Implementing the Almaty Declaration: Experiences and Future Opportunities” – Harbin, PR China

Implementing the Almaty Declaration: Experiences and Future Opportunities” – Harbin, PR China

Countries and areas of the WHO Eastern Mediterranean and European regions that participated in Operation MECACAR “Implementing the Almaty Declaration: Experiences and Future Opportunities” – Harbin, PR China 26 September 2007 Geneva, 7-9 Nov. 2005 (UN system) Local Regional Global 1 5 9 Development of ‘Rapid response’ Expanded global integrated teams of experts anti-viral stockpile national plans 2 Aggressive control of 6 10 Global strategy Avian Influenza in birds Stronger country and for vaccine research and human pandemic regional capacity and development preparedness 3 7 11 Assess needs of Costing of country Expanded network of veterinary plans and regional and influenza laboratories infrastructures global requirements 4 8 12 Voluntary compliance Finalize coordination Multi-country technical of International Health framework building on networks Regulations existing mechanisms Influenza Regional Meeting (12-13 June 2006) Principles: Joint funding and planning of agencies & donors Move towards performance-based mechanism towards regional collaboration to fight influenza threats Sponsors: WHO, UNICEF, UNDP, FAO, USAID, US-CDC, European Commission, World Bank, ADB (contributions: $ 7,000 - $ 25,000) Extra speakers: UNSIC & OiE Central Asia Roundtable Participating (=CAREC): Invited: • Kazakhstan, Kyrgyz • International Republic, Tajikistan, organizations Turkmenistan, Uzbekistan • Greater Mekong • Russian Federation Sub-Region • XUAR, PR China (e.g. Thailand) • Afghanistan, Mongolia Experts (human & animal health sector, coordination & communication) & Senior officials Institutional framework • Intersectoral government co-ordination (agriculture, health, emergencies/ KAZ) -> endorsed 7 April • Interagency co-ordination (ADB, EC, UNSIC & 3 UN agencies [FAO, UNICEF, WHO], USAID, World Bank) -> weekly teleconference meetings (27 March, 3 & 10 April) • Conference Secretariat linked with technical working group & administrative support -> established 29 March Country needs (next 2-3 yrs) 1. Coordination & communication 2. Surveillance & early warning (animal & human influenza) 3. Response capacity to handle local outbreaks 4. National health system strengthening, including surge capacity to address generalized epidemics (a.o: lab equipment, protective clothing, overtime payment for staff, etc…) Central Asian & Caucausus: $ 45 million (including $10 to $ 15 million self-funded) other Asian developing countries: $ 711 (incl. $240- $380) Regional needs (next 2-3 yrs) 1. Stockpiles of drugs & medical equipment -> economies of scale 2. Exchange of information (transparent & immediate reporting) through: a) Regional training of animal and health workers b) Regional networking (workshops, communication system) Animal (FAO): $ 10 to 20 million for CAREC-countries Human (WHO): $ 11 million for CAREC countries Influenza Almaty Declaration (13 June 2006) 18.Create 3 working groups who draft plans: (a) Disease surveillance & response (b) Laboratory capacity building (c) Public communication, governance 17.Coordination committee with first priority: Establish mechanism for regular exchange of information, including early-warning system. Influenza Committee of donors & technical agencies – (Tele)conference Meetings in Almaty 1. 27 March 2006 (European Commission) 2. 12 June 2006 (ADB & Eur. Commission) 3. 6 December 2006 (USAID & US-CDC) 4. 18 May 2007 (ADB & US-CDC & WB) Burning questions: • Joint planning for capacity building (human/ animal health) • Common technical guidance on diagnostics Immunization: MECACAR < 80% 1993 80-89% >89% No report 1999 Routine immunization coverage (OPV3 in children < 1 year old) Immunization MECACAR Meetings: 1. 29-30 January 1995 (Ankara, Turkey) 2. 27-28 September 1995 (Tehran, Iran) 3. 14-16 October 1996 (Tashkent, Uzbekistan) 4. 20-22 October 1997 (Rome, Italy) 5. 20-22 October 1998 (Cairo, Egypt) 6. 20-22 October 1999 (Ankara, Turkey) 7. 19-21 March 2001 (Cairo, Egypt) 8. 8-10 September 2003 (Budapest, Hungary) 9. 29-31 August 2006 (Istanbul, Turkey) • 17 May 2007 (Geneva, Switzerland) / MECACAR New Millenium MECACAR: polio eradication & measles elimination Immunization Days in Kyrgyz Republic, Iraq and Afghanistan (1995) Incidence of poliomyelitis > 10 1994 1 - 10 0 polio No report 2000 Poliomyelitis & AFP reported cases EURO (10 countries) EMRO (8 countries) Surveillance quality Non-polio AFP < 1 AND > 80 % adequate specimen (2 within 14 days) Non-polio AFP >= 1 OR >= 80 % adequate specimen (2 within 14 days) Non-polio AFP >= 1 AND >= 80 % adequate specimen (2 within 14 days) No report MECACAR Meetings 1. 29-30 January 1995 (Ankara, Turkey) 2. 27-28 September 1995 (Tehran, Iran) 3. 14-16 October 1996 (Tashkent, Uzbekistan) 4. 20-22 October 1997 (Rome, Italy) 5. 20-22 October 1998 (Cairo, Egypt) 6. 20-22 October 1999 (Ankara, Turkey) 7. 19-21 March 2001 (Cairo, Egypt) 8. 8-10 September 2003 (Budapest, Hungary) 9. 29-31 August 2006 (Istanbul, Turkey) • 17 May 2007 (Geneva, Switzerland) / MECACAR New Millenium MECACAR New Millenium (17 May 2007) Commitment for: • common indicators to guide actions • mechanism for timely exchange of information about polio, measles and other outbreaks in our countries; • continued efforts to achieve international partnerships and support. Areas where autochthonous malaria cases reported, Trans–Caucasian countries, 2006 Georgia Armeni a Azerbaijan Areas with reported autochthonous cases of malaria, Central Asia, 2006 AREAS WHERE AUTOCHTHONOUS CASES ARE REPORTED AREAS WHERE AUTOCHTHONOUS CASES OF P. FALCIPARUM ARE REPORTED Malaria Strata in Central Asia Number of P. falciparum cases and their active foci in Tajikistan, 2000-2006 900 180 800 160 700 140 600 120 500 100 Number of cases Number of foci 400 80 300 60 200 40 100 20 0 0 2000 2001 2002 2003 2004 2005 2006 NUMBER OF FOCI OF P. FALCIPARUM MALARIA IN TAJIKISTAN DISTRICTS FOCI 2002 Darvoz 4 Dushanbe 8 Rudaki 7 Rasht 1 Vahdat 6 Varzob 1 Faizabad 1 Shahrinav 1 Javan 16 Bohtar 7 Nurek 5 Vahsh 5 Kumsangir 1 Sarband 3 Dangara 7 Muminobod 1 Dushanbe Hovaling 1 Baldjuvan 13 Kolhozabad 23 Kurgan- Jilikul 4 Tube Jomi 15 Kurgan-Tube8 Vose 2 158158 Shurobad 2 Huroson 2 Pjanz 6 Kuljab 8 Active foci of P. falciparum malaria (residual & new) NUMBER FOCI OF P. FALCIPARUM MALARIA IN TAJIKISTAN DISTRICTS OF FOCI Horog 1 2004 Dushanbe 1 Rasht 1 Rudaki 3 Vahdat 3 Varzob 1 Javan 5 Bohtar 3 Vahsh 10 Dangara 5 Temurmalik 2 Jomi 23 Kurgan- 2 VoseTube 1 Dushanbe Huroson 2 Pjanz 7 Kurgan- Tube 7070 Active foci of P. falciparum malaria (residual & new) DISTRICT NUMBER FOCI OF P. FALCIPARUM MALARIA IN TAJIKISTAN S OF FOCI Dushanbe 1 2005 Rudaki 2 Vahdat 1 Javan 2 Vahsh 11 Dangara 8 Temurmal ik 2 Jomi 5 Jilikul 1 Nurek 5 Huroson 10 Vose 1 Dushanbe Kurgan- Tube 4949 Active foci of P. falciparum malaria (residual & new) FOCI OF P. FALCIPARUM MALARIA IN TAJIKISTAN NUMBER DISTRICT S OF FOCI 2006 Dushanbe2 Vakhdat 4 Nurobod 1 Vahsh 3 Temurma lik 1 Jomi 3 Nurek 1 Dushanbe Kurgan- 1515 Tube Active foci of P. falciparum malaria (residual & new) Re-emergence of malaria, PR China (2003).

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