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

Objectives

Papua New Guinea’s national contingency framework seeks to prepare for, detect, contain and mitigate avian influenza in humans and pandemic influenza through a whole-of-government response that protects health, essential services, social stability and the economy.[1][2][3]It uses a graduated six-phase framework informed by World Health Organization guidance, while allowing non-sequential movement between phases according to national risk.[4][5]

• Strengthen integrated human and animal surveillance, rapid detection, diagnosis, characterisation and response to novel influenza viruses, including monitoring of influenza-like illness, severe respiratory disease, animal outbreaks and possible human-to-human transmission.[3][6][7]
• Prevent avian-to-human transmission and avoid preventable virus entry through poultry and wildlife control, quarantine, border measures, infection prevention, food safety, exposure reduction and public education.[3][8][9][10]
• Contain outbreaks early through case isolation, clinical care, contact tracing, quarantine where warranted, laboratory confirmation, targeted antiviral measures, social distancing and transparent risk communication.[11][12][13]
• Reduce illness, deaths, social disruption and economic effects, maintain essential services and infrastructure, and support recovery of services, trade, production and affected communities after containment or pandemic waves.[3][14][15]
• Protect health workers, emergency responders and vulnerable populations through training, infection-control systems, personal protective equipment, medicines, vaccination when available, clinical triage and priority-setting arrangements for scarce resources.[16][17][18]
• Provide timely, credible information to the public, health workers, media, communities and service providers, promoting hand hygiene, respiratory hygiene, food safety, reduced risky behaviour and adherence to outbreak-control measures.[3][19][20]

Implementation

Implementation combines national policy direction and coordination with local outbreak management led by district and provincial authorities, supported by the National Department of Health and intersectoral partners.[16][21]The National Influenza Pandemic Threat Response Coordination Body, National Task Force, Technical Working Group and National Incident Room provide the principal national coordination, technical, operational and reporting mechanisms.[22][4][21]

• Coordinate the response through the National Department of Health as a key health combat agency, working with provincial and district health authorities, hospitals, laboratories, veterinary services, emergency agencies, churches, non-governmental organisations, private providers and international partners.[3][14][23]
• Assign national oversight of phase designation and escalation to advice from the Coordination Body and Technical Working Group, with final decisions by the Prime Minister and, where applicable, the National Executive Council.[24][22]District and provincial responses predominate during alert phases, supported nationally, while Phases 5, 6 and recovery require a national response.[24][22]
• Operate nationwide notifiable-disease surveillance through the National Department of Health Disease Control Branch, requiring health workers and laboratories to report notifiable diseases and unusual clusters without delay.[11]Notify the World Health Organization within 24 hours of assessment of events that may constitute a public-health emergency of international concern, including recognised human A/H5N1 or other novel influenza cases.[14][13]
• Maintain hospital and health-centre sentinel surveillance, including weekly reporting of influenza-like illness, and support event-based reporting by communities of unusual disease clusters or deaths in people or animals.[25]Develop animal surveillance through the National Agriculture Quarantine and Inspection Authority, including surveillance of wetlands, migratory birds, poultry, imported birds and ports of entry.[7]
• Strengthen laboratory systems through safe specimen collection, packaging, transport and referral to international reference laboratories, while developing domestic diagnostic and biosafety capacity.[23][7][25]
• Maintain a National Incident Room in the Disease Control Branch in Port Moresby, staffed by epidemiology, infection-control and surveillance personnel and providing continuous coverage during avian or pandemic influenza signals.[21]Use it to coordinate investigations, contact tracing, reporting, situational analysis and communication between national and subnational authorities.[21]
• Prepare hospitals and health services for triage, isolation, clinical management, field facilities, staff surge, specimen handling and infection-control training.[23]Require each administrative level of the health system to develop operational plans and standard operating procedures aligned with the national plan.[6]
• Maintain stockpiles and deployment arrangements for personal protective equipment, antibiotics, antivirals, hand-hygiene products, bleach and available vaccines, alongside procedures for storage, distribution and mass deployment.[26]Plan vaccine procurement, allocation, management and priority groups nationally when pandemic vaccine becomes available.[16][27]
• Protect continuity of water, electricity, telecommunications, transport, ports, aviation, security, food, sanitation and other essential services through cross-government and emergency-service planning.[28][19]Assess staffing, bed capacity, supplies, workforce absenteeism and service pressures during pandemic response.[18][27]
• Review and update plans, guidance, legislation, standard operating procedures and preparedness arrangements as knowledge and circumstances change, using simulations, emergency exercises, field experience and lessons from pandemic waves.[2][16][19][15]
• Mobilise technical and financial support from development partners, including the World Health Organization and donor agencies, while national coordination structures seek timely personnel, funding and other resources for technical agencies.[1][2][22]Explicit allocations include 7,140,000 Kina for Phase 1 and 6,610,000 Kina for Phase 5, although the supplied material does not provide a consolidated overall programme budget.[9][29]

Monitoring & Evaluation

The plan establishes a multi-level surveillance, reporting and review system for detecting animal and human influenza threats, guiding phase changes and assessing response performance. It combines routine notifiable-disease reporting, sentinel surveillance, laboratory confirmation, field investigation, international notification and oversight by national coordination structures.[4][11][21][7][15]

• Maintain nationwide surveillance for notifiable diseases through the National Department of Health Disease Control Branch, supported by health-service providers and health authorities.[5][11]
• Require health-care workers and pathology laboratories to report notifiable diseases and unusual clusters promptly when an epidemic is suspected or anticipated.[11]
• Operate hospital sentinel surveillance with weekly reporting of health-care visits, influenza-like illness and demographic data, and establish one health-centre sentinel site in each province, reporting weekly to the National Department of Health.[25]
• Strengthen animal surveillance through wetland, poultry, port-of-entry and community-based reporting systems, including urgent reporting of unusual human or animal disease clusters and deaths.[7][25]
• Maintain a national database of human avian and pandemic influenza cases, analyse sentinel and field-investigation data, monitor regional and international intelligence, and provide situational reports to the national focal point.[21]
• Use laboratory confirmation, including viral culture, polymerase chain reaction, antigen testing or serology, to classify cases and trigger activation following a confirmed human case of A/H5N1 or another novel influenza strain.[12][30]
• Notify the World Health Organization within 24 hours of assessing a possible public-health emergency of international concern and within 24 hours of recognising a human case of A/H5N1 or another novel influenza strain.[14][13]
• Monitor response progress through the Technical Task Force, provide regular written briefs to national leadership, and require ministries and agencies to report data, control measures and lessons learnt.[22][4][15]
• Test provincial plans, reporting mechanisms, hospital readiness, surge capacity, infection control, laboratory biosafety and specimen-management arrangements.[21][23]
• Use simulation exercises and plan revision to review preparedness, intervention effectiveness and requirements for subsequent pandemic waves.[16][19][31]
• Shift surveillance from case-based and virological reporting to aggregate data collection as transmission becomes widespread, with case definitions adapted for greater reliance on clinical and epidemiological information.[27]

Quantitative indicators, performance targets, audit arrangements and a consolidated evaluation framework are generally not specified. The plan nevertheless identifies reporting lines, named responsible bodies, surveillance activities, field implementation monitoring and regular briefing arrangements as its principal accountability mechanisms.[4][21][6][30]

Costing & Financing

Financing provisions combine specified activity budgets with broad commitments to mobilise domestic and external resources. The National Coordination Body is expected to secure approvals and timely resources for technical agencies, while national, provincial and district authorities are to mobilise contingency resources and refine cost estimates.[22][16][18]

• Mobilise technical and financial support from development partners, including support acknowledged from the World Health Organization, AusAID and the United States Agency for International Development.[1][2][25]
• Allocate resources for preparedness coordination, staff training, stockpiles, surveillance, laboratory capacity, public health guidance, specimen transport, personal protective equipment, antivirals, vaccines and communications.[26][32][33][9]
• Provide for procurement, allocation, management and funding of antiviral medicines and pandemic vaccines, including prioritisation arrangements when supplies are constrained.[16][27]
• Include budgets, stockpiling and surge-capacity requirements in provincial pandemic plans, with the Department of the Prime Minister and National Executive Council identifying and designating financial resources.[21][23]
• Establish provisions for animal-culling compensation, including a contingency compensation fund if highly pathogenic avian influenza is identified in domestic poultry.[10]
• Assign a stated total Phase 1 budget of 7,140,000 Kina and a stated total Phase 5 budget of 6,610,000 Kina.[9][29]

Although numerous individual allocations are specified, the supplied material does not provide a consolidated whole-plan budget, a total Phase 2 or Phase 6 budget, funding-gap analysis, detailed disbursement arrangements, costing methodology or economic assumptions.[10][29][31][27]