UN System Influenza Coordination (UNSIC) PROGRESS REPORT 1st January !

"t# $%ril &""' INTRO(UCTION The period January - April 2007 witnessed new outbreaks of the Highly Pathogenic Avian nfluen!a "HPA # virus H$%& in poultry in 'any parts of the world( Afghanistan) *angladesh) +a'bodia) +hina) ,gypt) Hong -ong) Hungary) ndonesia) Japan) -uwait) .aos) /yan'ar) %igeria) Pakistan) 0ussia) 1audi Arabia) 1outh -orea) Turkey) 2- and 3ietna'4 As this report is being finali!ed) HPA is also being suspected in 5hana4 The upsurge in reported outbreaks of HPA does not co'e as a surprise as it follows the sa'e pattern as previous years in which there has been an increase in the virus spread during the period 6ece'ber to April4 Hu'an H$%& cases have been confir'ed in +hina) ,gypt) ndonesia and) for the first ti'e) in +a'bodia) .aos and %igeria4 There have been no reports of sustained hu'an-to-hu'an trans'ission of the virus( the 7orld Health 8rgani!ation "7H8# pande'ic alert phase re'ains at phase 94 1everal countries " ndonesia) ,gypt and %igeria# are currently of special concern as the virus is en!ootic "i4e4 per'anently present# in so'e of their poultry4 +ountries facing ongoing outbreaks - such as -uwait) Afghanistan) Pakistan and *angladesh - are paying particular attention to the need to sta'p out HPA infections to prevent the disease fro' beco'ing en!ootic4 n January) 2%1 + developed a list of priority outco'es for 2007) drawing on the conclusions of the 6ece'ber 200: *a'ako +onference on Avian and Hu'an nfluen!a "AH # and on outputs of the 2% 1yste' +onsolidated Action Plan for AH of %ove'ber 200:4 2%1 + tea' 'e'bers are working with the 2% agencies) funds and progra''es and their partners to ensure that they contribute to these outco'es in a synergi!ed 'anner( "a# coordinated inter-agency action in line with the Action Plan "b# successful intergovern'ental processes on AH at global and regional level; "c# review of AH strategies and identification of best practices for effective i'ple'entation; "d# coordinated AH co''unications; "e# tracking and analysis of the global AH response and the progress 'ade by individual countries; "f# synergi!ed 2% syste' contribution to country AH action;

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UN System Influenza Coordination (UNSIC) PROGRESS REPORT 1st January !"t# $%ril &""'

"g# longBter' co''it'ent of resource providers to the adeCuate funding of global AH activities and "h# syste's for assisting national) regional and global institutions so that they are ready to 'itigate the social) econo'ic) governance and hu'anitarian i'pacts of the ne@t influen!a pande'ic4 This co'ple'ents ongoing international efforts to prepare the health sector for effective action in different pande'ic phases B in line with the newly agreed nternational Health 0egulations " H0# 200$4 The present report gives account of 2%1 +Ds work in the first four 'onths of 2007 in relation to these priority outco'es4 1) Coordinated Intera*en+y $+tion

Interagency Coordination 6uring the period covered by this report) different 2% speciali!ed agencies "notably ?A8 and 7H8) but also 2%7T8) +A8 and .8#) funds "including 2% +,?#) progra''es "specifically 2%6P) 7?P and 2%H+0#) coordinating bodies "such as 8+HA and 2%65# and their partners "including the 8i,) 7orld *ank) ?0+ and 8/# have taken forward their co''it'ents to support national) regional and global AH efforts4 ?or 'ost of these organi!ations the co''it'ents are spelt out in the Consolidated UN System Action Plan "http(EEwww4undg4orgEinde@4cf'FPGA7>#4 ?A8 and 8i, have led on ani'al health work) with ?A8 reorgani!ing its capacity to respond on ani'al health issues to take account of the 'any fold increase in the de'ands being faced "reflected in increasing nu'bers of staff involved and levels of funds being handled#4 7H8 led on hu'an health work) specifically on global surveillance of HPA virus infections in hu'ans) develop'ent of contain'ent strategies and options for i'proving access to pande'ic vaccines4 7hile both ?A8 and 7H8 devised co''unication 'essages) 2% +,? "benefiting fro' generous Japanese 5overn'ent 1upport# has led in developing co''unications 'aterials to support 'obili!ation of societies to change poultry rearing and hygiene behaviours "and so reduce ani'al to hu'an transfer of HPA #4 The Technical Working Group (TWG) on In luen!a and the "eputy Secretary# General$s Steering Committee on In luen!a have 'et to review progress and discuss the way forward4 n the T75) participants worked on the 5eneral Principles for 2% 1yste' 8perations in the event of a pande'ic "prepared by 2%1 +#) and reco''ended their endorse'ent by the 1teering +o''ittee4 /e'ber agencies of the 1teering +o''ittee e'phasi!ed their continued co''it'ent to have 2% country progra''e contingency plans finali!ed and i'ple'entable as soon as possible4 They have been involved in defining priorities for 2%1 +Ds activities in 2007) highlighting the co'pletion of the intensive phase of contingency planning and the coordination of AH co''unications4

UN System Influenza Coordination (UNSIC) PROGRESS REPORT 1st January !"t# $%ril &""'

Coordination at country le%el 2%1 +) Hointly with the 7orld *ank) issued a Study on Coordination o A%ian and &uman In luen!a Acti%ities "http(EEwww4undg4orgEinde@4cf'FPGA7I# which analy!es current coordination 'echanis's in countries facing AH threats4 The 1tudy also e@a'ines advantages and disadvantages of different coordination arrange'ents and proposes best practice principles to pro'ote better synergy for the i'ple'entation of AH activities4 As a follow-up to the 1tudyDs reco''endations) 2%1 + is currently developing tools that reflect the strengths of different 2% syste' bodies in-country and that will help country tea's i'prove coordination of e@ternal assistance4 Support to coordination in Asia n Asia) the new head of the 2%1 + Asia Pacific 0egional Hub "AP0H# in *angkok) /s4 Annu .ehtinen) has taken up her position on /arch 2:th 2007 to continue the valuable work of /s4 Anne Ancia4 /s4 .ehtinen reports to the 1enior 2% 1yste' +oordinator for Avian and Hu'an nfluen!a4 6uring the period covered by this report) staff in the AP0H contributed to the success of consultations organi!ed by partners on the regional response to A ) pande'ic preparedness and business continuity4 These include the AP,+ Health Task ?orce 'eeting) an A1,A% workshop on HPA control and eradication) a si'ulation e@ercise organi!ed by the /ekong *asin 6isease 1urveillance "/*61# and a 7H8 'eeting on cross border issues4 n January) AP0H tea' 'e'bers visited /ongolia to assist in the develop'ent of a national contingency plan and facilitated the +oordinatorDs visit to ndonesia) Thailand and +hina4 They also convened a regional 'eeting with representatives of 2% agencies and partners to e@change infor'ation on the current AH situation and to solve challenges related to infor'ation sharing) co''unication and i'ple'entation of strategies4 2% syste' country level coordinators for influen!a were newly appointed in ndonesia "Jonathan Agranoff B full ti'e# and +hina "Henk *ekede') 7H8 representative B part ti'e#4 Intensi%e Support or National Coordination (Nigeria' (gypt) At the reCuest of %igeriaDs 2% 0esident +oordinator and the %ational 5overn'ent an 2%1 + tea' 'e'ber supported the 2% +ountry Tea' "2%+T# as it assisted the 5overn'ent to finali!e its integrated national AH plan4 The final draft plan) which was for'ally received by the /inister of Health on 27 /arch) focuses on state-centre and livestock-health relations and addresses ways in which to ensure effective i'ple'entation of strategies4 1i'ilarly) at the reCuest of the %ational 5overn'ent and 0esident +oordinator in ,gypt an 2%1 + tea' 'e'ber spent several weeks in +airo to support the 0esident +oordinatorDs 8ffice in assisting the 5overn'ent to prepare its integrated national plan on AH 4 The plan is now finali!ed and work is underway with the 5overn'ent) donor agencies and the 7orld *ank to ensure that financial and technical assistance for its i'ple'entation starts to flow4

UN System Influenza Coordination (UNSIC) PROGRESS REPORT 1st January !"t# $%ril &""'

&)

Inter*o,ernmental Pro+esses

At the fourth inter-govern'ental conference on Avian and Pande'ic nfluen!a in *a'ako "6ece'ber 200:#) participants agreed that the ne@t such progress review 'eeting would take place in 6elhi "at the invitation of the 5overn'ent of ndia# at the end of 20074 They also reCuested the speciali!ed agencies to convene a technical 'eeting in 'id 2007 to review current strategies in response to avian influen!a and to the threat of a hu'an pande'ic4 The nternational Partnership on Avian and Pande'ic nfluen!a " PAP # and the ndian 5overn'ent) with 2%1 + involve'ent) have initiated the preparatory process leading to the "elhi International Con erence which is now set to take place on A-: 6ece'ber 20074 This process includes a preli'inary 'eeting between 'e'bers of the PAP core group and the ndian 5overn'ent in June and proposed follow-up work B including detailed planning - in 1epte'ber4 As in previous events) 2%1 + offers to assist with ensuring a coordinated 2% syste' contribution to this key event4 ?A8) 8 , and 7H8) with support fro' 2% +,? and 2%1 +) are organi!ing the Technical )eeting or A%ian and &uman In luen!a Strategic *e%ie+ and ,est Practice which is set to take place in 0o'e on 27 - 2> June 20074 This 'eeting will assess and evaluate progress and i'pacts of strategies being i'ple'ented to control HPA and to prepare for the ne@t hu'an influen!a pande'ic4 t will also review ways in which strategy i'ple'entation is supported at national) regional and global level and identify priorities and ways forward4 The agenda is now being finali!ed and provides for the participation of e@perts fro' ?A8) 8 ,) 7H8) the 7orld *ank and other 2% agencies) funds and progra''es4 ,@perts fro' donor agencies will also be invited4 *elations +ith *esource Pro%iders 6uring the period covered by the report) 2%1 + has 'aintained regular dialogue with resource providers including the 7orld *ank) the Asian 6evelop'ent *ank) the ,uropean +o''ission and the 5overn'ents of Australia) +anada) %orway) the 2nited -ingdo' and the 2nited 1tates4 The 2% 1yste' +oordinator visited 5er'any) the current ,2 presidency) to discuss har'oni!ation of approaches to AH responses4 0egarding financial needs for AH work in Africa) 2%1 + is working with the 7orld *ank to follow up on outco'es of the *a'ako +onference) including the pro'pt disburse'ent of e@isting grants and loans to African countries to ensure swift i'ple'entation of key AH activities4 n ?ebruary 2007 the /anage'ent +o''ittee for the UN Central -und or In luen!a Action (C-IA) 'et for the first ti'e4 The +o''ittee) chaired by the 2% 1yste' +oordinator for Ani'al and Hu'an nfluen!a) consists of all agencies participating in the 2% 1yste' +onsolidated Action Plan and the 7orld *ank as a per'anent observer4 The +? A is now operational with a contribution of 216 242 'illion fro' %orway4 8ther donors have e@pressed interest in contributing and are being approached by 2%6P which acts as the Ad'inistrative Agent of the ?und4 The +? A is to enable the i'ple'entation
A

UN System Influenza Coordination (UNSIC) PROGRESS REPORT 1st January !"t# $%ril &""'

of critical activities of 2% agencies and partners that cannot be adeCuately funded through bilateral funding or that respond to unforeseen urgencies4 !) Glo-al Readiness to miti*ate t#e so+ietal im%a+t of t#e ne.t Influenza Pandemi+

2%1 + is working towards "a# i'proved standards of contingency planning by national and local institutions within all countries) "b# effective preparation of hu'anitarian actors for the effects of an influen!a pande'ic) "c# 'easured and docu'ented readiness of the 2% syste' to operate within the conte@t of the ne@t influen!a pande'ic) and "d# the synergi!ed develop'ent of high Cuality pande'ic si'ulations4 The UN System Pandemic In luen!a Contingency (PIC) Support Team n January) 2%1 + J together with 8+HA) 2%6P and other 2% agencies J created the 2% 1yste' P + 1upport Tea'4 The P + Tea' co'prises a s'all office in 5eneva and si@ 0egional Planning 8fficers posted around the world4 This tea' is an integral part of 2%1 +) ad'inistered by 8+HA and 'ostly staffed with second'ents fro' donors and 2% agencies4 The leader of the P + 1upport Tea') *ill Paton) reports directly to the +oordinator4 The P + 1upport Tea' focuses on a# i'proving the readiness of the 2% at country level to cope with a sudden pande'ic) b# assisting 2%+Ts in supporting national authorities to i'prove standards of influen!a pande'ic preparedness by national and local institutions within their countries) and c# preparing the 2% syste' for delivering hu'anitarian assistance in a pande'ic) together with their partners4 n doing so) the Tea' seeks to sti'ulate a vibrant inter-agency network to support contingency planning outside the health sector in order to 'itigate the 'any i'pacts of the ne@t influen!a pande'ic4 P +Ds e'erging strategy co'bines the creation of tools to assist the 2% and countries in their effort to prepare for a pande'ic and of on-line tracking indicators for the 'easure'ent of their level of preparedness4 A process has been initiated to build consensus a'ong key hu'anitarian partners J 2% and non-2% alike J as to how hu'anitarian assistance can be best delivered in a pande'ic4 nter-agency assess'ent 'issions in this regard are about to be conducted in selected countries and a brainstor'ing workshop to review options and establish priorities is set to take place in early /ay 20074 Current status o UN System Contingency Planning or the ne.t in luen!a pandemic 2%1 +) with support fro' an inter-agency group of e@perts) is currently undertaking the final round of reviews of the 2%+TsD pande'ic contingency plans4 1o far 9$ out of &A0 2%+Ts have sub'itted their plans4 There is a notable i'prove'ent in the way the plans address operational continuity and support to national preparedness response) two areas that had been identified as reCuiring greater attention in the first round of reviews4 t has) however) not proved possible to conclude the intensive phase of country tea' contingency planning by the end of /arch 2007 as had been anticipated4 The tracking

UN System Influenza Coordination (UNSIC) PROGRESS REPORT 1st January !"t# $%ril &""'

and support syste' being developed by the P + 1upport Tea' will help 2% country tea's to 'ove forward with co'pleting the revision of their plans) and testing the' through si'ulations4 0ealistically) though) this process is unlikely to have been co'pleted before the end of the third Cuarter of 20074 The P + tracker will help 2%1 + co'pare preparedness across regions and identify country tea's who need intensive assistance4 Hence) it will also help with the sustained 'onitoring of preparedness on a continuing basis4 At 2% headCuarter level) 2%1 + has provided support to ensure that pande'ic preparedness is as well addressed) and adeCuately funded) in %airobi as in %ew <ork and other headCuarters4 n contributing to the review of preparedness plans in 2% syste' headCuarter units) 2%1 + has been ensuring that pande'ic readiness is integrated into an ongoing function to guarantee operational continuity in the face of 'aHor e@ternal threats4 2%1 + drafted and secured agree'ent on 5eneral Principles for 2% 1yste' 8perations which identify how the different ele'ents of the 2% syste' will work with each other and with 'e'ber states in the event of a pande'ic4 These broad principles) due to be endorsed by the 2% 1teering +o''ittee on nfluen!a in early /ay 2007) will be the basis for the drafting of a 'ore detailed and prescriptive +oncept of 8perations "+8%8P1#4 The synergi!ed de%elopment o high /uality pandemic simulations n order to test basic assu'ptions of the 2%+T plans and to identify possible gaps) 2%1 + has developed si'ulation 'aterials and 'ade the' available to 2%+Ts on its website4 2%1 +) in close cooperation with a private sector partner) has also developed a set of pande'ic si'ulation 'aterial for a larger audience) including national authorities) the 'edical sector) 2% agencies) %58s and various branches of the private sector4 A two-day workshop was held in 0o'e in ?ebruary to pre-test this 'aterial4 1everal 2% agencies) including 7H8) 2% +,? and 7T8) have conducted si'ulation e@ercises with obHectives ranging fro' awareness raising to testing basic assu'ptions on pande'ic plans and conducting specific drills to test aspects of operational continuity4 These si'ulations have proven to be very useful to identify potential weaknesses) and have presented opportunities to practice inter-agency coordination for the event of a pande'ic4 /) Tra+0in* and Re%ortin* on %ro*ress

The 2% and 7orld *ank co'pleted their second report analysing the i'pact of efforts "at global) regional and national level# to address avian influen!a threats and prepare for the ne@t pande'ic4 This progress report B titled *esponses to A&I Threats0 1uly to "ecem2er 3445 "http(EEwww4undg4orgEinde@4cf'FPG2>I# B also provides a global overview of e@penditure of funds and related gaps and needs) with updated details on pledges 'ade during the *a'ako +onference4

UN System Influenza Coordination (UNSIC) PROGRESS REPORT 1st January !"t# $%ril &""'

A new 'echanis' for data collection and analysis is being devised by 2%1 +E P + tea' to facilitate the tracking of progress and should be operational in ti'e to contribute to the third 2% and 7orld *ank Progress 0eport now being developed for period January to July 20074 1) Coordination of Communi+ation

+o''unications on influen!a issues covers( "a# 8utbreak +o''unications about both avian influen!a in poultry and hu'an cases of avian or pande'ic influen!a B this calls for precise protocols and identified spokespersons with clear responsibility and accountability) "b# +o''unication support for efforts to 'obili!e societies "and groups within societies# to appreciate the risks associated with AH and change their behaviour in ways that reduce these risks B this calls for longer ter') sustained invest'ent in co''unications work) dovetailed to progra''e activities and incentives) and "c# The effort to synergi!e the work of different 2% syste's agencies and their partners B this calls for open) responsive and efficient co''unications channels between focal persons in different agencies4 t includes the sharing of infor'ation about 'eans to ensure the health and safety of 2% syste' personnel and continuity of essential operations in the event of a pande'ic4 The 2% 1yste' +oordinator has encouraged consistency) synergy and coordination of co''unications fro' within the 2% syste' in all these areas4 The coordination is undertaken in a way that per'its individual agencies and offices to have whatever visibility is desirable) but which encourages the' to use an agreed and co''on series of 'essages and interpretations) to be reflected B to the e@tent possible - in national and international co''unication 'edia4 To this end) 2%1 + is currently also reva'ping the 2% portal for AH "influen!a4un4org# so as to 'ake it 'ore interactive4 2%1 + has recently been supported in its efforts on co''unication by a new staff 'e'ber 'ade available to the tea' on a part-ti'e basis by the 2% 6epart'ent of nfor'ation "6P #4 1peciali!ed agencies have been very active in their respective areas of AH co''unication since the beginning of the year( 7H8 organi!ed a +onference on Pande'ic nfluen!a +o''unications in +airo on &9-&$ /arch) ?A8 and 8 , a 'eeting on Ani'al Health +o''unications in 0o'e on &:-&> April) and 2% +,? the 2nd nteragency 0egional /eeting on 1trategic +o''unication on AH in Pana'a +ity on 2A April4 A further stocktake of co''unication for social 'obili!ation will take place in /ay 20074 These results-oriented 'eetings contribute to the sharpening of co''unications strategies and synergi!ed i'ple'entation by different 2% agencies and other stakeholders4

UN System Influenza Coordination (UNSIC) PROGRESS REPORT 1st January !"t# $%ril &""'

To the sa'e end) 2% 6P is convening the 2% inter-agency co''unications group on influen!a "2%+5#4 At its 'eeting of A April) the 5roup) initially co'posed of 7H8) ?A8) 2% +,?) 2%6P) 2%1 + and 6P ) e@tended 'e'bership to all agencies contributing to the 2% 1yste' Action Plan4 8n 2: April) the 5roup conducted an interagency si'ulation e@ercise on co''unications in the event of a pande'ic with the obHective of gaining insight into each agencyDs roles) responsibilities and procedures for co''unications coordination4 This tabletop e@ercise linking &9 2% and non-2% bodies in $ locations was facilitated by 7H8 and 6P 4 The findings of the si'ulation will be discussed in a follow-up 'eeting in order to analy!e obstacles of co''unication coordination a'ong 2% agencies and its partners and identify opportunities for i'prove'ent4 2 Con+lusions

The 2% 1yste' +oordinator and the 2%1 + tea' continue to function as a s'all catalytic group encouraging different 2% syste' entities fro' three centres of operation B *angkok) 5eneva and %ew <ork) together with si@ regional focal points4 The tea' now has sufficient 'e'bers to deliver what is e@pected of the'( it is vital that the 2% syste' and partners take advantage of this opportunity to prepare adeCuately for the e'ergence of a virus capable of sustained hu'an-to-hu'an trans'ission4 8nce that virus does e'erge it will be too late to prepare4 /uch has already been achieved) but a great deal 'ore needs to be done if the world is to respond effectively to the continuing spread of Highly Pathogenic Avian nfluen!a and be ready to 'itigate the ne@t influen!a pande'ic4