International avian influenza and pandemic preparedness and response: Emerging challenges

The global spread of H5N1 avian influenza A virus is a major human health threat due to its considerable pandemic potential. A pandemic could kill millions, especially in developing countries. Preparedness is crucial to prevent or delay a pandemic, and to reduce morbidity and mortality. Significant global investment has been directed toward helping developing countries build pandemic preparedness capacity; the U.S. Government (USG) is the leading international investor.

The U.S. Department of Health and Human Services, Office of Global Health Affairs recently completed an analysis of perceived gaps in international pandemic preparedness. This report presents key findings and timely information which can be used by policymakers and other stakeholders for planning and program development.

A multifaceted approach to data collection was employed, including a comprehensive literature review and roundtable discussions with subject matter experts from U.S. academic institutions, non-government organizations, and USG Agencies. A modified Delphi process yielded a prioritized list of critical gaps in international pandemic influenza planning, programmatic, and response activities. These emerging challenges include:

1. Need to revise National Preparedness Plans to more accurately reflect nations' dependence on and integration with global markets for supply chains.

2. Promote sustainability of pandemic preparedness by integrating with other disease programs and by making them more directly relevant to local conditions and needs.

3. Increase coordination and collaboration between the animal health and public health sectors.

4. Conduct efficacy studies on non-pharmaceutical interventions.

Further study and analysis are recommended in order to build upon these findings and assess implications for pandemic influenza policy and program development.