Inter-Agency Review of UN System Country Contingency Plans

Inter-agency review of UN system country contingency plans (CP)

for an avian and human influenza (AHI) pandemic

Country: DPRK

Last update of CP: September 2006

Review team: Peter Scott-Bowden, Sandor Beukers, Gregoire de Brancovan, Denis Charles, Jean-Marc Cordaro, Wendy Cue, Safari Djumapili, Megan Gilgan, Nankhonde Kasonde, Dr. Osman Mansoor, Wendy Morotti, Ingo Neu, Gabriella Waaijmann, Daniela Wuerz

Rapporteur: Ingo Neu

Review date: December 2006

The indicators for this review have been derived from the Pandemic Planning and Preparedness Guidelines for the United Nations System of 15 March 2006, the UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01March2006 and the United Nations Administrative Guidelines for an Influenza Pandemic Situation of 23May2006. The structure of this review sheet shall not prejudice the structure of UNCT pandemic contingency plans. The number of “yes”, of “partly achieved”, and of “no” are no judgement on the plan’s quality but rather an effort to asses the degree of implementation reached at the moment of completion of the plan.

Indicator / Comment /
Planning and Coordination
As requested by the Secretary-General, in March 2006, all country offices are to undertake pandemic preparedness planning in line with the following documents.
- the Pandemic Planning and Preparedness Guidelines for the United Nations System of 15March2006
- the UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01March2006
- the United Nations Draft Administrative Guidelines for an Influenza Pandemic Situation of 23 May 2006
It is suggested that in a revised version of your CP the reference documents for your pandemic preparedness planning are mentioned.
1.1  Common UNCT AHI Focal point appointed.
Agencies have appointed their own AHI Focal Point. / Yes
No / As described in Chapter C on page 4 and in Annex 8 Dr. Vason Pinyowiwat from WHO has been appointed as the AHI focal point for the UNCT.
Six UN agencies are mentioned to be working in DPRK (UDNP, UNICEF, UNFPA, WFP, WHO and FAO) and the plan seems to have been developed in conjunction with all these agencies. An AHI task force has been commissioned to draft the detailed contingency plan.
It would be good to include a list with the contact details for the AHI focal points of all six UN agencies and eventually of the AHI task force in the plan. A template can be found and downloaded from http://www.undg.org/content.cfm?id=1892.
1.2 UNCT has engaged national authorities and key stakeholders were engaged in planning process. Arrangements for notification and information sharing have been made. / Yes / Consultations with the government were held and communication channels were established.
It would be good to add a list with the contact details and perhaps to briefly describe the notification arrangements in the text on page 6 of the plan.
A template can be found and downloaded from http://www.undg.org/content.cfm?id=1892.
As mentioned in the first review, a good example for (documenting the) coordination with national authorities on pandemic preparedness planning can be found in the Malawi plan (see http://www.undg.org/content.cfm?id=1786 password: unsic123).
1.3 Coordination with non-UN partners (foreign missions, NGOs, private sector etc.) is on-going. / Yes / A link with the EU embassies is part of the UN security plan and regular inter-agency meetings, including International Organisations and embassies take place every week.
Private sector involvement is not mentioned, but this may be due to the particular situation and conditions in DPRK?
It still would be good to add a list with the contact details and a template can be found and downloaded from http://www.undg.org/content.cfm?id=1892.
1.4 Key risks and contingencies identified by UNCT. / Yes / Risk analyses and mitigation strategies are described in the plan and included as Annex 1.
The matrix does not mention gaps in the National Preparedness Plan or limited National response capacities as risks. That indicates that the national plan is considered to be comprehensive and well designed and that the national capacities might need no special assistance by the UN system or others.
If this assumption is not the case, it should be considered to include the status of the national preparedness plan and the lack of national response capacities and resources as a potential risk, which needs to be addressed.
1.5 Response actions matrix with responsibilities and timelines developed. / Partly achieved / Annex 4 of the plan describes in principle activities seems to be the response action matrix, but it does not contain timelines and is rather broad. The matrix should be a more detailed kind of checklist of activities to be taken at a certain time, especially during phase 3 in order to achieve preparedness.
The toolbox contains two different templates that can be used as guidance on how to define the specific steps.
http://www.undg.org/content.cfm?id=1892
1.6 Timeline for simulation exercises included in plan. / Partly achieved / The need for simulation exercises is clearly seen and described.
It would be good to include a timeline for the simulation exercises, including the details of the person/agency responsible for planning/organising it.
(see toolbox at http://www.undg.org/content.cfm?id=1892); password: unsic 123)
1.7 Chain of authority developed for pandemic situation, including activation and implementation of plan. / Yes / The management structure in case of increasing alert levels is described.
On security-related issues, especially if WHO pandemic level increases, the SMT should meet immediately to review existing security plans and make any necessary modifications. With regards to health, the WHO and UN Physician would serve as an advisor to the UNCT and SMT on any modifications to the staff medical contingency plan and would share WHO recommendations as they are available.
In regards to programmatic issues, including decisions on programme suspension, adjustments or continuation in certain geographic areas and special circumstances, the UNCT/SMT should discuss and exchange information on the agency plans and provides final decision accordingly.
Staff Health and Safety
2.1 Identification of community and hospital based healthcare providers completed. / Yes / Only the Friendship hospital appears to be available for expatriates. Arrangements have been made to have a room and equipment available for UN personnel in case of a pandemic.
It would be useful to incorporate some details in the plan following the template at: http://www.undg.org/content.cfm?id=1893 (password: unsic 123).
2.2  Assessment of community and hospital based healthcare providers completed. / Yes / An assessment was carried out in 2005. It is recommended to consider, whether updates after a certain time (every 2 years or similarly) might be planned and mentioned.
2.3 Arrangements to set-up fever clinics for treatment of staff made. / No / No fever clinic is described in the plan. However, the plan includes plenty of details for the medical management in different situations. Due to the relatively low number of UN staff, the arrangements described in the plan might be sufficient without a fever clinic.
2.4 Necessary medication (Tamiflu, antibiotics in quantities according to UNMS Guidelines) and appropriate Personal Protective Equipment (PPE) and masks procured. / Yes / Tamiflu is already available for all staff and their dependants.
PPE is procured for the essential staff (10% of total).
Other items such as vaccines, antibiotics, masks, etc. are all covered and described in sufficient detail in the plan.
2.5 Responsibility for procurement of medication and protective equipment assigned (lead agency or agencies individually). / Yes / Responsibility is with WHO.
2.6 Staff provided with information on keeping themselves safe and prepared. / Yes / Regular information updates are foreseen. The plan includes the information from the toolbox for the staff. It might be sufficient to use these materials and to adjust them in certain instances, where the specific conditions for the staff in DPRK might make it necessary.
As long as the information from the toolbox is sufficient and appropriate for the country team, it might not be necessary to develop additional materials, but it should be tested, whether the materials achieve the required effect among the staff.
2.7 Psychosocial support providers identified. / Yes / The measures described in the plan are based on the template in the toolbox. A matrix is included in the plan, describing the action to be taken in order to achieve the objectives that are proposed in the UN guidelines.
It would be good to include a timeline in order to be able to monitor the progress of implementation and achievements.
The plan clearly emphasizes on the importance of the role the stress counselor would have to play during higher alert phases. It might be worthwhile considering whether that should be reflected in the description of the response management structure.
2.8 Staff tracing system prepared. / No / It is not evident in the plan whether a staff tracing system is available/considered yet. It would be useful to prepare such lists including the following information:
§  Name of staff member
§  Staff member’s dependants: including ages of children under 18
years
§  Address and telephone number, mobile number, and e-mail
address
§  Personal/family compliance with UN Medical plan for pandemic
influenza.
§  Next of kin and contacts.
2.9 Security threat analysis prepared. / No / Annex 1 of the plan provides a table of general “Risk/Threat Analysis and Mitigation Actions”. The plan does not include a security threat analysis as such and does not provide details for different alert phases. A template for such a table can be found at: http://www.undg.org/documents/8933-2_8_Security_threat_analysis.doc.
2.10 Staff contact system established and tested. / No / The plan includes the contact details of the Security Wardens and Emergency Contact Numbers in Annex 8, providing information on how the staff can contact the wardens.
The plan does not describe whether a system is prepared that will assure that staff themselves can be contacted by the wardens in all phases, but it might have been prepared by the different agencies. Although the contact details of the staff might not need to be included in the plan, it would be good to mention, what preparations have been made to assure that staff can be contacted.
Business Continuity
3.1  Programmes prioritised, pandemic critical ones identified, and agreement reached on those that can be suspended or scaled back. / No / It is mentioned in the plan that each agency is going to prepare individual BCP, but there is not further information or timeline for it.
A template for prioritizing programs is available in the Toolbox (at
http://www.undg.org/content.cfm?id=1894; password: unsic123).
3.2  Critical functions identified to ensure operational continuity for prioritised programmes and activities. / No / No details are available in this plan, but it might be that individual agencies have prepared their plans including these details.
A template that can be downloaded and used after necessary adaptation to the UNCT requirements at: http://www.undg.org/content.cfm?id=1894.
3.3  Critical staff identified, including those that will work from home, and from office/facilities. Alternates identified. / Yes / A table is included in the plan based on the template of the toolbox. The table is reduced to 3 critical issues (IT/Communication; staff; office supplies…) and does not differentiate the responses by alert phases. It should be considered to elaborate some more details of this table and to structure it according to alert phases.
3.4  Checklist for operational continuity for phase 4, 5, 6 actions and responsibilities developed. / No / The plan includes a table in Annex 2, which describes elements of operational continuity, but it is not very detailed and does not address different situations in different alert phases. It also lacks timelines and assignment of responsibilities for specific responses.
A template that can be adjusted and used is available at: http://www.undg.org/content.cfm?id=1894.
3.5  Requirements assessed and access to supplies ensured for critical staff in offices/facilities for a six week period. / Yes / Annexes 13 and 14 contain a list of supplies that staff could stock and additional recommendations. It is recommended to assure that the list, which was taken from the toolbox, is indeed appropriate given the specific circumstances in DPRK. Mention should be made whether this list is checked and considered appropriate for the conditions in the country.
3.6  Requirements assessed and access to supplies ensured for staff at home for six week period. / Yes / Annexes 13 and 14 contain a list of supplies that staff could stock and additional recommendations. It is recommended to assure that the list, which was taken from the toolbox, is indeed appropriate given the specific circumstances in DPRK. Mention should be made whether this list is checked and considered appropriate for the conditions in the country.
3.7  Ensure that those working from home are able to perform critical functions (i.e. phone, internet, radios, generators etc). / No / No details are available in the plan, but it might be that individual agencies have prepared their plans including these details.
3.8  HR and admin policies and actions agreed/ developed regarding travel, leave, pay, and other administrative questions. / No / The needs for such arrangements are mentioned in the plan, but no details are described.
A matrix to plan and implement certain measures is available at:
http://www.undg.org/content.cfm?id=1894 (password: unsic 123)
Communications (UNCT)
4.1 UN System internal communication strategy agreed. / No / The issue is mentioned in the plan, but no details attached.
A template is available at:
http://www.undg.org/content.cfm?id=1895
(password; unsic 123)
4.2 Strategy for external communication with relevant stakeholders agreed. / No / The issue is mentioned in the plan, but no details attached.
A template is available at:
http://www.undg.org/content.cfm?id=1895
(password; unsic 123)
Budget
5.1 Budget for staff health and safety actions from medical guidelines developed for all agencies. / Yes / The budgetary requirements for the procurement of stocks are included in the plan.
5.2 Budget for operational continuity and additional programme activities during a pandemic developed. / No / No details of budgetary requirements (radios, office supplies, etc.) are included.
A template is available at:
http://www.undg.org/content.cfm?id=1896
(password; unsic 123)
Support for National Preparedness and Response
6.1 UNCT has been requested or has offered to provide support for the national preparedness and response planning. / No / The issue is mentioned in the plan, but no details attached.
A template is available at:
http://www.undg.org/content.cfm?id=1897
(password; unsic 123)
In addition, the template 1.5 of the toolbox might provide further assistance to make plans accordingly.
6.2 Components of national preparedness and response planning that align with agency mandates and operational capacities have been identified. / No / The issue is mentioned in the plan, but no details attached.
A template is available at:
http://www.undg.org/content.cfm?id=1897
(password; unsic 123)
6.3 Additional or extended operations, programmes and support, if required and capacity exists, have been planned and prepared for. / No / The issue is mentioned in the plan, but no details attached.
A template is available at:
http://www.undg.org/content.cfm?id=1897
(password; unsic 123)
6.4 Joint planning with the government, including joint prioritization of actions, areas and groups requiring special attention has been undertaken. / No / The issue is mentioned in the plan, but no details attached.
A template is available at:
http://www.undg.org/content.cfm?id=1897
(password; unsic 123)
General Comments
The country team has certainly invested significant time and effort in order to revise their contingency plan and tremendous improvements are noticeable. This is the more commendable as the UN system in DPRK has very few agencies and officials who are busy with many other activities as well.
The first parts regarding coordination & planning and staff safety health are already very good and leave little to be improved further. Certain details should be attached and in most cases the templates available in the toolbox will make this rather easy. In addition, the plans of the individual agencies should be included.
Although the business continuity part seems to be less developed, these parts can also be completed rather quickly using the mentioned templates.
As for many countries, the main issues remain with the support that the UN system will provide to the government to respond to an increased alert level or even to a pandemic. The country team should try to describe how the different agencies would work together with the different Ministries and support certain activities in different alert phases. This would of course require the Government either having already comprehensive preparedness and response plans available or working on them and communicating them with the UN agencies.
To address these issues in the Contingency Plan might also help the country team to take stock of the remaining issues, to identify remaining gaps and eventually the needs for additional external assistance from the regional and/or global support teams.

7