London School of Hygiene & Tropical Medicine

Considerable gaps exist among European national pandemic plans, according to a new report published in the online edition of The Lancet on 20 April 2006.

The report, 'How prepared is Europe for Pandemic Influenza? An analysis of national plans', reveals marked discrepancies in pandemic preparedness across Europe. The authors conclude that further planning and implementation is needed so that governments can effectively respond in the event of a pandemic, recommending action by the European Union to ensure governments work together towards a coordinated approach.

Dr Richard Coker, the report's lead author said: "Wide gaps exist in the pandemic preparedness of European nations. With the ongoing spread of the H5N1 avian influenza virus in birds, and the impending threat of a pandemic, European nations need to work together to adequately prepare for the onset of such a pandemic."

The researchers reviewed the preparedness initiatives of all 25 European Union member states, as well as Bulgaria, Norway, Romania and Switzerland. 21 published national plans were eligible to be included in the final analysis.

The completeness and quality of these 21 national preparedness plans was assessed based on the World Health Organization's (WHO) preparedness checklist², addressing levels of:

• Planning and coordination
• Surveillance
• Public health interventions (public health control measures, vaccines and antivirals)
• Health system response
• Maintenance of essential services
• Communication
• Putting plans into action

Based on these evaluation criteria, the completeness score of the plans ranged from 24% to 80%, with the average level of completeness calculated as 54%.

With 194 confirmed cases of avian influenza in humans to date³, experts, including the WHO, agree that the next influenza pandemic is inevitable. Detailed planning is essential to ensure a coordinated response to a pandemic, both across Europe and within each member state, to minimise serious illness, deaths and overall societal disruption. The WHO's Global Influenza Preparedness Plan⁴ provides guidelines for governments on preparing for and managing an influenza pandemic is the benchmark against which all national preparedness planning should be implemented.

Dr Coker said, 'As yet, Europe is only moderately prepared for the threat of an influenza pandemic. The existing gaps underline the need for increased cooperation between countries in policy, planning and resource distribution. It is vital that the European Union takes action to ensure that such gaps are filled and Europe is adequately prepared across regional, national and international levels."

The Schhol researchers acknowledge that only those plans available for analysis at the time of research (November 2005) were included and further plans, or portions of plans, under review, amendment or pending finalisation were therefore not included in the analysis. As such, it is possible that some of the gaps exposed are being or have since been addressed.