1. Influenza Pandemic: A Threats to Regional and National Health and Development
CSRU, SEARD

2. “Timely production of sufficient vaccines remains the biggest challenge... antiviral production also remains inadequate” Facing up to flu. Editorial. Nature 2012; 482:131 “Ample supply of vaccine was not available until the after the second wave of H1N1 pandemic had subsided” Osterholf MT, Kelley NS. Mammalian-transmissible H5N1 influenza: facts and perspective. MBio 2012

3. YES OR NO, ARE YOU READY FOR A INFLUENZA PANDEMIC?

4. HOW DO YOU KNOW A PANDEMIC-READY NATIONAL SOCIETY WHEN YOU SEE ONE?

5. A PANDEMIC READY NS
Policies and guidelines for Non-Pharmaceutical Interventions at the household and community level
Adapted and updated tools and messages
A functioning network with local stakeholders
Trained human resources in all provinces and districts
Detailed, multi-sectoral pandemic preparedness and response plan
Access to funding

6. Why are we talking about influenza pandemic????
Enormous public health impact of the event
Pandemics are inevitable – occur throughout history at irregular intervals
There will be little warning between onset of a pandemic and it’s arrival
Outbreaks will occur simultaneously in many areas
SEA countries also shares the same risk as many countries do
Recent outbreak of H7N9 and sporadic cases of avian influenza A(H5N1)

7. Border closures & travel restrictions are likely, & may delay spread of the virus, but are unlikely to stop it……

8. World Health Organization
平成31年4月14日
Another Pandemic Is a Matter of History Pandemics have occurred repeatedly for centuries
Pandemics in 20th Century and Circulating Influenza Strains
Influenza pandemic is rare but recurrent events.
In 20th century, we experienced 3 pandemic influenza; Spanish flu in 1918, Asian flu in 1957 and Hong Kong flu in 1968.
In 1918 we had Spanish Flu, which was said that 40 to 50 million were estimated death.
Pandemic influenza seemed to be circulated the world with years cycle, however, after Hong Kong Flu, we haven’t experienced pandemic for 37 years.
This bar shows the major Influenza A subtype by year.
As you see, Spanish flu is caused by H1N1. Asian Flu by H2N2, and today both H3N2 and H1N1 influenza subtype continue to co-circulate.
This change of influenza type imply two things
One: when you have new strain that is the time you have pandemic.
Two : One type can never continue to be major strains and changes at some point.
I don’t know the reason, but some virologist explain as antibody pressure, meaning that gradually many people become immune and at some point they have to change dramatically their antigenic characteristics to survive.
Circulation of multiple influenza A subtypes at the same time is a relatively new phenomenon.
No Pandemic for > 40 years

9. Another Pandemic Is a Matter of Science
World Health Organization
World Health Organization
14 April 2019
平成31年4月14日
Another Pandemic Is a Matter of Science
Constant ongoing changes in influenza virus genes is fundamental process
Mechanism by which animal viruses can adapt to people
Transformation into a "human" influenza virus
Capacity to sustain transmission among humans
Example is community outbreaks of seasonal influenza 9

10. Another Pandemic Is a Matter of Modernization
Modern social conditions favour faster spread & larger pandemics
More international travel
1950: 25 million tourist trips per year
2005: >800 million
20 fold increase in trade
Larger domesticated animal populations
Larger cities with bigger populations

11. Public health Intervention Surge-generating event
Pandemic Preparedness
Baseline demand
Outcomes
Public health Intervention
Surge capacity
Surge in demand
Surge-generating event
Outputs
Direct health impact
(morbidity,mortality)
Indirect health impacts

12. Avoidable deaths and potential gains through resource increases
Given actual resource capacity
Cumulative pandemic deaths
If sufficient resource capacity
Time

13. What we are planning?

14. Pandemic Influenza Preparedness Program Targeted Communities
Activities at Country Level
Country preparedness and contingency Plan
Community based Interventions
Advocacy campaign
Capacity Building
Mass and Social Media
Pandemic Influenza Preparedness Program
Program Initiation
Program Planning
Program Implementation
Program Evaluation and Impact
Development of Regional Standard Operating Procedure
Technical support and Guidance
Coordination and Networking
Targeted Communities
Activities at Regional Level
Pandemic Preparedness Network
Advocacy and Partnership
Knowledge Management
Updating tools and roster

15. Thank You