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Pandemic 2009 evaluations

Updated 21 Mar 2012 

Evaluations and lessons learnt

With the pandemic finishing many countries and international bodies are undertaking evaluations or even formal enquiries to assess how well their plans and preparations worked against the particular features of the 2009 pandemic. ECDC is aware of at least 16 international and multinational evaluations that are underway and are relevant to European countries. Some are general but many more relate to specialist areas like vaccination, surveillance or communications. There are also many national evaluations and lessons learnt exercises.  In this table ECDC lists and describes the evaluations it is aware of and that have published a report (interim or final) or have announced some initial details. International reports come first followed by country specific reports from European countries organised alphabetically.  ECDC would welcome details of other evaluation and lessons learnt exercises that have been published. These should be sent to influenza@ecdc.europa.eu

Table: Official evaluations relating to the EU/EFTA Countries of the 2009 pandemic

Institution/
Country

Date published

Title / Subject

Scope



Link


Institution A-Z
 
 

Council of Europe

24 June 2010

Handling of the H1N1 pandemic – Parliamentary Assembly of the Council of Europe

Handling of the Pandemic by WHO, European Institutions and WHO

Handling of the H1N1 pandemic: PACE calls for safeguards against ‘undue influence by vested interests’

EPSCO (EU Health Council) 13 September 2010
EU Health Council – Council conclusions on Lessons learned from the 2009 A/H1N1 pandemic – Health security in the European Union General aspects based on the preceeding expert meeting and informal Council in July 2010 Council Conclusions

EPSCO (EU Health Council)

5/6 July 2010

EU Health Council – Informal Council meeting of Health Ministers under the Belgian Presidency

General aspects based on the preceeding expert meeting

Informal Meeting Of The EPSCO Council Regarding Public Health

European Commission 16 April 2010 Assessment Report on the EU-wide response to Pandemic (H1N1) 2009 (covering the period 24 April 2009 – 31 August 2009) Examine the response at MS and EC level to the first four months of the pandemic (H1N1) 2009 (excluding vaccine policy issues) Assessment Report on the EU-wide Response to Pandemic (H1N1) 2009
European Commission 25 August  2010 Assessment Report on EU-wide pandemic vaccine strategies Documenting the varied higher level pandemic vaccine strategies developed by Member States, and some of their experiences in implementing them. Provides a point of departure for improving preparedness for future pandemics
(does not include local implementation or vaccine coverage/uptake)
Assessment Report on EU-wide pandemic vaccine strategies

European Union - Belgian Presidency

1/2 July 2010

Conference on lessons learned from the Influenza Pandemic A(H1N1) 2009, Brussels

Expert Meeting: General but special emphasis on Communications, Surveillance, Vaccines & Antivirals and Cross-Sectoral Aspects

Pandemic preparedness and response, European presidency, Belgium

European Parliament  - ENVI Committee (Workshop) 5 October 2010 Workshop on the handling of the pandemic, Brussels At this workshop it was decided that a report must be written and brought as an own initiative to the full Committee in 2011 Video of the workshop
European Parliament  - ENVI Committee (ECDC Evidence) 5 October 2010 ECDC Director’s oral evidence to the Workshop on the handling of the pandemic, Brussels ECDC Director’s  Evidence
European Parliament - ENVI Committee (Report) 9 February 2011 Report on the evaluation of the management of H1N1 influenza in 2009-2010 in the EU (2010/2153(INI)) - Rapporteur: Michèle Rivasi This is the official report of a motion for a European Parliament Resolution on the evaluation of the management of A (H1N1) 2009 influenza in 2009-2010 in the EU Report on evaluation of the management of H1N1 influenza in 2009-2010 in the EU (2010/2153(INI)) - Committee on the Environment, Public Health and Food Safety
European Centre for Disease Prevention and Control (ECDC) Nov 2011 Review of ECDC’s response to the influenza pandemic 2009/10 This report presents the final conclusions from an evaluation of ECDC’s response to the 2009 influenza pandemic. Review of ECDC’s response to the influenza pandemic 2009/10
European Centre for Disease Prevention and Control (ECDC) November 2010 ECDC special report, the 2009 A(H1N1) pandemic in Europe- a review of the experience Description of the epidemiology of the pandemic in Europe The 2009 A(H1N1) pandemic in Europe, a review of the experience, November 2010
European Medicines Agency (EMA) 29 April 2011 European Medicines Agency (EMA) 2009 Influenza Pandemic Evaluation
Summary of the key activities overseen by the Agency during the pandemic and a listing of the lessons the Agency staff learnt Pandemic report and lessons learned - Outcome of the European MedKicines Agency's activities during the 2009 (H1N1) flu pandemic
Finland -MoH 2010 Review of the response to the first wave of the 2009 A(H1N1) pandemic Management of the response at national and regional levels of healthcare sector Review of response to first wave of 2009 A(H1N1) pandemic (in Finnish)
WHO Regional Office for Europe December 2010 Recommendations for Good Practice in Pandemic Preparedness Lessons to be learnt in improving pandemic preparedness and some recommendations for WHO

Recommendations for good practice in pandemic preparedness

WHO Regional Office for Europe Review

WHO (Fineberg Committee)

5 May 2011

Independent review by expert group nominated by Member States and chaired by Dr Harvey Fineberg of the handling of the 2009 Pandemic especially by WHO and the application of the 2005 International Health  Regulations (IHR)

Global handling of the Pandemic under the International Health Regulations

Report of the Review Committee on the Functioning of the International Health Regulations (2005) in relation to Pandemic (H1N1) 2009
WHO (ECDC Evidence) September 2010 WHO Reviewing the 2009 Pandemic and the 2005 International Health  Regulations (IHR) Global handling of the Pandemic under the International Health Regulations ECDC Evidence September 2010
VENICE (Vaccination) November 2010 Overview of pandemic A(H1N1) 2009 influenza vaccination in Europe. Preliminary results of survey conducted by VENICE, 2010 A conventional VENICE survey reporting the vaccination policies and measuring the coverage Presentation at the ESCAIDE Conference

Country  A-Z
  
 

France – Parliament, the Senate (1) 8 July 2010 Managing pandemics: H1N1, and what about if it has to be done again? – Minutes of public hearing on June 14, 2010 (La gestion des pandémies : H1N1, et si c'était à refaire ? » (compte rendu de l'audition publique du 14 juin 2010) Follow-up of the first Enquiry (pandemic vaccination programme) carried out by body under  the French Senate, the ‘Evaluation Parliamentary Office for Scientific And Technologic decisions’. Rapport de Mme Marie-Christine BLANDIN, sénatrice et M. Jean-Pierre DOOR, député, fait au nom de l'Office parlementaire d'évaluation des choix scientifiques et technologiques (in French)
France – Parliament, the Senate (2) 29 July 2010 Report of a committee of enquiry on the role of pharmaceutical companies in the handling of the 2009 pandemic by the French government
(Report de la commission d’enquête sur le rôle des firmes pharmaceutiques dans
la gestion par le Gouvernement de la grippe A (H1N1)v)
The handling of the pandemic in France with specific recommendations Report of the French Senate into the handling of the pandemic (in French)
France – Parliament, the National Assembly 6 July 2010
A Commission of enquiry into the planning and managing of the programme of A(H1N1) vaccination in France (in French)
(La Commission d’enquete la manière dont a été programmée, expliquée et gérée la campagne de vaccination contre la grippe A(H1N1))
The pandemic vaccination programme in France – with recommendations N° 2698 Rapport d'enquête de M. Jean-Pierre Door sur la manière dont a été programmée, expliquée et gérée la campagne de vaccination contre la grippe A(H1N1) (in French)

Germany

 

02 May 2010

 

First review of the A(H1N1) pandemic in Germany 2009/2010 (Erster Erfahrungsaustausch zur H1N1-Pandemie in Deutschland 2009/2010)

 

General handling inside Germany

First exchange of experiences concerning the pandemic in Germany 2009/2010 (in German)

 

Germany December 2010 Special issue of the German Language Journal Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2010  Vol 53: Issue  12,  Dec Multi-author scientific review of the handling of the pandemic in Germany including epidemiology, vaccine, planning, communication and state (Lander) and local levels Listing of the articles with links to English Language Abstracts
The Netherlands - Berenschot for the Minstry of Health and Sport 9 March 2011 Evaluation of the approach towards new influenza A/H1N1 / Berenschot Process evaluation concerning  the crisis management of H1N1 – lessons learned about best practises and aspects for improvement

Evaluatie Nieuwe Influenza A (H1N1) (de Mexicaanse griep) (in Dutch)

The Netherlands -  Health Care Inspectorate and the Public Order and Safety Inspectorate for the Ministry of Health and Sport

February 2011

GHOR-institutions (Geneeskundige Hulpverleningsorganisatie in de Regio) were insufficiently visible for (health)care partners/ GHOR functioning during H1N1 /Inspection for the healthcare and inspection of the public order and safety

Evaluative study concerning the role of the medical aid organisations in the Regions of the Netherlands during the control of new influenza A(H1N1) - Especially the role of the medical aid organisations with regard to the health care sector

GHOR-bureaus tijdens Mexicaanse griep onvoldoende zichtbaar voor de zorgpartners (in Dutch)

The Netherlands - Ministry of Health and Sport

14 June 2011

Prevention policy for the public health/H1N1/ministry of health

Response of the Ministry of Health to the two reports Bried vad de Minister van Volksgezondheid, Welzijn en Sport (in Dutch)

The Netherlands – RIVM, National Institute for Public Health and the Environment

July 2011

Chronological overview of the 2009/2010 H1N1 influenza pandemic and the response of the Centre for Infectious Disease Control RIVM

Detailed chronological description of the pandemic and the response in the Netherlands to inform evaluations of the response

Chronological overview of the 2009/2010 H1N1 influenza pandemic and the response of the Centre for Infectious Disease Control RIVM (in English)
Norway 13 October 2010  Directorate for civil protection and emergency preparedness: New influenza A(H1N1) 2009 – a review of the experiences in Norway.   Review of all aspects of the management of the pandemic at the national level

Ny influensa A(H1N1) 2009: Gjennomgang av erfaringene i Norge (In Norwegian) Summary in English

 

Portugal-Directorate General of Health November 2010 The A(H1N1) 2009 pandemics in Portugal – a National Report. - Relatório da Pandemia da Gripe em Portugal Review of Portugal’s Response and the Epidemiology of the Pandemic as it affected Portugal Relatório da Pandemia da Gripe em Portugal (in Portugese)
Spain November 2010 Report of the analysis of action taken in terms of surveillance during the 2009 influenza A(H1N1) pandemic Specific review of aspects related to surveillance during the pandemic at national level 

Informe del analisis de las actuaciones en materia de vigilancia durante la pandemia de gripe por virus A (H1N1)2009

(ECDC note - in English)

Spain December 2010 Analysis of action taken in terms of vaccines and antivirals during the 2009 influenza A(H1N1) pandemic Specific review of aspects related to vaccines and antivirals during the pandemic at national level

Analisis de la actuacion en materia de vacunas y antivirales durante la pandemia de gripe por virus A (H1N1)2009

(ECDC note - in English)

Sweden – Government of Sweden
1 March 2011 Influenza A(H1N1)2009: Evaluation of preparation and handling of the pandemic A multi-agency review of the Swedish Response to the pandemic with eight separate strands or areas A(H1N1) 2009 – An evaluation of Sweden's preparations for and management of the pandemic

Switzerland

April 2010

Review of Switzerland’s H1N1 immunization strategy

Immunisation and Vaccines

Switzerland – publishes a 2009 pandemic national evaluation especially relating to immunisation

Switzerland (2nd evaluation) August 2010 Pandemic influenza H1N1 - evaluation of the Swiss Federal Office of Public Health’s crisis organization Continuation of the first evaluation; looking at the Swiss Federal Office of Public Health’s organization and processes during the management of the pandemic

Grippe pandémique H1N1 - Evaluation de l'organisation et des processus de l'OFSP (French)

Influenza A (H1N1): la strategia vaccinale sottoposta a una valutazione esterna (Italian)

Grippe A H1N1: Impfstrategie in einem externen Audit überprüft (German)

UK

July 2010

The 2009 Influenza Pandemic: an independent official review of the UK response to the 2009 influenza pandemic

General handling inside the UK

The 2009 Influenza Pandemic: an independent official review of the UK response to the 2009 influenza pandemic

UK July 2010 Learning the lessons from the H1N1 vaccination campaign for Health Care Workers Vaccination of Health Care workers
Lessons from vaccinating health care workers
UK July 2010 Report of the Swine Flu Critical Care Clinical Group and Key Learning Points for Future Surge Planning Care of severely ill patients Clinical care and surge capacity

 

ECDC comments on national evaluations of the 2009 pandemic

 

The 2009 Influenza Pandemic: an independent official review of the UK response to the 2009 influenza pandemic

An independent team was appointed by the UK government to review the UK response to the 2009 influenza pandemic and to draw lessons learned and recommendations for future pandemic preparedness planning. The review was conducted by evaluating over 700 documents from key organisations and interviewing almost 100 people with various responsibilities in the pandemic response locally, nationally and internationally. Although some of the recommendations are UK specific, others will be useful for other European countries.

 

European Union Review of the Pandemic and its handling and Belgian Presidency Informal Council

On July 1-2nd 2010 the Belgian Presidency and the European Commission undertook a conference in Brussels where the pandemic and its handling was reviewed. Press Release The presentations will be available through the conference web-site. The findings of the meeting were discussed at the informal Health Council of Health Ministers (EPSCO) on July 5th 2010.
 

WHO is reviewing the 2009 Pandemic and the 2005 International Health Regulations (IHR)

World Health Organization (WHO) is reviewing the handling of the 2009 pandemic as the major part of a broader review of the functioning of the International Health Regulations (2005).

The review has three aims:

  • To assess the functioning of the International Health Regulations (2005) in relation to the current pandemic (H1N1) 2009 and other public health events 

  • To review the scope, appropriateness, effectiveness, and responsiveness of global actions as well as the role of the WHO Secretariat in supporting pandemic preparedness, alert and response in relation to the pandemic. 

  • Based on the above, to identify and review the major lessons learnt from the global response to the current pandemic and to recommend actions to be taken by Member States and the Director-General to strengthen the preparedness and response to potential future influenza pandemics and other public health emergencies.

Read the WHO report: Report of the First Meeting of the Review Committee on the Functioning of the International Health Regulations (2005) in Relation to Pandemic (H1N1) 2009 

Further information: How will the global response to the pandemic H1N1 be reviewed?

EU States evaluations of the response to the 2009 influenza – Germany

This report is the result of an evaluation workshop held in Berlin in March, organised by the German Robert Koch Institute but involving representatives from the German Laender (the regions), the Federal Ministry of Health, academic partners, the Paul Ehrlich Institute and ECDC. The main objective was putting together contributions from the experiences on the 2009 influenza A(H1N1) pandemic which, in turn, could feed into broader evaluations on national and/or international levels. The invitees to the workshop - structured around short presentations, group work and plenary discussions - were representatives from different professions involved in the 2009 influenza A(H1N1) pandemic response in Germany.
The main experiences reported from the meeting were the following:
  • The extensive pandemic preparations in Germany were helpful.
  • The early warning systems were reliable.
  • The vaccines were available within a few months, although in limited amounts.
  • Areas for improvement identified were the logistics of vaccine distribution and logistics, the mechanisms for the reimbursement of the cost of vaccination, the availability of surveillance and monitoring systems, the integration of physicians in decision-making processes/health education, and the need for proactive communication strategies.
  • Investments in the above mentioned areas would help to improve public health protection in the future.
 

EUropean States evaluations of the response to the 2009 influenza – SWITZERLAND

Switzerland is the second European country known to have published the results of an evaluation of its national 2009 influenza A(H1N1) pandemic activities, this time on immunization strategies.
The Swiss evaluation was specific and focused on immunisation strategies and the document is accompanied by a Management summary Annex.
 
This review is the result of a request by the Head of the Pandemic Task Force (“Sonderstab”) who commissioned an international expert panel in collaboration with the consultants Ernst & Young to undertake an evaluation of the preparation and implementation of the Swiss immunization strategy. 
Its main aim was to assess vaccination planning, purchase, approval, delivery, distribution, execution and re-utilisation/removal.
 

Summaries of the 2009 pandemic

 
Scope
Source, Title, Date
Subject
Link
Global
WHO: Evolution of a Pandemic
Chronological account of the pandemic and the response
Europe (EU and EEA Countries)
ECDC: The 2009 A(H1N1) pandemic in Europe -  a review of the experience, November 2010
Epidemiology of the pandemic in the EU and EEA countries
Europe (EU, Norway and Iceland) Eurosurveillance, Surveillance trends of the 2009 influenza A(H1N1) pandemic in Europe, 2011 Epidemiology and virology of the
official length of the 2009 pandemic in the 27 EU Member States plus Norway and Iceland.
Surveillance trends of the 2009 influenza A(H1N1) pandemic in Europe
The Netherlands
Chronological overview of the 2009/2010 H1N1 influenza pandemic and the response of the Centre for Infectious Disease Control RIVM 2011
Epidemiology of the pandemic in the Netherlands and a chronological account of the response to it
Chronological overview of the 2009/2010 H1N1 influenza pandemic and the response of the Centre for Infectious Disease Control RIVM (in English)
Portugal
Directorate General of Health: Relatório da Pandemia da Gripe em Portugal, November 2010
Epidemiology of the pandemic in Portugal and the response to it
Relatório da Pandemia da Gripe em Portugal (in Portugese)
 
United Kingdom
Health Protection Agency and other UK Agencies:  Epidemiological report of pandemic (H1N1)
2009 in the UK, October 2010
Epidemiology of the pandemic in the UK
Epidemiological report of pandemic (H1N1) 2009 in the UK
 
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