National Avian Influenza Control and Pandemic Preparedness Plan 2006 - 2010

Objectives

The 2006–2010 national plan aims to prevent and control avian influenza and strengthen preparedness for a possible human influenza pandemic, reducing health risks and associated social and economic consequences.[1]Its strategic framework combines animal-health control, human surveillance and response, laboratory and clinical readiness, and community education and action.[2][3][4]

• Develop a disease-free avian influenza management system, including safer poultry production, controls on poultry movement and slaughter, outbreak containment, compensation arrangements, regulatory measures, and strengthened veterinary expertise.[2][5][6][7]
• Strengthen early detection, outbreak investigation and rapid response at provincial, district and village levels, linking human and animal health information to identify outbreaks, trends, unusual incidence and populations at risk.[2][3][8]
• Establish routine influenza surveillance using laboratory and influenza-like-illness surveillance, initially through pilot hospitals in Vientiane and subsequently through wider provincial and national expansion.[3]
• Improve laboratory capacity for influenza identification, specimen handling and biosafety in the short term, with longer-term development of virus-isolation and molecular diagnostic capacity.[3]
• Strengthen clinical and public-health preparedness through case-management, triage, infection-control and intensive-care guidance; trained health workers; antivirals; personal protective equipment; temporary care facilities; and arrangements for mass fatalities during a pandemic.[3][9][10]
• Develop and test national, sectoral and provincial pandemic preparedness and response plans, supported by legal measures for surveillance, reporting and public-health action consistent with the International Health Regulations (2005).[9]
• Promote culturally appropriate health education and community action on avian and pandemic influenza, addressing local knowledge, attitudes and practices and supporting public cooperation with prevention and containment measures.[9][4]
• Support research on vaccination, compartmentalisation for inter-provincial trade, and avian influenza infection in wildlife.[5]

Implementation

Implementation is designed as a multisectoral, decentralised and internationally supported programme, coordinated across animal health, public health, communications and community systems.[1][11]The Ministry of Health and Ministry of Agriculture and Forestry are central implementing institutions, supported by the National Centre for Laboratory and Epidemiology, the National Committee for the Control of Communicable Diseases, the National Avian Human Influenza Coordination Office, United Nations agencies, donors, hospitals, local authorities, non-governmental organisations, mass organisations and other government departments.[12][8][10]Existing delivery capacity includes the National Centre for Laboratory and Epidemiology, 18 provincial surveillance units and 141 district health offices, although staffing, equipment, communications, isolation facilities, laboratory biosafety and diagnostic capacity are identified as constraints.[13]

• Coordinate national planning through a national committee, working groups, a contingency plan, an operational and hotline centre, and strengthened information networks and surveillance information management.[6][5]
• Assign operational roles across relevant ministries, including health, agriculture and forestry, finance, commerce, industry, information and culture, and communications, transport, posts and construction, alongside donors and other partners.[6][7][11]
• Train provincial, district and village personnel, including rapid response teams, village health volunteers and veterinary workers, to recognise and report unusual events, verify rumours, investigate cases, trace contacts, identify risk factors and undertake joint human-animal health responses.[3][9][8]
• Use hospital reporting, routine public-health channels, village volunteers, public reports, non-governmental organisations and embassies as inputs to early warning, with rapid notification of suspected cases to public-health authorities.[3][9]
• Improve the timeliness and usefulness of the existing computerised, symptom-based Early Warning Outbreak Recognition System, integrate it with routine national surveillance, and combine laboratory, influenza-like-illness, human and animal surveillance data.[13][3]
• Develop standard operating procedures and guidance for outbreak containment, specimen collection, transport, testing, biosafety, infection prevention and control, clinical management, movement restrictions and risk communication.[6][3][10]
• Deliver risk communication through the Lao Women’s Union, Buddhist organisations, schools participating in the Blue Box Programme, radio and other mass media, with designated spokespersons, trained journalists, tested messages, emergency contacts databases and potential pandemic hotlines.[9][14]
• Maintain coordination through information sharing, meetings, workshops, field visits, joint investigations, regional and international participation, and collaboration with neighbouring countries and the Association of Southeast Asian Nations.[11]
• Mobilise resources through a detailed five-year activity plan that records priorities, timelines, estimated costs, donor commitments and potential implementing partners.[15]The prioritised avian-influenza control strategy is estimated at 57.07 million United States dollars over five years, while Strategy 4 on community education and health communication has a stated budget of 2.02 million United States dollars.[2][4]
• Establish contingency funding for outbreak response and operational surveillance, procure equipment, medicines, antivirals and protective supplies, and use compensation or indemnification to encourage poultry culling and outbreak control.[7][8][16][9]

Monitoring & Evaluation

Monitoring centres on integrated early warning, surveillance, notification and rapid response for animal and human influenza. Existing capacity includes the National Center for Laboratory and Epidemiology, 18 Provincial Surveillance Units and 141 district health offices, but reporting and response are constrained by workforce, equipment, laboratory and communications limitations.[13]

• Integrate influenza surveillance into routine weekly surveillance, combining laboratory-confirmed and influenza-like-illness data to identify trends, unusual incidence and groups at risk.[3]
• Improve the timeliness and practical use of Early Warning Outbreak Recognition System data and link human and animal surveillance geographically and over time.[3]
• Collect unusual-event reports and rumours from health facilities, village volunteers, the public, non-governmental organisations and embassies, then verify them through trained provincial and district rapid response teams.[3]
• Require rapid notification of suspected cases to public-health authorities and strengthen disease notification and movement controls for animal outbreaks.[3][6]
• Investigate suspected cases and contacts, identify outbreak sources and risk factors, conduct joint animal-human health field investigations, and provide feedback meetings and on-the-job training.[8][11]
• Develop legal support for surveillance, reporting and public-health action consistent with the International Health Regulations (2005).[9]
• Use outbreak simulation exercises, communication-message testing, emergency contact databases and rumour surveillance as preparedness and operational monitoring mechanisms.[8][9][14]

Influenza, avian influenza and influenza-like illness were not yet reportable diseases in the pre-existing system, although inclusion was under way.[13]The plan identifies priority, timeline, estimated-cost, donor-commitment and potential-partner fields for activities, but the supplied material does not specify quantitative performance indicators, reporting intervals, evaluation schedules, reporting templates, independent review processes or a comprehensive accountability framework.[15][3]

Costing & Financing

The five-year avian-influenza control strategy is costed at 57,070 in US$000, with separate estimates for priority and desirable activities across years 1 to 3 and years 4 to 5.[2]The extracts also identify numerous activity-level budgets in United States dollars for outbreak preparedness, laboratory and clinical capacity, community communication, surveillance, compensation, transport, research and networking.[5][6][7][11][8][10][4]

• Allocate 27,607 in US$000 for desirable preparedness and pandemic activities in years 1 to 3, 14,554 in US$000 for priority activities in those years, 12,649 in US$000 for desirable activities in years 4 to 5, and 2,261 in US$000 for priority activities in years 4 to 5.[2]
• Provide contingency resources for operational surveillance and response, including 1,000 United States dollars per suspected case, a 100,000 United States dollar multisectoral operational fund, a 500,000 United States dollar fund for outbreak-containment supplies, and 100,000 United States dollars for communication-related contingency.[8][7][14]
• Support compensation for poultry farmers affected by outbreaks and develop compensation schemes as an incentive for reporting and culling.[7][2]
• Fund laboratory expansion, biosafety upgrades, diagnostic equipment, reagents, personal protective equipment, staff training, molecular methods and longer-term virus-isolation capacity.[2][3]
• Mobilise resources from the Ministry of Agriculture and Forestry, Ministry of Finance, donors and other partners, while using the detailed plan to record donor commitments and prospective implementing partners.[5][7][11][15]

Contextual estimates place the 2004 avian-influenza outbreak investigation, response and management cost at approximately 4 million US dollars.[17]Average per-capita income was reported as 375 US dollars and health spending as about 12 US dollars per person, with households financing more than half of health expenditure through medicines and user fees.[17][13]Funding is described as essential, but the supplied material does not provide a consolidated financing strategy, complete funding schedule, verified financing gap, financing shares or economic assumptions.[15][8][4]