10. Governing body matters

10.1 Key issues arising out of 75 WHA and EB 150 & 151 Influenza preparedness in WHO’s South- East Asia region

3 June 2022

In the Seventy-fifth World Health Assembly in 2022, the Director-General reported implementation on influenza preparedness, the adopted decision in WHA73(14). It was pointed out that   influenza preparedness is addressed holistically through the Global Influenza Strategy (2019-30) by providing (a) better tools for prevention, detection, control, and treatment of influenza and (b) building stronger country capacities meeting national needs in integration with national health security and universal health   coverage.

All Member States (MS) In WHO’s Southeast Asia Region (SEAR) played a proactive role in influenza preparedness, particularly, through National Influenza Centers (NIC) in the Global Influenza Surveillance and Response System (GISRS) that celebrates 70 years of functionality in 2022. It is reiterated the need for three remaining MS without NICs to enhance their efforts to upgrade national influenza public health laboratory to the status of NIC for enhancing influenza preparedness in collaboration with and technical support of the WHO coordinated GISRS.

The decennial active Pandemic Influenza Preparedness (PIP) Framework has been instrumental as the key guidance parameter for pandemic influenza preparedness and response in SEAR.    WHO objectively prioritized countries in SEAR that need more support for development of PIP capacities to receive PIP Partnership Contribution (PC) funds.

Based on experience of the current pandemic, it is necessary to highlight that the current influenza structure in the region be effectively utilized for (a) sustainable integrated surveillance for respiratory viruses of pandemic potential and(b) implementing the regional roadmap for diagnostic preparedness, integrated regional laboratory networking and genomic surveillance (2023-27).

Member states in SEAR are congratulated for implementation of the global influenza strategy and the PIP framework in the region in the context of COVID-19 pandemic by having re-prioritized them in synergy with COVID-19 pandemic response. It is noted that MS have   successfully leveraged existing influenza national capacities, an outcome of the global influenza strategy, built over the years under PIP for COVID-19 response. At the same time, COVID-19 stressed the need for continued and on-going improvement of influenza sentinel surveillance including surveillance at animal- human interface as a pre-condition for early warning and alert for response to non-seasonal influenza and other respiratory borne pandemic threats.

A special reference is made to the effective use of the well-established South-East Asia and Western Pacific annual bi-regional meeting platform by MS, WHO and partners for establishment and sustenance of policy guidance and strategic directions for influenza control, prevention, and pandemic preparedness synergistically in two WHO regions.

WHO under influenza preparedness agenda played an active   role to solicit MS inputs, expertise, experience, and support through regional consultations on (1) Implementation of WHO guidance on maintaining influenza surveillance and monitoring of SARS-CoV-2 through national surveillance systems during the COVID-19 pandemic in the SEA Region Member States and (2) sustainable, integrated, resilient surveillance systems for respiratory viruses of pandemic potential? The latter fed regional needs, concerns, and specific suggestions into the WHO Global Consultation on “Crafting the Mosaic”: Resilient surveillance systems for respiratory viruses of pandemic potential to draft the   global guidance which will be released soon. 

In terms of the progress being made across all MS, Influenza like illness (ILI) and Severe Acute Respiratory Infections (SARI) sentinel surveillance is functional in all MS. Eight MS have NICs while other 3 MS work very closely with WHO and WHO Collaborating Centers to meet the standards to upgrade their Influenza Public Health Laboratories    to NICs. All MS have national influenza pandemic preparedness plans (IPPP). Six countries have updated their IPPPs using the Pandemic Influenza Risk Management framework since 2017 and four are currently involved in the updating process.  Across the SEAR, three MS have endorsed national policies for seasonal influenza vaccines.

 As in most parts of the world, COVID-19 pandemic has severely impacted on health systems built for preparedness and response to Influenza pandemics in MS of the SEAR. However, with efforts to reprioritize influenza related interventions in synergy with COVID-19 pandemic response, MS have maintained and even enhanced surveillance as the core function of PIP. Whereas in 2020 we witnessed a global decline in the testing of samples for influenza viruses, in 2021, the South-East Asia Region saw a significant improvement, with a 300% increase on 2020 levels, which was also an increase on pre-COVID performance.

Moving forward, WHO reiterates the   importance of influenza preparedness in SEAR and its awareness of multiple challenges lying ahead in implementing the global strategy and PIP framework. As such, WHO accords a high priority to influenza preparedness given its importance to the Regional Strategic Roadmap on Health Security and Health System Resilience for Emergencies (2023-2027) that was endorsed in the 75th session of the RC and acceleration of the progress towards universal health coverage, with advancing access to global influenza tools.

WHO strongly advocates   for and supports addressing systemic issues faced by countries in   virus-sharing with the GISRS and access to benefits therein by MS.? There is a request for Member States in SEAR to provide the highest political and policy level support to plan for mitigating the potential public health impacts of the implications of the Nagoya Protocol implementation in MS with   respective bio -diversity secretariats in relevant non-health ministries in their respective MS.  

WHO assures policy, strategic and technical support to Member States to establish efficient, cost effective, sustainable integrated sentinel surveillance for respiratory viruses of pandemic potential using influenza systems as the foundation while being supplemented with other key resilient surveillance system   elements?

 To reflect the progress made by Member States on SEAR. during the 75th Regional Committee   session, two publications titled “Status of Influenza in WHO South-East Asia Region 2021 (compendium)” and “Pandemic influenza preparedness (PIP): Implementation of the Pandemic Influenza Preparedness (PIP) Framework Partnership Contribution (PC) funds in the WHO South-East Asia Region - Annual report 2021”  that indicate the  progress of influenza preparedness in the region through implementation of the Global Influenza strategy (2019-30) and the PIP framework   were launched by WHO’s Health Emergencies Programme.