UN System Influenza Coordination (UNSIC)
PROGRESS REPORT
1st January – 30th April 2007
INTRODUCTION
The period January - April 2007 witnessed new outbreaks of the Highly Pathogenic Avian Influenza (HPAI) virus H5N1 in poultry in many parts of the world: Afghanistan, Bangladesh, Cambodia, China, Egypt, Hong Kong, Hungary, Indonesia, Japan, Kuwait, Laos, Myanmar, Nigeria, Pakistan, Russia, Saudi Arabia, South Korea, Turkey, UK and Vietnam. As this report is being finalized, HPAI is also being suspected in Ghana. The upsurge in reported outbreaks of HPAI does not come as a surprise as it follows the same pattern as previous years in which there has been an increase in the virus spread during the period December to April. Human H5N1 cases have been confirmed in China, Egypt, Indonesia and, for the first time, in Cambodia, Laos and Nigeria. There have been no reports of sustained human-to-human transmission of the virus: the World Health Organization (WHO) pandemic alert phase remains at phase 3.
Several countries (Indonesia, Egypt and Nigeria) are currently of special concern as the virus is enzootic (i.e. permanently present) in some of their poultry. Countries facing ongoing outbreaks - such as Kuwait, Afghanistan, Pakistan and Bangladesh - are paying particular attention to the need to stamp out HPAI infections to prevent the disease from becoming enzootic.
In January, UNSIC developed a list of priority outcomes for 2007, drawing on the conclusions of the December 2006 Bamako Conference on Avian and Human Influenza (AHI) and on outputs of the UN System Consolidated Action Plan for AHI of November 2006. UNSIC team members are working with the UN agencies, funds and programmes and their partners to ensure that they contribute to these outcomes in a synergized manner:
(a) coordinated inter-agency action in line with the Action Plan
(b) successful intergovernmental processes on AHI at global and regional level;
(c) review of AHI strategies and identification of best practices for effective
implementation;
(d) coordinated AHI communications;
(e) tracking and analysis of the global AHI response and the progress made by individual countries;
(f) synergized UN system contribution to country AHI action;
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United Nations System Influenza Coordination
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UN System Influenza Coordination (UNSIC)
PROGRESS REPORT
1st January – 30th April 2007
(g) long–term commitment of resource providers to the adequate funding of global AHI activities and
(h) systems for assisting national, regional and global institutions so that they are ready to mitigate the social, economic, governance and humanitarian impacts of the next influenza pandemic. This complements ongoing international efforts to prepare the health sector for effective action in different pandemic phases – in line with the newly agreed International Health Regulations (IHR) 2005.
The present report gives account of UNSIC’s work in the first four months of 2007 in relation to these priority outcomes.
1. Coordinated Interagency Action
Interagency Coordination
During the period covered by this report, different UN specialized agencies (notably FAO and WHO, but also UNWTO, ICAO and ILO), funds (including UNICEF), programmes (specifically UNDP, WFP and UNHCR), coordinating bodies (such as OCHA and UNDG) and their partners (including the OiE, World Bank, IFRC and IOM) have taken forward their commitments to support national, regional and global AHI efforts. For most of these organizations the commitments are spelt out in the Consolidated UN System Action Plan (http://www.undg.org/index.cfm?P=479). FAO and OiE have led on animal health work, with FAO reorganizing its capacity to respond on animal health issues to take account of the many fold increase in the demands being faced (reflected in increasing numbers of staff involved and levels of funds being handled). WHO led on human health work, specifically on global surveillance of HPAI virus infections in humans, development of containment strategies and options for improving access to pandemic vaccines. While both FAO and WHO devised communication messages, UNICEF (benefiting from generous Japanese Government Support) has led in developing communications materials to support mobilization of societies to change poultry rearing and hygiene behaviours (and so reduce animal to human transfer of HPAI).
The Technical Working Group (TWG) on Influenza and the Deputy Secretary-General’s Steering Committee on Influenza have met to review progress and discuss the way forward. In the TWG, participants worked on the General Principles for UN System Operations in the event of a pandemic (prepared by UNSIC), and recommended their endorsement by the Steering Committee. Member agencies of the Steering Committee
emphasized their continued commitment to have UN country programme contingency plans finalized and implementable as soon as possible. They have been involved in defining priorities for UNSIC’s activities in 2007, highlighting the completion of the intensive phase of contingency planning and the coordination of AHI communications.
Coordination at country level
UNSIC, jointly with the World Bank, issued a Study on Coordination of Avian and Human Influenza Activities (http://www.undg.org/index.cfm?P=478) which analyzes current coordination mechanisms in countries facing AHI threats. The Study also examines advantages and disadvantages of different coordination arrangements and proposes best practice principles to promote better synergy for the implementation of AHI activities. As a follow-up to the Study’s recommendations, UNSIC is currently developing tools that reflect the strengths of different UN system bodies in-country and that will help country teams improve coordination of external assistance.
Support to coordination in Asia
In Asia, the new head of the UNSIC Asia Pacific Regional Hub (APRH) in Bangkok, Ms. Annu Lehtinen, has taken up her position on March 26th 2007 to continue the valuable work of Ms. Anne Ancia. Ms. Lehtinen reports to the Senior UN System Coordinator for Avian and Human Influenza. During the period covered by this report, staff in the APRH contributed to the success of consultations organized by partners on the regional response to AI, pandemic preparedness and business continuity. These include the APEC Health Task Force meeting, an ASEAN workshop on HPAI control and eradication, a simulation exercise organized by the Mekong Basin Disease Surveillance (MBDS) and a WHO meeting on cross border issues. In January, APRH team members visited Mongolia to assist in the development of a national contingency plan and facilitated the Coordinator’s visit to Indonesia, Thailand and China. They also convened a regional meeting with representatives of UN agencies and partners to exchange information on the current AHI situation and to solve challenges related to information sharing, communication and implementation of strategies. UN system country level coordinators for influenza were newly appointed in Indonesia (Jonathan Agranoff – full time) and China (Henk Bekedem, WHO representative – part time).
Intensive Support for National Coordination (Nigeria, Egypt)
At the request of Nigeria’s UN Resident Coordinator and the National Government an UNSIC team member supported the UN Country Team (UNCT) as it assisted the Government to finalize its integrated national AHI plan. The final draft plan, which was formally received by the Minister of Health on 27 March, focuses on state-centre and livestock-health relations and addresses ways in which to ensure effective implementation of strategies.
Similarly, at the request of the National Government and Resident Coordinator in Egypt an UNSIC team member spent several weeks in Cairo to support the Resident Coordinator’s Office in assisting the Government to prepare its integrated national plan on AHI. The plan is now finalized and work is underway with the Government, donor agencies and the World Bank to ensure that financial and technical assistance for its implementation starts to flow.
2. Intergovernmental Processes
At the fourth inter-governmental conference on Avian and Pandemic Influenza in Bamako (December 2006), participants agreed that the next such progress review meeting would take place in Delhi (at the invitation of the Government of India) at the end of 2007. They also requested the specialized agencies to convene a technical meeting in mid 2007 to review current strategies in response to avian influenza and to the threat of a human pandemic. The International Partnership on Avian and Pandemic Influenza (IPAPI) and the Indian Government, with UNSIC involvement, have initiated the preparatory process leading to the Delhi International Conference which is now set to take place on 4-6 December 2007. This process includes a preliminary meeting between members of the IPAPI core group and the Indian Government in June and proposed follow-up work – including detailed planning - in September. As in previous events, UNSIC offers to assist with ensuring a coordinated UN system contribution to this key event.
FAO, OIE and WHO, with support from UNICEF and UNSIC, are organizing the Technical Meeting for Avian and Human Influenza Strategic Review and Best Practice which is set to take place in Rome on 27 - 29 June 2007. This meeting will assess and evaluate progress and impacts of strategies being implemented to control HPAI and to prepare for the next human influenza pandemic. It will also review ways in which strategy implementation is supported at national, regional and global level and identify priorities and ways forward. The agenda is now being finalized and provides for the participation of experts from FAO, OIE, WHO, the World Bank and other UN agencies, funds and programmes. Experts from donor agencies will also be invited.
Relations with Resource Providers
During the period covered by the report, UNSIC has maintained regular dialogue with resource providers including the World Bank, the Asian Development Bank, the European Commission and the Governments of Australia, Canada, Norway, the United Kingdom and the United States. The UN System Coordinator visited Germany, the current EU presidency, to discuss harmonization of approaches to AHI responses.
Regarding financial needs for AHI work in Africa, UNSIC is working with the World Bank to follow up on outcomes of the Bamako Conference, including the prompt disbursement of existing grants and loans to African countries to ensure swift implementation of key AHI activities.
In February 2007 the Management Committee for the UN Central Fund for Influenza Action (CFIA) met for the first time. The Committee, chaired by the UN System Coordinator for Animal and Human Influenza, consists of all agencies participating in the UN System Consolidated Action Plan and the World Bank as a permanent observer. The CFIA is now operational with a contribution of USD 2.2 million from Norway. Other donors have expressed interest in contributing and are being approached by UNDP which acts as the Administrative Agent of the Fund. The CFIA is to enable the implementation of critical activities of UN agencies and partners that cannot be adequately funded through bilateral funding or that respond to unforeseen urgencies.
3. Global Readiness to mitigate the societal impact of the next Influenza Pandemic
UNSIC is working towards (a) improved standards of contingency planning by national and local institutions within all countries, (b) effective preparation of humanitarian actors for the effects of an influenza pandemic, (c) measured and documented readiness of the UN system to operate within the context of the next influenza pandemic, and (d) the synergized development of high quality pandemic simulations.
The UN System Pandemic Influenza Contingency (PIC) Support Team
In January, UNSIC ― together with OCHA, UNDP and other UN agencies ― created the UN System PIC Support Team. The PIC Team comprises a small office in Geneva and six Regional Planning Officers posted around the world. This team is an integral part of UNSIC, administered by OCHA and mostly staffed with secondments from donors and UN agencies. The leader of the PIC Support Team, Bill Paton, reports directly to the Coordinator.
The PIC Support Team focuses on a) improving the readiness of the UN at country level to cope with a sudden pandemic, b) assisting UNCTs in supporting national authorities to improve standards of influenza pandemic preparedness by national and local institutions within their countries, and c) preparing the UN system for delivering humanitarian assistance in a pandemic, together with their partners. In doing so, the Team seeks to stimulate a vibrant inter-agency network to support contingency planning outside the health sector in order to mitigate the many impacts of the next influenza pandemic. PIC’s emerging strategy combines the creation of tools to assist the UN and countries in their effort to prepare for a pandemic and of on-line tracking indicators for the measurement of their level of preparedness. A process has been initiated to build consensus among key humanitarian partners ― UN and nonUN alike ― as to how humanitarian assistance can be best delivered in a pandemic. Inter-agency assessment missions in this regard are about to be conducted in selected countries and a brainstorming workshop to review options and establish priorities is set to take place in early May 2007.
Current status of UN System Contingency Planning for the next influenza pandemic
UNSIC, with support from an inter-agency group of experts, is currently undertaking the final round of reviews of the UNCTs’ pandemic contingency plans. So far 35 out of 140 UNCTs have submitted their plans. There is a notable improvement in the way the plans address operational continuity and support to national preparedness response, two areas that had been identified as requiring greater attention in the first round of reviews. It has, however, not proved possible to conclude the intensive phase of country team contingency planning by the end of March 2007 as had been anticipated. The tracking and support system being developed by the PIC Support Team will help UN country teams to move forward with completing the revision of their plans, and testing them through simulations. Realistically, though, this process is unlikely to have been completed before the end of the third quarter of 2007. The PIC tracker will help UNSIC compare preparedness across regions and identify country teams who need intensive assistance. Hence, it will also help with the sustained monitoring of preparedness on a continuing basis.
At UN headquarter level, UNSIC has provided support to ensure that pandemic preparedness is as well addressed, and adequately funded, in Nairobi as in New York and other headquarters. In contributing to the review of preparedness plans in UN system headquarter units, UNSIC has been ensuring that pandemic readiness is integrated into an ongoing function to guarantee operational continuity in the face of major external threats.