Group 1 report to the plenary 3 rd NIC Meeting, WPR-SEAR

Objective 1: Need to strengthen surveillance Surveillance strategy was adapted to the changing pandemic phase in all countries: Attempts and challenges faced in monitoring severity Serological surveillance

Objective 2: Need to strengthen NIC contingency planning Q4:Existance of NIC contingency plan and how have NICs handled increased workload – So far, amongst the developing countries only Thailand has NIC contingency plan – BSL level required will affect greatly the contingency plan.

Objective 3: Need for timely shift from containment to mitigation and identify possible public health measures Q6:Mitigation measures implemented so far – Public education on personal hygiene. Modalities: – School-based hygiene education done in Thailand and Fiji. – Media campaign in Australia. Contents: – Cough etiquette – Staying at home when sick – Hand-washing – Mask wearing (in some countries) – School closure Many countries applied it despite some perceived it as ineffective. Some countries applied in context of containment. Destructive consequence in some countries.

Objective 3: Need for timely shift from containment to mitigation and identify possible public health measures Q7:Decision making process in applying public health measures e.g. school closure – Resource stretch triggered alteration from containment to mitigation. – National level made the decision on who to prioritize in antiviral Tx, hygiene practices, school closure, etc. in Australia. – MOH decided initial school closure in Malaysia but the direction altered afterward to let each school to decide. Q8:Experiences and lessons learned from public health measures application – Fiji ; sugar production company was engaged in hygiene practices while they maintain their productive capacity (major economy on the island). – Over-reaction to media campaign experienced in Australia.

Objective 3: Need for timely shift from containment to mitigation and identify possible public health measures Q9:Primary concerns, needs and priorities in coming months – Stock piling of not only antivirals but also antibiotics and other pharmaceuticals pose concern to developing nations. – Zanamivir stock pile in preparation of resistance. Influenza virus develop resistance to zanamivir less frequently. – WHO has set no definite standard of what to stockpile to what extent.

Objective 4: Need for regional influenza information sharing mechanism Q10:Needs of knowing other countries’ information – Virus spread does not observe national boundary. – Neighboring countries’ measures affect the epidemiology of a certain country. – Optimal use of internet technology for information sharing expected. – Information overflow is also posing a problem.

Objective 4: Need for regional influenza information sharing mechanism Q11:Necessity of regional influenza information sharing mechanism Needs: Information sharing through IHR system does not capture seasonal influenza. Monitoring non-pandemic strains is essential particularly for updating the candidate vaccine virus. Periodical regional updates and discussion will be necessary to move forward in pandemic response. Points to consider Feedback should be quick since the evolution of the situation is rapid. WHO CC feedback to NICs intended/PAC-Net in place and considered useful. Regional mechanism may be prone to the level of transparency of the surveillance of each country. Epidemiological and laboratory data matching is difficulty even in-country (expect regional mechanism to facilitate link?)

Other proposals and feedbacks Country-specific rather than generic WHO guidance was proposed by some countries (Maybe more the MOH responsibility?). NICs face challenge on how to communicate interpretations of the surveillance data in-country (e.g. CFR or number of deaths that provoked lots of public queries and concerns).