South Eastern Europe SEE PUBLIC HEALTH PREPAREDNESS SUPERCOURSE

South Eastern Europe (SEE) PUBLIC HEALTH PREPAREDNESS SUPERCOURSE NETWORK -NEW EDUCATIONAL PATWAY FOR GLOBAL PUBLIC HEALTH SECURITY(1) Elisaveta Stikova, Ronald La. Porte, Faina Linkov, Margaret Potter, David Piposzar, Sam Stebbins

SEE Public Health Preparedness Supercourse Network Learning objectives n n 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 n Present position n 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 n n n Co-Authors and collaborators: Ronald E. La. Porte, Ph. D, UPGSPH, Director, Disease Monitoring and Telecommunication, WHO Collaborating Center Faina Linkov, Ph. D, 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 21 th Century n n n 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 n n 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 Chan Director-General of the WHO

Why SEE Public Health Preparedness Supercourse Network? n n n 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? n n 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

Question! n How can we improve public health preparedness education worldwide? Answer! n Get better lectures n Why don’t we share our most exciting Power. Point lectures for free? www. pitt. edu/~super 1/

Disaster n n Supercourse is highly valuable tools presenting: n network of 64000 scientists from 174 countries n set of 3623 lecture in 26 languages 270 Disaster Lectures from 50 countries n n n 1 Nobel Prize winner 75% full professors 52 countries

Disasters as a asymmetric threats The component of asymmetric attacks are: n n n 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: n. Rapid contact of Supercourse Network’s expert n. Rapid Just In Time development of customized lectures created by experts with vetting n. Rapid dissemination n. Continuously updated learning as crisis enfolds n. Expert reach back

Where public health threats come from? n Speed and volume of travel and trade Occurrence of new and reemerging pathogens Environmental degradation Natural disasters n Terrorism n n n

Hazard classification: natural hazards ORIGIN PHENOMENA/EXAMPLES Foods, debris and mudflows n Tropical cyclones, storm surges, wind, rain Drought, wild land fires, temperature extremes, n Permafrost, snow avalanches n Hydrometeorological hazards Earthquakes, tsunamis n Volcanic activity and emissions n Mass movements, landslides, rockslides, surface collapse, n Geological hazards Biological hazards n Outbreaks of epidemic diseases, plant or animal contagion and extensive infestations

Hazard classification -technological and environmental related- TECHNOLOGICAL HAZARDS • 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: n 2031 events of potential international public health concern n 290 in the WHO European Region n 2. 44 million people live with HIV/AIDS n 450 000 infected and 69000 deaths of TB n 70 000 multy drug-resistant TBC every year

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

Confirm cases of A/H 5 N 1 Avian Influenza

Classification of natural disaster Natural disasters Biological Geophysical Climatological Hydrological Meteorological Epidemics Insects infestations Animal attacks Earthquakes Volcanoes Droughts High temperatures Wildfires Floods Mass movements Storms n n n 1483 events reported between 1990 -2006 42 millions affected; 98119 killed people More than 130 billion euros economic lost

Natural disasters and accidents in Europe, 1990 -2006 Type Number Flood 344 Extreme t 0 112 Drought 31 Wildfire Earthquake Accidents Avalanche Windstorm Total 58 102 609 57 170 1483 Deaths 3 593 52119 Affected 11566 509 1 389 529 Cost 66093052 9024788 2 14 865 575 14297309 228 21840 16856 2084 1397 98119 286 969 5 875 138 137 638 90 196 8 063 234 42274 788 3540357 30225449 11697048 156589 33114822 168149414

Natural disasters around the world, 2007

Natural disasters by groups and their impact, 2007 Legend: Geophysical Meteorological Climatological Hydrological Victims Occurence Damages*

China Rep. Macedo nia 120 117 437 48, 8 % Swaziland India 35, 4% 38 145 269 10 top countries by victims, 2007 Bangladesh Lesotho 22 935 841 19, 4% Zimbabwe 2 117 207 18% Philippines Bangladesh 2 023 221 14, 4% Mexico Zambia 1 858 058 12, 8% Pakistan Legend: Dominica 1 653 622 Geophysical 10, 5% China Rep Veit Nam Climatological Hydrological Meteorologic 1 647 928 9, 1% Columbia Bolivia 8, 4% 1 613 736 Zambia Belize 1 553 536 120 100 80 60 40 6, 4% 20 10 20 30 40 50

Occurence 7 Victims per 1000 488 inhabitant 6 Bulgaria Romania 62 6 5 United Kingdom Spain 4 Grece Germany France 3 2 Russia Macedonia Switzerland Austria Belgium 1 Italy Croatia Poland Slovenia Ukraine Serbia Albania Moldavia Rep. Slovakia Canary Is. Montenegro Netherlands Hungary Czech Rep. 10 1000 100 000 10 000 Victims

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