WHO urges countries to scale up preparedness for next pandemic

With the WHO European Region still lagging behind in its preparations to face the next influenza pandemic – only a third of the Region’s 53 countries have revised their national pandemic preparedness plans – WHO/Europe is urging countries to scale up their efforts.

“Much progress has been made since the 1918–1919 pandemic that caused up to 50 million deaths worldwide. Since then, landmark discoveries such as antibiotics and influenza vaccines, better health systems and living conditions have equipped us with stronger weapons to fight the deadly disease,” says Dr Caroline Brown from WHO/Europe, High Threat Pathogens. “However, we do not know when the next pandemic will hit and how bad it will be. So we need to scale up efforts and be ready no matter when it hits, how severe it is and how fast it spreads.”

Looking back at the 1918–1919 and 2009 pandemics

A century ago, the 1918–1919 influenza pandemic caused an estimated 20–50 million deaths globally. About 2.64 million of those deaths occurred in countries now part of the European Union. The high death toll was due to a number of factors, such as the virulence of the virus, the mass movement of people during the First World War and the lack of antibiotics to treat pneumonia.

In the recent 2009 pandemic, the estimated deaths were 100 times lower, between 150 000 and 580 000. While improved health systems preparedness contributed to the reduced number of deaths, the 2009 pandemic was not as virulent as the previous one.

However, there are similarities too: in both pandemics, most deaths occurred in young and otherwise healthy adults, as well as in groups usually at higher risk of complications, such as young children and elderly people. In the aftermath of the 2009 pandemic, the Review Committee of the International Health Regulations (IHR) concluded that “the world is ill-prepared to respond to a severe influenza pandemic or to any similarly global, sustained and threatening public-health emergency”.

Collaboration for effective surveillance and preparedness

In recognition of influenza's potential for catastrophic impact, the Global Influenza Surveillance and Response System (GISRS) was established just 4 years after the WHO constitution came into force. In the 65 years since then, the GISRS has supported timely and effective global collaboration in the area of influenza. In addition, European Region influenza networks have been contributing to global surveillance since 1996 and, for the past decade, the influenza network has comprised 50 out of the European Region’s 53 Member States.

Following the most recent pandemic, the Pandemic Influenza Preparedness Framework was established in 2011 to ensure that countries share influenza viruses with WHO. In return, those most in need receive benefits such as capacity-building, including support in developing national pandemic preparedness plans.

However, only 16 Member States in the European Region have published updated plans since the 2009 pandemic.

The coming 6th Joint WHO/Europe–European Centre for Disease Prevention and Control (ECDC) Annual European Influenza Surveillance Meeting in Copenhagen, Denmark on 6–8 June will acknowledge the work and dedication of the regional influenza network in combatting influenza, and will call on all countries to contribute to European Region and global health security by developing pandemic preparedness plans according to international standards. “Until everyone is safe, no one is,” concludes Dr Brown.