Ministerial Statement
November 7, 2003
Fourth ministerial meeting on Health Security and Bioterrorism
Berlin, Germany, November 7th, 2003
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We, the Ministers/Secretaries/Commissioner of Health and the
Director-General of the World Health Organization, met in Berlin
for the 4th Ministerial Forum of the Global Health
Security Initiative. International collaboration continues
to be important to protecting the public health security of
our citizens and those of the international community. We discussed
the challenges facing us, explored potential solutions and
agreed on steps to further protect public health security globally.
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One challenge we face is ensuring timely and effective communications
among our national governments in order to deal with public
health crises such as an outbreak of smallpox. In September
2003, Canada coordinated Exercise Global Mercury -
a smallpox outbreak simulation exercise to evaluate health
communications among our governments, in response to the fictitious
discovery of an outbreak of smallpox. This exercise tested
international capacity for the rapid exchange of information,
and provided insights into international communications that
such a public health crisis can generate.
We commend the effort of all member countries and organizations
in making Exercise Global Mercury a success. This
exercise was entirely successful in reaching its objectives.
We have endorsed the final evaluation report on Exercise
Global Mercury, and have asked our officials to undertake
the necessary work from the lessons learned during this exercise
in order to improve international communications capabilities
of our public health professionals to deal with an actual public
health emergency.
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We thanked the UK for leading the work on the risk incident
scale. A preliminary assessment highlighted the need for the
supporting material to be updated on an ongoing basis in accordance
with developments in the evidence base. We endorsed progress
made on developing a set of principles for risk management
and communications in the event of a chemical, biological and
radio-nuclear incident. We have asked our officials to further
develop and refine their work and to bring forward a set of
principles for our consideration at the 5th Ministerial
meeting.
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From the outset of the Global Health Security Initiative we
have attached considerable importance to strengthening our
public health preparedness and response to a possible smallpox
incident. We all have a stake in preventing the occurrence
of such an incident, and in being fully prepared if the need
arises. Since we last met in Mexico City in December 2002:
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The United States and the World Health Organization (WHO)
have completed a model train-the-trainers course on containing
a smallpox outbreak. We agreed that the training materials
for this course will be made available to the international
community. To this end, we approved a distribution plan
to be implemented without delay.
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Italy has completed a report on strategies for isolation
techniques for patients with smallpox and other highly
contagious viral agents based on a meeting of experts,
and we have decided that this report should be shared with
other countries. We agreed to continue our collaboration
in this area.
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Our countries have successfully evaluated and shared information
on the effectiveness of our respective smallpox detection
assays at a smallpox practical laboratory workshop hosted
by the United States. We are pleased to report that all
countries performed to an acceptable standard. We agreed
to continue our collaboration in this area.
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We reaffirmed our commitment to strengthening the WHO
smallpox vaccine reserve. The form of support for this
global vaccine reserve is at the discretion of each member
of the Global Health Security Initiative. Ongoing work
on the logistical management of the reserve is underway
in cooperation with WHO.
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We have shared lessons learned from the experiences our
countries have had with their smallpox vaccination programmes.
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We have consolidated our effort on smallpox and risk management
and communications by forming a new Working Group on Risk Management
and Coordination.
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Steps were taken to strengthen the coordination and collaboration
among participating national high-level laboratories through
the Global Health Security Action Group (GHSAG) Laboratory
Network:
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We approved the Terms of Reference for the GHSAG Laboratory
Network.
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We are addressing the challenges related to the issue
of transporting diagnostic specimens and reference materials
across international borders, and have agreed to work together
to that end.
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We welcomed the external quality assurance program developed
by Germany for the Network.
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We welcomed the smallpox laboratory training exercise
developed by the US for the Network.
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We shared lessons learned from our laboratory experiences
with severe acute respiratory syndrome (SARS).
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We recognize concerns surrounding biosafety and health
security standards outside of GHSAG countries and support
the need for evidence-based research to improve global
standards in this area.
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The UK will host an anthrax testing workshop in March
2004.
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We approved the generic criteria for priority chemicals, developed
by the working group led by Japan, to improve preparedness
for and response to chemical events. We anticipate proceeding
to the next steps, such as identifying those chemicals for
international collaboration, developing the inventory of scenarios
and research, as well as a study on the feasibility of an international
exercise.
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To underscore our commitment to improve public health security
globally, we decided to undertake work in new areas concerning
radio-nuclear threats, field epidemiology practices, and collaboration
on research.
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We endorsed the proposal from France to address radiological
and nuclear threats to public health and health security.
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We approved the initiative by Mexico to improve the field
epidemiology response to a public health emergency of international
concern.
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Led by the European Commission, we will pursue better
collaboration on research in order to, for example, facilitate
the exchange of information, the identification of common
interests and research gaps, and to consider opportunities
for joint research.
We have called for concrete progress in these areas for our
5th Ministerial meeting.
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Furthermore, we recognize that preparedness for and response
to bioterrorism have much in common with preparedness for and
response to naturally occurring global health threats such
as pandemic influenza. Much work needs to be done to enhance
preparedness by member countries and globally by addressing
critical issues for an effective pandemic response. To this
end we have agreed to the Terms of Reference for the Technical
Working Group on Pandemic Influenza Preparedness. The Technical
Working Group will focus on critical gaps related to the rapid
development, evaluation and availability of pandemic influenza
vaccines; and, the optimal use of antiviral drugs. This group
will carry out its work in conjunction with the WHO and other
appropriate international organizations.
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While membership in the Global Health Security Initiative
remains the same, we will initiate steps to more fully share
with other countries appropriately designated information and
outcomes from the Global Health Security Initiative, including
the possibility of periodic information sessions determined
by the World Health Organization at the World Health Assembly.
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We have accepted the invitation of France to host the 5th Ministerial
meeting in Paris in the autumn of 2004.
This statement was endorsed by:
- Mr. Ian C. Green, Deputy Minister of Health, Canada on behalf
of the Honourable Anne A. McLellan, Minister of Health, Canada
- Mr. David Byrne, Commissioner of Health and Consumer Protection,
European Union
- L'honorable Jean-François Mattéi, Ministre de la Santé, de
la famille et des personnes handicapées, France
- The Honourable Ulla Schmidt, Federal Minister for Health, Germany
- Professor Girolamo Sirchia, Minister of Health, Italy (in absentia)
- Mr. Yoshiharu Otsuka, Vice-Minister of Health, Labour and Welfare,
Japan, on behalf of The Honourable Chikara Sakaguchi, Minister
for Health, Labour and Welfare, Japan
- The Honourable Julio Frenk, Minister of Health, Mexico
- The Rt. Honourable John Hutton, Minister of State for Health,
United Kingdom
- The Honourable Tommy G. Thompson, Secretary of Health and Human
Services, United States
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