Improving New Zealand's preparations for the next pandemic

Scott, Julia; Wilson, Nick; Baker, Michael G

New Zealand's pandemic planning is currently embedded in the Civil Defence and Emergency Management framework (see Figure 1 ). This arrangement is recommended by WHO 14 Commentary countries aiming to prevent and respond to the international spread of disease. 19(a2) They require States to assess, strengthen and maintain core capacities for surveillance, risk assessment, reporting and response, and notify WHO of all events that may represent a Public Health Emergency of International Concern, including unnamed diseases or events, aiming for an all-hazards approach. 19 Antimicrobial resistance is not specifically listed in the IHR, but is included in the guide to implementation as a risk to be targeted by national initiatives. 20 Although the IHR have been widely criticised, it was a lack of implementation rather than the agreement itself that was responsible for failures in this response, according to the Review Committee on the role of the IHR (2005) in the Ebola outbreak and response. 21 Unfortunately there has been only a partial international response to the IHR, with just 35% of State Parties (including New Zealand) having core capacities in place by the end of 2015. 21, 22 Full implementation will require support for lowincome countries to strengthen their health systems. 21 The Review Committee has developed a draft implementation plan for their recommendations. This aims to: accelerate countries' implementation of IHR, with particular focus on countries with high vulnerability to emerging infectious diseases and low capacity; strengthen WHO's capacity to implement IHR and respond to emergencies; and improve monitoring of IHR core capacities by introducing a joint external evaluation tool. 23 One facet of this implementation plan is the development of a five-year global strategic plan by WHO and will emphasise the importance of making use of existing frameworks, including the Asia Pacific Strategy for Emerging Diseases (APSED). 23 Other frameworks have been developed to assist countries to implement the IHR, notably the Global Health Security Agenda (GHSA each with five-year targets, actions and indicators. These action packages are intended to facilitate specific commitments and leadership from countries involved. An assessment tool for essential national structures and functions has also been developed and piloted. 25 The recently developed IHR (2005) core capacities joint external evaluation tool is structured similarly, with 19 areas grouped under the headings 'prevent' , 'detect' , 'respond' and other IHR-related hazards and points of entry. 23 It is recommended that countries undertake one external evaluation every four years. 23 APSED is a strategic framework for countries of the Western Pacific and South East Asian regions to strengthen their capacity to manage and respond to emerging infectious disease threats, and comply with IHR (2005). 27 It recommends collaboration mechanisms between human and animal health sectors, and that national pandemic preparedness and response plans should be integrated into a public health emergency plan for all emerging infectious diseases. 28 Its third version is currently in draft and now has eight focus areas: public health emergency preparedness; surveillance risk assessment and response; laboratories; zoonoses; prevention through health care (including antimicrobial resistance); risk communication; regional preparedness alert and response; and monitoring and evaluation. 9 At a recent (F