; 510 AFRO; 318 AMRO; 149 EMRO; 300 SEARO; 405 AFRO AMRO EMRO EURO SEARO EURO; 785 WPRO 3
Public Health Emergency Contingency Plan (PHECP) at designated PoE in WHO / European Region, 2011 ports 157 56 74% yes no airports 132 19 87% ground crossings 224 197 53% 0 50 100 150 200 250 300 350 400 450 PoE public health emergency preparedness Emergency planning: Developing, exercising and maintaining a PHECP at designated PoE Improving readiness An ongoing, continuing process for capacity building Examples: link with Emergency Operation Centre (EOC), risk assessment capacity 4
Two-Tiered Approach for PHEP FIRST TIER Emergency Planning Develop Revise Plan Exercise Evaluate SECOND TIER Increasing Readiness Actions specific to emergency Actions based on routine activities WHO Guide on PHECP Moving from pandemic influenza response planning towards generic public health emergency planning http://www.wpro.who.int/emerging_diseases/doc uments/phecp_guide/en/index.html 5
WHO Guide on PHECP Bridge the gap between legal requirements and pragmatic readiness and response capacity Purpose and scope of PoE emergency planning Guiding principles and key planning consideration Recommended structures Recommended steps to develop a PHECP for a designated PoE Core themes and guiding principles Who needs to communicate? When to communicate? What key information? What communication method? simplicity All documents must be understood easily and quickly Realistic response capability One size does NOT fit all communication Proportionality and practicability Multi-agency, multisectoral Harmonization with existing plans collaboration Minimal disruption To passengers and cargo 6
Key planning considerations Provide the right information and data to the right people Decision support Clear definitions Ensure phrases and keywords are clearly defined Sharing the right information, to the right people, at the right time, in the right format Communi cation Ensure agencies align their plans as part of multiagency response The right people upskilled, trained and empowered People Interoperability of plans Relationships Connect the right people to share information quickly Command and control Empower the right people to make decisions Strategic relations 7
Operational relations Operational response Command & control structure Roles & responsibilities Formal alert codes or phases (if used) Initial actions or protocols Activation / Deactivation / EOC 8
Example: Command and Control Structure Summary and next steps for States Parties Develop and maintaining capacities for preparedness and response Designate PoE: only 2/3 of EURO countries have designated PoE, second lowest rang comparing with other regions) Implement PHECP at all designated PoE: only 65% of designated PoE have PHECP, best value for airports Utilize existing national and local public health systems and services to support PoE public health functions (e.g. vector control) Link PoE to National IHR Focal Point (communications and collaboration with other sectors) Identify and train Points of Entry staff on new documents and procedures Strengthen expert communication and network on PoE Collaborate internationally with other States Parties (e.g. joint designation of PoE) 9
PoE key provisions for WHO Coordinate, collaborate and assist countries and international bodies with IHR implementation Develop and publish WHO procedures and guidelines Provide standing and temporary recommendations of appropriate public health measures If requested by State Party, WHO may arrange to certify that a designated airport or port meets the requirements provided in IHR Annex 1 Publish list of certified airports and ports Thank you WHO EURO IHR Contact Point Tel: +45-39171440 E-mail: ihradmin@euro.who.int IHR website: http://www.who.int/ihr 10