Pandemic influenza preparedness and response planning in the European Community

PURPOSE : to adopt plans on pandemic influenza preparedness and response planning in the EU.

CONTENT : this Communication outlines the key elements and sets of actions of the Community Pandemic Influenza Preparedness and Response Plan. Implementation will require more detail to be developed for those charged with operational tasks in the Commission, the ECDC, the EMEA and the Member States’ authorities. It will need periodic revision in the light of international discussions and on the basis of experience, during seasonal influenza and from cross-countries exercises.

Close co-operation will continue under the auspices of the Commission between human and animal health authorities and experts at national and European level in the area of influenza virus infections. In this context, a mutual exchange of experiences in contingency planning is of major importance, as contingency plans in animal health are already well established and have proven to be effective in the past. Preparing and responding to influenza pandemics presents a formidable challenge and requires increased efforts by the Member States and the Commission. This should be done as part of a more general approach to public health emergencies, in order to use scarce resources effectively, benefit from the widest possible expertise and keep procedures and functions manageable and as simple as possible; the Commission has published a communication on generic public health emergency planning to aid these efforts. The European Centre for Disease Prevention and Control (ECDC) can provide a structured and systematic approach to the surveillance and control of influenza and other communicable

diseases that might affect the people of the European Union. The ECDC can mobilise and significantly reinforce the synergies between the existing national centres for disease control and will no doubt help the Commission and the Member States to deal effectively with influenza.

Inter-sectoral action will be a key issue in tackling pandemic influenza. Many actions have already been undertaken at national and at EU level to ensure that measures in the various sectors of policy are effective and coordinated. But more needs to be done and the Commission and the Member States are carrying work forward in this respect. Particularly important will be the tackling of the pandemic problem at its source; the external action of the Community, in this respect, is important in helping the competent international organisations and third countries to face up to a possible pandemic and reduce its spread and impact.

A crucial element of responses to a pandemic at any level is to ensure that they are multisectoral and encompass services outside the health sector. Member States and the Commission must, therefore, have in place and update strategies for planning and coordination that will facilitate multi-sectoral collaboration.

The development of plans for pandemic influenza involves the principles and components of a planning process presented in the Commission Communication on strengthening coordination on generic preparedness planning for public health emergencies at EU level. Application of this planning process to pandemic influenza has identified the following key topics on which to base the EU pandemic influenza plan:

1. Planning and coordination : EU added value can be achieved by improving coordination and communication among the Commission and the Member States with assistance from the ECDC, other European agencies such as the EMEA and the European Food Safety Agency (EFSA), and with the WHO;
2. Monitoring and assessment : the most important task of the surveillance and diagnostic systems of the Member States is to provide early detection and characterisation of pandemic strains from clinical or other specimens and a reliable risk assessment as to its potential to cause widespread outbreaks in humans;
3. Prevention and containment :  a key countermeasure for preventing influenza is vaccination. As part of the prevention and containment plan the following could be pursued: provision of estimates of the need for vaccines, anti-virals and antibiotics from Member States according to the likely scenarios for their use; determination of priority groups for vaccination, when vaccine is in short supply; establishment of options for public health measures to minimise morbidity and social disruption when there is rapid accumulation of cases of influenza; collection of information from manufacturers about production capacities and plans for vaccines, antivirals and antibiotics. The Commission agreed with the Member States a policy document on public-private partnership (PPP) between public bodies and the vaccine industry to deliver influenza vaccine to the EU population in the shortest possible time in the event of influenza pandemic;
4. Health system response :  it is important that hospitals have well established emergency plans to handle numerous cases and ensure continuity and resilience, clinical guidelines are ready, supplies are available and staff is aware of admission criteria. It is Member States responsibility and competence to ensure that citizen have access to best practice and it is a Community objective that inequities in this area are smoothed among countries and regions. Moreover, staff working in health care should be aware of and trained in infection control measures;
5. Communication : a communications plan has to be prepared for each phase and level. The more serious the threat, the more important it will be to ensure efficient communication to the general public and to the media.