Evaluation of Local Preparedness for Influenza Pandemic in Taiwan

Background: Asia countries have been most affected by H5N1 influenza since 2003, and would be possibly the first to face the next pandemic. Taiwan, situated in Asia, has formulated the strategic plan for pandemic influenza. But according to SARS experience, the implementation of the local governments will be the crucial element. Methods: Twenty-five local governments were asked to complete their preparedness and response plan by 2004. In 2005, we evaluated those plans with 4 indicators, including cross-sectoral coordination, surveillance, medical resources mobilization, and personal protective equipments (PPE) management. In 2006, an exercise assuming a cluster of H5N1 cases occurred in their prefectures was conducted to examine their implementations. An expert committee was organized to observe the performances Results: The average score of evaluation was 78%. The governments in central area got highest scores which seems to be consistent with their performance during SARS outbreak wherein the impact were minimized. All scored high in cross-sectoral coordination. 92% of them were familiar with surveillance system. Although the Material Information System controls the stockpile and usage of PPE was developed after SARS epidemic, only 56% could utilize efficiently. The major gap was in medical resource mobilization. Only 52% local governments could totally grasp the healthcare workers, ambulances, medical equipments, alternative medical facilities and funeral capacity. Fourteen governments attended the exercise all could run the mechanism smoothly and conduct early containment, but outsourcing was needed for larger clusters. Conclusion: Most local governments in Taiwan had included essential elements in their plans, but the executive and technical procedures have to be further practiced and promoted continually. Evaluation, exercise and then comparison among peers can facilitate the revision of the plans and better practice. We conclude that these processes are valid to improve the overall preparedness.