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H1N1 Outbreak in North Korea

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H1N1 Outbreak in North Korea

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  1. H1N1 Outbreak in North Korea By See-Won Byun, Paul Choi, Kevin Shepard, Adrian Yi, Yun Yi

  2. Introduction

  3. Actors

  4. Task: Simulate Collaboration to Prevent a Global Pandemic

  5. North Korea

  6. North Korea: Responsible Offices

  7. North Korea

  8. South Korea

  9. South Korea: Responsible Offices Foreign and Security Policy Coordination Council Direct Control: Chief of Staff Chair: MOFAT Minister Council Members: Defense Minister NIS Chief, Chief of the PM Office, Unification Minister, Sr. Pres. Sec. For. Affairs & Nat’l Sec. System & Actors I - Macro:

  10. South Korea: Responsible Offices (2) System & Actors II - Micro:

  11. South Korea

  12. United States

  13. United States: Responsible Offices Overseas Response Domestic Response

  14. United States

  15. Japan

  16. Japan: Responsible Offices

  17. Japan Actors & Roles Ministry of Health, Labor, and Welfare (MHLW) • Adopts response policies • Leads planning & coordination among relevant government bodies: Cabinet Secretariat; Ministries of Foreign Affairs; Finance; Environment; Land, Infrastructure & Transport; Agriculture, Forestry & Fisheries; Education, Culture, Sports, Science & Technology; Ministry of Defense; Coast Guard; National Police Association; Small & Medium Enterprise Agency • Coordinates international & local efforts in public & private sector: Healthcare providers & suppliers; Medical institutions; Social welfare facilities; Public transportation; Media; Private & nonprofit corporations Prime Minister • Takes lead from MHLW at human-human transmission phase National Institute of Infectious Diseases • As WHO collaborating center conducts surveillance; provides technical assistance for development of national & regional health programs

  18. Japan

  19. China

  20. China: Responsible Offices

  21. China

  22. Coordinating a Response In Resolving the issue,“How do regional actors collaborate in order to get the DPRK to cooperate in order to prevent a global pandemic?”, the following should be considered: • Prioritization of objectives • Coordination of resources • Division of cost/burden • Areas for Joint Response: (1) Detection & reporting (2) Assessment & decision-making (3) Resource mobilization (4) Implementation (5) Monitoring & evaluation • Common Priorities/Challenges • Interagency; public-private; civil-military; domestic-international coordination mechanisms • Availability of supplies: Possible nationalization of production facilities • Pandemic-related global economic crisis; social instability at home • Spread of biological terrorism DPRK-Specific Challenges • Uncertain DPRK leadership response: reluctance toward info-sharing, foreign intervention • DPRK non-membership in international organizations • DPRK domestic situation; possible insurgency against police & military enforcement of quarantine • Diplomatic/political tensions: DPRK-Japan, DPRK-U.S., inter-Korean • Inefficient distribution of external supplies to DPRK (and who distributes/how); Training of international & DPRK staff for common understanding; human & material resource constraints • Lack of legal & other national capacities to implement measures, standard operating procedures • Delay in DPRK-WHO reporting; Lack of rapid & transparent info-sharing

  23. Reading Lists Required Reading • “Pandemic H1N1 Influenza: The Evolving Saga,” Smart Global Helath.org. http://www.smartglobalhealth.org/issues/entry/h1n1-influenza • The pandemic influenza challenge: Multilateral perspectives on preparedness, response planning, and areas for cooperation, James Schoff and Marina Travayiakis, IFPA Jan 2007, http://www.ifpa.org/pdf/pandemicDTRA_s.pdf • Reform locally, act globally?  Crisis management trends in Korea, James Schoff and Choi Hyun-jin, KEI Apr 2008, http://www.magnetmail.net/images/clients/KOREA/attach/SchoffChoiFINAL.pdf • General understanding of DPRK government view of NGO’s, by Gordon Flake: http://www.mansfieldfdn.org/pubs/pub_pdfs/hirctestimony.pdf • Preparing for the next influenza pandemic: roles and responsibilities of Roche and other stakeholders, Roche May 2008, http://www.roche.com/sus_csoc-acc_influenza.pdf Recommended Reading • WHO, “Coordinated approach for responding to early pandemic events”, Japan-WHO Joint Meeting on Early Response to Potential Influenza Pandemic in Asia, Tokyo, Japan, 12-13 January 2006. • “The Pandemic Influenza Challenge: Multilateral Perspectives on Preparedness, Response Planning, and Areas for Cooperation,” IFPA, January 2007. http://www.ifpa.org/pdf/pandemicDTRA_s.pdf • Trilateral tools for managing complex contingencies: US-Japan-Korea cooperation in disaster relief and stabilization/reconstruction missions, James Schoff IFPA Nov 2005, http://www.ifpa.org/pdf/Trilat_Tools_DC_Seminar_Rprt_1105.pdf • Most recent population data for the DPRK: http://unstats.un.org/unsd/demographic/sources/census/2010_phc/North_Korea/2008_North_Korea_Census.pdf • Huang Yanzhong, “China’s Reaction to H1N1 Pandemic Flu,” EAI Background Brief No. 498, January 8, 2010. http://www.eai.nus.edu.sg/BB498.pdf • “China’s H1N1 Response and Public Opinion: Promise and Potential Challenges,” CSIS, Novmber 5, 2009. http://www.smartglobalhealth.org/blog/entry/chinas-h1n1-response-and-public-opinion-promise-and-potential-challenges/

  24. Related Sites • MED Pandemic Influenza Information: http://medical.state.gov/index.cfm?fuseaction=public.display&id=4d41223b-890b-4fc1-b1c9-11578578f25a • Office of Foreign Missions Pandemic Influenza http://www.state.gov/ofm/c19455.htm • US Department of Defense Global Emerging Infections Surveillance and Response System (DoD-GEIS): http://fhp.osd.mil/aiWatchboard/ • Hawaii’s Department of Health: http://hawaii.gov/health/about/H1N1.html • Pacific Public Health Surveillance Network: http://www.spc.int/phs/PPHSN/index.htm • World Health Organization http://www.who.int/csr/disease/swineflu/en/ • Center for Disease Control: http://www.cdc.gov • http://wwwn.cdc.gov/travel/contentSwineFluMexico.aspx • http://wwwn.cdc.gov/travel/contentSwineFluUS.aspx • http://www.pandemicflu.gov • Chinese Center for Disease Control and Prevention: http://www.chinacdc.net.cn/n272562/

  25. References • DPRK leadership chart: http://www.fas.org/irp/dni/osc/dprk-leaders.pdf • WHO general outlook on North Korea: http://www.who.int/countries/prk/en/ WHO coverage of 2005 Avian Flu outbreak: http://www.who.int/csr/don/2005_03_30/en/index.html • WHO assistance on measles outbreak: • http://www.who.int/immunization/newsroom/north_korea_measles/en/ • Example of NK refusing help: http://www.wfp.org/stories/north-korea-political-agreement-reached-still-no-response-humanitarian-crisis • NK treatment of US NGOs: http://blogs.abcnews.com/politicalradar/2009/03/north-korea-can.html • “North Korea Rejects US Food Aid, Kicks Out US NGOs,” http://blogs.abcnews.com/politicalradar/2009/03/north-korea-can.html • “NGOs Remain Committed to N. Korea Despite Expulsion” http://www.christianpost.com/article/20090321/ngos-remain-committed-to-n-korea-despite-expulsion/index.html • “First NGO Heading for North Korea this Week,” http://www.dailynk.com/english/read.php?cataId=nk00600&num=5243 • S. Korean NGOs say aid for N.Korea is going to waste in Incheon Harbor,” http://english.hani.co.kr/arti/english_edition/e_northkorea/362526.html • “Pandemic Influenza Preparedness and Response Plan 2006,” Ministry of Health & Welfare, Korea Centers for Disease Control & Prevention, 2006. ROK Pandemic Flu Response Plan

  26. References (cont.) • http://www.redorbit.com/news/health/731721/report_scarlet_fever_spreads_in_nkorea/index.html http://www.eugenebell.org/eng/business/business_01.html • http://www.caritas.or.kr/DPRK/ • http://www.phac-aspc.gc.ca/tmp-pmv/pub-eng.php Canada - Public Health Agency - Travel Advisories • http://www.fco.gov.uk/en/travelling-and-living-overseas/travel-advice-by-country/north-central-america/mexico UK - Foreign and Commonwealth Office - Travel Advice – Mexico • WHO's International Health Regualtion system (http://www.who.int/features/qa/39/en/index.html • The pandemic influenza challenge: Multilateral perspectives on preparedness, response planning, and areas for cooperation, James Schoff and Marina Travayiakis, IFPA Jan 2007, http://www.ifpa.org/pdf/pandemicDTRA_s.pdf • (Abstract only) When the flu comes: political and economic risks of pandemic disease in Asia, Ann Marie Kimball, NBR Sep 2006, http://www.nbr.org/publications/element.aspx?id=339 • “Japan’s contribution to the early response to pandemic influenza,” Presentation at Japan-WHO Joint Meeting on Early Response to Potential Influenza Pandemic, Tokyo, Japan, 12-13 January 2006, http://www.wpro.who.int/NR/rdonlyres/239FAEA5-255F-4611-A434-30F59FEAB335/0/DP6_Japan.pdf. • Pandemic Influenza Preparedness Action Plan of the Japanese Government, 2005 (rev. 2007), http://www.mhlw.go.jp/english/topics/influenza/dl/pandemic02.pdf. • DPRK Pandemic Control Plan : http://ochaonline.un.org/roap/WhatWeDo/PandemicPreparedness/PreventionandControloftheNextPandemic/NationalPlansofCountriesinAsiaPacific/tabid/4308/language/en-US/Default.aspx • USFK Public Health Emergency Officers (PHEO) program • http://8tharmy.korea.army.mil/g1_AG/Programs_Policy/UploadedFile/USFK/USFK%20Reg%2040-4%20Public%20Health%20Emergency%20Officer%20(PHEO).pdf