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Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2008; all rights reserved.
Pandemic influenza preparedness in Africa is a profound challenge for an already distressed region: analysis of national preparedness plans
<nobr>Giuseppina Ortu</nobr>, <nobr>Sandra Mounier-Jack</nobr> and <nobr>Richard Coker<sup>*</sup></nobr> Communicable Disease Policy Research Group, Health Policy Unit, Department of Public health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
*Corresponding author. Communicable Disease Policy Research Group, Health Policy Unit, Department of Public health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Tel: +44 (0) 20 7927 2926. Fax: +44 (0) 20 7612 7812. E-mail: richard.coker@lshtm.ac.uk
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<!-- ABS --> A new highly pathogenic strain of influenza virus, H5N1, has<sup> </sup>emerged causing severe outbreaks in poultry and high mortality<sup> </sup>rates when humans are infected. The threat of a new influenza<sup> </sup>pandemic has prompted countries to draft national strategic<sup> </sup>preparedness plans to prevent, contain and mitigate the next<sup> </sup>human influenza pandemic.<sup>
</sup> To evaluate preparedness for an influenza pandemic in the African<sup> </sup>region we analysed African national preparedness plans available<sup> </sup>in the public domain. A data extraction tool, based on a World<sup> </sup>Health Organization checklist for influenza epidemic preparedness,<sup> </sup>was designed in consultation with pandemic influenza planning<sup> </sup>experts and experts on the region's public health challenges.<sup>
</sup> Thirty-five plans were identified and available from 53 African<sup> </sup>countries. Most plans are relatively robust in addressing detection<sup> </sup>and containment of influenza in animals but strategic preparedness<sup> </sup>to respond to pandemic human influenza is weak. In most plans<sup> </sup>communication strategies have been developed with the aim to<sup> </sup>raise awareness of transmission factors and promote hygiene<sup> </sup>measures. By contrast, the human health care sector is ill-prepared.<sup> </sup>Case management, triage procedures, identification of health<sup> </sup>care facilities for patient treatment (including home care and<sup> </sup>provisions for the distribution and administration of pharmaceuticals)<sup> </sup>are poorly addressed by most plans. The maintenance of essential<sup> </sup>services in the event of a pandemic is absent from most plans.<sup>
</sup> Whilst many African countries have strategic pandemic influenza<sup> </sup>preparedness plans, most are developmental in nature and lack<sup> </sup>operational clarity, or focus principally on the containment<sup> </sup>of avian influenza rather than pandemic human influenza. Clear<sup> </sup>strategies, that are operational, need to be developed that<sup> </sup>reflect the realities of national context and resource constraints<sup> </sup>and that meet national objectives. These objectives need also<sup> </sup>to be coherent with international imperatives such that the<sup> </sup>global threat of pandemic influenza can be met effectively and<sup> </sup>efficiently.<sup> </sup>
Key Words: Africa, pandemic influenza, policy
Accepted for publication 4 March 2008.
Pandemic influenza preparedness in Africa is a profound challenge for an already distressed region: analysis of national preparedness plans
<nobr>Giuseppina Ortu</nobr>, <nobr>Sandra Mounier-Jack</nobr> and <nobr>Richard Coker<sup>*</sup></nobr> Communicable Disease Policy Research Group, Health Policy Unit, Department of Public health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
*Corresponding author. Communicable Disease Policy Research Group, Health Policy Unit, Department of Public health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Tel: +44 (0) 20 7927 2926. Fax: +44 (0) 20 7612 7812. E-mail: richard.coker@lshtm.ac.uk
<script type="text/javascript"><!-- var u = "richard.coker", d = "lshtm.ac.uk"; document.getElementById("em0").innerHTML = '<a href="mailto:' + u + '@' + d + '">' + u + '@' + d + '<\/a>'//--></script>
<!-- ABS --> A new highly pathogenic strain of influenza virus, H5N1, has<sup> </sup>emerged causing severe outbreaks in poultry and high mortality<sup> </sup>rates when humans are infected. The threat of a new influenza<sup> </sup>pandemic has prompted countries to draft national strategic<sup> </sup>preparedness plans to prevent, contain and mitigate the next<sup> </sup>human influenza pandemic.<sup>
</sup> To evaluate preparedness for an influenza pandemic in the African<sup> </sup>region we analysed African national preparedness plans available<sup> </sup>in the public domain. A data extraction tool, based on a World<sup> </sup>Health Organization checklist for influenza epidemic preparedness,<sup> </sup>was designed in consultation with pandemic influenza planning<sup> </sup>experts and experts on the region's public health challenges.<sup>
</sup> Thirty-five plans were identified and available from 53 African<sup> </sup>countries. Most plans are relatively robust in addressing detection<sup> </sup>and containment of influenza in animals but strategic preparedness<sup> </sup>to respond to pandemic human influenza is weak. In most plans<sup> </sup>communication strategies have been developed with the aim to<sup> </sup>raise awareness of transmission factors and promote hygiene<sup> </sup>measures. By contrast, the human health care sector is ill-prepared.<sup> </sup>Case management, triage procedures, identification of health<sup> </sup>care facilities for patient treatment (including home care and<sup> </sup>provisions for the distribution and administration of pharmaceuticals)<sup> </sup>are poorly addressed by most plans. The maintenance of essential<sup> </sup>services in the event of a pandemic is absent from most plans.<sup>
</sup> Whilst many African countries have strategic pandemic influenza<sup> </sup>preparedness plans, most are developmental in nature and lack<sup> </sup>operational clarity, or focus principally on the containment<sup> </sup>of avian influenza rather than pandemic human influenza. Clear<sup> </sup>strategies, that are operational, need to be developed that<sup> </sup>reflect the realities of national context and resource constraints<sup> </sup>and that meet national objectives. These objectives need also<sup> </sup>to be coherent with international imperatives such that the<sup> </sup>global threat of pandemic influenza can be met effectively and<sup> </sup>efficiently.<sup> </sup>
Key Words: Africa, pandemic influenza, policy
Accepted for publication 4 March 2008.
