Supporting influenza pandemic preparedness

The World Health Organization had estimated that an influenza pandemic could cause up to 150 million deaths, and governments throughout the world have called on the School’s experts to help them avert such a catastrophic scenario.

In 2005 Richard Coker, professor of public health, and Sandra Mounier-Jack, senior lecturer at the School, designed a framework to analyse national preparedness for an influenza pandemic in European and Asian countries. The analysis showed that 21 European countries were well prepared in some areas, but had key gaps in others, such as maintenance of essential services and public health interventions.

The evaluation also showed that low and middle-income countries were particularly ill prepared and that there was a need for a framework both to evaluate and improve pandemic planning and preparedness. This was a particular concern in South East Asia where conditions are still fertile for the emergence of novel influenza viruses and where the H5N1 virus is still circulating.

In 2007 Coker conducted a pilot project in Thailand using three pandemic scenarios to determine needs, availability and gaps. Building on this, the European Union and Rockefeller Foundation funded the AsiaFluCap project, which developed a framework to assess pandemic response capacity in six South East Asian countries. They found inequities of resources both between and within countries and showed how these could increase the number of pandemic findings.

Because of the AsiaFluCap findings Taiwan redistributed supplies of the anti-viral drug, Oseltamivir (marketed as Tamiflu), to ensure more equitable coverage across the country. And strategies for risk communication were also revised.

In 2011 Coker and colleagues conducted two detailed country case studies in Cambodia and Indonesia in collaboration with local academics and officials. This research into the whole gamut of influenza preparedness has informed policy on investment and allocation of health care resources in both countries.

Coker and other researchers have also developed a software tool, launched in 2012, which allows policy makers and others to measure preparedness against a set of 28 key health care resources.

The UK government commissioned Coker and Mounier-Jack to help develop cross-government strategy on human pandemic and avian influenza and Mounier-Jack became specialist adviser to the House of Lords inquiry into pandemic preparedness in 2008, as well as contributing to the independent inquiry into the UK’s response to the 2009 influenza pandemic.

In 2011 she was appointed specialist adviser to a House of Commons inquiry to review scientific advice and evidence in emergencies. Coker has also contributed research findings to the annual United Nations and World Bank reports on influenza preparedness.