Inter-agency review of UN system country contingency plans (CP)
for an avian and human influenza (AHI) pandemic
Country: Afghanistan
Last update of CP: 2 May 2006
Review team: Peter Scott-Bowden, Nankhonde Kasonde, Hermann Nicolai, Nabila Alibhai, Pier-Luigi Martinesi, Gregoire de Brancovan, Daniela Wuerz, Dr. Osman Mansoor
Review date: 26 June 2006
Indicator / Yes / No / Comment /Planning and Coordination
Plan was endorsed by the SMT on 8 May 2006.
The plan does not indicate whether it was endorsed by the UNCT.
The plan is based upon the UNMS Staff Contingency Plan Guidelines for an Influenza Pandemic
It is not based upon the UN Secretary-General’s Pandemic Planning and Preparedness Guidelines for the UN System – March 2006.
1.1 AHI Focal point appointed. / No / It appears that the plan was approved by the SMT (we don’t know if the SMT has appointed a focal point: this isn’t clear).
The plan would benefit by including the name of the dedicated AHI focal point plus alternate.
1.2 UNCT and/or AHI coordinator has had a discussion and agreed on contact/liaison with national pandemic preparedness and response authorities? Including contacts, notification and information sharing agreements. / No / Not documented.
It appears that there have been discussions / meetings with the Government, and there is a national plan. Although key government contacts may be recorded in the security management plan it is useful to have one document where such details are recorded in one place.
1.3 Coordination mechanism with non-UN partners (WB, NGO, etc) active. / No / It would benefit from stating this at the beginning of the document. The coordination forum should include names of participating entities / agencies. On Annex 11, the plan shows a list of agencies / entities including ADB, WB, IMF amongst others who are also listed as being part of the UN DSS list, and records numbers of international and national staff together with a budget breakdown (this is good).
1.4 Key risks and contingencies identified by UNCT. / No / The plan indicates on page 4, sub-para 4, that the virus may affect UNAMA’s mandate and the mandate of agencies, and those agencies may be required to continue their critical functions and delivery of life-saving services. The plan does not indicate how this will be done, and key risks are not identified.
1.5 Response actions matrix with responsibilities assigned. / No / An excellent matrix with response actions and responsibilities in regard to support for national preparedness planning and response is provided in the Azerbaijan CP in annex 2.
A good list of some of the key requirements for operational continuity can be found in the Georgia CP in annex 4 (although responsibilities for these activities still need to be allocated).
A good response actions matrix in regard to to staff health and safety can be found in the Pakistan CP and in the Poland CP in annex 6 (although responsibilities for these activities still need to be allocated in Poland CP).
1.6 Simulation exercise completed. / No / Not documented. You may wish to consider a desk-top simulation to test your plans.
1.7 Joint UN/national avian influenza plan. / No / Joint plan is not a requirement but could be considered in some countries where it appears useful.
Staff Health and Safety
2.1 Identification of local health support facilities completed. / Yes
2.2 Assessment of local health support facilities completed. / Yes / The plan provides an indication of the general capacity of hospitals to manage patient care. However, it doesn’t appear to identify materials or expertise to manage H5N1 cases. Perhaps this could be re-examined by the medical services team.
2.3 Appropriate PPE / No / Both procurement and estimated time for arrival (ETA) not documented.
2.4 Masks procured / No / Both procurement and estimated time for arrival (ETA) not documented.
2.5 Oseltamivir procured (sufficent for 30% of staff). / No / Both procurement and estimated time for arrival (ETA) not documented.
2.6 Antibiotics procured (sufficient for 10% of staff). / No / Both procurement and estimated time for arrival (ETA) not documented.
2.7 Lead agency for procurement for UNCT identified. / No / Both procurement and estimated time for arrival (ETA) not documented.
2.8 Staff provided with information on keeping themselves safe and personal preparedness. / Yes / Material for staff is attached. System for advising on ‘staff personal preparedness’ is not clear.
2.9 Psychosocial support providers identified. / No / Pakistan CP is a good example for preparedness planning in regard to psychosocial support to staff and dependents.
The importance of psychosocial support for staff health and security is often underestimated. The UNCT is requested to include this aspect in the CP.
2.10 Tracing system/unit prepared and staff trained. / No / Not documented. Consider to establish system for tracing staff members. Experience shows the merit for such a system. This will involve close coordination between HR and security to track staff.
2.11 Security threat analysis prepared. / No / A good matrix on security threat analysis may be found in the Malaysia CP (although further consideration may be given to phase 6 and to recurrent pandemic waves in that matrix). It provides a useful framework as it is geared to decision making and is flexible.
Pandemic situation may entail serious security threats. Some analysis on this will raise awareness.
Note that according to the UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01 March 2006 the WHO pandemic alert phases are no longer linked to the UN security phases.
2.12 Staff contact system established and tested. / No / Presume it is part of the country’s crisis response plan.
Business Continuity
3.1 Programmes prioritised, pandemic critical ones identified, and agreement on those that can be suspended/scaled back. / No / Not documented.
A good example is given in annex 3 of the Georgia CP at http://www.undg.org/content.cfm?id=1662 password: unsic123.
Foreseeable absenteeism during an influenza pandemic will exclude full continuation of each and every UN program in the host country. It is strongly recommended that UN agencies plan for a situation of very limited human resources by prioritizing programs.
3.2 Critical functions required to continue these prioritised programmes and activities identified. / No / Not documented.
Whilst a mix of critical functions and staff has been identified, there needs to be a link to the continuity of programmes and alternates.
3.3 Critical staff identified, including those that will work from home, and from office/facilities. Alternates identified. / No / Not documented.
A good model of defining the critical staff (and alternate) in relation to the function can be found in the Georgia CP.
Another very useful matrix can be found in the Malaysia CP.
Please identify critical staff who can work from home.
Some CPs have given staff numbers required to maintain critical functions. This seems a reasonable approach. Other CPs include even a list with names of critical staff. Given the high fluctuation of staff in many country offices this may be, however, a difficult exercise to maintain at many places.
3.4 Checklists for phase 4, 5, 6 actions and responsibilities drafted, together with trigger events. / No / Not documented.
A good checklist is provided in the Azerbaijan CP in chapter D III (although, where appropriate, triggers should be added).
The triggers based on WHO pandemic alert phases need to recognize that WHO phases are global and not reflective of the situation in any one country.
The key triggers for a country response will be based on where the human-to-human transmission is occurring. This will apply at all phases, as even in phase 6 (pandemic), initially not all countries will be affected.
UN actions are likely to be affected by the assessment of the Pandemic Alert Phase by national authorities, and these need to be identified/discussed. This will in turn help the UN to plan when the virus starts spreading human-to-human - whether in the country, a close neighbour, or far away.
3.5 Requirements assessed and supplies arranged for critical staff in offices/facilities – six week period. / No / Not documented.
UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01 March 2006 provides good list of supplies in annex 8.
3.6 Staff to ensure access at home for food and water for six week period. / No / Not documented.
UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01 March 2006 provides good list of supplies in annex 8.
3.7 For those working from home ensure that they are able to perform critical functions i.e. phone, internet, radios, generators etc – geared for six weeks. / No / Not documented.
As working from home could be an option to assure business continuity in a pandemic situation mention should be made of provisions to assure this.
3.8 HR and Admin officers clear about policies and actions regarding travel, leave, medical, pay, tracing unit etc. / No / Partly documented. Needs further elaboration. Travel, leave, pay and other administrative issues should be carefully considered, and planned for. See HR Administrative Guidelines which can be found on the web link www.influenza.undg.org
Communications (UNCT)
4.1 UN System internal communication strategy agreed. / No / The in-country mechanism for AHI seems to be the UN SMT. Whilst this may in part be useful, the team should consider establishing a crisis management team for AHI which should look at the broader objectives requested in the UN S-G’s Pandemic Planning and Preparedness Guidelines for the UN System (see www.avianinfluenza.undg.org)
Careful coordination with government, UNAMA, and agencies will be required. ‘If’ an internal communication strategy does exist it needs to be documented.
4.2 Strategy for external communications with relevant stakeholders. / No / Not documented.
Budget
5.1 Budget for staff safety and security actions from medical guidelines for all agencies. / No / Whilst Annex 11, indicates that 23 agencies and entities in Afghanistan it mentions 12 agencies which are not included in the budget breakdown. If they are conducting their own procurement of materials and supplies, their status should be recorded in the plan together with time-lines for compliance.
5.2 Budget for programme continuity and additional programme activities during a pandemic. / No / Not documented. The plan for programme should include some indicative costs.
An excellent table with costs for programme continuity and additional programme activities during a pandemic is given in the Azerbaijan CP in annex 2.
Support for National Preparedness and Response
6.1 UN been requested to provide support for the national preparedness and response planning. / No / Not documented. It is assumed that technical liaison is on-going with technical agencies, even if there has been no official request.
6.2 Identification of components of national response and preparedness plans that align with agency mandates and operational capacities. / No / Not documented.
6.3 Plan and prepare for additional or extended operations, programmes and support if required and capacity exists. / No / Not documented.
An excellent table with costs for programme continuity and additional programme activities during a pandemic is given in the Azerbaijan CP in annex 2.
General Comments
The plan is a good start, but needs to be broadened to include a number of key features as indicated within the UN Secretary-General’s Pandemic Planning and Preparedness Guidelines for the UN System (15 March 2006).
Specifically, it should address many of the non-bio-security issues. A good starting point for this will be a hazard and risk analysis which shouldn’t just be from a security perspective but be inclusive of all sectors and also focus on operations/business continuity, and if possible support to national planning. Through such analysis, critical actions to mitigate these threats can be established, and contingencies prioritised, from which a common scenario can be built. This is particularly important for individual agencies and the UN Mission who will benefit from this process.
Given the fluid situation within Afghanistan, it may be essential to build your plan around a number of core themes. These could include, flexibility, sustainability, and lastly make sure there is a platform for making decisions, not just on safety and security, but also continuity of operations.
Good starting point, and all contributors to this process should be commended for their efforts to date.