1. -NEW EDUCATIONAL PATWAY FOR GLOBAL PUBLIC HEALTH SECURITY- (1) South Eastern Europe (SEE) PUBLIC HEALTH PREPAREDNESS SUPERCOURSE NETWORK Elisaveta Stikova, Ronald LaPorte, Faina Linkov, Margaret Potter, David Piposzar, Sam Stebbins

2. SEE Public Health Preparedness Supercourse Network Learning objectives Enlighten public health importance of disasters Increase knowledge about epidemiological aspects of main disasters and their public health consequences Classify emergencies and disasters using relevant definitions and criteria List and describe different phases of disaster management

3. SEE Public Health Preparedness Supercourse Network Elisaveta-Jasna Stikova Present position 1991-Present, Professor, University “Ss. Cyril and Methodius”, Medical faculty, Skopje, Macedonia (courses taught: Occupational Health, Public Health, Medical Ecology, Hygiene) 2002 – Present, Advisor in the National Public Health Institute, Skopje, Macedonia 2009 – Fulbright Visiting Scholar, Pittsburg University, Graduate School of Public Health – New Educational Pathway for Global Public Heath Security

4. SEE Public Health Preparedness Supercourse Network Co-Authors and collaborators: Ronald E. LaPorte, PhD, UPGSPH, Director, Disease Monitoring and Telecommunication, WHO Collaborating Center Faina Linkov, PhD, Assistant Professor, Cancer Institute Margaret Potter, JD, MS, Associate Dean and Director, UPGSPH, Center for Public Health Practice David Piposzar, MPH, UPGSPH, PPLI Co-director Sam Stebbins, MD, MPH, UPCPHP Principal Investigator/Director, Center for Public Health Preparedness

5. Global Public Health Threats in 21th Century Emerging and epidemic prone diseases Environmental changes and natural disasters Human-made (technological) disasters Chemical, biological and radiological terror threats International crises and humanitarian emergencies

6. World Health Day 2007 debate on International Health Security The uncertainty and destructive potential of public health threats gives them a high public and political profile When the world is collectively at risk, defence becomes a shared responsibility of all nations. Dr Margaret Chan Director-General of the WHO

7. Why SEE Public Health Preparedness Supercourse Network? Public health threats are many and diverse, they are multiplying and moving faster than even before going far beyond the national borders They present new challenges and require an urgent and collaborative response Strengthening of public health preparedness, planning and timely response are ultimate goals to minimize human suffering caused by global public health threats

8. Why SEE Public Health Preparedness Supercourse Network? Achievement of this goal needs development of public health experts’ networking, new knowledge and skills. New SEE Public Health Preparedness Supercourse Network would prevent public health threats and protect human health by networking of scientists, experts and students from SEE region

9. www.pitt.edu/~super1/ Question! How can we improve public health preparedness education worldwide? Answer! Get better lectures Why don’t we share our most exciting PowerPoint lectures for free?

10. Disaster Supercourse is highly valuable tools presenting: network of 64000 scientists from 174 countries set of 3623 lecture in 26 languages 270 Disaster Lectures from 50 countries 1 Nobel Prize winner 75% full professors 52 countries

11. Disasters as a asymmetric threats The component of asymmetric attacks are: Unpredictable Disruptive Unexpected Targeting weaknesses Impossible to conceived before event Threats to Military, Government, Civilians, Information Infrastructure Disasters are asymmetric threats

12. SEE Public Health Preparedness Supercourse lecture for asymmetric threats Public Health Preparedness Network would offer: Rapid contact of Supercourse Network’s expert Rapid Just In Time development of customized lectures created by experts with vetting Rapid dissemination Continuously updated learning as crisis enfolds Expert reach back

13. Where public health threats come from? Speed and volume of travel and trade Occurrence of new and reemerging pathogens Environmental degradation Natural disasters Terrorism

14. Hazard classification: natural hazards ORIGINPHENOMENA/EXAMPLES Hydrometeorological hazards Foods, debris and mudflows Tropical cyclones, storm surges, wind, rain Drought, wild land fires, temperature extremes, Permafrost, snow avalanches Geological hazards Earthquakes, tsunamis Volcanic activity and emissions Mass movements, landslides, rockslides, surface collapse, Biological hazards Outbreaks of epidemic diseases, plant or animal contagion and extensive infestations

15. Hazard classification -technological and environmental related- T E C H N O L O G I C A L H A Z A R D S technological of industrial accidents (explosions, fires, spills) infrastructure failures industrial pollution nuclear release and radioactivity toxic waste, dam failure, transport E N V I R O N M E N T A L D E G R A D A T I O N : land degradation deforestation desertification wild land fires land, water and air pollution, climate change ozone depletion.

16. Emerging and epidemic prone diseases From 1 January 1998 to 31 December 2006, WHO identified: 2031 events of potential international public health concern 290 in the WHO European Region 2.44 million people live with HIV/AIDS 450 000 infected and 69000 deaths of TB 70 000 multy drug-resistant TBC every year

17. Selected infectious diseases, 39 new emerging pathogens from 1973-2000

18. Confirm cases of A/H5N1 Avian Influenza

19. Classification of natural disaster 1483 events reported between 1990-2006 42 millions affected; 98119 killed people More than 130 billion euros economic lost Natural disasters Biological Epidemics Insects infestations Animal attacks Geophysical Earthquakes Volcanoes Climatological Droughts High temperatures Wildfires Hydrological Floods Mass movements Meteorological Storms

20. Natural disasters and accidents in Europe, 1990-2006 Type NumberDeathsAffectedCost Flood 3443 59311566 50966093052 Extreme t 0 112521191 389 5299024788 Drought 31214 865 57514297309 Wildfire 58228286 9693540357 Earthquake 102218405 875 13830225449 Accidents 60916856137 63811697048 Avalanche 57208490 196156589 Windstorm 17013978 063 23433114822 Total 14839811942274 788 168149414

21. Natural disasters around the world, 2007

22. Natural disasters by groups and their impact, 2007 Occurence Damages* Legend: Geophysical Meteorological Climatological Hydrological Victims

23. Macedo nia 48,8 % China Rep. 120 117 437 India 38 145 269 Lesotho 19,4% Zimbabwe 18% Bangladesh 14,4% Zambia 12,8% Dominica 10,5% China Rep 9,1% Bolivia 8,4% Belize 6,4% Bangladesh 22 935 841 Zimbabwe 2 117 207 Philippines 2 023 221 Mexico 1 858 058 Pakistan 1 653 622 Veit Nam 1 647 928 Columbia 1 613 736 Zambia 1 553 536 Swaziland 35,4% Geophysical Climatological Hydrological Meteorologic 120100806040201020304050 10 top countries by victims, 2007 Legend:

24. BulgariaRomania United Kingdom Macedonia Spain Grece GermanyFranceRussia Austria Italy Croatia SloveniaUkraineSerbia Poland Albania Belgium Slovakia Canary Is. Montenegro Moldavia Rep. Czech Rep. Netherlands Hungary Occurence Victims per 1000 inhabitan t Victims Switzerland 7 6 5 1 2 3 4 488 62 6 10100100010000100 0001 000 00010 000 000

25. Thematic frame: Extra tropical cyclone Kyrill - damages CountryDamages 2007 US$ (‘000) Germany5 500 000 United Kingdom1 200 000 Netherlands 550 000 Belgium 450 000 Austria 400 000 France 250 000 Czech Rep. 150 000 Denmark 100 000 Poland 100 000 Slovenia 100 000 Switzerland 100 000 Total9 010 000

26. Disaster mortality in relation to development status

27. Distribution of technological accidents by type, 1980–2002

28. Sites of major technological accidents (1998–2002)

29. Toxic spoil from mining activities

30. Industrial accidents Fertiliser factory explosion in Toulouse, 2001 2400 injured 22 killed

31. Climate changes

32. Background information: Health consequences of floods in Europe

33. Background information: do not forget chronic diseases-epidemiological transition

34. Background information: do not forget crises and humanitarian emergencies