Inter-Agency Review of UN System Country Contingency Plans
Inter-agency review of UN system country contingency plans (CP)
for an avian and human influenza (AHI) pandemic
Country:Egypt
Last update of CP:15 December 2005
Review team:Peter Scott-Bowden, Sandor Beukers, Gregoire de Brancovan, Denis Charles, Wendy Cue, Megan Gilgan, Nankhonde Kasonde, Dr.Osman Mansoor, Pier-Luigi Martinesi, Wendy Morotti, Hermann Nicolai, Ussama Osman, Daniela Wuerz
Review date:30 August 2006
The indicators for this review have been derived from the Pandemic Planning and Preparedness Guidelines for the United Nations System of 15 March 2006, the UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01March2006 and the United Nations Administrative Guidelines for an Influenza Pandemic Situation of 23May2006. The structure of this review sheet shall not prejudice the structure of UNCT pandemic contingency plans. The number of “yes” and of “no” are no judgement on the plan’s quality but rather an effort to asses the degree of implementation reached at the moment of completion of the plan.
Indicator / Yes / No / CommentPlanning and Coordination
The CP was completed before the UN Secretary General sent out inMarch2006 the Pandemic Planning and Preparedness Guidelines for the United Nations System of 15 March 2006 and the UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01March2006. The CP, therefore, focuses on staff health and security while following the
WHO Health and Medical Services Contingency Plan for an Influenza Pandemic of 30May2005. It does not yet consider the other two important tasks of business continuity and of support to the national government as requested in the Pandemic Planning and Preparedness Guidelines for the United Nations System of 15March2006.
As requested by the Secretary-General, in March 2006, all country offices are to undertake pandemic preparedness planning in line with the following documents.
-the Pandemic Planning and Preparedness Guidelines for the United Nations System of 15March2006
-and the UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01March2006
The following guidelines have been issued since then and should also be considered:
-the United Nations Administrative Guidelines for an Influenza Pandemic Situation of 23 May 2006
It is suggested that in a revised version of your CP the reference documents for your pandemic preparedness planning are mentioned as you have aptly done already in the original version.
1.1AHI Focal point appointed. / No / The CP does not indicate whether a common AHI focal point for all UN agencies in Egypt has been appointed. An earlier UNSIC survey could also not clarify whether the Egypt UNCT has a common AHI focal point.
1.2UNCT and/or AHI coordinator has had a discussion and agreed on contact/liaison with national pandemic preparedness and response authorities, including contacts, notification and information sharing agreements. / No / While it is assumed that the UNCT or the AHI focal point has had contacts with the host government on pandemic preparedness planning it is suggested that such contacts are mentioned in the CP.
A good example for (documenting the) coordination with national authorities on pandemic preparedness planning can be found in the Malawi plan (see password: unsic123).
1.3Coordination with non-UN partners (WB, NGO, etc) active. / No / Not documented. WB and other non-UN international agencies are part of UNCT but no indication whether there are contacts with national and international NGOs and other international actors (diplomatic missions).
It is presumed that there may have been some linkages with outside entities (non-UN) which could be given visibility in the plan.
1.4Key risks and contingencies identified by UNCT. / Yes / A brief analysis is made in section B./Background.
The updated version of the CP should look beyond the threats and risks to health and safety of UN staff and consider also threats and risks to business continuity (i.e. absenteeism of staff, disruption of programs) and to UN agencies’ capacity to support the host government in its fight against a human pandemic (i.e. lack of human resources and finance by UN agencies). Good examples of a hazard and risk analysis may be found in the CPs for Malaysia,Georgia (annexes 1 and 2) CPs and Malawiat ( password: unsic123).
1.5Response actions matrix with responsibilities assigned. / Yes / The response actions matrix is concerned with WHO phase 3 only and is essentially focused on staff health and safety, and has not yet considered business continuity and support for national preparedness planning and response. Responsibilities should be assigned in a response actions matrix.
A good response actions matrix in regard to staff health and safety can be found in the Serbia and Montenegro CP, in the Pakistan CP and in the Poland CP in annex 6 (although responsibilities for these activities still need to be allocated in Poland CP). A good response actions matrix in regard to staff health and safety in French language can be found in the Guinea CP.
A good list of some of the key requirements for operational continuity can be found in the Georgia CP in annex 4 (although responsibilities for these activities still need to be allocated).
A good matrix with response actions and responsibilities in regard to support for national preparedness planning and response is provided in the Azerbaijan CP in annex 2.
1.6Simulation exercise completed. / No / Not documented.A plan may benefit from conducting a simulation based on its assumptions and procedures, including the communication tree, critical staff and preparedness actions at both UNCT and agency levels.A timeline could be given for an eventual simulation exercise.
1.7Joint UN/national avian and human influenza plan. / No / Not documented. A joint plan is no requirement but could be considered in some countries where it appears useful.
Staff Health and Safety
When planning for staff health and security the CP is guided by the WHO Health and Medical Services Contingency Plan for an Influenza Pandemic of 30May2005. Since then the UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 05October2005 and its update of 01March2006 brought a policy change from departure/early departure to recommending confinement to the duty station residence in the event of a pandemic as an alternative which would help prevent staff safety from being compromised by exposure to pandemic influenza. Furthermore the WHO pandemic alert phases are no longer linked to the UN security phases.
2.1Identification of local health support facilities completed. / Yes / A list with health care facilities is provided in annex 2.
The Bhutan CP in its section C. Medical Interventions gives a good example for preparing in a country with weak (or overwhelmed) medical facilities by mobilizing a “UN health/medical team” from amongst staff and dependents with medical background. See password: unsic123 .
2.2Assessment of local health support facilities completed. / No / A good list of indicators for an assessment can be found in the Armenia CP in annex 2.
2.3PPE procured. / No / Planned but not completed as of date of this CP. The CP shows good awareness of this requirement. Confirm that PPEs have been acquired. If not, a timeline could be given in an update of the CP.
As per UNMS Guidelines of 1 March 2006 PPE kits are for critical staff with high risk of exposure. See p. 19, para, 7.Stockpile full PPE to cover two changes per day for six weeks for staff whose critical functions or work will involve high risk exposure.
2.4Masks procured. / No / Planned but not completed as of date of this CP. The CP shows awareness of this requirement. Confirm that masks have been acquired in the meantime. If not, a timeline could be given in an update of the CP.
Stockpile surgical masks for all staff and dependents (2 per day for six weeks).
2.5Oseltamivir procured (sufficient for 30% of staff). / No / Planned but not completed as of date of this CP. The CP shows awareness of this requirement. Confirm that anti-virals have been acquired in the meantime. If not, a timeline could be given in an update of the CP.
2.6Antibiotics procured (sufficient for 10% of staff). / No / Planned but not completed as of date of this CP. The CP shows awareness of this requirement. Confirm that antibiotics have been acquired in the meantime. If not, a timeline could be given in an update of the CP.
2.7Lead agency for procurement for UNCT identified. / Yes / CP indicates that there is a lead agency for common procurement for different items.
The response actions matrix should also indicateresponsibility for procurement.
2.8Staff provided with information on keeping themselves safe and personal preparedness. / Yes / CP shows overall good awareness of information needs of staff. Inclusion of information leaflets on avian influenza and human pandemic as annexes to the CP may be considered. Examples for such information material drawn from the UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01March2006 can be found in many of the CPs at password: unsic123 .
Please consider attaching information materials as an annex.
Pakistan CP and Mauritania CP may be visited as good examples on staff information.
2.9Psychosocial support providers identified. / No / The importance of psychosocial support for staff health and security is often underestimated. The UNCT is requested to include this aspect in the CP.
Serbia and Montenegro CP (annex 7), Pakistan CP and Mauretania CP (in French language) are good examples for preparedness planning in regard to psychosocial support to staff and dependents.
2.10Tracing system/unit prepared and staff trained. / No / Not documented. Consider to establish system for tracing staff members given the high number of UN staff in Egypt. Experience shows the merit for such a system. This will involve close coordination between HR and security to track staff.
2.11Security threat analysis prepared. / No / A pandemic situation may entail serious security threats. Some analysis on this will raise awareness.
A good matrix on security threat analysis may be found in the Malaysia CP (although further consideration may be given to phase 6 and to recurrent pandemic waves in that matrix).It provides a useful framework as it is geared to decision making and is flexible. A good example of a security threat analysis in French language is in the Mauretania CP.
Note that according to the UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01 March 2006 the WHO pandemic alert phases are no longer linked to the UN security phases.
2.12Staff contact system established and tested. / Yes / Provided in annexes 4a and 4b.
Business Continuity
Although the CP implicitly shows awareness of the importance of business continuity it does not elaborate on this important aspect of contingency planning.
A good example for appropriate overall planning for business continuity can be found in the Mauritania CP (in French language).
3.1Programs prioritised, pandemic critical ones identified, and agreement on those that can be suspended/scaled back. / No / Foreseeable absenteeism during an influenza pandemic will exclude full continuation of each and every UN program in the host country. It is strongly recommended that UN agencies plan for a situation of very limited human resources by prioritizing programs.
A good example is given in annex 3 of the Georgia CP at password: unsic123.
3.2Critical functions required to continue these prioritised programs and activities identified. / No / Identification of critical functions should be done independently from identification of critical staff as the list of critical staff will be basedon an assumption of whatthe critical functions are. A list of critical functions makes this assumption explicit.
3.3Critical staff identified, including those that will work from home, and from office/facilities. Alternates identified. / Yes / A list of critical staff is provided in annex 3. Have you also determined alternates?
Some CPs have given staff numbers required to maintain critical functions. This is the recommended approach. Other CPs include even a list with names of critical staff. This is a welcome precision but given the high fluctuation of staff in many country offices this may be difficult to maintain over a longer period of time.
The review team notes that in many contingency plans no distinction is made between critical staff that have to stay in the premises and critical staff that can perform their critical function from home via telecommute. The UNCT should consider the possibility of critical staff to also work from home, allocate the necessary resources (laptops etc.) and identify alternates. Please include a list of critical position-holders and alternates, differentiating between those staying in the premises and those working from home in the CP.
3.4Checklists for phase 4, 5, 6 actions and responsibilities drafted, together with trigger events. / No / A good checklist is provided in the Azerbaijan CP in section D III and in the Malawi CP in section 8.1 (although, where appropriate, triggers should be added in the Azerbaijan plan and triggers and responsibilities in the Malawi plan).
The triggers based on WHO pandemic alert phases need to recognize that WHO phases areglobal and not reflective of the situation in any one country.
The keytriggers for a country response will be based on where the human-to-humantransmission is occurring. This will apply at all phases, as even inphase 6 (pandemic), initially not all countries will be affected.
UN actions are likely to be affected by the assessment of the Pandemic Alert Phase by national authorities, and these need to be identified/discussed. This will in turn help the UN to planwhen the virus starts spreading human-to-human- whether inthe country, a close neighbour, or far away.
3.5Requirementsassessed and supplies arranged for critical staff in offices/facilities – six week period. / No / As isolating critical staff at the office will be an option to assure business continuity in a pandemic situation mention should be made of provisions to assure this.
UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01 March 2006 provides good list of supplies in annex 8.
Identification of support services for critical staff may have to be considered. (see guidelines).
3.6Staff to ensure access at home for food and water for six week period. / No / UNMedical Services Staff Contingency Plan Guidelines for an Influenza Pandemic of 01 March 2006 provide a good list of supplies in annex 8.
3.7For those working from home ensure that they are able to perform critical functions i.e. phone, internet, radios, generators etc – geared for six weeks. / No / As working from home will be an option to assure business continuity in a pandemic situation mention should be made of provisions to assure this.
3.8HR and Admin officers clear about policies and actions regarding travel, leave, medical, pay, tracing unit etc. / Yes / CP shows awareness of implications of an influenza pandemic on travel and pay. It could further elaborate on other questions such as leave and tracing.
Please refer to the United Nations Administrative Guidelines for an Influenza Pandemic Situation of 23May2006, found on
Communications (UNCT)
4.1UN System internal communication strategy agreed. / Yes / The CP shows awareness of internal communication requirements which has value of an internal communication strategy. For a revised plan the UNCT should keep in mind that possibly unprecedented measures for business continuity will also require intensive communication with staff.
CP appropriately emphasizes communication requirements in regard to health and safety but should also keep in mind that possibly unprecedented measures for business continuity will also require intensive communication with staff.
UNCT may like to consider assigning a focal point for communication.
4.2Strategy for external communications with relevant stakeholders. / No / The Lesotho CP can be visited as a CP with good awareness of external communication requirements.
Although CP briefly mentions external communication requirements it does not elaborate on this. It is suggested that an updated CP assigns overall responsibility for the coordination of external communications.
Budget
5.1Budget for staff health and safetyactions from medical guidelines for all agencies. / Yes / Budget is provided in annex 6a and annex 7.
5.2Budget for program continuity and additional program activities during a pandemic. / No / A good table with costs for program continuity and additional program activities during a pandemic is given in the Azerbaijan CP in annex 2.
Support for National Preparedness and Response
6.1UN been requested to provide support for the national preparedness and response planning. / No / Not documented. It is assumed that technical liaison with national government is on-going through technical agencies, even if there has been no official request. A revised plan should reflect this.
6.2Identification of components of national response and preparedness plans that align with agency mandates and operational capacities. / No / Although the team has presumably prepared their contingency plan also considering planning assumptions of the national authorities, there are no explicit linkages within the plan.
6.3Plan and prepare for additional or extended operations, programs and support if required and capacity exists. / No / Agood example for planning for programme continuity is provided by the Malawi CP (section 8) at password: unsic123
General Comments
The CP is a good start on which to build on. The UNCT should be commended for drafting and sending the CP at an early stage. It is acknowledged that a revised plan is in preparation by the Egypt UNCT. The review team has nevertheless decided to proceed with the review of the old plan in order to provide input for the ongoing revision.
The next step should be to develop guidance for business continuity and for support to the national government. Concrete actions (with responsibilities and timelines) to be undertaken now for preparedness, could be defined as well as the actions to be instituted when there is a new virus with human-to-human transmission that has appeared (i) anywhere in the world (ii) in a close neighbour or country with many links; (iii) in the country; (iv) as the epidemic in the country wanes – with possibility of second wave to be considered.
Critical to the next step will be the linkage with the national plan. (Some governments have established a high level umbrella group to coordinate a multi-sector response. This has included not just the MOH and MOA, but also ministries responsible for trade, finance, transportation and national security amongst others).
As hazard and risk analysis as well as scenario building clearly help to identify priorities in contingency planning this exercise is recommended when further developing the CP.
For national planning, assess what services are likely to collapse as a result of a worst-case scenario, what services will continue. In addition, chain of command issues should be considered if key people are sick or unable to perform their functions.