London School of Hygiene & Tropical Medicine

An analysis of pandemic preparedness plans from Latin American countries has indicated that although most now have national strategic plans in place, it is the wealthiest countries that tend to have the most complete plans.

The study, by a team based at the London School of Hygiene & Tropical Medicine, is the first analysis of national strategic pandemic preparedness plans in the Latin America Region and is published in the journal Health Policy and Planning. It adds to a body of research the same team has conducted in Europe, Asia and Africa and identifies a number of strengths, but highlights the existence of strategic differences between countries, notably in the level of preparation for outbreak early containment, and national strategy on border control measures.

Latin America includes a variety of low-middle and upper-middle income countries, with wide variation in social and political conditions, within which the different preparedness plans have been developed. The research team evaluated fifteen national plans from 17 Latin American countries against the criteria drawn from the World Health Organisation checklist.

Countries demonstrated different degrees of preparedness, with the wealthiest countries tending to have the most complete plans. The best prepared countries were Chile, Uruguay, Mexico, Argentina and Brazil while Bolivia, Columbia, Ecuador, Guatemala and Honduras performed less well. Costa Rica, El Salvador, Paraguay, Peru and Venezuela were in the middle group in terms of preparedness. A number of plans were found to still be at the development stage and authors identified a need for more emphasis on strengthening the operability of plans, and testing them.

Overall, countries were found to be well prepared in terms of surveillance, and in communications with the public and with health care personnel. But gaps were found in other areas, such as the organisation of health care services’ response, the planning and maintenance of essential services and the provision of containment measures such as stockpiling vaccines and antivirals.

The authors comment: ‘Our analysis also shows varying degrees of preparedness amongst countries. Plans highlight that in low-resource settings, external funding is needed to ensure that sustainable levels of preparedness can be achieved.

‘The ability of different health systems to respond to emergencies varies considerably, especially in low-income settings where infrastructure is fragile, resources limited and current capacity insufficient. Preparedness levels for both vaccination and antiviral drugs are poor. Currently, only Brazil has production capacity for influenza vaccines, but both Mexico and Brazil were granted new funds from WHO in 2007 to increase regional vaccine production capacity. The current situation regarding swine flu, which has affected Mexico so profoundly, would indicate that this capacity now needs to be stepped up as a matter of urgency’.

• Pandemic influenza preparedness in Latin America: analysis of national strategic plans, Health Policy and Planning, doi:10.1093/heapol/czp019