Pandemic Influenza Preparedness Framework
What is the purpose of the PIP Framework?
The Pandemic Influenza Preparedness Framework (PIP Framework) is helping Member States, laboratories, industry, and civil society work together to better prepare the world for an influenza pandemic.
The PIP Framework was set up to introduce greater equity and solidarity among nations when the next pandemic strikes. The best defense against influenza is vaccination. However, many countries do not have the capacity to develop vaccines on their own, relying instead on products manufactured by others. Moreover, with current technologies, producing a safe and efficacious vaccine requires at least 4–6 months from the time a virus emerges. Even then production will take time – therefore, each dose that will become available will be precious.
Under the PIP Framework, WHO will have real-time access to approximately 10% of global vaccine production and will be able to send life-saving doses to developing countries in need. In this manner, all countries – whether rich or poor – will have access to some vaccine at the same time.
How does the PIP Framework work?
The PIP Framework has two goals that are pursued on an equal footing, promoting:
- the sharing of influenza viruses that could cause a pandemic, and
- access to capacity-development and products such as vaccines.
Influenza viruses are shared through the Global Influenza Surveillance and Response System (GISRS), a network of more than 150 public health laboratories located around the world. In addition to serving as a virus sharing platform, GISRS also shares genetic sequence data derived from these viruses, develops and shares reagents, and undertakes risk assessments. One of its critical functions is to develop candidate vaccine viruses, which are used by manufacturers to develop vaccines against seasonal and pandemic influenza.
In exchange for receiving influenza viruses with pandemic potential and associated data from GISRS, manufacturers contribute to pandemic preparedness in two ways: they pay an annual Partnership Contribution (totaling US$ 28 million) to WHO, and they agree, under legally binding contracts, to provide vaccines, antivirals, diagnostic kits or other products to WHO at the time of the next pandemic .
How is the annual US $28 million Partnership Contribution spent?
Partnership Contribution is split between preparedness funds, which are used to help countries prepare for a pandemic, and response funds, which are placed in a contingency fund that will be drawn upon in case of a pandemic. Currently 70% of funds are used for preparedness and 30% are allocated for response, as decided by the WHO Executive Board.
Funds allocated for preparedness support five areas of work:
- laboratory and surveillance capacities
- burden of disease studies
- regulatory capacities
- risk communications
- planning for deployment.
Within these areas of work, priority countries were chosen on the basis of various criteria including existing capacity and funding. A new high-level implementation plan is being developed, in consultation with industry, civil society, and other partners, to determine future priority areas and countries.
What is the relationship between seasonal and pandemic influenza viruses?
Seasonal and pandemic influenza are connected and both are shared within GISRS. The PIP Framework only applies to influenza viruses that have the potential to cause a pandemic.
A pandemic virus may develop from a mutated seasonal virus. The laboratory detection and analysis capacity required for seasonal viruses is the same as that required for detecting a potentially pandemic virus. Also, the capacity to produce a pandemic vaccine depends on robust seasonal vaccine production – in a pandemic, manufacturers will use the same seasonal vaccine production facilities to produce the pandemic vaccine.
Who oversees the implementation of the PIP Framework?
An Advisory Group of 18 independent experts from all six WHO regions advises the Director-General on the implementation of the PIP Framework and interacts with industry, civil society, and other stakeholders. The Director-General promotes the PIP Framework’s implementation, while the World Health Assembly is ultimately responsible for oversight, direction, and coordination.
What are the results of the 2016 review of the PIP Framework? In 2016, the PIP Framework was reviewed for the first time, and progress in implementation was assessed. The key conclusion is that the PIP Framework is a “bold and innovative tool” for preparedness that has ensured “confidence and greater predictability” in the world’s ability to respond to an influenza pandemic.
The review offers several recommendations to improve implementation, such as:
- to produce with urgency recommendations to clarify the handling of genetic sequence data;
- to undertake a study to determine the implications and desirability of including seasonal influenza viruses in the PIP Framework
- to develop a comprehensive evaluation model to allow for more regular and thorough assessment of progress.