New collaborating centre studies pandemic preparedness

WHO

In August 2010, Dr Margaret Chan, WHO Director-General declared the influenza pandemic over. As organizations and governments assess the effectiveness of national and international responses to the pandemic, stakeholders also consider how useful and effective preparedness plans and activities proved to be.

With WHO/Europe, the WHO Collaborating Centre for Pandemic Influenza and Research, based at Nottingham University in the United Kingdom, has undertaken such a study. Its aim was to evaluate how preparedness activities aided the response to pandemic (H1N1) 2009, identifying good practices for the future and areas where continued or additional WHO support is still needed.

Conclusions on pandemic response

The study identified several elements vital to effective pandemic preparedness. Unsurprisingly, these included political support, funding, and multisectoral and interdisciplinary involvement both horizontally and vertically: a pandemic is more than a health issue, and all levels of the system need to own plans as a shared responsibility. “These elements were so widely acknowledged that we can conclude that they should be promoted and promulgated as the cornerstones of future pandemic preparedness activities,” said Professor Jonathan Van-Tam, head of the WHO Collaborating Centre for Pandemic Influenza and Research.

Interviews with a range of stakeholders also revealed less successful elements of preparedness and identified areas for improvement. Future plans must address how to involve frontline health care workers more closely, how to make communications more effective and how to improve the logistics of vaccine distribution.

Finally, the study asked what WHO can do now to continue to support countries in pandemic preparedness. Does it need to continue planning as before or change it radically? Interviewees agreed that WHO needs to take a closer look at the pandemic phases – how they are defined, what messages and actions are linked to each phase, and how to integrate improved flexibility within future plans – to ensure that the designation scale can deal with different levels of pandemic severity.

A final report of the study’s conclusions will be published by the end of 2010.

How the study was conducted

Six randomly selected countries in the WHO European Region with different pandemic preparedness plans, plus Denmark as a pilot country, took part in the study. A total of 49 interviews were conducted with representatives of health ministries and civil emergency-response organizations, public health and regional health care authorities, hospital doctors and general practitioners, resulting in over 90 hours of information.

The participants at a two-day WHO workshop in October 2010 endorsed the conclusions of the study.

WHO Collaborating Centre for Pandemic Influenza and Research

Following several years of close cooperation with WHO/Europe, the Health Protection Research Group of the Division of Epidemiology and Public Health at the University of Nottingham, United Kingdom, was designated a WHO collaborating centre in September 2010.

The Centre includes a team of six full-time staff, six PhD students and many secondees. It conducts research on influenza, and has close links with the United Kingdom Government as part of the country’s influenza advisory apparatus. The Health Protection Research Group was formed in October 2007 as a result of a unique partnership between the Health Protection Agency, East Midlands and the University of Nottingham. “I feel it is a huge honour to have been designated a WHO collaborating centre, and so does my team. It is an honour, but also a significant responsibility to ensure that the arrangement delivers for both sides. To be associated with WHO as a preferred partner is advantageous: it brings prestige to the Centre, and acts as a catalyst for attracting high-calibre staff. I hope that our new status will be fruitful for both parties,” commented Professor Jonathan Van-Tam, head of the Centre.

Professor Van-Tam has worked with WHO since 2004. The Research Group is a magnet for people interested in influenza, and includes several with experience working for and with WHO.

Before the pandemic, Professor Van-Tam undertook several missions for WHO/Europe, mainly to eastern European countries, and ran training sessions for country experts and WHO staff.

“Jonathan is an inspirational teacher and has excellent communication skills. Since an important aspect of our work is knowledge transfer, I was looking for a way to consolidate our collaboration. This became the Collaborating Centre. The evaluation of how countries’ pandemic preparedness aided the response to the pandemic is the first big project with the Centre, and has been extremely fruitful,” said Dr Caroline Brown, programme manager responsible for influenza and other respiratory pathogens at WHO/Europe.

Future collaborative activities include a study on the reasons why health care workers accepted or refused the H1N1 vaccine in both the United Kingdom and the WHO European Region as a whole.