National Capacities of Alert and Response for Infectious Diseases, under the IHR(2005) Chile, 2010 Chile, Ministry of Health, Department of Epidemiology
IHR(2005) Implementation National Policy/Priority: Law (Official publication) CORE CAPACITY REQUIREMENTS FOR SURVEILLANCE AND RESPONSE Detection Local Level Communication Preliminary control Control, confirmation and support Intermediate level Evaluation and communication to the national Evaluation and notification to WHO National level Public Health response
Surveillance and Response: What does Chile have for surveillance? • Legislative background • Supreme Decree N°158 and Technical Standard • IHR: Law (2008) • Epidemiology Department at national and regional level (Chile has 15 Regions): • Epidemiologists, all with master degree in Public Health, geographer, journalist, computer technicians. • Network with more than 3000 delegates of epidemiology at local level. • Multidisciplinary Rapid Response Team • Laboratory Network • National Reference Laboratory and national laboratories network • International Networks: WHO respiratory viruses, WHOGSS y PulseNet Latin America
Surveillance System Statistics Department – Ministry of Health National Department of Epidemiology Reference Laboratory Technical reports, Bulletins, Web site (ISP) L a b o r a t o Intermediate level r y N e t Technical reports w o r k Health care Community Local laboratory Sanitary Offices Facilities and Schools in entry poins Hospitals Rumors
What does Chile have for surveillance? • Computer development • Computer equipment upgrade at national and regional level (15) • Development of differents applications • Capture Data • Epidata (Inmediate disease notification, outbrakes) • Filemaker (Daily notifications) • On line system (sentinel surveillance) • ISIS (PAHO’s: AFP surveillance, measles and rubella) • SIME (PAHO’s: Public Health Event Management) TENDENCIA SEGÚN TIEMPO Y ESPACIO DEL BROTE DE LA NUEVA INFLUENZA A (H1N1). TENDENCIA SEGÚN TIEMPO Y ESPACIO DEL BROTE DE LA NUEVA INFLUENZA A (H1N1). CHILE, SE 28, 2009 CHILE, SE 28, 2009 • Arica Arica Arica Arica Data Analysis Tarapacá Tarapacá Tarapacá Tarapacá Antofagasta Antofagasta Antofagasta Antofagasta • Atacama Atacama Atacama Atacama SPSS Coquimbo Coquimbo Coquimbo Coquimbo • Epiinfo 6.2, Epiinfo 2002 Valparaíso Valparaíso Valparaíso Valparaíso Metropolitana Metropolitana Metropolitana Metropolitana O’ Higgins O’ Higgins O’ Higgins O’ Higgins • Maule Maule Stata Maule Maule Tasa máxima/100000 hab. Tasa máxima/100000 hab. Bíobío Bíobío Bíobío Bíobío < 50 < 50 Araucanía Araucanía Araucanía Araucanía • Arcview 50 - 100 50 - 100 Los Ríos Los Ríos Los Ríos Los Ríos 100 - 200 100 - 200 Los Lagos Los Lagos Los Lagos Los Lagos 200 - 500 200 - 500 • SigEpi > 500 > 500 Aisén Aisén Aisén Aisén • Instant Atlas Magallanes Magallanes Magallanes Magallanes 18 18 19 19 20 20 21 21 22 22 23 23 24 24 25 25 26 26 27 27 28 28 29 29 30 30 31 31 32 32 33 33 Fuente: Vigilancia centinela de Enfermedad Tipo Influenza Fuente: Vigilancia centinela de Enfermedad Tipo Influenza Semanas epidemiológicas Semanas epidemiológicas
What does Chile have for surveillance? • Dissemination and communication mechanisms • El Vigía (semestral bulletin), BEM (monthly electronical bulletin) and • web page: http://epi.minsal.cl, www.influenza.cl, bioterrorism International network • MERCOSUR, APEC, PAHO/WHO, ORAS-CONHU • Network for Emergent diseases of South Cone
Department of Epidemiology web site: Bioterrorism Protocols to response front suspicious packages and envelopes
Emergency Committee of Chemical and Biological Weapons Since Sept 2001, the WHO made an international call to strengthen national capabilities for responding to the possible use of chemical and biological weapons. On 28 September, the Ministry of Health formed a “Committee for Bioterrorism Risk Assessment”. The Committee is composed of representatives of the following areas: Epidemiology Department Environmental Health National Reference Laboratory (ISP) Unit of Chemistry and Pharmacy Central Warehouse Healthcare Network Infectious Diseases Advisors Toxicology advisors Communication Department Governmental Institutions : National Government, Ministry of Defense; Fire Department; Military and law enforcement; others.
Protocol Anthrax attack ISP Medical Response for anthrax cases Department of Epidemiology: Police: Specialist Fire protocols developed in 2001: detect, Group (GOPE) Department listing exposes, collect specimens, carries the package isolated the Investigación epidemiológica identify other cases and exposes and to ISP place and indicate chemoprophylaxis: proceed to Ciprofloxacine or peniciline. decontaminate Community, rumors, others Community, rumors, others
What does Chile have for response? CREATION OF NATIONAL IHR FOCAL POINT Objective: To facilitate national and international communication, information processing and decision making regarding public health. Functioning: 24/7 15 Regional IHR Focal Points in coordination 24/7 with Border Sanitary Offices and National IHR Focal Point. National Centre for communication with WHO 24/7 Coordinate response: SAG, GOPE, SAMU, FFAA, ONEMI, ISP
Redefinition of Sanitary Procedures • Revision of the legislative and regulatory background • Points of entry designations • Ports, Airports, ground crossings • Creation of Sanitary Offices (SO) in points of entry • Sanitary measures • Manual of procedures • Contingency plans • Definition of capabilities • Information Systems
Designation of Ports (WHO) • Selection Criteria: • Movement of vessels • Anual demand for certificates in 2006 and 2007. • Capacity and geographic distribution • Survey to establish the capacity to develop health inspections of ships and issuance of Health Certificates. • IHR Designated Ports: 19 Port of Valparaíso ‐ Chile List of chilean ports designated is in the WHO web site: http://www.who.int/ihr/ports_airports/portslanding/es/index.html
Implementation of 6 Sanitary Offices in Entry Points • Reduce the risk of international spread of disease through: • The adoption of permanent and effective public health measures and • The dotation of response � Human Resources: 29 new officials capacities at airports, ports and ground crossings.
IHR, Human Resources dotation • Budget for implementation of IHR. • Estimation of needs for the Sanitary Offices (SO): number of people and infrastructure for the sanitary control • Airport and SO: • 3 to 6 people for each SO (total, 29) • Priority of professionals and technicians in the area of health, with experience in patient care. • Designated Ports (to WHO) • 6 technicians with inspection functions • 6 paramedic technicians with surveillance functions.
Implementation of Sanitary Offices in Entry Points • Manual of Functions of Designated Entry Points: standarize health measures related to the entry of passengers at airports and ground crossings. • Contingency Plans : National level Plans (Example: Pandemic Flu Preparedness), regional levels and for each entry point according to potential risks. Web site: www.pandemia.cl
Basic Capacities in the context of MERCOSUR Within the framework of MERCOSUR, the instruments of evaluation of capacities were elaborated for: • Core capacity requirements for surveillance and response: Annex 1 A of IHR(2005) • Core capacity requirements for designated airports, ports and ground crossings: Annex 1 B of IHR(2005) Intention: to know the system monitoring and response capacity for planning the implementation of new capacities in fulfillment of the demands of IHR(2005)
Preliminary results
Percentage of fulfillment of the National basic capacities Porcentaje de cumplimiento de las capacidades basicas de vigilancia y respuesta. Nivel Nacional, Chile 2009. 100 90 80 70 % alcanzado 60 50 40 30 20 10 0 Promedio Marco Legal Promedio capacidad Promedio investigar, Administrativo para detectar, evaluar y intervenir, comunicar notificar
International airport of Santiago, Chile. Porcentaje de cumplimiento de capacidades básicas, Aeropuerto AMB. Programas de Chile, 2008. supervisión, Sala 100 aislamiento, 90 Manuales % alcanzado operacionales 80 70 60 50 40 30 20 10 0 Promedio capacidad Promedio capacidad Promedio capacidad para comunicar básica de rutina para responder ante una ESPII
Next steps • Plans of Action: actions to address identified needs in the capacity at national, sub-national and local levels.
Invest in Health, Build a Safer Future • World Health Day 2007 Key: Surveillance A good surveillance system allows timely and adequate response. Detection Detection Verification tion Verifica Risk Evaluation Risk Evaluation Response Response
Public Health Emergencies ♦ Human health is an essential component but ..... not all ♦ Responsibility extends to all government and society.
Recommend
More recommend
