Strengthening One Health approaches through tabletop simulation exercises

Strengthening One Health approachesthrough table-top simulation exercisesKatinka de Balogh, Sigfrido Burgos, Morgane Dominguez, Juan Lubroth andJan Slingenbergh

Background• During simulations a “dangerous situation” is created within a safe (virtual) environment to practice and learn and become better prepared in case the real danger happens.• There are different kind of simulation exercises• In 2006, USAID approached FAO and WHO-Euro to jointly develop table-top simulation exercises for highly pathogenic avian influenza (HPAI/H5N1)

Different kinds of simulation exercises• Field• Table-top/desk-top• Computer based• Combinations of the above

Preparedness Planning 5

Purpose of the FAO/WHO/USAID integrated simulation exercises project• Enhance preparedness and capacity of countries to face outbreaks of HPAI (and other zoonotic disease) in animal and human population• Identify strength and weaknesses of the HPAI contingency plans• Test the chain of command• Improve communication, coordination and collaboration of the different sectors involved. 3

How and where?• 2 day integrated table-top exercises developed together with the Health Protection Agency of the UK• Combined table-top and field exercises developed with DAI• Exercises implemented in various countries: Armenia, Azerbaijan, Albania, Serbia, Bosnia&Herzegovina, Macedonia, Ukraine, Tajikistan, Egypt, Mauritania, Zambia, etc

The pandemic phases 7

Set up ………๏ 2 day event๏ 50-60 participants (+ observers)๏ plenary sessions (simultaneous translation)๏ working group sessions (whispering translation for observers)๏ simulated press releases and press conference๏ special programme for observers

Participants• central and local observers governments • from neighbouring• public health, countries veterinary, wildlife • regional and• laboratory, academia international• police forces, civil institutions defense• private sector

Exercise AgendaDay 1 Arrival and registration (including refreshments) Welcome The present situation of HPAI in animals and humans Exercise Briefing Session 1 – suspected outbreak in animals Presentation of the scenario = video footage Players work in groups (at tables) Press statements Plenary feedback Session 2- confirmed outbreak in animals, suspected human casesDay 2 Session 3- widespread transmission in animals and human Session 4 – end of outbreak and rehabilitation Simulated press-conference Plenary feedback/end of exercise Hot Debrief/evaluation of event 14

Additional tools๏ Video footage๏ Sketch๏ Injects๏ Large map๏ Simulated press conference 12

Bosnia & Herzegovina ZambiaUsing a large map to illustrate and Introducing the scenarioEnhance discussions through a theatre sketch

Injects – Provide a new angle Stimulate discussions

Some lessons learned- Very good tool for testing and enhancing emergency preparedness- Need to be conducted in national language (translations)- For many countries it is a new interactive working method- There is a time-limit (2 days max), what is achievable?- Positive experience with use of “large map” to illustrate interventions and enhance discussions- Importance of a very good event control team and facilitation of group discussions- There needs to be a clear follow-up after the simulation (how to address the findings)

More...• FAO has developed a toolbox that assists countries with the organization of integrated simulation exercises.• Including a training module on how to organize table-top simulation exercises• A simulation exercise on Rift Valley fever has been developed and pilot tested (Croatia)• Generic simulation exercises are in preparation

Zambia ArmeniaAzerbaijan Serbia

Regional exerciseIssues to be addressed:• cross border communication and cooperation• outbreak communication• cross border movement (control)• harmonization of procedures (e.g. Compensation)• how to deal with outbreak in border area, …etc 27

One Health Animal Health Human Health Ecosystem Health Thank you!

Follow-up in country after exercise๏ Presentation of Exercise report๏ Identified needs discussed in country๏ Elaboration of Action plan in country๏ Presented to donors for funding๏ Improvement of country preparedness 26 b

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Strengthening One Health approaches through tabletop simulation exercises

by Global Risk Forum GRFDavos on Feb 27, 2012

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