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Latin America and the Caribbean prepare for a pandemic

Worldwide, more than half the people who have contracted the H5N1 bird flu virus strain have died from the disease, according to the World Health Organization’s official tally. Just in 2006, 55 of the 85 people who contracted the disease died from it.  

Although it is difficult for a person to catch the virus currently, unless s/he comes into close contact with an infected bird, health experts are concerned that the virus could mutate into a “human-adapted” form that could be easily transmitted among people and start a flu pandemic. So it’s little wonder that public health officials in the Americas have been working to prepare for such a possibility in the hemisphere.

At a recent conference titled “Responding to an Influenza Pandemic in the Americas,” hosted by the Center for Strategic and International Studies (CSIS) and the Pan American Health Organization (PAHO) in Washington, DC, experts warned that although the health consequences of an influenza pandemic could be enormous, possibly killing millions of people, many other sectors of the economy would be seriously affected as well.

If a flu pandemic were to begin, you would see disruption of trade and commerce around the world, not to mention an increased demand for law enforcement and security, interruptions in public services, and a deterioration of social support mechanisms, predicted Dr. Mario Libel, PAHO advisor on communicable diseases.

People should be aware that in a pandemic situation, extreme staff shortages of between 25 and 40 percent are likely to occur in all sectors of the economy, including essential services such as healthcare, transportation and electricity, warned Barbara Graff, director of emergency management of the US city of Seattle, Washington.

On a local level, Graff stressed the importance of establishing community partnerships now to plan for pandemics and other emergencies. “It’s vital to include everyone who’s likely to be affected [by a pandemic]—fire fighters, the police, schools, the Red Cross, businesses and chambers of commerce, telecommunications services, public utilities…everyone,” Graff said.
 
While community planning is important at the local level, it’s also important for countries to have a coordinated national preparedness plan, said Dr. Clarissa Etienne, assistant director of PAHO. Dr. Etienne reported that all countries in the region of the Americas, with the exception of 4 or 5 small countries in the Caribbean, have already submitted such a plan to PAHO. “They are in various stages of complexity,” she said.

Dr. Etienne and other health experts say that efforts to avert a pandemic are much more likely to succeed if countries and sectors cooperate to strengthen efforts against both avian and pandemic flu. “All sectors, including all sectors of government but also civil society and the private sector, need to be involved in this process,” said Dr. Etienne. “It is critical that we all work together to prevent this threat or to mitigate its effects.”

Pandemic flu preparations in Brazil

Brazil has had a national influenza pandemic preparedness plan (NIPPP) in place for several years, said Brazilian under secretary of Health Surveillance Dr. Jarbas Barbosa da Silva. The country began planning for a flu pandemic in 2003, when the World Health Organization first recommended that all countries do so. “Now, we’re working on creating state preparedness plans; our target date for completing these plans is the end of June 2006,” said Barbosa da Silva.

Brazil’s plan has six facets, Barbosa da Silva indicated, strengthening public health surveillance, a health supplies strategy, determining the likely demand for healthcare, developing technical standards and training for doctors, nurses and other healthcare providers, social communication activities, and containment measures.

Barbosa da Silva puts particular emphasis on public health surveillance. “The impacts of a delay in reporting new influenza cases can make a huge difference in the burden on the healthcare system, and even more so in a pandemic situation” he said. That’s because in a pandemic, even a one-day delay creates an opportunity for the virus to spread from a few to many individuals.

“Brazil has an emergency room for health surveillance, staffed by a team of epidemiologists, who monitor the national animal and public health situation for cases influenza, as well as other diseases,” Barbosa da Silva continued.

Barbosa da Silva concedes that in the event of a full-fledged influenza pandemic, Brazil is not in a position to vaccinate its citizens against the virus. “We probably won’t have vaccines, since it’s not very feasible to increase global production capacity in the short term.”

But the country does have a pilot unit with the capacity to make H5N1 vaccines on a small scale. In addition, the country has purchased 90 million doses of antiviral drugs—good for 9 million treatments—for stockpiling purposes, Barbosa da Silva indicated.

To help prepare doctors and nurses for an influenza pandemic, the Brazilian Ministry of Health, along with PAHO and the Brazilian Federal Council of Medical Doctors, has developed an online self-directed training course that covers patient care as well as biosafety measures. 

“Communicating with the public is also a priority in a pandemic situation,” Barbosa da Silva said. “After all, this is not just a public health problem, it also has psychological and social aspects that can only be handled by providing transparent information and inspiring confidence in the government.”

On July 11, the IDB and PAHO are co-hosting a seminar at IDB headquarters in Washington, DC, on the role of the press in communicating the possible consequences of avian and pandemic flu for Latin America and the Caribbean.