EpiSouth Plus (2010-14)

Health Security Workshop: How to benefit from European projects? CHAFEA – Brussels, 13-14 November 2014

Maria Grazia Dente

Communicable Disease Epidemiology Unit

National Institute of Health, Rome-Italy

EpiSouth Plus

(2010-14)

General Objective

to increase the health security in the Mediterranean area and South-East

Europe by enhancing and strengthening the preparedness to common

health threats and bio-security risks at national and regional levels in the

countries of EpiSouth Network in the framework of the IHR implementation

1. ITALY 2. FRANCE 4. SPAIN 5. BULGARIA 6. CROATIA 7. GREECE 8. MALTA 9. ROMANIA 10. SLOVENIA

11.MECIDS-Middle East

Consortium on Infectious Disease Surveillance;

12.WHO-IHR International Health Regulations Coordination, Lyon, France

1. ALBANIA 2. ALGERIA 3. BOSNIA & HERZEGOVINA 4. EGYPT 5. FYROM–Former Yugoslav Republic

of Macedonia 6. ISRAEL 7. JORDAN 8. KOSOVO 9. LEBANON 10. LIBYA 11. MONTENEGRO 12. MOROCCO 13. PALESTINE 14. SERBIA 15. SYRIA 16. TUNISIA

Partners in EpiSouth Plus

1. ECDC-European Centre for Disease Prevention and Control, Stockholm, Sweden;

2. EUROPEAN UNION DG SANCO Public Health Directorate, Luxembourg;

3. EUROPEAN AGENCY FOR HEALTH AND CONSUMERS, Luxembourg;

4. EUROPEAN UNION EuropeAid, Brussels, Belgium;

5. MOH-Ministry of Health, Rome, Italy;

6. WHO–EMRO Regional Office for Eastern Mediterranean, Cairo, Egypt;

7. WHO-EURO Regional Office for Europe, Copenhagen, Denmark;

8. SHIPSAN- Ship sanitation project

9. SEEHN- South East Europe Health network

http://www.episouthnetwork.org/

Collaborating Institutions in EpiSouth Plus

Objectives

i. Establishment of a Mediterranean Regional Laboratories Network

ii. Promotion of common procedures in Generic Preparedness and Risk Management

iii. Enhancing Mediterranean Early Warning Systems and cross-border Epidemic Intelligence

iv. Facilitating IHR implementation

Methods 1. Network development

- The EpiSouth Network was shaped around the definition coined by Chisholm in

1998 that identifies a Network as “a set of autonomous organizations that come

together to reach goals that none of them can reach separately”.

-the strategies were considered in the light of critical aspects connected with the

desirable long term impact of the results.

2. Implementation of the activities

-training needs assessments;

-prioritization exercises;

-situation analysis;

-development of Strategic Documents based on studies and lessons learned;

-design and delivery of trainings and technical workshops;

-a web based access-restricted platform, to share cross-border alerts for early

warning;

- a web based portal to disseminate project’s information and results.

From an European

project… (9 EU Countries)

… to a

Mediterranean Network of

PHI/MoH and LAB (27

Countries: 10 EU, 17 non-EU)

Main results and achievements

* Croatia EU Country on 1° July 2013

Main results and achievements

• Network development (Public Health Institutes/MoH and Lab)

Main results and achievements

• Training

Capacity building process

Core-Capacity for preparedness Assessments (Epi & Lab training needs)

Two Workshops (sharing experiences);

Four Trainings (strenghtening

capacities: Preparedness , WNV, Dengue, biosafety);

EI stages

Ca

pa

citie

s in

sta

lled

Emergency Preparedness &

Response Planning (EPREP) Tool

Simulation Exercise (performing)

Identification of priority areas for lab network

• Questionnaire to define the priority areas for the Region (Aug. 2011)

West Nile virus, Biosafety and Dengue -first questionnaire (27 countries) to select the Lab to be included in the EpiSouth Lab Network as per set minimum requirements (Lab that are a reference for Dengue and West Nile or the Lab of Virology which are dealing with these pathogens if no specific reference laboratories exist); - second questionnaire to assess the needs of the selected lab;

12

13

-one-week training on Dengue/Biosafety at Institut

Pasteur, Paris (July 2012)

-one-week training on WNV at ISCIII, Madrid (June

2013)

- Evaluation Quality Assessment for Dengue and West

Nile

-«onsite» training

- stages at the Institut Pasteur

Lab capacity building

3 different tools to share information on public health threats

Weekly e-Web bulletin

n=264 (since March 2008)

PUBLIC

ad hoc

Thematic Notes (CCHF, Melamine, Arenavirus, H1N1,

Alkhurma, West Nile, Hajj pilgrimage, Olympic games, FIFA

world cup, NCoV , YF, etc.)

PUBLIC

Live Secure platform

For EpiSouth countries

RESTRICTED

Added Value of the EpiSouth Thematic Notes

Availability of an overview on selected health threats from the unique

regional perspective of the Mediterranean.

Increased awareness of public health risks from this Mediterranean regional

perspective

Leading to…

More than thematic notes… annual surveys.

Since unprecedent WN outbreak in 2010: close monitoring of the all related events (eweb and thematic notes)

Survey launched in EpiSouth countries during 3 consecutive years:

3 outbreaks documented: 2010, 2011 & 2012.

Contribution from FPs and country laboratory contacts

Excellent Response rate and countries’ feedback

Enhanced collaboration between EPI and LAB Networks

SUPPORT THE IMPLEMENTATION OF IHR-WHO IN THE MEDITERRANEAN

COUNTRIES

The “EpiSouth Plus National Situation Analysis” (ENSA), was designed to describe

how four countries of the EpiSouth network have addressed coordination of

surveillance between PoE and NHS:

How the exchange of information is organized;

Availability of formal procedures in place and legal constraints;

Main strengths and challenges.

F. Riccardo, P. Nabeth, G. Priotto, M.G. Dente, A. Leventhal, L. Vellucci, T. F. Melillo, S. A. Saleh, A. Rguig on

behalf of the EpiSouth WP7 Steering Team. The EpiSouth Plus Project. Situation analysis on coordination of

surveillance between points of entry and the national health system- Methodology Available at:

http://www.episouthnetwork.org/sites/default/files/outputs/wp7_ensa_methodology.pdf

F. Riccardo, P. Nabeth, G. Priotto, MG. Dente, S. Declich. The EpiSouth Plus Project. WP7 – EpiSouth

Plus Strategic Document: Coordination of epidemiological surveillance between points of entry and the

national health system in the framework of the international health regulations 2005 in the EpiSouth region.

Available at: http://www.episouthnetwork.org/.

The EpiSouth National situation analysis

Italy Participating for scenario 2: Large

States with extensive coastlines and

strongly decentralized health systems

Malta Participating for scenario1: Small

coastal states and islands

Jordan Participating for scenario

3: States with little or no

coastlines

Morocco Participating for scenario 4:

Large States with extensive

coastlines and centralized HS

PARTICIPATING COUNTRIES

The EpiSouth National situation analysis Recurring strengths> reccomandations

• Invest on a solid legal framework that is supportive to the

implementation of coordinated surveillance between PoE and NHS

in the framework of IHR. This framework should establish a strong

link between the IHR NFP and the Competent Health Authorities

(CHA) at PoE;

• Ensure the presence of dedicated personnel covering the function

of CHA in PoE. This personnel should work with other actors in the

PoE, in liaison with the IHR NFP;

• Elaborate and update national protocols and local processes and

procedures on coordination of human health surveillance between

PoE and the NHS;

• Ensure, through training, that those protocols, processes and

procedures are known and applied consistently at central and PoE

level.

Sustainability

Networks (Epi & Lab)

Identification of further needs and priorities

New Projects:

MediLabSecureIntegrated Surveillance.pptx

MediEpiet

Methodology Appropriate/suitable

approaches for other initiatives and studies

WHO Guidance for PoE

Chafea Celeste Study on preparednessISS MG DENTE Celeste.pptx

Deliverables Possible use in other contexts

EPREP Tool

Lab resources mapping

Lab Directory

EpiSouth Project

European Health Award 2014

Winner

EHFG President Prof Helmut Brand said in his praise of the project:

• “The project is of particular importance for strengthening preparedness to health

threats, health security and bio-security, also outside the EU“.

• “The achievements of EpiSouthPlus are an eloquent example that in the field of

public health, cross-border cooperation is not just useful but, in many cases

such as these, simply indispensable”

The Award is dedicated to all those who have inspired, participated,

supported, and advised the EpiSouth Network. It is thanks to those

experts that the implementation of the EpiSouth and the EpiSouth Plus

Projects’ activities was possible and that the Projects’ results were

achieved.

Acknowledgements

The EpiSouth-Plus project was co-funded by the European Union DG

SANCO/EAHC, now renamed Consumers Health And Food Executive

Agency (CHAFEA), and DEVCO/EuropeAid together with the

participating national partner Institutions. The financial support of the

Italian Ministry of Health and ECDC is also acknowledged.

The contents of this presentation are the sole responsibility of the authors and can in no way be taken to reflect the views of the European Union.

EpiSouth Plus Leadership Project leader: S. Declich – ISS, Italy Coordination, co-leaders: M.G. Dente – ISS, Italy & M. Bejaoui – MoH, Tunisia Dissemination, co-leaders: M.Fabiani – ISS, Italy & D. Lausevic – PHI, Montenegro Evaluation, leader: G. Salamina – ASLTO1, Italy Lab Network, co-leaders: K. Victoir – IP, France & G. Korukluoglu – PHI, Turkey Preparedness Planning, co-leaders: F. Simon Soria, R. Cano, C. Martin Pando – ISCIII, Spain & D. Hannoun – PHI, Algeria & D. Simic – PHI, Serbia Early Warning and Cross-border Epidemic Intelligence, co-

leaders: P. Barboza, Fatima Aït-Belghiti- InVS, France & MECIDS (Israel, Jordan,

Palestine) IHR Implementation, co-leaders: F. Riccardo – ISS, Italy and P. Nabeth – WHO, France