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Preventing disease Promoting and protecting health CARPHA A New Caribbean Public Health Agency: Responding to public health emergencies Dr Babatunde Olowokure Director Surveillance, Disease Prevention & Control Division CARPHA CARIB


  1. Preventing disease Promoting and protecting health

  2. CARPHA A New Caribbean Public Health Agency: Responding to public health emergencies Dr Babatunde Olowokure Director Surveillance, Disease Prevention & Control Division CARPHA CARIB RISK CLUSTER 4 June 2014 Martinique Preventing disease, promoting and protecting health

  3. OVERVIEW • General description of CARPHA • Responding to public health emergencies: – Flooding - St Lucia – Emerging disease - Chikungunya • Vector control • Take home messages Preventing disease, promoting and protecting health

  4. The Agency • The Caribbean Public Health Agency (CARPHA) is the new single regional public health agency for the Caribbean. • Legally established in July 2011 by an Inter-Governmental Agreement (IGA) signed by Caribbean Community (CARICOM) Member States and began operation in January 2013. • CARPHA combines the functions of five previous Caribbean Regional Health Institutes (RHIs) into a single agency: – Caribbean Environmental Health Institute (CEHI) – Caribbean Epidemiology Centre (CAREC) – Caribbean Food and Nutrition Institute (CFNI) – Caribbean Health Research Council (CHRC) – Caribbean Regional Drug Testing Laboratory (CRDTL) • CARPHA is an institute of CARICOM and addresses public health issues requiring regional response and, where appropriate coordination. Preventing disease, promoting and protecting health

  5. Member Countries: 24 • Dominica • Anguilla • Grenada • Antigua & Barbuda • Haiti • Aruba • Guyana • Bahamas • Jamaica • Barbados • Montserrat • Belize • St. Kitts & Nevis • Bermuda • St. Lucia • BES Islands (Bonaire, Saba • St. Maarten & St Eustatius) • • St. Vincent & the Grenadines British Virgin Islands • • Suriname Cayman Islands • • Trinidad & Tobago Curacao • Turks & Caicos Islands Preventing disease, promoting and protecting health

  6. Our Mission • To provide strategic direction in analysing, defining and responding to public health priorities of CARICOM, in order to prevent disease, promote health and respond to public health emergencies. • To support solidarity in health, as one of the principal pillars of functional cooperation, in the Caribbean Community. Preventing disease, promoting and protecting health

  7. CARPHA: EMERGENCY PREPAREDNESS AND RESPONSE Preventing disease, promoting and protecting health

  8. Emergency response to flooding in St. Lucia and St Vincent & the Grenadines: • On the 24th of December 2013, heavy rains from a low- pressure trough caused significant damage in the Eastern Caribbean Islands of St. Vincent, Dominica and St. Lucia • Most of the damages caused were as a result of flooding especially in the low lying areas. • Assistance was provided by CARPHA St Lucia in facilitating access to emergency water treatment solutions to these countries in the aftermath of the storm through contributions from Operation Blessing, the US Centers for Disease Control and Prevention and Procter and Gamble. Preventing disease, promoting and protecting health

  9. Emergency response to flooding in St. Lucia and St Vincent & the Grenadines: • Operation Blessing dispatched an engineer to St. Lucia to reactivate a portable water treatment system for field deployment • US CDC supplied a total of 28 residual chlorine field test kits (20 to St Lucia and 8 to St Vincent) and Procter and Gamble supplied 3 boxes (720) water disinfection sachets to St Vincent. • The St Lucia team also participated in a field assessment along with a PAHO assessment team. • A lessons learned meeting has been proposed by CARPHA to MOH St Lucia – to include review of vector control measures Preventing disease, promoting and protecting health

  10. Preventing disease, promoting and protecting health

  11. The emergence of CHIK in the Caribbean • The Caribbean Public Health Agency (CARPHA) received reports of cases of chikungunya on the island of Saint Martin in early December 2013. • This was the first time that locally transmitted chikungunya (CHIK) had been identified in the region. • Additional cases have since been reported in other countries/territories in the Region • As at 2 June 2014 there have been 5,252 confirmed/probable cases reported by 18 countries/territories in the region • Experience elsewhere suggests long-term health impacts Preventing disease, promoting and protecting health

  12. CHIKINGUNYA CASES: 2 June 2014 Country/Territory # Confirmed/Probable Cases # Suspected Cases Anguilla 33 N/A Antigua & Barbuda 4 N/A Aruba 1 N/A British Virgin Islands 20 N/A Dominica 122 1,817 Dominican Republic 17 38,639 French Guiana 222 N/A Guadeloupe 1,328 (1) 23,100 Guyana 2 N/A Haiti 632 N/A Martinique 1,515 (9**) 29,200 Puerto Rico 1 N/A St. Barthelemy 135 520 St. Kitts and Nevis 22 N/A St. Lucia 5 N/A St. Vincent & the Grenadines 57 110 Sint Maarten 343 N/A St. Martin Preventing disease, promoting and protecting health 793 (3***) 3,320 **Includes 2 death indirectly related to Chikungunya and seven deaths whose relation to Chikungunya fever is being determined ***Includes one death indirectly related to Chikungunya due to co-morbidities and one death whose relation with Chikungunya fever could not be established (EW 09 2014)

  13. CHIK – CARPHA response Coordination • CARPHA quickly established an incident management team to coordinate the response among member states, and with partners • The response was multidisciplinary and multifaceted • CARPHA - important role in catalyzing and coordinating the response. Partnership with PAHO/WHO • CARPHA working closely with PAHO in response to the outbreak – Joint outbreak response to St Maarten – Coordinated supply of bednets to Dominica for use in hospitals – Support reporting by CMS to PAHO/WHO IHR NFP – Discussions on vector control, insecticide resistance and environmental sanitation – Regular bimonthly teleconferences – Ad hoc calls and conferences as required on technical issues as they arise Preventing disease, promoting and protecting health

  14. CHIK – CARPHA response Field response • CARPHA has deployed teams to the field to support CMS in: – St Maarten (jointly with PAHO/WHO) and Dominica Laboratory response • CARPHA provides diagnostic testing for member states • A network of laboratories in the Caribbean, including those of CARPHA, US CDC, and Institut Pasteur in French Guiana are conducting appropriate diagnostic tests to confirm the presence of the chikungunya virus in suspected patients. • Assesses insecticide resistance of vector Preventing disease, promoting and protecting health

  15. CHIK – CARPHA response Communication • CARPHA has a dedicated chikungunya page on its website – including: – Weekly updates to reflect changes in the number of reported cases. – Media statements – Vector control • Regular and ad hoc teleconferences with Member States to: – share information – provide technical advice • Regular teleconferences are held with: – Representatives from: Institute Pasteur – Cayenne; ECDC; Public Health England; US CDC; Public Health Agency of Canada (PHAC); PAHO and others. Preventing disease, promoting and protecting health

  16. Chikungunya – vector control … coming to a place near you soon… …are you prepared? Preventing disease, promoting and protecting health

  17. Preparedness and Response Preventing disease, promoting and protecting health

  18. Preparedness and Response Preventing disease, promoting and protecting health

  19. Importance of Vector Control • No vaccines or treatment available for vector- borne diseases such as dengue and chikungunya • Most effective tool for prevention and control of these diseases is vector control through Integrated Vector Management (IVM) Preventing disease, promoting and protecting health

  20. CARPHA’S Role in Vector Control • Provide technical advice and assistance to countries in preparedness for and response to outbreaks of vector-borne diseases • Provide assistance to countries in the development of IVM plans as part of the Integrated Management Strategy for Dengue (IMS-Dengue) prevention and control (partnership with PAHO) • Build capacity in countries through training of Environmental Health and Vector Control Officers in: – Basic microscopic identification of mosquitoes of public health importance – Methods of vector control – Vector surveillance Preventing disease, promoting and protecting health

  21. CARPHA’S Role in Vector Control • Conduct needs assessments and evaluations of vector control programmes, and make recommendations for improvements • Provide guidance to countries in monitoring and evaluation of vector control programmes • Provide assistance to countries in the development of research protocols and execution of research projects • Conduct evaluations of “new” vector control tools • Provide services such as: • Microscopic identification of arthropods of public health importance • Insecticide Resistance Testing ( Aedes aegypti ) – use WHO Bioassay methods Preventing disease, promoting and protecting health

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