Anticipation and response: pandemic influenza in Malawi, 2009

Sambala, Evanson Z.; Manderson, Lenore

From 2006, in anticipation of an outbreak of pandemic influenza, Malawi drafted a preparedness plan that would assist in reducing its threat and intensity. Although there was substantial preparedness planning and progress in its cycle of development, many planning tasks and responses remained unmet. The 2009 HIN1 pandemic influenza arrived sooner than was expected, and the plan was activated in April 2009 with inadequate time for influenza drills, exercises and simulations to test the plan. Surveillance at the time, however, included only screening for possible influenza cases at country borders. Activities were incomplete prior to and during the pandemic, and were characterised by poor reporting, lack of surveillance systems and infrastructure. Adequate reporting would have required building the capacity of the virology reference laboratory to conduct appropriate tests and collect appropriate and timely data to characterise the epidemic by person, place and time. This can be done through influenza web-based reporting systems and where possible, the use of rapid test technology in rural areas to capture real time surveillance data.