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International Pandemic Preparedness and Response Conference: 'Finding the Balance between Vigilance, Warning and Action and Lessons from Disaster Management'

Date: 18–19 April 2011
Venue: Traders Hotel, Singapore
Organised by: RSIS Centre for Non-Traditional Security (NTS) Studies

Two years on from the 2009 H1N1 outbreak, public interest in the matter, as well as the vigilance of some authorities involved, may have significantly waned. However, the need to be prepared for future pandemics remains important. It is thus an appropriate time to take stock of the lessons learnt from recent episodes of dealing with novel viruses, such as severe acute respiratory syndrome (SARS), H5N1 and H1N1, as well as many elements that make up the global disease burden including longer-standing health problems such as dengue, malaria, chikungunya and tuberculosis.

Many countries developed detailed plans for dealing with pandemics of emerging and re-emerging infectious diseases subsequent to SARS, but there remains much to learn and improve upon, not least of which is the need to turn plans into successfully implemented actions. It is also the case that plans have to operate across various sectors of government and society, as well as be flexible enough to adapt to changing conditions.

One criticism of the recent responses to H1N1 is that, when it became clear that the virus, while widespread, was relatively mild, some agencies and governments took considerable time to reflect this in their actions and communications.

The issue of communication is also particularly pertinent as clear, reliable and actionable information at such times is essential. Some have argued that it was the gap between public pronouncements and the reality on the ground that led to low vaccine uptake rates when it became available in the later stages of the H1N1 outbreak. This is unfortunate as, in many ways, the development of the H1N1 vaccine, less than six months after the virus was first identified, was itself a triumph of human ingenuity and social organisation. Accordingly, it remains important to manage both risks and perceptions.

Public responses to the recent outbreaks cover the spectrum of oversensitivity to complacency and fatigue. Each of these is a problem for the authorities, as they need to find an appropriate balance in periods of uncertainty.

This may be a particular challenge in developing countries, or those plagued by other natural disasters which occur more frequently. In such cases, competing resource commitments may divert funding away from the infrequent pandemic outbreaks, and towards the more common requirement of addressing regular needs, thereby relegating pandemic preparedness to a level where it may not receive the attention that some think it should.

In light of these issues and the need to find sustainable and feasible solutions to the challenges posed by future pandemic outbreaks, the Centre for Non-Traditional Security (NTS) Studies at the S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University, Singapore, convened the International Pandemic Preparedness and Response Conference 2011 themed ‘Finding the Balance between Vigilance, Warning and Lessons from Disaster Management’ in Singapore from 18 to 19 April 2011.

This Conference brought together a wide array of participants, including health professionals, academics, policymakers, government officials, representatives from regional and international organisations, security analysts and members of non-governmental organisations (NGOs) from across Asia and beyond to share information and exchange ideas on the lessons to take away from the handling and management of past pandemics in the region. The Conference also aimed to discuss and determine the best ways forward to prepare for future pandemics or outbreaks without compromising other health security and disease priorities.

The Conference addressed questions under six subthemes, and a number of noteworthy points were raised:

• Flexibility in pandemic preparedness and response

It was noted that in a world where no two pandemic pathogens are the same, it would be difficult and unwise to employ a single model of action to prepare for and respond to a pandemic threat. It was also argued that successful pandemic preparedness and response plans must be flexible, and at the same time, practical. They need to take into account country-specific considerations, capacities, existing mechanisms and structures, resource commitments and pre-existing disease burdens.

• Risk communication during and after pandemics

Risk can be under-communicated or over-communicated during a pandemic, each bringing with it its own undesirable set of consequences. It was argued that it remains tricky to find a balance between the two, and to communicate messages of risk in a moderate manner, thereby encouraging positive action while deterring panic among the public. It was also argued that the social and cultural context of risk communication during a pandemic needs to be more closely examined, and that in order to ensure more effective risk communication, there is a need to continue questioning and challenging the assumptions and preconceptions of the society and culture in which the communication takes place.

• One response plan for pandemics and other crises

It was contended that while it would be difficult to design one master response plan that would adequately address all the ramifications of a pandemic, greater multisectoral involvement in pandemic preparedness and response planning would greatly enhance national and international capacity to cope with a pandemic situation. It was also argued that by preparing sectors providing essential services such as water, healthcare and energy for a pandemic situation – through increased collaboration and cooperation, better resource allocation and planning, increased provision of information, and active coordination of each sector’s behaviours and actions – these sectors would also be better prepared to cope with other unexpected crises.

• International collaboration in pandemic preparedness

It was argued that although there are noteworthy efforts in international collaboration when it comes to pandemic preparedness, there remain significant gaps to be filled. Primary surveillance gaps exist because authorities lack an understanding of the communities they serve, and communities lack engagement with top-down legislation and efforts. International research collaboration continually encounters problems thanks to various structural barriers, as well as funding, resource and politically influenced imbalances. It was also noted that governance structures in various countries may vary due to political, economic, developmental and cultural differences, and these continue to hinder international collaboration. In spite of these obstacles, however, international collaborative projects, particularly those that involve the whole-of-society approach, are gaining momentum.

• Beyond pandemics: The non-pandemic disease burden

It was argued that contemporary global public health focuses on health security, and that this has resulted in an emphasis on urgency in relation to, and crisis management of, a few selected threats, one of which is the pandemic threat. It was also noted that not enough consideration is given to how a country’s ability to respond to a pandemic can be adversely impacted by its pre-existing disease burden of non-pandemic diseases, particularly within the Southeast Asian and Asia-Pacific context where many such diseases are endemic. It was argued that, in many cases, the effective management of the non-pandemic disease burden can help ease the many challenges posed by the clinical management of and responses to pandemic outbreaks.

• Ways forward and policy recommendations

It was noted that in a socio-cultural climate of pessimism and dwindling trust in government and authority, the context in which societies now respond to threats is the main determinant of the responses to them. It was suggested that this politicisation of health needed to be gradually reversed so as to ensure appropriate and measured response levels to a future pandemic threat. It was also proposed that greater attention is paid to clarifying the purpose of pandemic preparedness and response plans. More importantly, there is a need to examine what these plans have achieved; it is essential to look at where they were effective, where they did not deliver and how to bridge such gaps.

Click here for the programme.

Posted on: 18/4/2011 8:30:00 AM  |  Topic: Health Security

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