National Contingency Plan for Preparedness and Response for Influenza Pandemic Papua New Guinea

Objectives

Strengthen Papua New Guinea’s capacity to prevent, detect, contain, manage and recover from avian influenza and pandemic influenza through a whole-of-government National Contingency Plan for Pandemic Influenza. The Plan aims to minimise health, social and economic disruption, protect people and animal populations, and sustain essential services and national infrastructure during a pandemic.[1][2][3]

• Prevent the entry of avian influenza and reduce animal-to-human transmission through border measures, poultry surveillance, quarantine, safer poultry handling, food safety and protection of exposed workers.[4][5][6]
• Detect, diagnose, characterise and report novel influenza viruses, influenza-like illness and unusual severe respiratory disease rapidly through integrated human, animal, laboratory, sentinel and community surveillance.[3][7][8]
• Contain early outbreaks at source through case finding, isolation, clinical management, contact tracing, voluntary quarantine, infection control, targeted antiviral use and proportionate social-distancing measures.[4][9][10]
• Reduce morbidity and mortality through safe triage, referral, treatment, laboratory confirmation, personal protective equipment, antiviral medicines, vaccination when available and continuity of health services.[3][11][12]
• Maintain essential community functions, including food, water, shelter, sanitation, electricity, communications, transport, welfare support, safe burials and psychosocial care during isolation, quarantine and workforce disruption.[13][14][15]
• Provide timely, consistent and accessible information to the public, health workers, media and service providers to promote protective behaviours, reduce risky poultry exposure and build confidence in response measures.[3][16][17]

Preparedness is structured around World Health Organization pandemic phases and a graduated response that may escalate from local and provincial action to national mobilisation according to the evolving threat.[18][19]The Plan is intended to remain adaptable as scientific knowledge, including knowledge of A/H5N1 influenza, and effective containment approaches develop.[2]

Implementation

Implement the Plan through a coordinated, multisectoral emergency-management model linking national leadership and policy direction with provincial, district, community and facility-level delivery. The National Influenza Pandemic Threat Response Coordination Body leads national coordination, supported by the National Task Force, Technical Working Group, Secretariat, National Focal Point and National Incident Room.[19][20][21]

• Direct national phase decisions and escalation to a national response through the Prime Minister and/or National Executive Council, on advice from the Coordination Body; retain predominantly local and provincial responses in Phases 2 to 4 and national responses in Phases 5, 6 and recovery.[19]
• Coordinate human-health action through the National Department of Health, including the Disease Control Branch, National Focal Point and National Incident Room, while the National Agriculture Quarantine Inspection Authority leads animal-health investigation, surveillance and containment.[21][13]
• Mobilise provincial and district health authorities to adapt national guidance, establish local plans and standard operating procedures, identify rapid-response teams, assess surge capacity, manage local surveillance and report promptly to national authorities.[22][23][15]
• Operate surveillance through hospital, health-centre, laboratory, animal-health and community reporting systems, including one sentinel health centre per province and weekly reporting of influenza-like illness using the nationally adopted World Health Organization case definition.[7][8]
• Notify the World Health Organization within 24 hours after assessing events that may constitute a public health emergency of international concern, including laboratory-confirmed human A/H5N1 or other novel pandemic-prone influenza cases.[24][25]
• Strengthen laboratory capability through specimen collection, safe packaging and transport, regional reference laboratory support, and longer-term investment in Biosafety Level 3 and polymerase chain reaction diagnostic capacity.[23][8]
• Deliver facility-level infection prevention and clinical care through triage, respiratory protection, patient isolation or cohorting, hand hygiene, environmental cleaning, safe waste management, treatment, referral and discharge precautions.[26][11][27]
• Train health workers, veterinarians, veterinary extension officers, emergency personnel, students, trainees and volunteers in surveillance, specimen management, infection control, personal protective equipment and emergency response.[20][15]
• Engage churches, non-governmental organisations, communities, private-sector organisations, emergency services and welfare partners to support health care, risk communication, relief supplies, essential services and local implementation.[2][23][14]
• Collaborate with the World Health Organization, Food and Agriculture Organization of the United Nations, World Organisation for Animal Health, Secretariat of the Pacific Community, donor agencies and regional networks for epidemic intelligence, technical assistance, laboratory support, containment capacity and financing.[2][20]

Governance includes regular monitoring of response progress through the Technical Task Force, written briefings and reports to the Coordination Body, Prime Minister and/or National Executive Council, and post-pandemic reports from participating ministries and agencies on actions taken, lessons learnt, effectiveness and gaps requiring revision of the Plan.[19][20][28]The document includes resource mobilisation responsibilities for central agencies and identifies budgets for some phase activities, including a six-phase summary budget of 53,801,000 Kina, but does not provide a complete financing framework or all funding sources.[13][17]

Monitoring & Evaluation

The plan establishes a multi-level surveillance, reporting and accountability system for early detection, investigation, containment and management of avian influenza and pandemic influenza. It combines human and animal surveillance, laboratory diagnosis, local-to-national escalation, international notification, incident coordination and post-pandemic review, but generally does not set numerical performance indicators or a unified evaluation framework.[3][29][24][28]

• Maintain national, provincial, district, community, hospital, laboratory and animal-health surveillance to detect influenza-like illness, pneumonia clusters, respiratory deaths, animal infections and possible novel influenza strains.[21][23][7][30][31]
• Operate sentinel surveillance through one health centre in each province, covering 20 sites, with weekly reporting of influenza-like illness using the national World Health Organization case definition.[8]
• Collect hospital data on daily health-care visits and influenza-like illness cases, transmit forms every Monday to the Department of Health Disease Control Branch, and analyse data cumulatively.[30][8]
• Intensify avian influenza surveillance in wetlands in Western Province, the Sepik River Region, Gulf, Madang and Manus; undertake weekly virological surveillance of migratory birds; and strengthen monitoring at ports of entry.[30]
• Develop laboratory capacity for influenza testing, including collection of human and animal specimens, use of regional reference laboratories, and longer-term Biosafety Level 3 and polymerase chain reaction capacity.[23][8]
• Require immediate notification when clinicians identify suspected pandemic influenza or A/H5N1 infection, and route confirmed-case reports through provincial and national authorities to the National Focal Point, National Task Force, National Coordination Body and national leadership.[11][25]
• Notify the World Health Organization within 24 hours after assessing information about an event that may constitute a public health emergency of international concern, including laboratory-confirmed human A/H5N1 or other novel influenza cases.[24][25]
• Use the National Incident Room and national case database to collate surveillance and field-investigation data, interpret national and international intelligence, support contact tracing and disseminate situational reports.[21][23]
• Monitor implementation progress through the Technical Task Force, provide written briefs to the National Influenza Pandemic Threat Response Coordination Body and national leadership, and report regularly to the Prime Minister and/or National Executive Council.[19][20]
• Test plans through exercises involving response partners, revise arrangements as necessary, and require participating ministries and agencies to report on data, control measures and lessons learnt across pandemic periods and phases.[15][32][28]
• Evaluate intervention effectiveness and require the National Task Force to identify the effectiveness and gaps of the National Pandemic Influenza Contingency Plan for subsequent revision.[20][28]

Accountability is supported by defined reporting lines, the National Focal Point’s coordination role, National Task Force oversight, ministerial and executive briefings, statutory disease-reporting duties, and legal powers for animal-disease control and quarantine.[29][21][13][33]Quantitative indicators, performance targets, standard reporting templates, independent review arrangements and detailed evaluation schedules are not specified in the supplied material.[1][32][17]

Costing & Financing

Financing arrangements focus on mobilising personnel, supplies and external assistance for preparedness and response. The plan assigns resource-identification responsibilities to central government bodies, provides several explicit preparedness and phase 6 budget lines, and identifies substantial resource needs, although many sections do not specify funding sources, gaps or economic assumptions.[19][13][34][17]

• Secure timely personnel, funds and technical assistance through the National Influenza Pandemic Threat Response Coordination Body, central agencies and local and international development partners.[19][20]
• Assign Treasury responsibility for identifying resources, Finance responsibility for appropriating and distributing funds, and National Planning and Rural Development responsibility for coordinating international support and donors.[13][33]
• Prioritise investment in trained staff, public-health infrastructure, laboratory capacity, infection control, personal protective equipment, antivirals, antimicrobial medicines, possible vaccines, non-pharmaceutical interventions and risk communication.[3]
• Include provincial budgeting, stockpiling of essential equipment and surge-capacity assessment within provincial pandemic plans.[23]
• Coordinate national funding, procurement, allocation and management arrangements for antiviral medicines and pandemic vaccines, and refine cost estimates and response options across national, provincial and district authorities.[22]
• Use external support for surveillance and laboratory strengthening, including World Health Organization and Australian Agency for International Development support for plan development and World Health Organization assistance, supported financially by the United States Agency for International Development, for influenza-like illness sentinel surveillance over five years.[1][8]
• Allocate an unspecified currency amount of 4,000,000 for a domestic stockpile of personal protective equipment, antibiotics, antivirals, hand-hygiene products, bleach and vaccines, the largest specified Phase 1 allocation.[34]
• Budget 7,120,000 Kina for listed Phase 6 activities and 53,801,000 Kina as the summary budget for all six phases.[17]

Resource requirements also include specimen transport, laboratory supplies, biocontainment equipment, welfare supplies, food, water, shelter, communications and continuity measures for essential services.[14][12][8]The supplied material does not specify an overall budget total for all plan components, consistent funding sources for every activity, financing gaps, expenditure schedules or economic assumptions.[4][22][34]