-NEW EDUCATIONAL PATWAY FOR GLOBAL PUBLIC HEALTH SECURITY-

(1)

South Eastern Europe (SEE)PUBLIC HEALTH PREPAREDNESS

SUPERCOURSE NETWORK

Elisaveta Stikova, Ronald LaPorte, Faina Linkov, Margaret Potter, David Piposzar, Sam Stebbins

SEE Public Health Preparedness Supercourse Network

Learning objectives Enlighten public health importance of

disasters Increase knowledge about epidemiological

aspects of main disasters and their public health consequences

Classify emergencies and disasters using relevant definitions and criteria

List and describe different phases of disaster management

SEE Public Health Preparedness Supercourse Network

Elisaveta-Jasna Stikova Present position

1991-Present, Professor, University “Ss. Cyril and Methodius”, Medical faculty, Skopje, Macedonia (courses taught: Occupational Health, Public Health, Medical Ecology, Hygiene)

2002 – Present, Advisor in the National Public Health Institute, Skopje, Macedonia

2009 – Fulbright Visiting Scholar, Pittsburg University, Graduate School of Public Health – New Educational Pathway for Global Public Heath Security

SEE Public Health Preparedness Supercourse Network

Co-Authors and collaborators: Ronald E. LaPorte, PhD, UPGSPH, Director,

Disease Monitoring and Telecommunication, WHO Collaborating Center

Faina Linkov, PhD, Assistant Professor, Cancer Institute

Margaret Potter, JD, MS, Associate Dean and Director, UPGSPH, Center for Public Health Practice

David Piposzar, MPH, UPGSPH, PPLI Co-director Sam Stebbins, MD, MPH, UPCPHP Principal

Investigator/Director, Center for Public Health Preparedness

Global Public Health Threats in 21th Century

Emerging and epidemic prone diseases Environmental changes and natural

disasters Human-made (technological) disasters Chemical, biological and radiological terror

threats International crises and humanitarian

emergencies

World Health Day 2007 debate on International Health Security

The uncertainty and destructive potential of public health threats gives them a high public and political profile

When the world is collectively at risk, defence becomes a shared responsibility of all nations.

Dr Margaret ChanDirector-General of the WHO

Why SEE Public Health Preparedness Supercourse

Network?

Public health threats are many and diverse, they are multiplying and moving faster than even before going far beyond the national borders

They present new challenges and require an urgent and collaborative response

Strengthening of public health preparedness, planning and timely response are ultimate goals to minimize human suffering caused by global public health threats

Why SEE Public Health Preparedness Supercourse

Network?

Achievement of this goal needs development of public health experts’ networking, new knowledge and skills.

New SEE Public Health Preparedness Supercourse Network would prevent public health threats and protect human health by networking of scientists, experts and students from SEE region

www.pitt.edu/~super1/

Question! How can we improve public health

preparedness education worldwide?Answer! Get better lectures

Why don’t we share our most exciting PowerPoint lectures for free?

Disaster Supercourse is highly valuable tools

presenting: network of 64000 scientists from 174

countries set of 3623 lecture in 26 languages

270 Disaster Lectures from 50 countries 1 Nobel Prize winner 75% full professors 52 countries

Disasters as a asymmetric threats

The component of asymmetric attacks are: Unpredictable Disruptive Unexpected Targeting weaknesses Impossible to conceived before event Threats to Military, Government, Civilians,

Information Infrastructure

Disasters are asymmetric threats

SEE Public Health Preparedness Supercourse lecture for asymmetric

threats

Public Health Preparedness Network would offer:

Rapid contact of Supercourse Network’s expert Rapid Just In Time development of customized

lectures created by experts with vetting Rapid dissemination Continuously updated learning as crisis enfolds Expert reach back

Where public health threats come from?

Speed and volume of travel and trade

Occurrence of new and reemerging pathogens

Environmental degradation

Natural disasters Terrorism

Hazard classification: natural hazards

ORIGIN PHENOMENA/EXAMPLES

Hydrometeorological hazards

Foods, debris and mudflows Tropical cyclones, storm surges,

wind, rain Drought, wild land fires, temperature extremes,

Permafrost, snow avalanches

Geological hazards Earthquakes, tsunamis Volcanic activity and emissions Mass movements, landslides,

rockslides, surface collapse,

Biological hazards Outbreaks of epidemic diseases,

plant or animal contagion and extensive infestations

Hazard classification -technological and environmental

related-

T E C H N O L O G I C A L H A Z A R D S•technological of industrial accidents (explosions, fires, spills)•infrastructure failures •industrial pollution•nuclear release and radioactivity•toxic waste, dam failure, transport

E N V I R O N M E N T A L D E G R A D A T I O N: •land degradation•deforestation•desertification•wild land fires•land, water and air pollution, •climate change•ozone depletion.

Emerging and epidemic prone diseases

From 1 January 1998 to 31 December 2006, WHO identified: 2031 events of potential international

public health concern 290 in the WHO European Region

2.44 million people live with HIV/AIDS 450 000 infected and 69000 deaths of TB 70 000 multy drug-resistant TBC every

year

Selected infectious diseases, 39 new emerging pathogens from 1973-2000

Confirm cases of A/H5N1 Avian Influenza

Classification of natural disaster

1483 events reported between 1990-2006

42 millions affected; 98119 killed people

More than 130 billion euros economic lost

Natural disasters

Biological Geophysical Climatological MeteorologicalHydrological

Epidemics Insects infestations

Animal attacks

EarthquakesVolcanoes

DroughtsHigh temperatures

Wildfires

FloodsMass movements Storms

Natural disasters and accidents in Europe, 1990-2006

Type Number Deaths Affected Cost

Flood 344 3 593 11566 509 66093052

Extreme t 0 112 52119 1 389 529 9024788

Drought 31 2 14 865 575 14297309

Wildfire 58 228 286 969 3540357

Earthquake 102 21840 5 875 138 30225449

Accidents 609 16856 137 638 11697048

Avalanche 57 2084 90 196 156589

Windstorm 170 1397 8 063 234 33114822

Total 1483 98119 42274 788 168149414

Natural disasters around the world, 2007

Natural disasters by groups and their impact, 2007

26

54

229

105

Occurence

16312

4597

24517

29559

Damages*

Legend:

Geophysical

Meteorological

Climatological

Hydrological

177932428

8052520125118723980280

Victims

Macedonia

48,8 %

China Rep.

120 117 437

India

38 145 269

Lesotho

19,4%

Zimbabwe

18%

Bangladesh

14,4%

Zambia

12,8%

Dominica

10,5%

China Rep

9,1%

Bolivia

8,4%

Belize6,4%

Bangladesh

22 935 841

Zimbabwe

2 117 207

Philippines

2 023 221

Mexico

1 858 058

Pakistan

1 653 622

Veit Nam

1 647 928

Columbia

1 613 736

Zambia

1 553 536

Swaziland

35,4%

Geophysical

Climatological

Hydrological

Meteorologic

120 100 80 60 40 20 10 20 30 40 50

10 top countries by victims, 2007

Legend:

Bulgaria Romania

United Kingdom

Macedonia

Spain

Grece

Germany France Russia

Austria Italy Croatia Slovenia Ukraine Serbia

Poland Albania

Belgium Slovakia Canary Is.Montenegro

Moldavia Rep.

Czech Rep.

Netherlands Hungary

Occurence

Victims per 1000

inhabitant

Victims

Switzerland

7

6

5

1

2

3

4

488

62

6

10 100 1000 10000 100 000 1 000 000 10 000 000

Thematic frame: Extra tropical cyclone Kyrill - damages

Country Damages 2007 US$ (‘000)Germany 5 500 000

United Kingdom 1 200 000

Netherlands 550 000

Belgium 450 000

Austria 400 000

France 250 000

Czech Rep. 150 000

Denmark 100 000

Poland 100 000

Slovenia 100 000

Switzerland 100 000

Total 9 010 000

Disaster mortality in relation to development status

0

10

20

30

40

50

60

70

80

90

low income middle income high income

Deаths/1000 population

Distribution of technological accidents by type, 1980–2002

Fire26%

Release into air

43%

Explosion24%

Other1%

Water contamination

6%

Sites of major technological accidents (1998–2002)

Toxic spoil from mining activities

Industrial accidents

• Fertiliser factory explosion in Toulouse, 2001

• 2400 injured

• 22 killed

Climate changes

Background information: Health consequences of floods in

Europe

Background information: do not forget chronic diseases-epidemiological

transition

Background information: do not forget crises and humanitarian

emergencies