How prepared is Europe for pandemic influenza? Analysis of national plans

BACKGROUND The threat of a human pandemic of influenza has prompted urgent development of national preparedness plans. We assessed these plans, to judge Europe's preparedness for pandemic influenza. METHODS Published national pandemic influenza preparedness plans from the European Union countries, the two acceding countries (Bulgaria and Romania), Norway, and Switzerland, were evaluated against criteria taken from a WHO checklist. Plans were eligible for inclusion if formally published between Jan 1, 2002, and Nov 30, 2005. FINDINGS 21 national plans were eligible for inclusion for analysis. Although preparation for surveillance, planning and coordination, and communication were good, maintenance of essential services, putting plans into action, and public-health interventions were probably inadequate. Few countries have addressed in their plans the need for collaboration with adjacent countries, despite this being an acknowledged imperative. Similarly, plans for the timely distribution of available medical supplies are notably absent. INTERPRETATION Governmental commitment in most European countries is strong, and levels of preparedness are broadly good. However, gaps in preparedness planning remain, and substantial variations exist between countries, with important implications for the region and nation states. Improved cooperation between countries may be needed to share experience, and to ensure coherence of approaches.