Pasirengimo Gripo Pandemijai 2019–2023 Metų Programos Patvirtinimo

Objectives

The 2019–2023 Influenza Pandemic Preparedness Programme seeks to reduce the scale and severity of an influenza pandemic’s impact in Lithuania through a phased, cross-sector framework that protects health, sustains essential services and meets essential public needs.[1][2]It applies principles of equality, impartiality, effectiveness, proportionality, non-discrimination and solidarity, and is aligned with European Union, World Health Organization and European Centre for Disease Prevention and Control preparedness guidance.[1][2][3]

• Apply four preparedness stages: the interpandemic period, alert period following detection of a novel human influenza subtype, pandemic period of rapid transmission, and transition period as risks decline.[4][5]
• Maintain continuity of institutional functions, healthcare provision, public administration, essential services, the economy, education, culture and social services when widespread illness disrupts normal operations.[2][6]
• Strengthen surveillance of influenza and acute upper respiratory infections in people, detect novel subtypes promptly, and coordinate this work with animal influenza and epizootic surveillance.[7][8][9]
• Improve prevention and containment through seasonal influenza vaccination, preparedness for pandemic vaccination, antiviral planning, infection prevention and control, public information, and cross-border coordination.[10][11][12][13]
• Increase seasonal influenza vaccination among risk groups towards the World Health Organization and European Union Council-recommended 75% coverage, recognising that Lithuania’s state-funded coverage had increased but remained among the European Union’s lowest.[10]
• Ensure access to vaccines and antiviral medicines, acknowledging that pandemic vaccine production may take approximately six to eight months and may not initially meet demand.[11]
• Prepare healthcare institutions to isolate and treat individual cases, manage outbreaks and high patient volumes, maintain patient flows, and use alternative premises where additional hospital capacity is required.[14][15][16]
• Maintain laboratory capacity for specimen referral, virus characterisation and reporting, including the National Influenza Centre’s role within the National Public Health Surveillance Laboratory and its links to the World Health Organization regional laboratory network.[17][7]
• Monitor the pandemic’s epidemiological, virological and clinical development, including illness, mortality, sickness absence, healthcare capacity, essential-worker availability, emergency workload and resource needs.[18]
• Evaluate pandemic impacts and preparedness at national, municipal and institutional levels, use lessons learnt to revise plans, and identify resources needed for future pandemics.[19][5][20]

Implementation

Implementation is organised through a 2019–2023 phased action plan embedded in Lithuania’s wider emergency-preparedness and civil-protection arrangements.[6][21][22]The Ministry of Health monitors programme implementation, while a specialist consultation group supplies evidence-based advice, reviews institutional readiness and activities, and considers epidemiological surveillance information before and during a pandemic.[6][23]

• Coordinate preparedness among the Ministry of Health, the Emergency Health Situations Centre, the National Public Health Centre, the National Public Health Surveillance Laboratory, the Centre for Communicable Diseases and AIDS, municipalities, healthcare providers, veterinary authorities, universities, professional bodies, economic operators and other state institutions.[24][25][7][26]
• Review pandemic and emergency-risk analyses, revise institutional preparedness plans, update national recommendations and legal documents, and use exercises to identify and correct weaknesses.[24][25][9]
• Assess health-system readiness against the World Health Organization influenza pandemic risk and impact management checklist, identify deficiencies and plan corrective measures.[26]
• Maintain reserves of antiviral medicines, personal protective equipment and other medical supplies; assess stocks, laboratory readiness and essential resources, including vaccines and human resources.[25][27][15]
• Use European Union joint procurement arrangements, joined by Lithuania in 2014, to support collective acquisition of medical countermeasures, including pandemic influenza vaccines.[11]
• Activate emergency governance when needed: the Government Emergency Situations Commission may propose a state-level emergency, with civil-protection forces coordinated through the State Emergency Situations Operations Centre or, where assigned, the Ministry of Health.[22]
• Coordinate notification, information exchange and response measures with the European Commission, the European Centre for Disease Prevention and Control, the World Health Organization, European Union Member States and neighbouring countries.[13][28][29]
• Provide targeted information to the public, media, risk groups, healthcare professionals and public authorities, evaluate communication outcomes, and update dissemination arrangements across pandemic stages.[11][12][20]
• Continue measures from earlier phases as transmission intensifies, adapt surveillance and response to current evidence, redistribute personnel and services where necessary, and provide psychological and social support to affected people, communities and healthcare workers.[30][31][32]
• Track implementation through eight measurable criteria covering sentinel surveillance, reference-laboratory functions, vaccination among people over 65, preparedness exercises, institutional emergency readiness, animal-influenza information, early warning and response, and national coordination under the 2005 International Health Regulations.[33][34]
• Target, by 2023, 100% performance in reference-laboratory functions, animal-influenza information, early warning and response, and International Health Regulations coordination; 80 exercise participants; and 75% emergency preparedness among health institutions.[33][34]
• Finance implementation through responsible institutions’ approved state and municipal budget appropriations, alongside European Union and other structural funds, international programmes, the Compulsory Health Insurance Fund budget and other lawfully obtained funds; no monetary programme allocation or total cost is specified.[6]

Monitoring & Evaluation

The programme establishes a phased monitoring and evaluation system for influenza pandemic preparedness during 2019–2023, combining epidemiological and virological surveillance, institutional readiness assessment, laboratory monitoring, exercise-based learning, public-information review and post-pandemic evaluation.[1][3][6][19]Eight implementation criteria, with baseline values where available and 2023 targets, provide the principal measurable accountability framework.[33][34]

• Maintain continuous surveillance of influenza and acute upper respiratory tract infections, coordinate human and animal influenza surveillance, investigate outbreaks, detect novel virus subtypes and monitor antiviral resistance.[7][8][9]
• Use national epidemiological data to assess pandemic stages and adjust response measures, recognising that phases may occur at different times across countries.[3][4]
• Assess preparedness and pandemic activities through a specialist consultation group that reviews institutional information and epidemiological surveillance data.[23]
• Monitor implementation through the Ministry of Health against the phased action plan and the evaluation criteria and target values in the programme annexes.[6][21]
• Review pandemic and emergency-risk analyses, conduct preparedness exercises and use exercise results to improve plans and institutional readiness.[24][25]
• Check national and municipal health-system preparedness against the World Health Organization influenza pandemic risk and impact management checklist, identify deficiencies and plan corrective measures during 2020–2022.[26]
• Track vaccination among state-funded risk-group populations using Centre for Communicable Diseases and AIDS data, while aiming to increase coverage towards the World Health Organization and European Union Council recommendation of 75%.[10]
• Apply municipal epidemic-declaration criteria generally based on at least 100 combined influenza and acute upper respiratory infection cases per 10,000 inhabitants per week, with clinical influenza accounting for approximately 30% of registered cases.[17]
• Monitor essential resources, including medicines, vaccines, medical supplies, human resources, healthcare capacity, bed-days, emergency workload, alternative care capacity and mortuary capacity as the pandemic develops.[27][18]
• Notify the European Commission and the European Centre for Disease Prevention and Control promptly about confirmed human cases of a novel subtype, and share laboratory information through European Union reference-laboratory arrangements.[28][27]
• Evaluate the effectiveness of transmission-control measures, information transmission, antiviral distribution and use, healthcare-facility conditions, and the implementation of response measures across the health system.[12][35][15][36][32]
• Evaluate pandemic impact and preparedness-plan implementation at national, municipal and institutional levels, then submit proposals for improvement and identify resources needed for future events.[19]

The measurable criteria cover sentinel clinical and virological surveillance, World Health Organization reference-laboratory functions, vaccination uptake among people aged over 65, preparedness exercises, emergency readiness of health institutions, animal-influenza information, early warning and response, and national coordination under the 2005 International Health Regulations.[33][34]Key 2023 targets include 100% performance for reference-laboratory functions, animal-influenza information, early warning and response, and International Health Regulations coordination; 80 exercise participants; and 75% emergency readiness among health institutions.[33][34]

Named data and reporting bodies include the Emergency Health Situations Centre, Centre for Communicable Diseases and AIDS, National Public Health Centre, National Public Health Surveillance Laboratory, State Food and Veterinary Service and Ministry of Health.[33][34]The extracts do not specify a comprehensive reporting timetable, indicator definitions for every action, audit procedures or sanctions for non-compliance.[26][37][16][31]

Costing & Financing

The programme is financed principally through general appropriations for responsible institutions under annual state and municipal budget legislation, supplemented by European Union and other structural funds, international programmes, the Compulsory Health Insurance Fund budget and other lawfully obtained funds.[6]No total programme budget, activity-level monetary allocation, costing methodology, expenditure estimate or quantified funding gap is provided.[6][33][34]

• Fund responsible institutions through approved state-budget appropriations and municipal budgets.[6]
• Mobilise supplementary support from European Union and other structural funds, international programmes, the Compulsory Health Insurance Fund and other lawful sources.[6]
• Plan financial resources for preparedness and response, including maintenance of essential energy and fuel supplies during a pandemic.[28]
• Review resource availability and capacity, address shortages, and identify further requirements for future pandemic waves and subsequent pandemics.[7][30][19][5]
• Maintain or replenish preparedness resources, including antivirals, pandemic vaccines, personal protective equipment, laboratory materials, infection-control supplies and essential medical equipment.[25][28][37][15][20]
• Use European Union joint procurement arrangements to support access to medical countermeasures, including pandemic influenza vaccines.[11]

State-budget funding is specifically associated with antivirals, medicines and healthcare services, although no amounts or procurement volumes are given.[38][36]The historical assessment found that the planned quantity of accumulated antiviral medicines was the only 2016–2018 evaluation target not fully achieved, without identifying a financial value or quantity.[4]

Some actions are conditional on additional targeted funds, but the relevant amount, source, timing and any funding shortfall are not specified.[39]The source identifies vaccination as economically effective and notes that a pandemic may increase demand for medicines, medical supplies and social services, disrupt planned healthcare and potentially require revisions to state-budget and public-sector plans.[2][10]