Fourth Ministerial Meeting on Health Security and Bioterrorism
November 7, 2003
1. We, the Ministers/Secretaries/Commissioner of Health and the Director-General of the World Health Organization, met in Berlin for the 4th Ministerial Forum of the Global Health Security Initiative. International collaboration continues to be important to protecting the public health security of our citizens and those of the international community. We discussed the challenges facing us, explored potential solutions and agreed on steps to further protect public health security globally.
2. One challenge we face is ensuring timely and effective communications among our national governments in order to deal with public health crises such as an outbreak of smallpox. In September 2003, Canada coordinated Exercise Global Mercury - a smallpox outbreak simulation exercise to evaluate health communications among our governments, in response to the fictitious discovery of an outbreak of smallpox. This exercise tested international capacity for the rapid exchange of information, and provided insights into international communications that such a public health crisis can generate.
We commend the effort of all member countries and organizations in making Exercise Global Mercury a success. This exercise was entirely successful in reaching its objectives. We have endorsed the final evaluation report on Exercise Global Mercury, and have asked our officials to undertake the necessary work from the lessons learned during this exercise in order to improve international communications capabilities of our public health professionals to deal with an actual public health emergency.
3. We thanked the UK for leading the work on the risk incident scale. A preliminary assessment highlighted the need for the supporting material to be updated on an ongoing basis in accordance with developments in the evidence base. We endorsed progress made on developing a set of principles for risk management and communications in the event of a chemical, biological and radio-nuclear incident. We have asked our officials to further develop and refine their work and to bring forward a set of principles for our consideration at the 5th Ministerial meeting.
4. From the outset of the Global Health Security Initiative we have attached considerable importance to strengthening our public health preparedness and response to a possible smallpox incident. We all have a stake in preventing the occurrence of such an incident, and in being fully prepared if the need arises. Since we last met in Mexico City in December 2002:
5. We have consolidated our effort on smallpox and risk management and communications by forming a new Working Group on Risk Management and Coordination.
6. Steps were taken to strengthen the coordination and collaboration among participating national high-level laboratories through the Global Health Security Action Group (GHSAG) Laboratory Network:
7. We approved the generic criteria for priority chemicals, developed by the working group led by Japan, to improve preparedness for and response to chemical events. We anticipate proceeding to the next steps, such as identifying those chemicals for international collaboration, developing the inventory of scenarios and research, as well as a study on the feasibility of an international exercise.
8. To underscore our commitment to improve public health security globally, we decided to undertake work in new areas concerning radio-nuclear threats, field epidemiology practices, and collaboration on research.
We have called for concrete progress in these areas for our 5th Ministerial meeting.
9. Furthermore, we recognize that preparedness for and response to bioterrorism have much in common with preparedness for and response to naturally occurring global health threats such as pandemic influenza. Much work needs to be done to enhance preparedness by member countries and globally by addressing critical issues for an effective pandemic response. To this end we have agreed to the Terms of Reference for the Technical Working Group on Pandemic Influenza Preparedness. The Technical Working Group will focus on critical gaps related to the rapid development, evaluation and availability of pandemic influenza vaccines; and, the optimal use of antiviral drugs. This group will carry out its work in conjunction with the WHO and other appropriate international organizations.
10. While membership in the Global Health Security Initiative remains the same, we will initiate steps to more fully share with other countries appropriately designated information and outcomes from the Global Health Security Initiative, including the possibility of periodic information sessions determined by the World Health Organization at the World Health Assembly.
11. We have accepted the invitation of France to host the 5th Ministerial meeting in Paris in the autumn of 2004.
This statement was endorsed by:
-- Mr. Ian C. Green, Deputy Minister of Health, Canada on behalf of the Honourable Anne A. McLellan, Minister of Health, Canada