Capacity of Thailand to Contain an Emerging Influenza Pandemic

Abstract

Southeast Asia will likely be the epicenter of the next infl uenza pandemic. To determine whether health system resources in Thailand are suffi cient to contain an emerging pandemic, we mapped health system resources in 76 provinces. We used 3 prepandemic scenarios of clustered cases and determined resource needs, availability, and gaps. We extended this analysis to a scenario of a modest pandemic and assumed that the same standards of clinical care would be required. We found that gaps exist in many resource categories, even under scenarios in which few cases occur. Such gaps are likely to be profound if a severe pandemic occurs. These gaps exist in infrastructure, personnel and materials, and surveillance capacity. Policy makers must determine whether such resource gaps can realistically be closed, ideally before a pandemic occurs. Alternatively, explicit assumptions must be made regarding allocation of scarce resources, standards of care, and priority setting during a pandemic.

Emerging infectious diseases in southeast Asia: regional challenges to control

“…At a national level, thriving private health-care sectors in many countries increasingly pose challenges to reporting systems, with some being either unwilling or unable to provide information. 60 Similar challenges arise from decentralised health systems-for example, in Indonesia and the Philippines, where local health authorities have become less active in case reporting compared with other countries. 61 Where vertical diseasespecifi c surveillance programmes have been developed, such as in Cambodia, there is a risk that parallel surveillance and laboratory testing systems, especially those funded through investments related to pandemic infl uenza preparedness or other global health initiatives, draw on limited existing capacity and contribute to a duplication of eff orts and ineffi cient use of resources.…”

“…Ongoing research within our group suggests that these disparities probably result in inequitable rates of preventable mortality from emerging infectious diseases. 60,76…”

Law, ethics and pandemic preparedness: the importance of cross‐jurisdictional and cross‐cultural perspectives

“…SARS provided a dramatic reminder of this a few years ago 26,44 and avian influenza may yet provide a far more dramatic reminder. Poorer countries may lack the health resources and infrastructure necessary to meet the challenges of a severe pandemic 45 . It is commonly pointed out that germs do not recognise borders and outbreaks of infectious disease can escalate rapidly across the globe.…”

Development of a resource modelling tool to support decision makers in pandemic influenza preparedness: The AsiaFluCap Simulator

“…For the availability of human resources, we included mean number of work hours per week, duration of day and night shifts and absenteeism percentages. The AsiaFluCap Simulator contains by default resource parameter values which are based on a literature study by the authors, a previous resource study for Thailand [49] and interviews with public health professionals participating in the AsiaFluCap project. These resource parameter values can differ strongly between and even within countries, therefore all resource parameter values can be varied in the tool.…”

“…With GIS software it is possible to create maps of resource demands, gaps or surpluses and the impact of shortages on public health (e.g. number of deaths due to resource gaps per 100,000 population) across regions during a pandemic scenario, similar to those presented in previous resource gap analysis studies [37,38,49].…”