Background In May 2003, the Chief Executive announced that the Government had begun to study the establishment of a CDC – like organisation in Hong Kong SARS Expert Committee ’ s Report released in Oct 2003 recommended the establishment of a Centre for Health Protection (CHP)

Health Protection Health protection is about the measures that public health authorities and others take to protect the population from communicable diseases and other public health hazards (Report of the SARS Expert Committee 2003 )

What differences will CHP make?

International and Mainland authorities Hospital Authority/ Private hospitals and practitioners Community Universities DH Existing Interface Gaps

Legislation SurveillanceScience Effective Health Protection System Risk Management Programme Development Source: Health Protection for the 21st Century, Health Canada

SCOPING Assessment of potential building blocks of health protection SCIENCE Support of a network of laboratories Laboratory enhancement Science-based practice SURVEILLANCE Strengthening of epidemiology as the core competency Enhanced surveillance EMERGENCY RESPONSE Multi-disciplinary emergency response Centralisation of field epidemiology services Strengthening of risk communication LEGISLATION Review of legislation in communicable disease control PROGRAMMME DEVELOPMENT Set up specialised health protection programmes Centre for Health Protection Public Health Laboratory Services Surveillance & Epidemiology Branch Emergency Response ＆ Information Branch Public Health Services Infection Control Branch Programme Management and Professional Development Branch EXPERTISE DEVELOPMENT Reorganisation of public health training Strengthening of field epidemiology as the core business for investigation, analysis and rapid response capability RESEARCH SUPPORT Incorporation of applied research INTERNATIONAL COLLABORATION Coordination in Pearl River Region Networking with international partners Review of mandate Promotion of standards

Organisation of CHP EMERGENCY RESPONSE AND INFORMATION BRANCH SURVEILLANCE & EPIDEMIOLOGY BRANCH PUBLIC HEALTH LABORATORY SERVICES PUBLIC HEALTH SERVICES INFECTION CONTROL BRANCH Controller, CHP PROGRAMME MANAGEMENT & PROFESSIONAL DEVELOPMENT BRANCH Director of Health

New functional elements Epidemiology Unit CD Surveillance Unit Emergency Response and Information Branch Programme Management and Professional Development Branch Infection Control Branch Health Protection Programmes for targeted diseases Existing services to be incorporated Regional Offices Disease Prevention and Control Division Central Health Education Unit TB & Chest Service Social Hygiene Service Special Preventive Programme Pathology Service

Hospital Authority / Private Hospitals & Practitioners Epidemic Intelligence Communicable Disease Notification Training Attachment Programmes Communicable Disease Information System Health Protection Programmes for targeted diseases Infection Control Multi-disciplinary Emergency Response Risk Communication Standardisation of Infection Control Practice Population Based Programmes Health Education Programmes Professional Development Multi-disciplinary Emergency Response Appointed Collaboration Centres Health Protection Programmes for targeted diseases CHP International & Mainland authorities Universities Community

Strengths of CHP Three Rs: Real-time surveillance Rapid intervention & resolution Risk communication

Functional Branches

Surveillance & Epidemiology Branch FUNCTIONS Use contemporary IT programmes and infrastructures to collect, collate, analyse and disseminate surveillance data on notifiable diseases and other communicable diseases Establish a central communicable disease information system Manage & respond to communicable disease outbreaks and develop control measures Mastermind a surveillance system for GD-HK-Macao and focus on the situation of communicable diseases in PRDR FACILITIES Epidemiology Unit and its Outbreak Teams Data Management Centre Communicable Disease Surveillance Unit

Priority issues Enhance comprehensiveness and sensitivity of disease surveillance E-Notification platforms for physician reporting Centralised notification system for receiving reports of institutional outbreaks Emerging infections surveillance network Expanded surveillance network: local and international

Priority issues Strengthen Epidemiology and surge capacities Epidemiology as core public health training Set up structured Epidemiology Training Programme for specialist development Exchange programmes and training for dealing with emerging pathogens Training for supporting professionals and public health partners

Infection Control Branch FUNCTIONS Develop, promulgate and evaluate best practices in infection control at health care and non-health care settings Coordinate, facilitate and support training in infection control for all levels of health care workers Support epidemiological investigation of nosocomial infections in hospital Conduct surveillance on infection hazards in health care and non-health care setting Set up epidemiology and infection control units in five major public hospitals FACILITIES Simulation Room Epidemiology and Infection Control Units

Expert Committees Technical Support Division Clinical Consultation & Investigation Division Branch Head Advisory Office Senior MicrobiologistSenior EpidemiologistSpecialist in ID Surveillance & Research Division Training programmes

Interface in Infection Control Practices Expert Panel on Infection Control CHP Infection Control Branch Recommendations Training programmes Training & technical support Advisory Office hospital-based Epidemiology and Iinfection Control Units Coordinating body Infection control committee

QMH QEH PWH TMH PMH Epidemiology and Infection Control Unit

Emergency Response & Information Branch FUNCTIONS Overall corporate planning Co-ordinate emergency response on a community/territory-wide basis Contingency planning Overall risk communication strategy Update information system needs Facilitate the development of preventive strategy and cross-sector logistic support Develop contingency plans and arrange drills FACILITIES Emergency Response Centre

Crisis Communication Lifecycle PrecrisisInitialMaintenanceResolutionEvaluation Be prepared. Foster alliance. Develop consensus recommendations. Test message. Acknowledge the event with empathy. Explain and inform the public in simplest forms, about the risks. Establish agency/ spokes-person credibility. Provide emergency courses if action (including how/ where to get more information). Commit to stakeholders and public to continued communication. Help public more accurately understand its own risks. Provide background and encompassing information to those who need it. Gain understanding and support for response and recovery plans. Listen to stakeholder and audience feedback, and correct misinformation. Explain emergency recommendations. Empower risk/ benefit decision-making. Improve appropriate public response in future similar emergencies through education. Honestly examine problems and mishaps, and then reinforce what worked in the recovery and response efforts. Persuade the public to support public policy and resource allocation to the problem. Promote the activities and capabilities of the agency (corporate identity reinforced- internally, too) Evaluate communication plan performance. Document lessons learned. Determine specific actions to improve crisis systems or the crisis plan. (Source: Crisis, Emergency & Risk Communication, CDC)

Public Health Services FUNCTIONS Support the control of communicable diseases in the community (TB, HIV, STI) Contribute to the surveillance of communicable diseases in Hong Kong Provide specialised clinical services Provide communicable disease treatment services Consist of TB and Chest Service, Social Hygiene Service and Special Preventive Programme FACILITIES Specialist Clinics Public Health Units

Priority issues To evaluate and improve the notification and reporting systems for STI, TB and HIV/AIDS To explore the role of information technology on surveillance and intersectoral coordination in relation to the above diseases To facilitate the training and interchange of expertise between the public health stream and the clinical stream

Public Health Laboratory Services FUNCTIONS Provide pathology service for communicable disease surveillance and control Provide laboratory support for outbreak investigations Develop infection control standards in laboratory settings Train microbiologists and infection control professionals for laboratory services Collaboration with laboratories in HA, AFCD, Govt Lab, local universities and overseas agencies FACILITIES Public Health Laboratory Centre

Priority issues To introduce new laboratories to improve investigative capacity, including the laboratories for antimicrobial resistance surveillance, molecular virology, etc. To develop and evaluate new test and optimize current tests for earlier laboratory confirmation of SARS CoV and shorten turn around time

Priority issues To strengthen the networking and coordination with local universities, HA and other health care institutions on laboratory research and support of communicable diseases control To enhance training for medical, scientific and technical staff

Programme Management & Professional Development Branch FUNCTIONS Coordinate and organise training activities for medical and nursing professionals of CHP, HA and other institutions Liaise with local and international institutions to arrange attachment and exchange programmes Carry out and coordinate research, including research projects in collaboration with universities, HA and other government departments Manage health protection programmes Coordinate with various advisory committees Undertake health promotion activities FACILITIES Library, IT facilities Training Office Research Office

Health Protection Programmes

Health Protection Programmes for targeted diseases/ health hazards Three Dimensions Multidisciplinary approach and intersectoral participation Prevention – intervention continuum Sustainable development

S & E ER & I PHLS PHS IC Controller, CHP Hospital XUniversity P CHP Scientific Committee for HP Programme B CHP Core Group for HP Programme A Advisory Committee Expert members Programme lead Programme lead HP Programme organisation

Implementation Milestones

Dec 2003 – Jan 2004 Consultations with stakeholders on the establishment of CHP

Mid 2004 To establish CHP under a transitional stage Appointment of Controller, CHP Establishment of the Surveillance & Epidemiology Branch & Infection Control Branch Enhancement of Multi-disciplinary Emergency Response Mechanism Endorsement of Manpower Enrichment / Redeployment Plan

2005 All functional elements of CHP to operate smoothly, including Implementation of CD information system (by phases) Implementation of manpower plan CHP IT platform in place (e.g. e- notification system, case notification system)

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