Overview

WHO previously published pandemic preparedness guidance in 1999 and a revision of that guidance in 2005. Since 2005, there have been advances in many areas of preparedness and response planning. For example, stockpiles of antiviral drugs are now a reality and a WHO guideline has been developed to attempt to stop or delay pandemic influenza at its initial emergence. There is increased understanding of past pandemics, strengthened outbreak communications, greater insight on disease spread and approaches to control, and increasingly sophisticated statistical modeling of various aspects of influenza.

Extensive practical experience has been gained from responding to outbreaks of highly pathogenic avian influenza A (H5N1) virus infection in poultry and humans, and from conducting pandemic preparedness and response exercises in many countries. There is greater understanding that pandemic preparedness requires the involvement of not only the health sector, but the whole of society. In 2007, the International Health Regulations (2005) (IHR, 2005) entered into force providing the international community with a framework to address international public health concerns.

In light of these developments, WHO decided in 2007 to update its guidance to enable countries to be better prepared for the next pandemic. Therefore this document published in April 2009 replaces the WHO Global Influenza Preparedness Plan (WHO/CDS/CSR/GIP/2005.5). This document should be used in conjunction with the WHO checklist for influenza preparedness planning published by the World Health Organization in 2005.

Contents

• FOREWORD
• ACKNOWLEDGEMENTS
• EXECUTIVE SUMMARY
• 1. INTRODUCTION
• 2. BACKGROUND
  • 2.1 How influenza viruses with pandemic potential develop
  • 2.2 Ensuring ethical pandemic preparedness and response
  • 2.3 Integrating pandemic preparedness and response into general emergency preparedness
• 3. ROLES AND RESPONSIBILITIES IN PREPAREDNESS AND RESPONSE
  • 3.1 National preparedness and response as a whole-of-society responsibility
  • 3.2 WHO
• 4. THE WHO PANDEMIC PHASES
  • 4.1 Definition of the phases
  • 4.2 Phase changes
• 5. RECOMMENDED ACTIONS BEFORE, DURING AND AFTER A PANDEMIC
  • A PHASES 1-3
  • B PHASE 4
  • C PHASES 5-6
  • D THE POST-PEAK PERIOD
  • E THE POST-PANDEMIC PERIOD
• ANNEX 1 PLANNING ASSUMPTIONS
• ANNEX 2 REVISION PROCESS

This guidance is an update of WHO global influenza preparedness plan, the role of WHO and recommendations for national measures before and during pandemics, published by WHO March 2005.¹

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

1

WHO Global Influenza Preparedness Plan. The role of WHO and recommendations for national measures before and during pandemics, World Health Organization. 2005 (WHO/CDS/CSR/GIP/2005.5)