South Africa prepares for future respiratory pathogen pandemics

South Africa gets “PRET^[1]”.
As part of South Africa’s ongoing efforts to prepare for future
respiratory pathogen pandemics, the country is developing a National
Respiratory Pathogen Pandemic Preparedness Plan. The Plan outlines key
activities for preparedness, response and recovery, aligning with the
World Health Organization’s (WHO) Preparedness and Resilience for Emerging Threats (PRET) initiative.

From
19–21 August 2024, multidisciplinary and multilevel stakeholders
convened in Johannesburg, South Africa, to participate in a tabletop
simulation exercise aimed at testing and refining the draft National
Respiratory Pathogen Pandemic Plan. This event was organized by the
National Department of Health, in collaboration with the National
Institute for Communicable Diseases, WHO, the International Organization
for Migration, and Doctors Without Borders. Attendees included
representatives from various sectors and organizations including The
Office of the Presidency, the National Disaster Management Authority,
South Africa Military Health Services, the Department of Agriculture,
Land Reform and Rural Development, Clinton Health Access Initiative,
Jhpiego and others.

Simulation exercises are essential tools for
countries to test and validate their preparedness and response
mechanisms for public health emergencies, including epidemics and
pandemics. This tabletop simulation exercise, known as Exercise
PanPRET-1, engaged stakeholders in a discussion-based setting where they
responded to a fictional scenario. The scenario unfolded in four
stages, beginning with the outbreak of a novel respiratory virus in
another country, progressing to the declaration of a pandemic, and
concluding with the end of the pandemic. At each stage, participants
were presented with injects and accompanying questions designed to
assess the functionality of preparedness and response systems based on
the draft plan.

Several key learnings emerged from this exercise.
The importance of strong multisectoral coordination and communication
mechanisms, even during peacetime (the interpandemic period), was
underscored. One of the notable outcomes was the development of
actionable recommendations aligned with the 5 Cs of the health emergency prevention, preparedness, response, and resilience framework and the International Health Regulations core capacities Health Regulations core capacities. These recommendations will be integrated into the next iteration of South Africa’s pandemic preparedness plan.

The
three-day event provided a valuable platform for participants to
reacquaint themselves with the draft plan, share insights and expertise,
and collaboratively develop actionable recommendations to finalize the
National Respiratory Pathogen Pandemic Preparedness Plan. Employing a
whole-of-government, whole-of-society approach, South Africa remains
committed to proactively prepare for future respiratory pathogen
pandemics.

Some reflections from the participants at the exercise:

The simulation exercise has been extremely valuable to ensure that pillar 10 of the Presidential Health Compact – Pandemic Prevention, Preparedness and Response (PPPR) results in adequate preparedness for the next pandemic. Stakeholders tabled recommendations to continue to refine the country’s PPPR strategy and strengthen health systems as an essential foundation. The Presidency remains committed to leading the country’s efforts and aligning with regional and global efforts.

Dr Lwazi Manzi, Pillar 10 (Pandemic Prevention, Preparedness and Response) Lead of the Second Presidential Health Compact, Office of the Presidency, South Africa

The pandemic simulation exercise was a great opportunity to share South Africa’s progress in pandemic planning and to test and evaluate our country systems. The more than 100 participants are testament to the value placed on pandemic preparedness. The quality of discussions and outputs will strengthen and catapult the next draft of the country’s pandemic preparedness and response plan.

Dr Wayne W. Ramkrishna, Deputy Director, Zoonotic Diseases, Communicable Diseases Directorate, National Department of Health, South Africa

An immense effort has been made by NDOH, supporting sectors and partner organizations to review the Pandemic Preparedness Plan for Respiratory Pathogens, to identify gaps and make recommendations for improvement. The knowledge, skill and energy in the room was incredible. MSF remain a committed partner on this journey toward preparedness.

Ms Camren McAravey, Country Operational Representative, Doctors without Borders

Recent global and country reviews into the response to pandemics of influenza and COVID-19 and outbreaks like cholera have all underscored the need for countries to invest in strengthening capacities for pandemic preparedness. WHO commends the South Africa Government for leading efforts to strengthen national capabilities for pandemic preparedness and response. We remain committed as WHO to walk the talk in support of Government efforts in this regard.

Dr Joseph Wamala, Epidemic Preparedness and Response Team Lead, WHO Country Office South Africa

The recent simulation exercise in South Africa is a clear example of how multisectoral engagement is cardinal in pandemic preparedness. By bringing together diverse stakeholders from across sectors, South Africa has set an example in the African region. It’s only through such collaborative efforts that we can build resilient systems capable of responding effectively to future pandemics.