The World Health Organization (WHO) and the European Commission are currently working together to improve influenza preparedness in the European Region. So far, only a few countries have submitted national influenza pandemic plans to WHO and/or the European Commission. To help countries that do not yet have a draft national influenza preparedness plan, and to update plans where they already exist, the European Commission and WHO held a two day workshop for all countries in the WHO European region on 2-3 March 2005.

The specific objectives of this workshop were to:

facilitate the processes involved in planning influenza pandemic preparedness

provide an opportunity to discuss the priorities of a pandemic plan with colleagues and facilitators

identify the way forward for WHO/EU member states as they develop their pandemic plans

identify whether further assistance is needed and, if so, what form it should take

To determine the stage of pandemic planning in the different European countries, a questionnaire was sent to all member states of the WHO European Region (56 countries, including 25 European Union member states) before the workshop, all of whom responded. Fifty of the respondents stated that a responsible national body exists which is working on pandemic preparedness. Thirty-one have a national preparedness plan available and published; of these, 18 are European Union (EU) states. The remaining states and entities either have a draft plan at differing stages of development, or do not have a plan (Table 1).

Within the European Union, considerable progress in influenza pandemic planning has been made in the last few years. In 2005, 18/25 (72%) EU countries had published plans. In 2000, just 4 of 11 (36%) EU countries surveyed had plans that were accepted by health authorities [1,2].

Table 1. Response from states/entities about the existence of a national influenza pandemic plan, 2005.

National Plan and Responsibilities	All respondents (56)		EU Member States (25)		non-EU states/entities (31)
Question	Yes	Percentage	Yes	Percentage	Yes	Percentage
Is there a responsible body and/or a responsible person working on influenza pandemic preparedness planning?	50	89%	25	100%	25	81%
Is there a national influenza pandemic preparedness plan available and published?	31	55%	18	72%	13	42%

National plans differ as far as the elements considered. The table below shows 10 components considered to be important and the percentage of countries which have these in their published or draft plan. Based on the response, it is clear that surveillance and provision of laboratory facilities are the two most developed components included in the pandemic plans (Table 2).
Of those that have a published plan, four countries have also conducted simulation exercises to test its efficiency and efficacy.

Table 2. Response to questions about important components included in national plan

	All 56 countries (31 have a published plan; 25 with draft or no plan)				EU member states (18 have a published plan; 7 with draft or no plan)				non-EU countries (13 have a published plan; 18 with draft or no plan)
Components of the plan	Percentage of countries with a plan	Percentage of countries with draft or no plan	Plan	Draft plan	Percentage of countries with a plan	Percentage of countries with draft or no plan	Plan	Draft plan	Percentage of countries with a plan	Percentage of countries with draft or no plan	Plan	Draft plan
Clear division of responsibilities, obligations and mandates?	81%	16%	25	4	78%	14%	14	1	85%	17%	11	3
Surveillance systems?	97%	36%	30	9	94%	71%	17	5	100%	22%	13	4
Laboratory capacity and role?	94%	28%	29	7	100%	57%	18	4	85%	17%	11	3
Healthcare organisation?	87%	20%	27	5	83%	14%	15	1	92%	22%	12	4
Maintenance of essential community services?	77%	16%	24	4	72%	0%	13	0	85%	22%	11	4
Strategy for antivirals?	81%	8%	25	2	83%	0%	15	0	77%	11%	10	2
Strategy for vaccines/vaccination?	87%	20%	27	5	89%	14%	16	1	85%	22%	11	4
Strategy for information to public and media?	84%	16%	26	4	72%	14%	13	1	100%	17%	13	3
Other public health measures (views on public gatherings etc.)?	77%	16%	24	4	72%	14%	13	1	85%	17%	11	3
Has the national plan been tested in a ‘table top’ or equivalent exercise?	13%	-	4	-	6%	-	1	-	23%	-	3	-

As well as specific questions related to the components of a pandemic preparedness plan, countries were also asked to provide details of their national influenza programme in the interpandemic period (Table 3). Almost all countries have a functional surveillance system and a vaccination programme for risk groups (100% of EU member states have these two components). Twenty four countries (13 EU and 11 non-EU) maintain stocks of antivirals.

National influenza plans from European countries and other countries worldwide that are available on the internet can be found here: http://www.eiss.org/html/pandemic_plans.html

Table 3. Components of national influenza programme (non-pandemic) in European Region countries

Components of national influenza programme	All countries (56)		EU member states (25)		non-EU countries (31)
Does a surveillance system for influenza exist?	98%	55	100%	25	97%	30
Is there a vaccination programme for risk groups?	88%	49	100%	25	77%	24
Are influenza vaccines offered free of charge for risk groups?	63%	35	72%	18	55%	17
Does the government maintain a stock of anti-viral drugs?	43%	24	52%	13	36%	11
Is there laboratory capacity for diagnosis of influenza?	80%	45	96%	24	68%	21