Gay Mitchell
Question:18 Mr. G. Mitchell asked the Minister for Health and Children if his attention was drawn to a threatened Europe-wide flu-pandemic; and the state of readiness here. [18404/04]
View answerTuesday, 22 June 2004
Questions (21)
Written answers
On 12 February I held an informal dinner for EU health ministers to discuss the matter of avian influenza and mutual co-operation in Europe to combat it. At the meeting the ministers agreed to keep each other informed in advance of taking any further control measures. They also agreed to endeavour to co-ordinate measures to protect public health to the greatest extent possible across the EU. Member states and the Commission agreed to engage with the pharmaceutical industry to consider the preparation of protocols for the manufacture, availability and distribution of vaccines and antivirals as part of pandemic planning preparedness.
Each state undertook to review their national pandemic preparedness plans. Health ministers also asked the Commission to bring forward its EU pandemic preparedness plan, as a matter of urgency.
On 12 May the matter was discussed at a meeting of EU health ministers. There was consensus on the need for member states and the European Commission to work together for early agreement on the adoption of a co-ordinated approach to the purchase of antivirals and vaccines.
On 2 June the health council agreed to extend the health security committee's mandate to cover the area of Community influenza pandemic preparedness and response planning for a temporary transitional period to the end of May 2005. A key task of the health security committee will be to assess the desirability or otherwise of any future collective negotiation process with the pharmaceutical industry for the development and purchase of vaccines and antivirals. Account shall be taken of the cost, storage, logistical and legal aspects of the area while respecting the competence of member states. A report on the issue is scheduled for consideration by the HSC in September.
Medical experts consider that it is almost inevitable that another influenza pandemic will occur but it is impossible to predict when. The outbreak of avian influenza in Asia earlier this year highlighted the need for vigilance and preparedness in this regard. Mortality during a pandemic is usually very high and may not be confined to the usual risk groups. An influenza pandemic would have serious effects in terms of mortality and morbidity. Services such as acute hospitals and general practice would experience greatly increased workloads, well in excess of those seen during more regular outbreaks of influenza.
I established a committee under the chairmanship of Professor William Hall, director of the National Virus Reference Laboratory. In September 2002 it presented an outline plan for influenza pandemic preparedness, entitled A Model Plan for Influenza Pandemic Preparedness, to my Department. A copy of it was forwarded to each health board and authority chief executive officer for circulation to all relevant personnel. In addition, each CEO was requested to establish a regional committee to develop a regional influenza pandemic plan that should include all key stakeholders. These plans will form part of the emergency plan for each region.
At present the model plan is being revised by an expert group that I established in late 2003 in light of the recent SARS experience. The outline plan sets out various recommendations and options. Following their detailed consideration the expert group will make specific recommendations on the implementation of various aspects of the plan. It will also give guidance, if required, to the health boards and regional committees to assist in the development of their regional plans. The group is comprised of medical experts as well as representatives of relevant organisations, including the Irish College of General Practitioners, Irish Medicines Board, NVRL, the National Disease Surveillance Centre and health board nominees. Its work was delayed by the ongoing non-participation of consultants in departmental committee meetings.
In addition, my Department established a contingency planning steering group last January. It will oversee the development of a generic public health contingency plan for the health system that would be activated in the event of a large-scale emergency resulting from an infectious diseases outbreak or incident such as SARS or an influenza pandemic to mitigate the impact of such an emergency. The plan will facilitate effective responses to international outbreaks and incidents. Work on the plan is progressing well as well as disease-specific operational plans for SARS and an influenza pandemic. I anticipate that the plan will be circulated to health boards shortly. It will enable health boards to develop, update and test their public health emergency plans.
The Health Act 1947 and the Infectious Diseases Regulations 1981 provide the legislative basis for the control of infectious diseases, including influenza, in Ireland. The national disease surveillance centre plays a key role in the prevention and management of infectious diseases here.
The Irish approach to an outbreak of an infectious disease is based on sound internationally accepted principles such as preventative measures, early identification of cases, effective clinical care including good hospital infection control, appropriate surveillance and contract tracing and management of contacts. The procedures for dealing with infectious diseases are based on these principles.
Many infectious diseases can be prevented by vaccine use. Immunisation against infectious disease has probably saved more lives than any other public health intervention, apart from the provision of clean water. Improvements in living standards have reduced the mortality from infectious diseases, but immunisation has also played a large role in the reduction of disease incidence. It would not have been possible to eradicate smallpox without vaccine. The eradication of polio in the European region is also largely due to immunisation. In recent years improved economic and social conditions, together with public health action, have virtually eliminated the pandemics of communicable diseases.
In the past I have, and will continue to do so, established expert committees or groups to advise on the most appropriate action given the particular circumstances of the outbreak concerned. Guidelines and protocols on the management of many different types of outbreaks have been developed based on the principles referred to above. They take into account guidance published by the World Health Organisation, the centres for disease control and prevention in the USA and a number of other reputable international public health bodies. Most outbreaks begin with the establishment of an outbreak control team that manages it and sets up the necessary control measures.
Vaccination is the principal measure for preventing influenza and reducing the impact of epidemics. The WHO recommends vaccination for elderly persons and persons of any age who are considered at high risk for influenza-related complications due to underlying health conditions. Vaccination will be the primary public health intervention in the event of an influenza pandemic. Until a specific vaccine against the prevalent strain of the influenza virus is developed, or has a chance to become effective in individuals, it will be necessary to use antiviral medicines to treat individuals who are ill, particularly those who may be more vulnerable to the virus. Essential workers and vulnerable groups must also be protected by such medicines. My Department secured a quantity of antivirals. Discussions are ongoing at national and EU level about the need to stockpile further supplies.