Abstract
ABSTRACT Background: In 2006, Malawi developed a national influenza plan to mitigate, prevent and manage the burden of infection should an outbreak occur. In 2009, it translated its contingency plan to respond to the unfolding influenza pandemic. However, little is known of how Malawi translated its national influenza plan into response actions, or the success of these responses. Objective: To investigate how Malawi translated its preparedness plan and so broaden our understanding of the outcomes of the responses. Methods: We draw on data from 22 in-depth interviews with government policymakers and people working at a policy level in various non-governmental organisations, conducted to assess the level of preparedness and the challenges of translating this. Results: Through a number of public health initiatives, authorities developed communication strategies, strengthened influenza surveillance activities and updated overall goals in pandemic training and education. However, without influenza drills, exercises and simulations to test the plan, activating the pandemic plan, including coordinating and deploying generic infection control measures, was problematic. Responses during the pandemic were at times ‘weak and clumsy’ and failed to mirror the activities and processes highlighted in the preparedness plan. Conclusions: Participants stressed that in order to achieve a coordinated and successful response to mitigate and prevent the further transmission of pandemic influenza, good preparation was critical. The key elements which they identified as relevant for a rapid response included effective communications, robust evidence-based decision-making, strong and reliable surveillance systems and flexible public health responses. To effectively articulate a viable trajectory of pandemic responses, the potential value of simulation exercises could be given more consideration as a mean of sustaining good levels of preparedness and responses against future pandemics. These all demand a well-structured planning for and response to pandemic influenza strategy developed by a functioning scientific and policy advisory committee.
Highlights
In 2006, Malawi developed a national influenza plan to mitigate, prevent and manage the burden of infection should an outbreak occur
The broad categories of analysis that policymakers primarily referred to were challenges and operational problems encountered when responding to a pandemic influenza
Discrepancies are expected in any pandemic planning nationally or internationally due to the uncertainty associated with pandemics, it is important to have a consistent basis for planning, especially if it is to be applied at both local and national levels
Summary
In 2006, Malawi developed a national influenza plan to mitigate, prevent and manage the burden of infection should an outbreak occur. The World Health Organization (WHO) issued warnings of the potential of serious disease through animal-to-human transmission, and expressed concern that once a pandemic had started, it would be too late to undertake many of the activities required to minimise its impact [3]. These threats of an imminent pandemic constituting a ‘Public Health Emergency of International Concern’ led to the publication of guidelines to assist its member states to prepare for a new pandemic in 1999 [3]. Most countries in Africa responded by developing plans aimed at reducing the transmission and threat intensity of pandemic influenza across rather than within national borders [7]
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