1. FAO/WHO/USAID development of integrated desktop simulation exercises on avian influenza in animal and human populations for Eurasia Dr. Katinka de Balogh

2. Overview ๏ Emergency preparedness and simulation exercises ๏ The Armenia pilot desktop simulation exercise ๏ The Albania desktop simulation exercise ๏ Upcoming simulation exercises (Azerbaijan, regional) ๏ Lessons Learned 2

3. Overall Aim of FAO/WHO/USAID project ๏ Enhanced preparedness and capacity of countries to face outbreaks of HPAI and other zoonotic diseases in animal and human populations ๏ Integration of animal and human health components of contingency plans ๏ Improved communication, coordination and chain of command between the different sectors involved. 3

4. Preparedness planning ๏ political commitment for preparedness planning ๏ funding made available ๏ persons identified to write the plan or provide inputs ๏ Plan adapted to the prevailing reality considering: - legislation - structures and mechanisms - chain of command - emergency resources - contingency plans/SOPs - capacity building needs, etc 4

5. Preparedness planning Evaluating preparedness through simulations: - tabletop - field - combined tabletop and field - computer 5

6. Country free of HPAI HPAI cases in humans HPAI outbreaks in animals (domestic/wildlife) Preparedness planning Control activities 6

7. Preparedness Planning 7

8. Start-up of the FAO/WHO/USAID project ๏ contracting the Health Protection Agency (UK) exercise team http://www.hpa.org.uk ๏ Feb. 2007 Rome meeting at FAO with WHO, USAID, HPA, resource persons, Armenia delegates to develop 1st pilot exercise for Armenia 8

9. The tabletop exercise ->define clearly the aim of the exercise -> realistic scenario -> participants carefully selected (stakeholders) -> available contingency plan available? -> ‘lessons learned’ to adapt exercise integrated simulation exercise for avian influenza in animal and human populations 9

10. The pandemic phases 10

11. Pre-event ๏ mission to country to host exercise (lead organisation) ๏ status of plans ๏ interest of MoA and MoH ๏ identify potential participants ๏ official letter ๏ determine dates ๏ focal points, scenario writer(s) (  training in UK) ๏ possible venue 11

12. Selecting the venue ๏ The main room: - space - carpet - electricity connections - round tables - event control table - observer tables - registration table (outside) - equipment ๏ coffee and tea, snacks ad libitum in room ๏ catering/lunch, reception 12

13. Selecting the venue ๏ translation facilities - simultaneous - for documentation ๏ computer ๏ printing, copying facilities ๏ projections ๏ microphones (mobile) 13

14. Past exercises ๏ one day (Armenia) ๏ two days (Albania, Azerbaijan) ๏ number of participants: max. 50 (+observers) 8-10 persons/round-table ๏ Ministry level, technical and local authorities 14

15. Session set ups ๏ plenary sessions (simultaneous translation) ๏ working group sessions (whispering translation for observers) ๏ special programme for observers ๏ simulated press releases and press conference 15

16. Exercise Agenda 0830Arrival and registration (including refreshments) 0900Welcome Introduction Exercise Briefing 1030 1200 Session 1 – Day 1 Players work in groups (at tables) Plenary feedback 1230Lunch 1315 1320 1515 Session 2 – Day 10 Players work in groups (at tables) Plenary feedback 1530Session 3 – Day 50 Players work in groups (at tables) 1630Plenary feedback & Player Hot Debrief 1700Depart 16

17. Exercise Structure Armenia Inter Ministerial Task Force (incl. other Ministries) Local Commission (incl. Community Level) Expert Group Rapid Response Team Observers GROUPS: 17

18. The methodology Scenarios Session 1: first outbreak of HPAI in animals suspected Session 2: outbreaks in animals confirmed first human cases, Session 3: human fatalities due to H5N1 Session 4: situation gets under control, rehabilitation phase 18

19. Scenarios and Injects Create situations; provide specific instructions or data; keeps the scenario on track 19

20. Answer sheets 20

21. Injects – Answer Sheets 21

22. Lessons learned Armenia ๏ one day ๏ homogenous groups ๏ low interaction between groups ๏ observers got some injects ๏ facilitators briefed ๏ follow-up meeting Albania ๏ two days ๏ mixed groups ๏ mock press conference ๏ neigbouring countries as observers (special programme provided) ๏ facilitators trained ๏ action plan followed by donor meeting 22

23. Some lessons learned - buy in of country - involvement of different sectors - language (translations) - new working methods/interactive - need for good organisation and facilitation - time-limit, what is achievable? - how to enhance discussions between groups - importance of a very good event control team - clear follow-up after the simulation 23

24. Follow-up in country after exercise ๏ Presentation of Exercise report ๏ Identified needs discussed in country ๏ Elaboration of Action plan in country ๏ Presented to donors for funding ๏ Improvement of country preparedness 24

25. Upcoming activities ๏ national exercise in Azerbaijan (1-2 July 2008) ๏ development of regional simulation exercise (fall 2008) ๏ regional exercise for the Balkan countries (end 2008/early 2009) 25

26. Regional exercise Issues to be addressed: - cross border communication and cooperation - outbreak communication - cross border movement (control) - harmonization of procedures (eg.compensation) - how to deal with outbreak in border area - - etc 26

27. emergency preparedness is a continuous process desktop simulation exercise is a useful tool to assess the contingency plan and communication mechanisms 27

28. Thank you for your attention! 28

29. Questions? 31