Ambassador Marcus L.J Hancock
Recently the World Health Organization (WHO) has increased its focus on the Asia – Pacific region as an area of especial importance in the context of pandemic planning and preparedness. This has probably largely been due to the regions potential as an “epicentre of emerging disease such as sever acute respiratory syndrome (SARS) and avian influenza” (1). The pandemic preparedness Of the country of New Zealand can be divided in to the analysis of seven factors: Planning, coordination and surveillance, Public health related interventional strategies, operational health care response, maintenance of essential services, communication and action planning (1).
New Zealand’s pandemic preparedness plan would best be classified as a strategic plan similar to those created by many Countries of the European Union, The United States and Canada. Such plans tend to focus on the management and distribution of resources that are currently available or stockpiled, such as vaccines and antiviral drugs (2, 3).
An outbreak in an Asia – Pacific country like New Zealand would likely originate in a rural area. New Zealand’s pandemic plan is therefore focused on early containment strategies in rural settings and is a particular strength of the plan. Animal cases were also looked during the development of the pandemic plan. As Such New Zealand’s plan, as in Hong Kong and Australia for example, explicitly link planned response in human pandemic planned response with avian influenza and emphasize integration in human and animal health (3, 4, 5).
Some of the strengths of New Zealand’s pandemic planning include: strong political support for preparedness planning, linked surveillance and response measures for animals and humans, multi sector cooperation, early containment strategies , capacity for increased organizational and financial support, inclusion of social distancing measures, multi country cooperation agreement (particularly with Australia), the development and distribution of educational materials for public consumption and the inclusion of the private health care sector in mobilization of response(1).
Gaps and weaknesses in New Zealand’s Pandemic plan might include: need for clearer allocation of operational responsibility at the local government level, the need to address imported epidemic situations (though less then endemic development) and the need to better specify use of prophylactics and the identification of priority groups(1,2,3,4).
One of the major challenges for New Zealand in pandemic planning is the development of the operational guidelines which delineate the allocation of resources at the primary care level. The need for such operational guidelines became apparent during the recent outbreak of H1N1 as many countries struggled to find the capacity to implement their actual preparedness plans. Another major challenge is the alignment and coordination of the national and local response; while most New Zealanders reside in cities a significant portion dwell in more remote settings (1, 5).
New Zealand may have an important role to play though its interaction with ASEAN – the association of Southeast Asian nations – acting as a resource and example for pandemic preparedness. The first East Asia summit on Avian influenza, held on December the 14th 2005 promoted the “ active cooperation and various regional initiatives of ASEAN in responding to the challenges posed by Avian influenza, inter – alia, through strengthening institutional linkages, developing partnership with all stakeholders, sharing information and coordination regional initiatives”(1).
Overall the quality and completeness of New Zealand’s Pandemic Plan is considered high and the country has developed a comprehensive guidance manual to facilitate a coordinated national response to the outbreak of influenza. The plan compares favourably to the ones developed by other European countries, the United States and Canada. By contrast several other countries of the Asian-pacific, including Thailand and china, have developed plans aiming at increasing the capacity to detect, prepare and respond to disease outbreaks. New Zealand’s plan could probably benefit from an increased emphasis upon operational responsibility at the local level; “logistical aspects of vaccination and antiviral stockpiling, distribution and delivery; or the maintenance of essential services” (1).
Without a greater international commitment to share scarce resources – some countries of the Asian pacific may suffer from an inability to access adequate resources and their inability to distribute them effectively. As these countries face such challenges more affluent countries are in a position to share their capacity to produce and supply vaccine. I would suggest New Zealand is in a strong position to act as primary responder in a situation of emerging pandemic in these countries and should seek to develop contingency plans with stakeholders in those regions. New Zealand should also work to strengthen its ties to China and Australia.
REFERENCES:
1.Mounier-Jack S, Coker RJ. How prepared is Europe for pandemic influenza? Analysis of national plans. Lancet. 2006;367:1405–1411. doi: 10.1016/S0140-6736(06)68511-5.
2. WHO. Asia Pacifi c strategy for emerging diseases. Geneva: World Health Organization, 2005.
3. WHO. 58th world health assembly. Geneva: World Health
Organization, 2005
4. WHO. Checklist for infl uenza epidemic preparedness. WHO/CDS/
CSR/GIP/2005.4. Geneva: World Health Organization, 2005
5. Ministry of Health, New Zealand. National health emergency plan: infectious diseases. Wellington: Ministry of Health, 2004. http:// http://www.moh.govt.nz/moh.nsf/238fd5fb4fd051844c256669006aed57/a7 c725c02e537849cc256ee50004c1b2?OpenDocument (accessed
March 13, 2006).