Public Release: 

Inconsistencies in pandemic flu preparedness between European countries

Considerable gaps exist among European national pandemic plans

London School of Hygiene & Tropical Medicine

Considerable gaps exist among European national pandemic plans, according to a new report published in the online edition of The Lancet on 20 April 2006.

The report, 'How prepared is Europe for Pandemic Influenza? An analysis of national plans', issued by the London School of Hygiene and Tropical Medicine (LSHTM), reveals marked discrepancies in pandemic preparedness across Europe. The authors conclude that further planning and implementation is needed so that governments can effectively respond in the event of a pandemic, recommending action by the European Union to ensure governments work together towards a coordinated approach.

Dr Richard Coker, the report's lead author said: 'Wide gaps exist in the pandemic preparedness of European nations. With the ongoing spread of the H5N1 avian influenza virus in birds, and the impending threat of a pandemic, European nations need to work together to adequately prepare for the onset of such a pandemic.'

The LSHTM researchers reviewed the preparedness initiatives of all 25 European Union member states, as well as Bulgaria, Norway, Romania and Switzerland. 21 published national plans were eligible to be included in the final analysis.

The completeness and quality of these 21 national preparedness plans was assessed based on the World Health Organization's (WHO) preparedness checklist , addressing levels of:

  • Planning and coordination
  • Surveillance
  • Public health interventions (public health control measures, vaccines and antivirals)
  • Health system response
  • Maintenance of essential services
  • Communication
  • Putting plans into action

Based on these evaluation criteria, the completeness score of the plans ranged from 24% to 80%, with the average level of completeness calculated as 54%.

With 194 confirmed cases of avian influenza in humans to date , experts, including the WHO, agree that the next influenza pandemic is inevitable. Detailed planning is essential to ensure a coordinated response to a pandemic, both across Europe and within each member state, to minimise serious illness, deaths and overall societal disruption. The WHO's Global Influenza Preparedness Plan provides guidelines for governments on preparing for and managing an influenza pandemic is the benchmark against which all national preparedness planning should be implemented.

Dr Coker said, 'As yet, Europe is only moderately prepared for the threat of an influenza pandemic. The existing gaps underline the need for increased cooperation between countries in policy, planning and resource distribution. It is vital that the European Union takes action to ensure that such gaps are filled and Europe is adequately prepared across regional, national and international levels."

The LSHTM researchers acknowledge that only those plans available for analysis at the time of research (November 2005) were included and further plans, or portions of plans, under review, amendment or pending finalisation were therefore not included in the analysis. As such, it is possible that some of the gaps exposed are being or have since been addressed.


Notes to Editors:
Copies of the LSHTM report can be downloaded from:

If you require a copy of the Lancet papers please contact LSHTM Press Office

For further information, please contact the LSHTM Press Office: Phone: +44 (0)20 7927 2073/2802. The Lancet: +44 (0)20 7424 4949.

This research was undertaken through an unrestricted educational grant from F. Hoffmann-La Roche Ltd.

Coker R. Mounier-Jack S. How prepared is Europe for Pandemic Influenza? An analysis of national plans. Lancet 2006; WHO. Checklist for influenza epidemic preparedness 2005.

Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO

WHO Global Influenza Preparedness Plan - the role of WHO and recommendations for national measures before and during pandemics 2005

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