i

	 	 	 	

North American Plan
 

For Animal and Pandemic

Influenza

Released on April 2, 2012
 

 

 

 

TABLE OF CONTENTS 

LIST OF ACRONYMS ................................................................................................................................... 1
 

EXECUTIVE SUMMARY ............................................................................................................................. 3
 

CHAPTER 1: INTRODUCTION................................................................................................................... 6
 

THE ANIMAL AND PANDEMIC INFLUENZA THREAT........................................................................................6
 

NORTH AMERICAN COOPERATION TO ADDRESS THE THREAT .......................................................................7
 

Objectives for Cooperation ............................................................................................................................... 8
 

A Collaborative and Comprehensive Approach....................................................................................................9
 

CHAPTER 2: EMERGENCY COORDINATION AND COMMUNICATIONS....................................12
 

OVERVIEW OF FEDERAL EMERGENCY MANAGEMENT STRUCTURES............................................................13
 

Canada ..................................................................................................................................................... 13
 

Mexico ...................................................................................................................................................... 14
 

United States .............................................................................................................................................. 16
 

INTERNATIONAL LEGAL FRAMEWORK .........................................................................................................18
 

NORTH AMERICAN COORDINATION .............................................................................................................19
 

JOINT EXERCISES AND TRAINING.................................................................................................................20
 

ANIMAL AND PANDEMIC INFLUENZA COMMUNICATIONS ............................................................................20
 

Coordinated Communications.........................................................................................................................21
 

EMERGENCY RESPONSE ASSISTANCE ..........................................................................................................22
 

CHAPTER 3: ANIMAL INFLUENZA........................................................................................................23
 

 .................................................................................................................................................................... 24
 

CURRENT FRAMEWORK FOR MANAGING LIVESTOCK AND POULTRY DISEASES OF NATIONAL IMPORTANCE

MOVING TOWARDS A FRAMEWORK FOR ANIMAL INFLUENZA: A NORTH AMERICAN PHASED APPROACH..25
 

CHAPTER 4: PANDEMIC INFLUENZA ..................................................................................................28
 

SURVEILLANCE, EPIDEMIOLOGY AND LABORATORY PRACTICES.................................................................28
 

Surveillance and Epidemiology........................................................................................................................29
 

Laboratory Practices ..................................................................................................................................... 30
 

MEDICAL COUNTERMEASURES ....................................................................................................................31
 

Research and Development.............................................................................................................................32
 

Regulatory Issues ......................................................................................................................................... 32
 

Stockpiles, Distribution, and Utilization Policies ...............................................................................................33
 

PERSONNEL EXCHANGE ............................................................................................................................... 33
 

Personnel Assistance during a Pandemic...........................................................................................................34
 

Public Health Liaisons ................................................................................................................................. 35
 

Animal Health Liaisons ..............................................................................................................................35
 

PUBLIC HEALTH MEASURES ........................................................................................................................36
 

CHAPTER 5: BORDER HEALTH MEASURES ......................................................................................38
 

TRILATERAL WORKING GROUP ON BORDER ISSUES ....................................................................................39
 

AIR TRAVEL ................................................................................................................................................. 39
 

Pre-Departure Measures for Flights When Disease Does Not Exist In North America ............................................39
 

Pre-Departure Measures for Flights When Disease Exists in North America .........................................................40
 

En Route Measures ..................................................................................................................................... 40
 

Arrival Measures ........................................................................................................................................ 41
 

MARITIME TRAVEL ...................................................................................................................................... 41
 

LAND BORDERS ........................................................................................................................................... 42
 

ii 
 

CHAPTER 6: CRITICAL INFRASTRUCTURE PROTECTION...........................................................43
 

THE NORTH AMERICAN FRAMEWORK .........................................................................................................44
 

CRITICAL INFRASTRUCTURE SECTORS .........................................................................................................45
 

Canada ..................................................................................................................................................... 45
 

Mexico ...................................................................................................................................................... 46
 

United States .............................................................................................................................................. 47
 

IMPROVING CRITICAL INFRASTRUCTURE RESILIENCE..................................................................................48
 

Joint Assessments of Risks and Interdependencies...............................................................................................49
 

Public and Private Sector Entities with International Operations...........................................................................49
 

Borders ...................................................................................................................................................... 50
 

Impact of Disease versus Impact of Border Disruptions........................................................................................50
 

PANDEMIC PREPAREDNESS AND RESPONSE MANAGEMENT FOR CRITICAL INFRASTRUCTURE .....................51
 

ANNEX I: TERMS OF REFERENCE FOR THE NORTH AMERICAN SENIOR COORDINATING 

BODY AND THE HEALTH SECURITY WORKING GROUP...............................................................52
 

I. NORTH AMERICAN SENIOR COORDINATING BODY (SCB) .......................................................................52
 

Overview and Mission .................................................................................................................................. 52
 

Objectives ................................................................................................................................................... 52
 

Organizational Structure ............................................................................................................................... 53
 

II. NORTH AMERICAN HEALTH SECURITY WORKING GROUP (HSWG) .......................................................54
 

Overview and Mission .................................................................................................................................. 54
 

Objectives ................................................................................................................................................... 54
 

Organizational Structure ............................................................................................................................... 54
 

ANNEX II: AVIAN INFLUENZA .............................................................................................................. 56
 

NOTIFIABLE AVIAN INFLUENZA...................................................................................................................57
 

ZONING AND COMPARTMENTALIZATION .....................................................................................................57
 

SURVEILLANCE/EPIDEMIOLOGY ..................................................................................................................58
 

Poultry Surveillance ...................................................................................................................................... 59
 

Wild Bird Surveillance ................................................................................................................................. 59
 

BORDER CONTROL MEASURES ASSOCIATED WITH NOTIFIABLE AVIAN INFLUENZA....................................60
 

LABORATORY PRACTICES ............................................................................................................................60
 

AVIAN INFLUENZA VACCINES......................................................................................................................61
 

PERSONNEL .................................................................................................................................................. 61
 

AVIAN HEALTH INFORMATION SHARING AND NOTIFICATION......................................................................62
 

AVIAN AND HUMAN HEALTH INTERFACE ....................................................................................................62
 

ANNEX III: CHIEF VETERINARY OFFICERS AGREEMENT..........................................................64
 

iii 
LIST OF ACRONYMS 

AI Avian influenza 

ANI Animal influenza 

APHIS Animal and Plant Health Inspection Service 

CBSA Canada Border Services Agency 

CFIA Canadian Food Inspection Agency 

CGPC-SEGOB General Coordination for Civil Protection of the Secretariat of 

Governance (Mexico) 

CIKR Critical infrastructure Key resource 

CIP Critical infrastructure protection 

CISEN Center for Investigation and National Security (Mexico) 

CNSS National Committee for Health Security (Mexico) 

CONOPS Concept of operations 

CSG General Health Council (Mexico) 

CVO	 Chief Veterinary Officer 

DFAIT Department of Foreign Affairs and International Trade (Canada) 

DHS Department of Homeland Security (United States) 

DOD Department of Defense (United States) 

DOS Department of State (United States) 

DOT Department of Transportation (United States) 

EOC Emergency operations center 

FAA Federal Aviation Administration (United States) 

FAO Food and Agriculture Organization 

GATT	 General Agreement on Tariffs and Trade 

GDP Gross domestic product 

GOC Government Operations Centre (Canada) 

HHS Department of Health and Human Services (United States) 

HSWG Health Security Working Group 

ICAO International Civil Aviation Organization 

ICH International Conference on Harmonization of Technical Requirements 

for Registration of Pharmaceuticals for Human Use 

IHR International Health Regulation 

IVPI Intravenous pathogenicity index 

LPAI Low pathogenic avian influenza 

NAFTA North American Free Trade Agreement 

NAI Notifiable avian influenza 

NALS North American Leaders Summit 

NAPAPI North American Plan for Animal and Pandemic Influenza 

NGO Non-governmental organization 

NOC National Operations Center (United States) 

NRF National Response Framework (United States) 

OFFLU OIE FAO network on animal influenza 

OIE World Organization for Animal Health 

PAHO Pan American Health Organization 

PHAC Public Health Agency of Canada 

1 
PHEIC Public health emergency of international concern 

PROCINORTE Cooperative Program in Agriculture Research and Technology for the 

Northern Region 

PS Public Safety Canada 

SAGARPA Secretariat of Agriculture, Livestock, Rural Development, Fisheries and 

Food (Mexico) 

SCB Senior Coordinating Body 

SCT Secretariat of Communications and Transportation (Mexico) 

SEGOB Secretariat of Governance (Mexico) 

SEMARNAT Secretariat of Environment and Natural Resources (Mexico) 

SENER Secretariat of Energy (Mexico) 

SNPC National System of Civil Protection (Mexico) 

SPP Security and Prosperity Partnership of North America 

SRE Secretariat of Foreign Affairs (Mexico) 

SS Secretariat of Health (Mexico) 

UN United Nations 

USD United States dollars 

USDA United States Department of Agriculture 

WHO World Health Organization 

WTO World Trade Organization 

WTO SPS Agreement on the Application of Sanitary and Phytosanitary Measures 

WTO TRIPS Agreement on Trade Related Aspects of Intellectual Property Rights 

2 
 

 

EXECUTIVE SUMMARY
 

Pandemic (H1N1) 2009 was the first public health emergency of international concern 

(PHEIC) declared under the International Health Regulations (2005) [IHR (2005)] and the 

first influenza pandemic in more than 40 years. Canada, Mexico, and the United States 

recognize that the risk of another pandemic has not diminished and that the world faces an 

ongoing threat posed by the emergence and spread of influenza viruses with the potential to 

cause a human influenza pandemic. The three countries continue to work together to 

strengthen their preparedness in anticipation of a highly contagious influenza virus or other 

pandemic either originating in or spread to this continent. 

The 2007 North American Plan for Avian and Pandemic Influenza1 resulted from the commitment 

made by the leaders of the three countries under the Security and Prosperity Partnership of 

North America (SPP). The plan included a comprehensive approach to prepare for avian and 

pandemic influenza in North America based on the assumption that a pandemic was likely to 

start outside of the region and focused on avian influenza because of the re-emergence of 

highly pathogenic avian influenza H5N1 virus in humans in 2003. 

Superseding the SPP, the North American Leaders Summit (NALS) provides a renewed 

collaborative framework among the governments of Canada, Mexico, and the United States. 

During the first NALS, held in August 2009 in Guadalajara, Mexico, the three leaders 

highlighted North America’s coordinated response to Pandemic (H1N1) 2009 as a global 

example of cooperation. The Leaders also reaffirmed their commitment to a continued and 

deepened cooperation on pandemic influenza preparedness. 

The North American Plan for Animal and Pandemic Influenza (NAPAPI) retains the key elements 

of the 2007 version, while incorporating the lessons learned from the North American 

response to Pandemic (H1N1) 2009, including recognizing that a pandemic influenza virus 

may emerge in our region and expanding the focus on animal influenza viruses to incorporate 

both avian and non-avian species. The NAPAPI outlines how the three countries intend to 

strengthen their emergency response capacities as well as our trilateral and cross-sectoral 

collaborations and capabilities in order to assist each other and ensure a faster and more 

coordinated response to future outbreaks of animal influenza or an influenza pandemic. 

The NAPAPI complements national emergency management plans in each of the three 

countries and builds upon the core principles of the International Partnership on Avian and 

Pandemic Influenza, the standards and guidelines of the World Organization for Animal 

Health (OIE), the World Health Organization (WHO) – including the IHR (2005), as well as 

the rules and provisions of the World Trade Organization (WTO) agreement – and the North 

American Free Trade Agreement (NAFTA). 

1 http://www.spp-psp.gc.ca/eic/site/spp-psp.nsf/vwapj/pandemic-influenza.pdf/$FILE/pandemicinfluenza.pdf 

3 
 

 

The NAPAPI provides a policy framework to enhance trilateral collaboration to: 

	 Detect, monitor, and control influenza outbreaks and attempt to limit transmission 

between animals and humans as well as human to human transmission; 

	 Facilitate communication among relevant authorities of the three countries in order to 

react and cooperate expediently in the case of an outbreak or a pandemic; 

	 Prevent or slow the entry of a novel strain of human influenza into North America 

and the propagation of the virus whether it emerges within or outside North America; 

	 Minimize illness and deaths; and 

	 Sustain infrastructure and mitigate social and economic impact. 

The NAPAPI addresses both animal and public health issues including early notification and 

surveillance, joint outbreak investigation, epidemiology, laboratory practices, medical 

countermeasures, personnel sharing, and public health measures. 

It also addresses border and transportation issues, including containment measures for air and 

maritime travel along with land border crossings. A series of layered, collaborative measures 

among the three countries, consistent with the IHR (2005), could slow the spread of a novel 

strain of influenza, providing valuable time to mobilize resources, coordinate responses, and 

mitigate morbidity and mortality, all while avoiding unnecessary interference with travel and 

trade. 

The NAPAPI recognizes the importance of working together with international organizations, 

such as WHO, Food and Agriculture Organization (FAO), and OIE, to develop guidance for 

surveillance systems for selected animal species that can host influenza viruses with zoonotic 

potential. These guidelines should consider the value of the surveillance from a public health 

perspective while recognizing the complexity of the food production systems, as well as the 

costs associated with the implementation of regulatory programs. 

Maintaining critical infrastructure and services have proven to be essential during a pandemic. 

While influenza cannot physically damage critical infrastructure, a pandemic could weaken it 

by diverting essential resources or removing essential personnel from the workplace. This 

Plan, therefore, extends beyond the health sector to include a coordinated approach to critical 

infrastructure protection, including the importance of business continuity planning and 

recognition of interdependencies among sectors. 

Under the NAPAPI, the three countries have established the North American Senior 

Coordinating Body (SCB)2

 formed by members of the health, agriculture, security and foreign 

affairs sectors to facilitate high level discussions on policy, planning and response activities for 

pandemic influenza. Under the direction of the SCB, the trilateral Health Security Working 

Group (HSWG) is composed of policy and technical subject matter experts for the three 

countries. This group is expected to develop and execute, in close coordination with federal 

2 The Security and Prosperity Partnership Coordinating Body has been renamed and the updated Terms of 

Reference for the North American Senior Coordinating Body can be found in Annex I. 

4 
partners, subject matter experts and, as appropriate, other stakeholders with Canada, Mexico, 

and the United States, comprehensive, coordinated, and evidence-based implementation 

actions guided by the principles established in this document. The NAPAPI Implementation 

Actions constitutes the first expected deliverable of the NAPAPI. 

In brief, the NAPAPI is a comprehensive cross-sectoral regional health security framework 

developed mainly with the input of the health, agriculture, security, and foreign affairs sectors 

to protect against, control and provide a public health response to animal and pandemic 

influenza in North America, while avoiding unnecessary interference with international travel 

and trade. 

5 
CHAPTER 1: INTRODUCTION
 

Pandemic (H1N1) 2009 was the first PHEIC declared under the revised IHR (2005), and the 

first influenza pandemic in more than 40 years. The pandemic was also the first significant 

test of both the IHR (2005) and global pandemic preparedness efforts, and challenged global 

and individual country assumptions regarding likely influenza pandemic scenarios. For 

example, Pandemic (H1N1) 2009 demonstrated that a new strain of influenza virus with 

pandemic potential emerging within North America and arising from a non-avian species 

origin, was entirely possible. 

Canada, Mexico, and the United States recognize the risk of another pandemic has not 

diminished and that the global community faces an ongoing threat posed by the emergence 

and spread of other influenza viruses with the potential to cause another influenza pandemic. 

The emergence of a human pandemic strain may depend on the evolutionary development of 

that strain within an animal host. However, the complex evolutionary dynamics of viral 

reassortment between animal and human influenza strains is not fully known. Pandemic 

(H1N1) 2009, a prima facie swine virus, resulted after multiple reassortment events between 

swine, avian, and human strains but how the virus initially became established in human 

populations is still being studied. Highly pathogenic avian influenza H5N1 virus re-emerged 

in Asia in late 2003 and spread to Europe, the Middle East, and Africa causing serious or fatal 

infections in humans. Although highly pathogenic avian influenza H5N1 has not achieved 

sustained transmission in humans, virulent genetic material from this virus may contribute to 

another influenza virus that has potential to cause a pandemic. 

The NAPAPI outlines how the three partner countries intend to work together to prepare for 

and manage animal and pandemic influenza, recognizing that controlling the spread of animal 

influenza or a novel strain of human influenza, with minimal economic and other social 

disruptions, is in the best interest of all three countries. Canada, Mexico, and the United 

States intend to develop implementation actions, in coordination with appropriate federal 

partners and other stakeholders within their respective countries. Once constituted these 

implementation actions are to serve as the first deliverable of the NAPAPI and include 

comprehensive, coordinated, and science-based actions designed to enhance our collective 

preparedness and response capabilities for animal and pandemic influenza. 

The Animal and Pandemic Influenza Threat 

An influenza pandemic occurs when a new influenza virus against which the majority of the 

human population has no immunity and which spreads easily from person to person emerges 

and sweeps across a country and around the world. 

Although a pandemic influenza virus, by definition, causes disease in humans, it may arise 

from mutations in an animal virus, such as swine influenza viruses. This process may also 

transpire in a human co-infected with both human and animal origin viruses. Pandemic 

strains may also arise through direct transfer from one species to another with little obvious 

change. Despite species barriers, interchange of influenza viruses among avian species, swine, 

6 
and humans does occur. Genetic reassortment events in animals or humans could lead to 

sustained human transmission with or without increased human pathogenicity. 

Swine, similar to humans and a number of other species, are susceptible to infection by both 

avian and human influenza viruses. A pig that is already infected with a swine influenza virus 

could be co-infected with either an avian influenza virus or a human influenza virus possibly 

leading to a double-reassortant influenza A virus. Further, co-infection of a swine influenza 

infected pig with both an avian influenza virus and a human influenza virus could result in the 

production of a triple-reassortant influenza A virus. A chimeric virus whose genetic lineage 

included swine, avian, and human viruses, caused Pandemic (H1N1) 2009, further illustrating 

the high mutability of influenza viruses and their diverse origins. 

Although avian and swine origin subtypes are the only animal influenza viruses known to have 

been associated with human pandemic strains, this fact does not preclude other animal 

influenzas from playing a role in the generation of a pandemic virus. Changes in an influenza 

virus that promote efficient human-to-human transmission and/or increase pathogenicity are 

difficult to predict. Furthermore, factors influencing the transmission from one species to 

another and then efficient replication are poorly understood and difficult to anticipate. 

Therefore, a holistic approach to understanding influenza viral dynamics must be considered 

with an emphasis on assessing and attempting to limit reassortments and interspecies 

transmission among human, swine, and avian strains of influenza. 

Since November 2003, more than 500 cases of human infection with highly pathogenic avian 

influenza (HPAI) H5N1 viruses and more than 300 deaths have been reported by more than a 

dozen countries in Asia, Africa, the Pacific, and Europe. Approximately 92% of confirmed 

cases and deaths occurred in five countries—China, Egypt, Indonesia, Thailand, and Vietnam. 

While overall mortality in these HPAI H5N1 cases is approximately 60%, to date there have 

been very few documented cases of human-to-human transmission. 

Over the last 100 years, the world has experienced four influenza pandemics: 1918, 1957 1968, 

and 2009. These pandemics have resulted in worldwide mortality of approximately 40 million, 

two million, and one million, respectively, for the 20th century pandemics, and an as yet 

unknown number of people who died as a result of the 2009 pandemic. Even though 

Pandemic (H1N1) 2009 was a recent event, the risk of another pandemic has not diminished. 

Neither the timing nor the possible severity of an influenza pandemic can be accurately 

predicted. The possibility exists that future influenza pandemics could result in considerable 

morbidity and mortality as well as social and economic disruption. The ongoing risk and the 

experience with Pandemic (H1N1) 2009 highlights the importance of trilateral cooperation to 

successfully address trans-border public health emergencies in North America. 

North American Cooperation to Address the Threat 

In March 2005, the Prime Minister of Canada, the President of Mexico and the President of 

the United States announced the establishment of the SPP to increase security and enhance 

prosperity among the three countries through greater cooperation and information sharing. 

The leaders met again in March 2006 to assess the progress of the SPP and to reaffirm their 

commitment towards enhancing the security, prosperity and quality of life of citizens 

7 
throughout North America. During this meeting, the three leaders agreed to advance the 

agenda of the SPP by addressing the threat of avian and pandemic influenza. The product of 

this high-level commitment was the North American Plan for Avian and Pandemic Influenza. 

The NALS superseded the SPP and provides an updated and vibrant collaborative framework 

among the governments of Canada, Mexico, and the United States. During the first NALS 

held in August 2009 in Guadalajara, Mexico, the three leaders highlighted North America’s 

coordinated response to Pandemic (H1N1) 2009 as a global example of cooperation. They 

also reaffirmed their commitment to a continued and deepened cooperation on pandemic 

influenza preparedness, including enhancing public health capabilities and facilitating routine 

and efficient information sharing among the three countries. In follow up to this high-level 

commitment, senior policymakers and subject matter experts from the health, agriculture, 

foreign affairs, and security sectors from the three countries reviewed and revised the North 

American Plan for Avian and Pandemic Influenza taking into account the lessons learned from 

Pandemic (H1N1) 2009, developing the NAPAPI. 

Objectives for Cooperation 

At the inaugural NALS in 2009 in Guadalajara, Mexico, the leaders of Canada, Mexico and the 

United States identified three broad categories for North American cooperation: the economy; 

health and security; and energy, the environment and climate change. In addressing health 

and security, the NAPAPI is built upon a set of objectives designed to guide collaboration at 

all stages of an influenza pandemic. These guiding objectives are: 

	 Share information among our governments in a timely and transparent manner to 

improve coordination of preparedness and response; 

	 Adopt a collaborative and comprehensive approach that incorporates animal and 

public health aspects in managing animal influenza outbreaks and influenza 

pandemics; 

	 Coordinate actions and leverage our respective capacities to ensure that rapid and 

effective steps are taken to deal with animal influenza outbreaks or a human influenza 

pandemic in North America; 

	 Explore the need for mutual assistance protocols recognizing that an influenza 

outbreak in one of the North American countries will spread to the others potentially 

affecting the health security of the region; 

	 Advise one another in advance of implementing any public health measure that could 

impact or influence the pandemic response activities of the other two countries; 

	 Base actions on the best available science and evidence-based decision making; 

	 Strive to ensure that the imposition and removal of veterinary or public health 

measures on the movement of people, animals and goods, under our national laws and 

international obligations, are not more restrictive or maintained for a longer period 

8 
than necessary to achieve the veterinary or public health objective; 

	 Ensure that the business continuity plans of our respective governments consider the 

highly interconnected nature of our economies; and 

	 Strive to utilize clear and consistent messaging to national and international public and 

animal health organizations in a proactive, timely and accurate manner. 

A Collaborative and Comprehensive Approach 

Given the broad health, social and economic impacts of an influenza pandemic, the three 

countries recognize the need for a comprehensive, cross-sectoral approach. Preparing for 

such an emergency may require the commitment of and cooperation among all segments of 

society: government, the private sector, local communities, and international partners. The 

purpose of the NAPAPI is to enhance collaboration mainly among the health, agriculture, 

security, and foreign affairs sectors of Canada, Mexico and the United States in order to: 

	 Detect, monitor, and control influenza outbreaks and attempt to limit transmission 

between animals and humans; 

	 Facilitate the communication between relevant cross-sectoral authorities of the three 

countries to react and cooperate expediently in the case of an outbreak; 

	 Prevent or slow the entry of a novel strain of human influenza to North America and 

the propagation of the virus whether it emerges within or outside North America; 

	 Minimize illness and deaths; and 

	 Sustain infrastructure and mitigate the social and economic impacts of a pandemic. 

Although influenza will not physically damage critical infrastructure, systems may be 

weakened by the absence of essential personnel in the workplace or the diversion of resources. 

The NAPAPI, therefore, extends beyond the health and medical sectors to include provisions 

related to critical infrastructure and the cross border movement of goods and services. 

In the context of movement of goods and services across our borders, the Pandemic (H1N1) 

2009 experience has shown the dramatic effect that non-science based decisions can have on 

international trade. When the Pandemic (H1N1) 2009 virus appeared to have originated in 

animals some countries implemented various bans on swine and pork products, contrary to 

the statements by relevant international organizations – OIE, WHO and FAO. 

The NAPAPI provides a framework for: 

	 The basic structure and mechanisms for trilateral emergency coordination and 

communication; 

	 Collaboration on the detection, prevention, control, and possible elimination of 

potentially zoonotic strains of animal influenza; 

9 
 

 

	 Collaboration on border management based on the best scientific evidence and 

information and which avoids unnecessary interference with travel and trade, 

consistent with the IHR (2005); and 

	 Collaboration on a North American approach to keeping critical infrastructure and 

essential systems functioning properly in the event of an influenza pandemic. 

The NAPAPI recognizes and intends to build upon the core principles of key international 

frameworks, agreements, and organizations dealing with animal and pandemic influenza 

issues. 

The WHO developed international guidance on pandemic preparedness and response, 

including Pandemic Influenza Preparedness and Response: A WHO Guidance Document with a series of 

six pandemic phases, released just before Pandemic (H1N1) 2009.3

 These WHO efforts were 

intended to improve international collaboration, coordination, transparency and management 

of risk in responding to pandemic influenza threats. The WHO’s international guidance 

formed much of the basis for the three countries’ planning for North American pandemic 

preparedness and response. This guidance is meant to be revised based on the findings of the 

IHR Review Committee and the lessons learned from the Pandemic (H1N1) 2009 response. 

The OIE provides guidelines, advice and standards to prevent, diagnose, and respond to 

outbreaks of notifiable avian influenza (NAI) within the Terrestrial Animal Health Code (2010) 

and the Manual of Diagnostic Tests and Vaccines for Terrestrial Animals (2008). These documents 

also provide standards and guidelines outlining how countries should provide international 

notification and continue or resume trade in animal commodities prior to, during, and 

following an outbreak. 

Similarly, FAO’s role in combating highly pathogenic avian influenza is to facilitate direct 

technical and resource assistance to help national governments align their prevention, control 

and response efforts with OIE guidelines. The FAO coordinates support to affected 

countries to assist their efforts to control the disease and provides assistance to countries at 

risk of introduction of the disease. These efforts are now augmented by a rapid response 

capability through the FAO/OIE Crisis Management Center. Also, the OIE FAO Network 

on Animal Influenza (OFFLU)4 works to reduce the negative impact of animal influenza 

viruses through the promotion of collaboration between animal and human health authorities 

and provides the current scientific foundation for the promulgation of animal health 

regulations and regulatory guidelines. 

Engaging the agriculture sectors of the three countries, the Cooperative Program in 

Agriculture Research and Technology for the Northern Region (PROCINORTE)5

 facilitates 

cooperative actions of mutual interest to the three countries on food security, control of pests 

and diseases and other issues related to food import and export. This organization also has a 

task force devoted to animal health issues including influenza. 

3 http://www.who.int/csr/disease/influenza/PIPGuidance09.pdf 4 http://www.offlu.net/index.html 

5 http://www.procinorte.net/Pages/Default.aspx 

10 
The NAPAPI also builds on the core principles of other international organizations and 

agreements including the International Partnership on Avian and Pandemic Influenza, the 

WTO, and NAFTA. 

The NAPAPI is not intended to replace or contradict existing arrangements or agreements. 

Each country’s laws are to be respected, and this Plan is to be subordinate and complementary 

to domestic response plans, existing arrangements and bilateral or multilateral agreements. 

This Plan reflects strong commitments by our North American leaders but is not legally 

binding. 

11 
CHAPTER 2: EMERGENCY COORDINATION AND 

COMMUNICATIONS 

Canada, Mexico and the United States intend to coordinate their emergency management 

activities, including public communications. The three countries share a common approach 

based on the four pillars of emergency management: prevention and mitigation, preparedness, 

response and recovery. The three partner countries intend to explore options for 

collaborating in each of these areas to manage the threat of animal and pandemic influenza. 

	 Prevention and mitigation activities are to be directed at minimizing the effects of 

an influenza pandemic, including direct outcomes (e.g., illness and death) and indirect 

associated effects (e.g., economic and social impacts). The three countries intend to 

implement these activities in a series of steps that should be coordinated to the 

greatest extent possible. 

	 Preparedness may require that national and regional contingency plans be in place for 

activities associated with an outbreak, including surveillance, detection, containment, 

mitigation, and response efforts. Protocols for mutual assistance (as permitted), 

training and regular joint exercises with stakeholders to practice and test these plans 

are essential. Trilateral preparedness requires that the three countries develop 

permanent mechanisms to share their updated national influenza preparedness plans, 

including their risk assessment and communication strategies. The three countries 

should establish detailed standard operating procedures to ensure relevant information 

exchange through predetermined, institutional points of contact. 

	 Response activities are to depend on the characteristics of the pandemic virus 

(virulence, attack rate, groups at highest risk, patterns of transmission), which cannot 

be known in advance. Uncertainty may prevail at early phases of an emerging event 

that can affect North America. Joint efforts among the three nations to facilitate 

information exchange on risk assessment, management and communication are key 

during this initial period before the threat is characterized and a course of action is 

established. If necessary, the three countries intend to implement activities such as 

animal or public health measures, information sharing and implementation of nonpharmaceutical interventions (e.g. hand washing, isolation of the sick, school closures), 

apply them consistently and regularly, and assess their efficacy to determine whether 

adjustments to a planned response are necessary. If necessary, and when the health 

security of the regions demands it, countries intend to explore mutual assistance. 

	 Recovery activities enable the restoration of “normal” or pre-pandemic service levels. 

The three countries intend to initiate these post-event activities as soon as possible, 

recognizing that they may start at different times across the continent as the pandemic 

waves move through geographic areas. 

12 
Overview of Federal Emergency Management Structures 

Canada, Mexico and the United States each have designated organizations, plans and facilities 

in place, consistent with their governmental structures and authorities, to manage these 

activities during an outbreak of animal influenza or an influenza pandemic. 

Canada 

Emergency management responsibilities in Canada are shared by federal, provincial and 

territorial governments and their partners, including individual citizens who have a 

responsibility to be prepared for disasters. Provincial and territorial governments have 

responsibility for emergency management within their respective jurisdictions. The federal 

government exercises leadership at the national level relating to emergency management 

responsibilities in its exclusive fields of jurisdiction and on lands and properties under federal 

responsibility. 

Key Organizations 

	 Public Safety Canada (PS) is the federal department that coordinates the overall 

federal government’s domestic response efforts and provides support to government 

and key national players in responding to events of national significance. Within PS, 

the Government Operations Centre (GOC) operates around the clock as a 

mechanism to communicate and coordinate with federal, provincial and territorial 

emergency operations centers. 

	 The Canadian Food Inspection Agency (CFIA) is mandated to take the lead role in 

responding to animal health emergencies and has developed many detailed plans and 

procedures in collaboration with the Public Health Agency of Canada (PHAC), WHO 

and others. The CFIA is the primary agency responsible for prevention, preparation 

and response to an animal influenza outbreak, supported by PS. The CFIA has 

collaborative agreements with federal and provincial government partners that outline 

roles and responsibilities prior to and during an animal influenza outbreak. 

	 The Public Health Agency of Canada (PHAC) monitors the international and 

domestic influenza situation and has developed The Canadian Pandemic Influenza Plan for 

the Health Sector in collaboration with provincial/territorial representatives. PHAC is 

the primary federal agency addressing pandemic influenza preparedness and response, 

supported by PS and Health Canada. PHAC also engages and coordinates efforts 

among domestic and international health partners. The IHR National Focal Point for 

Canada is located in the Centre for Emergency Preparedness and Response within 

PHAC. 

	 Health Canada is responsible for supporting preparedness and response efforts in 

First Nations on reserve and Inuit communities; ensuring regulatory preparedness, 

including accelerated approval of a pandemic influenza vaccine; and spearheading 

federal workplace health initiatives. 

13 
	 The Department of Foreign Affairs and International Trade (DFAIT) is 

responsible for the coordination of Canada’s international response, including 

international efforts to contain the spread of a pandemic virus; communicating with 

foreign governments and international organizations; and managing foreign offers of 

assistance. DFAIT is also responsible for providing travel advice and responding to 

the consular needs of Canadians in distress. 

Emergency Plans 

The Canadian Pandemic Influenza Plan for the Health Sector. The aim of this guidance document is 

to support health sector planning at the facility, local, regional, provincial/territorial and 

federal level. It covers prevention, preparedness and response activities including surveillance, 

vaccine programs, use of antivirals, health services, public health measures and 

communications. 

Notifiable Avian Influenza Hazard Specific Plan. This plan outlines the response to be undertaken 

by the CFIA when there is suspicion of a developing outbreak of NAI or when an outbreak 

occurs. 

The Federal Emergency Response Plan. The aim of this whole of government, all hazards plan is to 

harmonize emergency response efforts by the federal and provincial/territorial Governments, 

non-governmental organizations, and the private sector. The Federal Emergency Response Plan 

applies to domestic emergencies and to international emergencies with a domestic impact. 

An Emergency Management Framework for Canada. This Framework document establishes a 

common approach for the various federal, provincial and territorial emergency management 

initiatives. The Framework aims to enable consolidation of federal, provincial and territorial 

collaborative work and ensure more coherent, complementary actions among the different 

federal, provincial and territorial governmental initiatives. 

Health Portfolio Emergency Response Plan. This is an all-hazards plan that has been developed to 

coordinate federal health portfolio emergency response activities. This plan describes the use 

of an Incident Management System and the Health Portfolio Emergency Operations Centre 

which, when active during public health emergencies, become important contact points 

between Canada and the international health community. 

Mexico 

Key Organizations 

	 The General Health Council (CSG) is a body of the Mexican State directly 

dependent from the President of Mexico, chaired by the Secretary of Health, assigned 

to issue mandatory provisions in public health. The Council is the second health 

authority in the country, preceded only by the President. 

	 The Secretariat of Health (SS) is the federal agency head of the health sector. It has 

normative and steward functions and is also responsible for providing specialized 

14 
 

 

health care and financing. SS coordinates and conducts national surveillance, 

laboratory diagnosis, and disease prevention and control. Specific measures of 

preparedness and response for an influenza pandemic are stated in the National 

Preparedness and Response Plan for Pandemic Influenza, first published in September 2005. 

Within the SS lies the Directorate General of Epidemiology which serves as the IHR 

National Focal Point. 

	 The National Committee for Health Security (CNSS) includes federal agencies of 

all areas relevant to the response to a pandemic (the health sector, civil protection, 

armed forces, agriculture, environment, communications, transportation, and law 

enforcement). CNSS coordinates national preparedness and response activities related 

to public health emergencies such as an influenza pandemic, supporting the 

development and implementation of plans at the federal, state and local levels. The SS 

directly carries out epidemiological surveillance and laboratory confirmation, as well as 

health care services organization, regulation and provision. The preparedness and 

response activities to an influenza pandemic are stated in the National Preparedness and 

Response Plan for Pandemic Influenza, first published in September 2005. 

	 Emergency management of any kind in Mexico is coordinated by The General 

Coordination for Civil Protection of the Secretariat of Governance (CGPCSEGOB). The CGPC is an agency of the Secretariat of Governance and distributes 

available resources for coordination of all branches – civil and military, of the federal, 

state and local governments – for deploying emergency response personnel. It also 

operates resources through a network of civil protection agencies at the municipal and 

state levels. In the case of an influenza pandemic, the CNSS and the National 

System of Civil Protection (SNPC) work together to address the threat. CGPCSEGOB supports the response efforts lead by the Secretariat of Health. 

	 The Secretariat of Agriculture, Livestock, Rural Development, Fisheries and 

Food (SAGARPA) is the federal agency responsible for the regulation, administration 

and promotion of sanitary measures for protecting the overall animal production as 

well as reducing health risks associated with food. SAGARPA works closely with the 

Secretariat of Environment and Natural Resources (SEMARNAT), which is 

responsible for monitoring disease activity in and surveillance of migratory and other 

wild bird populations that could endanger the poultry industry. SAGARPA also 

conducts disease surveillance in livestock, laboratory diagnosis, inspection of farms 

and other facilities, and regulation of importation and exportation among activities 

related to food processing facilities. 

	 The Secretariat of Foreign Affairs (SRE) is responsible for coordinating Mexico’s 

diplomatic relations with foreign governments and international organizations at 

senior levels. It also directs international cooperative efforts. Furthermore, it 

provides assistance and guidance to ensure consular protection to the Mexican 

population living or traveling abroad during a pandemic. 

15 
 

Emergency Plans 

The first edition of the National Preparedness and Response Plan for Pandemic Influenza, published in 

2005, establishes the general principles of organization and response for mitigating the impact 

of a pandemic in the country and serves as guidelines for the multi-sectoral approach to 

pandemic response. This Plan defines the roles of all institutions represented at the CNSS 

before, during and after an influenza pandemic and models the development of state, local 

and institutional preparedness plans. The Plan contemplates six lines of action: health 

promotion and risk communications, coordination, epidemiological and laboratory 

surveillance, health care provision, strategic stockpile, and research and development. 

In 1995, SAGARPA led an eradication campaign against HPAI H5N2 under regulations that 

establish guidelines to detect, control, and eradicate the viral strain. These measures remain in 

place to regulate HPAI H5N2 and other avian influenza strains. The regulation of this current 

campaign will be substituted by the official “Agreement that addresses the sanitary measures that are to 

be applied to diagnosis, prevention, control, and eradication of notifiable avian influenza where this disease may 

be present in the zones of the Mexico.” 

In addition, SAGARPA has developed the Procedure Manual to Prevent, Control and Eradicate 

Highly Pathogenic Avian Influenza and a Task Force “DINESA” which integrates 47 Emergency 

Groups, of trained veterinarians in emergency response. These groups are distributed all over 

the country and capable of addressing any health emergency at any time. 

United States 

Key Organizations 

	 The Department of Health and Human Services (HHS) leads the federal 

government’s public health and medical response efforts to an influenza pandemic. 

Domestically, the HHS Secretary is the principal federal spokesperson for public 

health and medical issues, coordinating closely with the Department of Homeland 

Security (DHS) on public messaging pertaining to a pandemic. Internationally, HHS is 

a leader in public health programs and partnerships, providing essential assistance to 

governments and international organizations to help improve global health and build 

sustainable capacity worldwide, including influenza pandemic preparedness and 

response capacities. HHS, in coordination with other United States Government 

agencies, responds to requests for assistance from foreign countries and international 

organizations by contributing available HHS expertise and assets, including personnel 

and medical countermeasures (e.g. vaccines, antivirals and diagnostics). HHS shares 

responsibility with the Department of Agriculture (USDA) in the regulation of foods 

imported and processed domestically for consumption. The HHS Secretary’s 

Operation Center, an around the clock communications hub for coordinating United 

States public health and medical response, serves as the United States Government 

IHR National Focal Point. 

	 The Department of Homeland Security (DHS) leads the nation's efforts to prepare 

16 
for, protect against, respond to, recover from, and mitigate the risk of domestic 

natural and man-made disasters. DHS is also the federal agency responsible for 

controlling the movement of people and material through borders and ports of entry. 

In the context of a pandemic, as with any other domestic incident in which more than 

one department is involved, the Secretary of Homeland Security is responsible for 

providing overall coordination as the Principal Federal Official, in accordance with the 

National Response Framework. DHS coordinates actions with regard to overall nonmedical support and response and ensures necessary support to public health and 

medical emergency response efforts coordinated by HHS. Within DHS, the National 

Operations Center (NOC), a standing 24-hour, seven-days-per-week interagency 

organization that fuses law enforcement, national intelligence, emergency response and 

private sector reporting, is the primary national hub for domestic incident 

management, operational coordination and situational awareness. The NOC facilitates 

homeland security information sharing and operational coordination with other 

federal, state, local, tribal and non-governmental emergency operations centers. 

	 The Department of State (DOS) provides leadership and guidance on international 

activities to promote and support the federal government’s international efforts to 

prepare for and respond to an influenza pandemic. Through United States embassies 

abroad, DOS serves as the primary interlocutor with host governments on United 

States assistance and engagement and works to ensure the timely flow of information 

to and from United States missions abroad and the relevant United States 

Government agencies. DOS works to foster diplomatic engagement and 

communication with foreign governments, international organizations, foreign nongovernmental entities, United States citizens abroad and others on behalf of the 

federal government and conducts international public messaging on behalf of the 

federal government. 

	 The Department of Agriculture (USDA) works together with federal, state and 

industry partners to protect the United States against the rapid spread of highly 

pathogenic avian influenza and other influenzas of animal origin that may pose a 

threat to animal or public health. Activities include the development and distribution 

of emergency response guidelines for reportable animal diseases; oversight of response 

effort; provision of personnel, resources, and support for response efforts in 

cooperation with state and industry stakeholders; and ensuring compliance with OIE 

Terrestrial Code (2010). Safeguards include trade controls; wild bird monitoring; 

federal, state and industry pre-market testing of poultry; federal inspection procedures 

at slaughter and processing plants; and rapid response plans. The Department engages 

in surveillance for a wide variety of reportable livestock diseases including avian 

influenza. USDA participates in coordinated efforts to slow the spread of highly 

pathogenic avian influenza in poultry. It shares the responsibility to regulate food with 

HHS, and enforces sanitary and other measures on regulated products being imported 

or prepared for export. 

	 The Department of Defense (DOD) supports primary federal departments (DHS, 

HHS, and DOS) and state governments in limiting the impact of pandemic influenza. 

DOD works with the Canadian Department of National Defence and the Mexican 

17 
 

Ministry of Defense and military organizations to ensure a cooperative effort in 

applying military resources to prepare for and mitigate an influenza pandemic. In 

coordination with DOS and other agencies, DOD responds to requests for assistance 

from the United States Government and applies available resources with approval of 

the Secretary of Defense. 

	 The Department of Transportation (DOT) in cooperation with other key domestic 

(e.g., HHS, DHS and DOS) and international partners (e.g., Transport Canada and 

Mexico’s Secretariat of Communications and Transportation), is responsible for the 

coordinated development and implementation, to the extent consistent with its legal 

authorities, of transportation-focused plans to slow the spread of an animal influenza 

outbreak or influenza pandemic. DOT works with these key stakeholders on 

preparedness, prevention, response, mitigation and recovery efforts intended to 

sustain the United States transportation system, and where appropriate, may work with 

its partners in Canada and Mexico on these efforts and similar efforts to sustain their 

transportation systems. DOT’s Federal Aviation Administration (FAA), through the 

Air Traffic Organization, operates a critical infrastructure as the nation’s air navigation 

service provider. 

Emergency Plans 

HHS published a Pandemic Influenza Plan in November 2005 and the HHS Pandemic Influenza 

Implementation Plan in November 2006, both of which serve as blueprints for HHS pandemic 

influenza preparedness planning and response activities. The White House National Strategy for 

Pandemic Influenza and the subsequent Implementation Plan for the strategy served to guide the 

United States Government’s efforts to prepare for and respond to avian and pandemic 

influenza. 

The National Response Framework (NRF), administered by DHS, is the core plan for managing 

domestic incidents. It details the federal coordinating structures and processes used during 

natural and man-made disasters, including the federal pandemic response. It also defines 

federal departmental responsibilities for sector-specific responses and provides the structure 

and mechanisms for effective coordination among federal, state, local and tribal authorities, 

the private sector and non-governmental organizations (NGOs). 

International Legal Framework 

Canada, Mexico and the United States are States Parties to the IHR (2005)6 and, as members 

of the World Organization for Animal Health (OIE), they observe the guidelines and 

standards provided in the OIE Terrestrial Animal Health Code (2010). 

The purpose and scope of the IHR (2005) are to prevent, protect against, control and provide 

a public health response to the international spread of disease in ways that are commensurate 

with and restricted to public health risks, and which avoid unnecessary interference with 

6 International Health Regulations (2005), Resolution 58.3 of the 58th World Health Assembly, 23 May 2005, online: 

http://www.who.int/gb/ebwha/pdf_files/WHA58/A58_55-en.pdf 

18 
 

international traffic and trade. Under the IHR (2005) provisions, the States Parties, including 

Canada, Mexico and the United States have among others the following obligations: 

	 Notify the WHO of single cases of specific diseases, such as smallpox, human 

influenza caused by a new subtype and severe acute respiratory syndrome (SARS);7 

	 Notify the WHO of all events within their territory that may constitute a public health 

emergency of international concern;8 

	 Inform the WHO of evidence of public health risks outside their territory that may 

cause international disease spread;9 

	 Use existing national structures and resources to meet their core capacity requirements 

for surveillance, reporting, notification, verification, and collaboration activities and 

their activities concerning designated airports, ports and ground crossings;10 and 

	 Establish a National Focal Point as the contact point for the WHO on all IHR 

matters.11
 

Although not part of the IHR (2005) mandate, under our North American partnership, each 

country should simultaneously notify the IHR national focal points in the three countries as 

well when an IHR notification regarding animal and/or new subtype human influenza is 

communicated to the WHO via the Pan-American Health Organization (PAHO). 

In the event of an influenza outbreak in an animal species where there is a significant zoonotic 

risk to humans, each country should notify the OIE and implement contingency plans to 

control and/or eradicate the virus from domestic animal operations. If the outbreak of 

influenza is contained in the captive avian populations, the established protocol for its 

notification and control is expected to be carried out as usual. 

North American Coordination 

Canada, Mexico and the United States have established the North American Senior 

Coordinating Body to facilitate planning and response activities for pandemic influenza. This 

SCB, formed by senior officials from the health, agriculture, security and foreign affairs 

sectors serves as the contact group in the event of an outbreak of animal influenza with 

zoonotic potential or a novel strain of human influenza. The SCB is expected to convene and 

play a significant role in promoting coordination among the three countries to support rapid 

and coordinated decision making, facilitate information sharing and address other 

coordination issues. 

7 IHRs (2005), Article 6 and Annex 2. 

8 IHRs (2005) Article 6 

9 IHRs (2005) Article 9 

10 IHRs(2005) Annex 1 

11 IHRs (2005 Article 4 

19 
 

The trilateral HSWG, working under the direction of the SCB, is composed of policy and 

technical subject matter experts from the health, agriculture, security, and foreign affairs 

sectors of Canada, Mexico, and the United States. Collective efforts under the HSWG should 

facilitate the execution of SCB activities and lead the coordination of technical, scientific, 

diplomatic and public health efforts to improve pandemic influenza preparedness capabilities 

and facilitate information sharing among the three partner countries. The HSWG leads the 

development and implementation of the NAPAPI Implementation Actions. 

Each country intends to use existing emergency management structures for decision making at 

the national level. Canada, Mexico and the United States are to review existing emergency 

coordination and communication mechanisms and enhance the exchange of detailed 

operations plans. 

Joint Exercises and Training 

Prior to Pandemic (H1N1) 2009, the three countries participated in a series of trilateral 

exercises that were crucial to the successes in our individual and collective response. Canada, 

Mexico and the United States intend to continue working to enhance the interface among 

their respective emergency management/response structures through joint exercises and 

training. The three countries should make every effort to: 

	 Implement multilateral, scenario-driven exercises involving internal and external 

stakeholders to test planning actions; 

	 Continually assess preparedness activities to adjust objectives, effects and actions 

based upon changes in the economic and social environments; and 

	 Continuously assess planned response and recovery actions so that they remain the 

best projected actions to achieve success. 

Specifically, the authorities of Canada, Mexico and the United States intend to conduct 

trilateral or bilateral exercises to assess and strengthen their emergency response and 

contingency plans. In addition, each country intends to design and deliver training to 

maximize the effectiveness of its respective emergency response and contingency plans. 

Wherever possible, training and exercises should be designed to maximize stakeholder 

involvement. Canada, Mexico and the United States also intend to share post-event “lessons 

learned” that are applicable to animal and/or pandemic influenza response thus further 

informing exercise and training activities. 

Animal and Pandemic Influenza Communications 

Accurate and timely information before, during and after an outbreak of animal or pandemic 

influenza is critical to the successful management of the situation. All stakeholders, including 

the public and governments need appropriate information to make effective and timely 

decisions. 

20 
Strategic risk communications is a purposeful exchange of information enabling decisionmakers, stakeholders and the public to make well-informed decisions leading to responsible 

and ethical risk management. Risk management integrates communications and social science 

and fosters collaboration between experts and stakeholders to define and resolve a risk issue. 

The application of risk communications principles and practices can help reduce the 

consequences of an influenza pandemic, including loss of life, serious illness, and social and 

economic disruption. 

Effective communications to manage a potential risk involves more than the sharing of 

information in response to an outbreak of disease. Individuals require information in advance 

of an event to develop an understanding of the potential effects of an outbreak in either 

humans or animals and to take appropriate action. Once an outbreak has begun, individuals 

may have limited ability to absorb and respond to new information. 

The three countries, therefore, recognize the importance of risk communications to the 

effective management of an animal or influenza pandemic and support the application of its 

principles in influenza pandemic preparedness planning and mitigation strategies. 

Risk communications activities that the three countries may pursue include: 

	 Gauging the level of knowledge and concern among individuals and groups and the 

barriers to adopting appropriate behavior; 

	 Consulting with key organizations to solicit input and advice; and 

	 Disseminating information advising how people can protect themselves at the time of 

an outbreak (e.g., information on personal protective measures). 

Coordinated Communications 

Canada, Mexico and the United States are committed to planning and implementing effective 

risk communications strategies for a pandemic or specified animal influenza outbreaks, and 

intend to cooperate and coordinate activities, where possible as described below: 

	 The three countries recognize that collaboration on communications efforts at all 

stages of an influenza pandemic, including sharing of communications strategies and 

activities, helps minimize the possibility of conflicting information or contradictory 

messages; 

	 Every effort should be made to cooperate and coordinate actions and pursue common 

approaches to communicating accurate and timely information in order to instill 

confidence in the North American response and recovery strategies; 

	 Each country recognizes the challenges to be faced will differ in each stage of 

response to an influenza pandemic. The three countries intend to work together to 

focus on common elements for informed decision-making and actions; 

21 
	 Food safety and animal health messaging should be closely coordinated between 

animal health and public health authorities based on the best available science at the 

time taking care not to overstate or understate the risk; and 

	 The objectives of each country’s communications efforts should focus on 

coordinating actions and pursuing common approaches to achieve proactive, timely 

and accurate communications. 

To achieve these goals, the three countries intend to: 

	 Develop streamlined cross-sectoral mechanisms, including up-to-date contact lists for 

each country, for sharing communications strategies and plans and for identifying and 

addressing emerging issues, complementary to IHR (2005); 

	 Establish procedures and mechanisms for sharing, where possible, pre-release 

strategies and plans during an outbreak, including public messaging; 

	 Share best practices and social science knowledge, including behavioral research, to 

inform communications planning in the three countries; 

	 Share research and communications strategies on issues of key public interest and 

concern (e.g.; vaccine safety and effectiveness, animal health, food safety); 

	 Commit to developing opportunities to exercise the planned response; and 

	 Share any post-event evaluations or “lessons learned” in order to inform planning 

regarding communication approaches and products for similar events in the future. 

Emergency Response Assistance 

One of the main lessons learned from Pandemic H1N1 (2009) is the need to develop and/or 

enhance policy frameworks and protocols for regional assistance that will strengthen the 

health security of the region. Such assistance may be critical in a severe outbreak as it is clear 

that diseases know no borders and could affect our countries almost simultaneously. The 

provisions according to which Canada, Mexico or the United States may request emergency 

response assistance of one another include: 

	 When national human or material resources are overextended; 

	 When an influenza virus with pandemic potential in any of the three countries poses a 

potential threat to either of the other two countries; or 

	 When pandemic influenza requires robust coordination of the North American 

response in order to minimize the risk to animal and public health, minimize damage, 

and provide the basis for long-term social and economic recovery. 

22 
CHAPTER 3: ANIMAL INFLUENZA 

Prior to Pandemic (H1N1) 2009, North American preparedness efforts for an animal 

influenza outbreak, focused solely on avian influenza and assumed that an outbreak would 

likely start outside our region. The focus on the threat of avian influenza was based on the reemergence in humans of a highly pathogenic avian influenza H5N1 strain (HPAI H5N1) 

circulating in Asia, Africa, Europe, and other regions. Based on these assumptions, the North 

American Plan for Avian and Pandemic Influenza contained an Avian Influenza chapter, describing 

the collaboration framework in this area. However, Pandemic (H1N1) 2009 reinforced that a 

new strain of influenza virus with pandemic potential could emerge in our region and from a 

non-avian species, which highlighted the need to update our preparedness plans and expand 

the scope to include preparedness for animal influenza viruses beyond avian species. 

Recognizing the need to expand the scope of our collaboration to other animal species while 

also continuing to prepare for highly pathogenic avian influenza, the chapter on avian 

influenza from the North American Plan for Avian and Pandemic Influenza has been added as 

Annex II of this plan. The new chapter, entitled “Animal Influenza” describes the main areas 

for collaboration on animal influenza. 

There are multiple factors related to both animals and humans that heighten the potential for 

the emergence of pandemic influenza strains including: increased animal and human densities; 

prolonged and/or constant contact between humans and animals; high mobility of live 

animals and animal products; and rapid regional and global movement of people. Based on 

the lessons learned from Pandemic (H1N1) 2009 the countries recognize the need to develop 

a cross-sectoral synergistic approach for animal and human influenza preparedness that 

includes a close collaboration among the agricultural and public health sectors. The three 

countries intend to work closely to address the risk created by this human/animal interface 

and to ensure that public health programs for zoonoses and food safety and security can be 

supported, authorized, designed and implemented in a timely, feasible, coordinated and 

effective manner. 

Another important lesson learned from Pandemic (H1N1) 2009, was the detection of the 

human (H1N1) 2009 virus in swine, a currently non-reportable disease, required an animal 

health response outside the existing national and international regulatory framework. In the 

absence of swine disease reporting requirements our authorities undertook trilateral and 

international communications, based on ongoing collaboration among our agricultural sectors, 

to adapt existing policies and chart a joint course of response. This approach and many other 

actions taken by our respective agriculture sectors were consistent with the roles and 

responsibilities described for animal health authorities in the context of avian influenza 

preparedness described in the North American Plan for Avian and Pandemic Influenza, and 

included: 

	 Sharing surveillance data, diagnostic testing protocols, virus isolates, messaging about 

public health and food safety, and personnel which allowed for a common operating 

picture and strengthened integration of the scientific community; 

23 
 

 

 

	 Ensuring unrestricted trade in swine and pork among all three countries through a 

trilateral agreement based on science; and 

	 Ensuring that the key relationships were in place to facilitate collaboration among the 

animal and public health sectors. 

Pandemic (H1N1) 2009 underscored the need for systems to monitor both human and select 

animal populations in order to more effectively identify emerging influenza viruses with 

potential animal and public health impact. Any such monitoring system should include 

increased collection and dissemination to both animal health and pre-designated research 

laboratories of field samples from infected commercial swine and other species that can host 

influenza viruses. Analysis of these samples can help improve our understanding of influenza 

dynamics in animal populations and animal model experimentation may help inform whether 

the viruses pose any possible public health threat. 

Developing surveillance systems for influenza in swine and other animal species poses policy, 

regulatory, and economic challenges to the agriculture sector. Even more challenging is the 

development of decision guidelines addressing what actions are to be taken when an influenza 

isolate of concern is detected. Creating programs that support the development of these 

systems will require a strong and long term commitment from the leadership of the health and 

agriculture sectors in our three countries. Thus, this chapter describes the immediate steps the 

three countries propose to take toward developing and enhancing our collaboration on animal 

influenza preparedness and response. 

Current Framework for Managing Livestock and Poultry 

Diseases of National Importance 

The signing of the Uruguay round of the General Agreement on Tariffs and Trade (GATT)12 

and the formation of the WTO in the early 1990s set the legal stage for today’s interconnected 

global system of trade in livestock, poultry and their products. The WTO Agreement on the 

Application of Sanitary and Phytosanitary Measures13 established rules to govern the implementation 

of trade measures designed to safeguard animal, plant, and human health. The OIE sets 

international standards for the prevention, control, eradication and surveillance of animal 

diseases of significance for the international trade of livestock and poultry. In general these 

animal diseases have debilitating impacts on livestock populations and significant economic 

consequences, and/or pose significant zoonotic and public health threats. The OIE is also 

the reference body for the WTO in resolving trade disputes of commercial livestock, poultry 

and their products. 

The OIE guidelines for NAI in poultry were ratified in 2005 in response to the increasing 

incidence of highly pathogenic avian influenza in poultry, the greater global awareness of the 

zoonotic potential of HPAI H5N1, and recommendations by the WHO to more closely 

monitor avian influenza viruses with potential high impact on human health. 

12 http://www.wto.org/english/docs_e/legal_e/06-gatt_e.htm 13 http://www.wto.org/english/tratop_e/sps_e/spsagr_e.htm 

24 
 

The OIE recognizes the veterinary services of federal governments as the competent 

veterinary authorities. All federal program activities for diseases of livestock and poultry are 

built on a veterinary infrastructure framework consisting of three key elements, each grounded 

in federal regulation: disease-specific reporting requirements; disease-specific response 

programs and policies; and, producer compensation programs for livestock and poultry. 

Federal regulatory animal health programs are promulgated after careful consideration of the 

impact on commerce, prioritization of the benefits, consultation with stakeholders, and a 

committed source of public funding, as has been the case for NAI across North America. 

There are no similar guidelines for swine influenza because the disease exists worldwide and is 

self-limiting with low mortality rates in this species. However, Pandemic (H1N1) 2009 

underscored the need for a stronger degree of collaboration between animal and public health 

authorities to develop guidelines to address the animal/human health interface and emerging 

zoonotic and food safety concerns and the potential social and economic impact. 

Moving Towards a Framework for Animal Influenza: A North 

American Phased Approach 

For NAI, each country reports any incidence of the disease found in commercial poultry. 

This reporting could result in an export embargo of poultry and poultry products until the 

outbreak is resolved to the satisfaction of the affected country’s trading partners. Reporting 

for notifiable avian influenza is compulsory; however no comparable program exists for swine 

influenza. Thus, apart from NAI, surveillance in other animal species, such as swine, for 

emerging influenzas with zoonotic potential is limited. Open reporting of swine influenza 

cases could negatively impact commerce and trade regardless of the zoonotic potential due to 

public perception surrounding influenzas as occurred during the Pandemic (H1N1) 2009. 

Understandably, producers are often reluctant to participate in surveillance programs for nonnotifiable diseases. Notification of a new disease could result in loss of marketability of their 

products, loss of domestic markets and restrictions imposed on international trade. For these 

reasons, attempts to create voluntary programs for animal influenza have had limited success. 

Unless the entire trading community is held to the same measure of reporting by OIE 

standard, it is unlikely that increased submission of samples for analysis will occur. Moreover, 

entities that isolate the viruses may have intellectual property claims that need to be addressed 

in assuring availability of the virus samples. 

Under the NAPAPI, the three countries recognize the need to work together with 

international organizations, such as WHO, FAO, and OIE, to develop guidance for 

surveillance systems for select animal species that can host influenzas with zoonotic potential. 

With the exceptions of NAI and Pandemic 2009 H1N1 virus, there are no international 

requirements for tracking and reporting animal influenzas with zoonotic potential to the OIE, 

because these animal influenzas are largely not a threat to animal health or international trade. 

These strains when discovered in animals are then classified as “novel strains.” Although 

there is a clear definition for “novel influenza” for public health14 there is no corresponding 

definition for “novel” for animal health. Frequently, these influenza strains are subtypes or 

mutations new to science or are known subtypes that have been unreported in that animal 

14 http://www.cste.org/ps2009/09-ID-43.pdf 

25 
species. Such ambiguous labeling of viruses could have negative commercial implications if 

notification leads to a public health response which may not be warranted. Therefore, 

organizations such as OFFLU (OIE/FAO network on animal influenzas) and WHO are 

critical resources for efforts to establish international guidance on the characterization, case 

definition, and reporting of novel strains, as well as determining when public health action is 

warranted. These guidelines should consider the value of surveillance from a public health 

perspective while recognizing the complexity of the food production systems and the costs 

associated with the implementation of regulatory programs. 

Notwithstanding the aforementioned challenges, the three partner countries intend to identify 

opportunities to better prepare for and respond to emerging animal influenza threats by 

building upon existing mechanisms for collaboration on notifiable animal disease and the 

collaborative framework for AI in the North American Plan for Avian and Pandemic Influenza. We 

intend to implement a phased approach for moving forward in a cross-sectoral way involving 

multiple partners and stakeholders. As a first step the three partner countries plan to create an 

Animal Influenza Sub-working Group under the HSWG composed of animal and public 

health officials, and other relevant government authorities. This group is expected to create a 

workplan and conduct a series of activities designed to improve our collective preparedness 

for zoonotic influenza viruses which may include: 

	 Supporting the development of case definitions for animal influenzas of interest that 

may possess zoonotic potential ensuring the most viable zoonotic candidates are 

evaluated to conserve scientific resources and reduce the possibility of unnecessary 

trade implications; 

	 Supporting the development of standard indices ranking a particular virus in regard to 

its transmissibility and pathogenicity in the original host species and across species 

lines based on the behavior of the virus in that host, using epidemiological data and/or 

genetic/antigenic prognosticators, if known; 

	 Developing guidelines to enhance rapid access to isolates and diagnostic samples of 

animal influenza strains for animal and biomedical research which includes having 

systems and advance agreements in place that reduce custom and border impediments 

to the rapid movement of critical biological materials. Such agreements should include 

guidance on regulation for commercial couriers of biological samples to ensure 

unimpeded delivery; 

	 Strengthening protocols and procedures for cooperation and coordination between 

animal health diagnostic and public health laboratories across North America by 

standardizing material transfer agreements (MTAs) from the national/state/provincial 

originating laboratory to the OIE reference laboratory and cross-validating broad 

(multi-species) diagnostic platforms; 

	 Strengthening guidelines for joint animal and human health epidemiological 

investigations; 

26 
	 Serving as a forum to promote cross-sectoral public and animal health risk 

communications in response to outbreaks; and 

	 Developing and sharing effective, science-based public and employee health 

recommendations to reduce the potential of zoonotic transmission of animal 

influenza. 

27 
CHAPTER 4: PANDEMIC INFLUENZA
 

Canada, Mexico, and the United States recognize that controlling the spread of a novel strain 

of human influenza with minimal health impact and economic disruption is in the mutual best 

interest of all three countries. This chapter, therefore, assumes that a focus on preventing or 

delaying the spread of a novel strain of human influenza or mitigating the impacts of 

pandemic influenza should serve public health, social and economic goals. Likewise, this 

chapter and any resulting measures that may ensue are to be based on sound science and 

recognize that decision making on public health questions also needs to reflect cultural, 

ethical, legal, economic, logistical and political considerations. Lessons learned during 

Pandemic (H1N1) 2009 should also be shared and considered during future collaborative 

planning efforts. 

During the response to Pandemic (H1N1) 2009, the mutual benefits of a coordinated 

response to pandemic influenza were recognized by the three countries. Canada, Mexico, and 

the United States intend to continue to assist one another in domestic and international 

pandemic influenza preparedness and response efforts. They intend also to work together to 

implement appropriate public health measures at the shared borders. Health officials from the 

three countries intend to meet and/or communicate regularly to: 

	 Build upon existing programs and identify new opportunities for capacity-building in 

common areas of collaboration; 

	 Identify areas where the three countries need additional assistance; 

	 Identify challenges to the implementation of the NAPAPI; 

	 Develop implementation actions to move forward with collaboration in the areas 

identified in the NAPAPI; 

	 Communicate regularly on progress in areas of collaboration; and 

	 Identify opportunities to jointly plan for and exercise pandemic influenza 

preparedness and response. 

Surveillance, Epidemiology and Laboratory Practices 

An effective early warning surveillance system is essential to detect a disease outbreak early. 

The sooner potential threats are detected, the sooner the response mechanism can be 

triggered. Pandemic (H1N1) 2009 showed us that the sooner the virus can be identified, the 

sooner the vaccine development and manufacturing process can start. Thus, it is critical that 

federal, state/province/territorial, and local public health institutions employ enhanced 

surveillance systems for situational awareness of evolving disease characteristics. 

28 
 

During Pandemic (H1N1) 2009, pre-existing relationships government officials had with 

counterparts in the other North American countries allowed for quick access to critical 

information. These existing relationships facilitated surveillance and information sharing, 

including access to early epidemiologic information about cases. Furthermore, the Centers for 

Disease Control and Prevention (CDC) in its role as a WHO Influenza Collaboration Center 

for the Americas, performed confirmatory testing and rapidly produced a strain-specific 

laboratory test. Test kits and protocols were quickly distributed to international virology 

laboratories for use in identifying cases. Although laboratory testing capabilities were rapidly 

developed, low sensitivity field testing methods and changing case definitions led to 

uncertainty and potential misdiagnosis in the early days of the pandemic. 

Canada, Mexico, and the United States intend to apply the lessons learned during Pandemic 

(H1N1) 2009 and continue to strengthen surveillance, epidemiology and laboratory practices 

among the three countries. Objectives in this area include: 

	 Enhancing epidemiological, surveillance and laboratory diagnosis capabilities; 

	 Improving rapid detection and characterization of influenza strains that have
 

pandemic potential, and rapid investigation of possible human cases; 

	 Promoting collaboration on the epidemiological and laboratory assessment of 

infection with influenza strains that have pandemic potential; and 

	 Enhancing timely communication on surveillance, epidemiological and laboratory data. 

Surveillance and Epidemiology 

Canada, Mexico and the United States intend to strengthen our existing sharing of 

epidemiological and surveillance data and information as appropriate by: 

	 Collaborating to develop guidelines, principles and procedures for information and 

data sharing for novel and pandemic influenza viruses; 

	 Establishing a joint task team for risk assessment and analysis of epidemiologic and 

virologic surveillance data; 

	 Establishing and testing mechanisms for communication among institutions according 

to specific functions for exchanging epidemiological information; 

	 Considering the WHO case definitions when developing or revising case definitions 

used in national surveillance to minimize challenges when comparing data across the 

three countries; 

	 Sharing regular situation reports with essential epidemiological data, in the event of a 

pandemic; 

29 
	 Identifying areas of technical assistance needed for laboratory, surveillance and 

outbreak response; 

	 Providing technical assistance through cross-border projects to bolster surveillance 

efforts for seasonal and pandemic influenza; 

	 Exploring the development of joint investigation guidelines to strengthen cross-border 

collaborations on outbreak investigations; and 

	 Identifying a forum for regular communication and maintenance of contact lists in 

each country’s agencies responsible for surveillance. 

Laboratory Practices 

As observed during Pandemic (H1N1) 2009, the cross-border transport of specimens and 

isolates by federal, provincial and state laboratories in the three countries before and during a 

pandemic can facilitate diagnosis and contribute to the development and/or evaluation of 

reagents, tests, vaccines and antiviral drugs. The three countries should review and improve 

procedures to permit these materials to cross their borders without delay or payment of 

customs duties or fees. The three countries should continue to develop and exercise 

mechanisms for border security officials to facilitate the rapid exchange of laboratory samples, 

reagents, supplies and specimens. They should also improve chain-of-custody protocols for 

the proper and safe handling of the sample and reagents. The three countries should share 

existing procedures so that adequate supplies of diagnostic materials/reagents are available in 

the event of an influenza pandemic. 

Building on the existing capacity and experiences during Pandemic (H1N1) 2009, Canada, 

Mexico and the United States intend to continue collaborating on the following activities: 

	 Review and facilitate border and custom procedures for the rapid exchange of 

laboratory samples, reagents, supplies, and specimens; 

	 Continue joint technical review and sharing of assay methods, reagents and virologic 

data related to human cases of influenza; and 

	 Strengthen operating procedures/processes for sharing laboratory information before 

and during an emergency, including: 

o	 Examining information and communication technologies to identify opportunities 

that would enhance rapid data transfer; 

o	 Sharing data, data analyses and data interpretations; 

o	 Enhancing laboratory-to-laboratory communication; and 

30 
 

o	 Assessing the need for and providing additional, ongoing and updated training in 

laboratory diagnostics. 

Medical Countermeasures 

Medical countermeasures, including diagnostics, vaccines, and antiviral drugs were important 

resources in the response to Pandemic (H1N1) 2009. However, many countries around the 

world faced enormous challenges in acquiring these countermeasures due to the lack of 

availability and/or access to them. Instead, many countries had to rely on international 

donations of medical countermeasures, a process which proved challenging for the WHO and 

donor countries. There were insufficient global stockpiles of antiviral drugs and a lack of 

capability to rapidly scale-up vaccine manufacturing capacity to address the global demand. 

Together, these factors contributed to delayed access to medical countermeasures by both 

developing and developed countries, and to delayed delivery of donations from one country to 

another and through the WHO. 

Although preparedness efforts existed in our three countries, we were all impacted to different 

extents by the lack of adequate access to medical countermeasures, in particular the lack of 

timely access to vaccines, including types of vaccine for at risk populations, which could have 

helped counteract the second wave of the Pandemic (H1N1) 2009. Although countries’ 

authorities made every attempt to assist each other, there were no trilateral policies or 

assistance protocols in place to allow for an expedited collaboration in this area. 

Building on the existing capacity and experiences during the Pandemic (H1N1) 2009 response, 

Canada, Mexico and the United States intend to explore options for collaboration on: 

	 Establishing formal mechanisms for information exchange of domestic strategies for 

medical countermeasures with the goal of coordinating regional preparedness efforts 

to the extent possible (including research and development agendas, acquisition, 

stockpiling, distribution, approval, and utilization policies); 

	 Identifying, developing and harmonizing, to the extent possible, the regulatory systems 

and clinical trial capacity to determine medical countermeasure safety and efficacy 

enabling licensure of products needed during emergencies; 

	 Building and/or expanding domestic medical countermeasures stockpiles, 

development and/or acquisition programs by exploring innovative financing and 

procurement mechanisms, investments in accelerated development of new and more 

flexible technologies and platforms for development and manufacturing, and 

promotion of additional creative public-private partnerships; and 

	 Coordinating plans and principles for trilateral mutual assistance to the extent possible 

when doing so enhances the health security of the region including logistics for 

deployment, liability protections, and regulatory approval, and participating in trilateral 

preparedness exercises that address these topics. 

31 
Research and Development 

The trilateral partner countries recognizes the need to collaborate among ourselves and with 

international organizations to create and strengthen research and development programs to 

increase the availability of antiviral drugs and vaccines, including the need for modern, 

innovative and flexible scientific and technology platforms for development and 

manufacturing capacity. This collaboration promises to enhance our abilities to respond to 

pandemic influenza and to strengthen the overall public health system by creating platforms, 

systems, and expertise that can be applied to other public health threats. As such, the three 

countries intend to encourage the development of linkages between experts and the active 

sharing of updated information on research and development related to influenza vaccines, 

antivirals, antibiotics, and laboratory testing methods by: 

	 Jointly supporting, and establishing information exchange, on basic and applied 

research programs for influenza vaccines, antivirals, antibiotics, and laboratory testing 

methods; 

	 Sharing information with the research community through presentations, scientific 

publications, and discussions at international scientific meetings and workshops as well 

as communicating trilaterally on research needs and areas of interest specific to 

seasonal and pandemic influenza and when possible develop joint research and 

development projects; 

	 Providing the scientific community with fast and open access to information such as 

genome sequence information in the event of an outbreak caused by a new pandemic 

influenza strain to facilitate the fast development of medical countermeasures; and 

	 Sharing real-time information, as appropriate and where possible, on the results of 

clinical trials for influenza vaccines in the event of an influenza pandemic as well as 

sharing information, as appropriate, and where possible, derived from clinical trials, 

registries, authorizations for emergency use, and spontaneous adverse event reporting 

for influenza vaccines and antivirals. 

Regulatory Issues 

Where feasible, the three countries intend to work to share information and develop 

expedited, compatible regulatory approaches for developing, approving, and monitoring 

pandemic influenza vaccines and potential new medical countermeasures. These efforts 

should include sharing information on regulatory issues and decisions, and should be 

complementary and aligned with other international efforts carried out by the regulatory 

agencies in each country, WHO, and other international partnerships such as the Global 

Health Security Initiative. 

In preparing for a public health emergency, the three countries intend to collaborate to 

identify legal and regulatory challenges to the provision of mutual assistance with medical 

countermeasures and other supplies from national and/or international stockpiles in the event 

32 
of an actual emergency. Options for consideration could include expedited regulatory review 

in case of emergency use of medical countermeasures in our three countries. 

Stockpiles, Distribution, and Utilization Policies 

Pandemic (H1N1) 2009 demonstrated that having stockpiles of antivirals and programs in 

place to ensure the rapid development and acquisition of pandemic vaccines was crucial to 

respond to the pandemic. This prior planning accelerated the availability and access to 

medical countermeasures in countries where these core capacities were in place. The three 

countries recognize that preparedness in this area will be key to respond to future pandemics. 

While the three countries may have different approaches and resources to increase their 

medical countermeasures capacity for pandemic influenza, they intend to work together to 

complement their efforts by: 

	 Sharing strategies, best practices, and institutional points of contacts in each country, 

regarding the stockpiling of medical countermeasures for pandemic influenza 

including information about planning and/or modeling assumptions used when 

determining the requirements and contents of their stockpiles; 

	 Cooperating and identifying areas of technical assistance needed in the development 

of stockpiling strategies including infrastructure, cost/benefit analysis and shelf-life 

extension of products to maximize investment and availability, workforce 

development, and logistics for distribution; 

	 Sharing lessons learned from Pandemic (H1N1) 2009 and recommendations from 

WHO as well as current utilization policies with the goal of harmonizing 

recommendations for use of antiviral drugs (e.g., prophylaxis versus treatment only, 

criteria and timing for transition from prophylaxis to treatment only) and vaccines (e.g. 

prioritization of target populations, use of adjuvants) to maximize the impact of public 

communications and minimize the potential for confusion among the populations of 

our three countries; 

	 Reviewing country vaccination programs that were implemented during this pandemic 

with the goal of developing a clear understanding of key issues, including logistics, 

distribution, use, equity, public perception, safety of the vaccine, and the adequacy of 

in-country vaccine safety monitoring systems; and 

	 Developing protocols, and/or comprehensive standard operating procedures, to 

expedite potential deployment of countermeasures, when feasible, among the three 

countries and to WHO and/or other recipient countries in the event an international 

deployment similar to the one that occurred during Pandemic (H1N1) 2009. 

Personnel Exchange 

The three countries intend to work domestically with appropriate jurisdictions as well as 

together to facilitate the rapid exchange of public health liaisons, epidemiological, laboratory 

33 
and medical personnel. In the case of medical personnel exchange, licensure issues should be 

addressed, as well as credentialing, and liability protection, as appropriate. 

Trilateral objectives related to the exchange of personnel include the following: 

	 Facilitating the ability to provide personnel assistance in a pandemic; 

	 Establishing public health liaisons to help coordinate preparedness activities during 

inter-pandemic periods; and 

	 Exploring the establishment of animal health liaisons to help coordinate diagnostics, 

sample exchange and management, collaborative research efforts, and messaging on 

public health risks from any animal influenza virus. 

Personnel Assistance during a Pandemic 

The extent to which the three countries would be able to share personnel across borders 

during a pandemic depends on unknown factors, such as the severity, phase and duration of a 

pandemic. Pandemic influenza can spread rapidly from one country to another and Pandemic 

(H1N1) 2009 highlights how quickly this spread can happen when one continental partner is 

affected. When two or more countries are involved in a public health emergency, like 

pandemic influenza, the potential for spread by geographic proximity, cross-boundary 

movement of citizens, and exchange of animal commodities including live animals highlight 

the need to share information between counterpart institutions at all levels, and often joint 

actions. 

It is possible that a state or province/territory will request additional health care or public 

health personnel through its national government to respond to an emergency. Because each 

state or province/territory in the United States and Canada, respectively, controls the licensure 

of health professionals, the national government should encourage its states or 

provinces/territories to develop procedures for the exchange of licensed personnel (e.g. health 

care providers) that may include the temporary, rapid recognition of existing licenses or 

certificates. In the case of the Mexican states, the Federal Labor Law governs licensure. 

Thus, movement of personnel among and within the Mexican states and municipalities 

requires no additional procedures. Issues such as liability, indemnification, and proper 

documentation necessary to work in the other countries should be addressed as appropriate 

through relevant national, state or provincial/territorial authorities. 

In order to address these issues, Canada, Mexico and the United States intend to: 

	 Continue to discuss opportunities for the provision and exchange of personnel, on an 

as needed basis, and as part of continental and/or country level mutual assistance 

efforts; 

	 Identify the roles of federal, state/provincial/territorial, local and tribal (as appropriate 

in Canada and the United States) governments during a public health emergency; 

34 
 

	 Identify legal and regulatory challenges to the exchange of medical personnel, in the 

event of a public health emergency; and 

	 Identify possible federal solutions to allow the three countries to more effectively and 

efficiently assist one another during a public health emergency, where state, 

provincial/territorial and local jurisdiction is limited. 

Public Health Liaisons 

As a result of recommendations in the North American Plan for Avian and Pandemic Influenza the 

continental partners have established pilot programs to exchange public health liaison officers. 

Liaison officers proved valuable in pandemic planning and operations where they existed. 

Recognizing this value, the three countries intend to continue to discuss opportunities for the 

exchange of appropriate public health liaison officers among the key participating agencies 

involved in pandemic influenza preparedness to strengthen this program. The public health 

liaison officers are intended to: 

	 Act as a liaison between their countries and the host foreign public health 

department/agency facilitating communications, policy discussions and preparedness 

planning; 

	 Facilitate communications among countries’ emergency operations centers (EOCs); 

	 Facilitate the exchange of comprehensive descriptions of response systems within 

their federal governments, including key functions and updated lists of key contact 

personnel for each country’s public health emergency management teams; and 

	 Share information, including surveillance and epidemiologic data, and standard 

operating procedures during a response to pandemic influenza. 

Animal Health Liaisons 

Animal health liaison officers should be explored as a possibility to help coordinate efforts 

between countries when an animal influenza virus with zoonotic potential is identified. These 

officers would assist in the following: 

	 Facilitating cross-validation of diagnostics used in each country to identify the 

influenza strain; 

	 Facilitating sample transport and management across borders; 

	 Promoting cross-border research efforts to optimize resources; and 

	 Ensuring consistent cross-border animal health messaging relating to animal 

influenzas. 

35 
Public Health Measures 

Canada, Mexico and the United States may attempt to contain a novel strain of human 

influenza at its source, depending on the extent of the spread at the time of detection, the 

evidence of transmissibility, and feasibility considerations. The three countries intend to 

implement the necessary public health measures to mitigate the impact of a novel strain of 

human influenza in North America. Such efforts might delay its arrival, slow the virus’ 

spread, and reduce its impact in North America if the outbreak originates in another part of 

the world. The most recent pandemic began in North America and the three countries 

quickly determined containment was not feasible. This swift action freed resources for 

mitigation efforts and other public health measures. Education and voluntary personal 

preventive measures were some of the most effective mitigation measures used during the 

Pandemic (H1N1) 2009. However, a more comprehensive evaluation of the effectiveness of 

the measures implemented is still being conducted and should be shared among the three 

countries to inform future planning. Any public health measures employed during a pandemic 

should aim to allow the appropriate movement of people and cargo across mutual land 

borders and ports of entry in a manner that achieves the public health objective with minimal 

social and economic impact. Each country should gauge the severity of the influenza 

pandemic and implement public health measures and/or community-based interventions 

accordingly. 

In the absence of scientific effectiveness data for many of the potential public health 

measures, the NAPAPI is intended to help facilitate a coordinated approach to community 

disease control. This should reduce the need to explain and justify divergent approaches at 

the time of a pandemic and may also optimize public confidence at a time of much 

uncertainty. Many of the recommendations are contingent upon local triggers; therefore, the 

timing of their implementation would not necessarily be simultaneous across the countries. 

Ideally, however, the types of measures should be consistent. In general, the three countries 

concur that when persons infected with a novel virus first appear, aggressive measures may be 

valuable in slowing its spread, attenuating the impact, or possibly containing an evolving 

pandemic. Once the virus is widespread in North America, mitigation measures may be 

modified based on considerations with respect to any benefit they may have. 

The three countries recognize that issues of feasibility, logistics, impact, acceptability and 

compliance in implementing public health measures are shaped by the context in which these 

measures are applied. 

Public health measures are to be implemented based on the objective of the response activities 

(e.g., containment, control, impact mitigation). The objective, and therefore the public health 

measures implemented, should be based on the local and global epidemiology of the pandemic 

and may change over the course of the pandemic. 

The WHO pandemic phases and national pandemic severity metrics, proved less useful during 

Pandemic (H1N1) 2009 as tools for public health decisions. The three countries intend to 

share information on their assessment of severity and other metrics that may arise for 

planning purposes. Similarly, and in the context of local epidemiology, the countries intend to 

incorporate the updated WHO guidance regarding pandemic severity. 

36 
The countries also intend to share information on their planned approaches to public health 

measures such as the following: 

	 Public education (e.g. on hand washing, staying home from work when ill, workplace 

infection control); 

	 Use of medical countermeasures, such as antivirals and vaccines; 

	 Use of workplace measures and personal protective equipment (e.g. social distancing, 

enhanced ventilation, protective clothing, masks and personal respirators); 

	 School and community social distancing measures, including school closures and 

cancellation, postponement or modification of mass gatherings; 

	 Travel and border public health measures; and 

	 Isolation and quarantine. 

The three countries intend to develop in advance, comprehensive standard operating 

procedures and to define institutional points of contact in each country to achieve the active 

sharing of updated best practices as described above. 

Travel and border public health measures should be compatible with the IHRs (2005), tailored 

to the status of pandemic disease within North America and the level of public health risk 

associated with cross-border movement, and recognize the mutual benefits of ongoing trade 

and economic activity. 

37 
CHAPTER 5: BORDER HEALTH MEASURES 

If a novel strain of human influenza emerges within or outside North America, the three 

countries intend to work together to slow the introduction and/or spread of the virus 

to/within the continent by identifying symptomatic or exposed persons as they enter and or 

travel between Canada, Mexico or the United States. The countries also intend to implement 

appropriate public health measures, consistent with and complementary to containment at 

source, as guided by the IHR (2005) and subjected to applicable law in each country. 

Emphasizing a North American approach, rather than individualized approaches among the three 

countries, could provide a means of slowing the spread of a novel strain of human influenza 

into our respective countries. The approach could involve disease surveillance systems 

coupled with appropriate public health measures at North American airports, seaports and 

regional perimeters. 

The implementation of a North American response should remain flexible and adaptable to 

account for that fact that the specifics are unknown as to how a novel strain of human 

influenza will emerge and how a particular epidemic will unfold and spread. Nevertheless, 

certain unifying principles regarding a North American strategy on border protection are 

evident. Canada, Mexico and the United States intend to implement cooperative measures to: 

	 Slow the entry and spread of a novel strain of human influenza within North America; 

	 Mitigate disease, suffering and death; 

	 Coordinate appropriate border measures giving due consideration to the movement of 

people, live animals, and goods; 

	 Mitigate impacts to the economy and the functioning of our societies; and 

	 Facilitate the cross-border flow of medical equipment, materials, samples and reagents 

to assist other North American countries. 

All countries have the sovereign right to control the movement of people, live animals, and 

goods across their borders, in a manner consistent with their international obligations. 

However, in the event of pandemic, highly restrictive measures to control the movement of 

people, live animals, and goods might initially delay but would not stop the eventual spread of 

a novel strain of human influenza within North America, and could have significant negative 

social, economic and foreign policy consequences. Less restrictive measures could potentially 

slow the spread of disease to/within North America with fewer significant negative 

consequences. Such measures include the implementation of appropriate screening of 

passengers at North American airports, seaports, and land borders; restrictions on trade in 

select animal species and products that may carry an influenza virus with zoonotic potential; 

public health communications and education; and other similar measures. 

38 
 

 

Individual traveler screening for influenza-like illness and risk of exposure to a novel strain of 

human influenza of all persons entering and/or traveling across borders within North 

America may help slow the arrival and spread of pandemic disease on the continent. 

However, such screening will not detect asymptomatic infected individuals, and individuals 

with influenza-like illness may not be infected with a pandemic strain. Because some 

asymptomatic travelers who are incubating influenza may become symptomatic while en 

route, overall screening effectiveness may be improved by adopting a layered approach that 

includes pre-departure, en route and arrival screening measures, with appropriate public health 

measures for individuals suspected of being infected and contacts that may have been 

exposed. 

During Pandemic (H1N1) 2009, mitigation measures employed for residents of border and 

non-border communities included keeping people educated, asking sick people to exercise 

voluntary personal preventive measures when attending large events or traveling, and to stay 

home when possible. Although these measures did not contain the pandemic, they may have 

mitigated its impact. The quick decision of Canada, Mexico, and the United States to keep the 

borders open and minimize travel restrictions limited disruptions of travel and trade, avoided 

panic, and saved resources. 

Trilateral Working Group on Border Issues 

The three countries intend to establish a trilateral sub-working group on border measures 

under the HSWG including representation from public health, public safety, transportation, 

and other sectors, as appropriate. This group intends to apply a trilateral perspective to the 

review of border measures with the goal of improving cooperation on the prevention and 

mitigation of an outbreak of human influenza. The issues outlined in the sections below and 

the importance of public communications in implementing any measures undertaken should 

be addressed by this working group. 

Air Travel 

Pre-Departure Measures for Flights When Disease Does Not Exist In 

North America 

The IHR (2005) require all countries to possess the capacity to apply entry or exit controls for 

arriving and departing travelers in response to events that may constitute a public health 

emergency of international concern. 

Effective host-country exit measures of individuals prior to departure may reduce the risk of 

infected travelers exposing fellow travelers, aircraft and vessel crews, and others upon arrival. 

Travelers departing from affected countries may be screened prior to departure in accordance 

with guidance from WHO and the International Civil Aviation Organization (ICAO).15 This 

15 ICAO previously adopted guidelines regarding communicable disease/avian influenza that include provisions 

for exit screening of international travelers from affected areas. These guidelines can be found at 

http://www.icao.int/icao/en/med/guidelines.htm. 

39 
 

is to be consistent with applicable domestic law, and event-specific WHO guidance, and 

recommendations under the IHR (2005). Thus the three countries intend to: 

	 Share information and collaborate on travel measures to affected countries, with the 

collective understanding that many factors influence the decision on such measures; 

	 Pursue cooperative arrangements with the international community to encourage 

voluntary travel avoidance for non-essential travel from any affected country; and 

	 Coordinate public messaging to travelers departing North America for affected 

countries. Where appropriate, messaging should be well coordinated and consistent 

among the three countries and may include information such as location of outbreaks, 

steps to reduce one’s risk of infection and public health measures that may be 

performed upon arrival to affected countries and on flights returning to North 

America from affected countries. 

Pre-Departure Measures for Flights When Disease Exists in North 

America 

The Pandemic (H1N1) 2009 revealed that a novel strain of human influenza can emerge 

within North America. In accordance with the IHR (2005), North American countries are 

required to possess the capacity to apply entry or exit controls for departing travelers in 

response to events that may constitute a PHEIC. Exit measures for travelers departing North 

America, aimed at preventing exportation of disease, should employ a dynamic risk-based 

approach16 and be performed taking into account WHO and ICAO guidance, as well as with 

applicable law. 

An integral part of measures to prevent exportation of disease from North America to other 

countries should be a public education and communications campaign that is well coordinated 

and consistent among the three nations. Messages may include information such as providing 

steps to reduce one’s risk of infection; asking all people, well and sick, to exercise voluntary 

personal preventive measures when attending large events or traveling; recommending sick 

people stay home when possible; and providing information on public health measures that 

may be performed upon arrival to other countries and on flights returning to North America. 

En Route Measures 

Given the short incubation period of influenza and the length of some international flights, 

one can assume that some travelers with influenza will develop their first symptoms during the 

journey. Additional training of flight and cabin crews to detect and manage ill travelers may 

potentially decrease the risk for others on board, as well as at the point of arrival in North 

America. When combined with pre-departure exit measures, appropriate application of 

16 Measures that are applied to individual travelers to determine the likelihood of infection with a pandemic 

influenza virus and that may include assessment of signs/symptoms of illness and potential exposure (travel and 

activity history). 

40 
 

screening measures may help detect those who have developed signs of illness en route. Thus, 

the three countries intend to: 

	 Collaborate to determine best practices for the in-flight management of ill travelers 

based on symptoms and existing reporting requirements; 

	 Work with international partners, aircraft operators, and other stakeholders to explore 

ways to improve the existing ICAO standard17 and guidance relating to the reporting 

of suspected cases of communicable disease and other public health risks on board 

aircraft bound for North America; and 

	 Continue developing trilateral concept of operations for the handling of reports 

received by air traffic services units of Canada, Mexico, and the United States of 

suspected cases of communicable disease or other public health risks on board 

aircraft. 

Arrival Measures 

Given the relatively short transit times for air travel when compared to maritime travel, a virus 

originating overseas is most likely to arrive in North America via air travel. Coordinated 

implementation of appropriate public health measures for aviation passengers arriving in 

North America may allow the three countries to slow the spread of the virus into and within 

the continent while minimizing the need to perform screening at mutual land borders. During 

a pandemic, travelers with influenza-like illness and travelers who could potentially have been 

exposed to pandemic influenza should undergo appropriate public health screening. 

Appropriate public health messages should also be provided to travelers as part of the arrival 

measures. Messages should be well coordinated and consistent, where appropriate, among the 

three countries and could include information about how to limit the spread of disease, how 

to recognize symptoms, and when to seek medical care. 

Canada, Mexico and the United States intend to collaboratively establish common criteria and 

protocols for entry screening of all travelers on flights bound for North America and, 

coordinate implementation of a risk-based approach to screening during a pandemic if 

necessary. The three countries intend to minimize arrival screening measures and maintain 

existing pre-clearance arrangements employed for air travelers within North America to the 

extent practicable. 

Maritime Travel 

Although maritime crew and passenger transport today represents a small fraction of total 

entries to North America, and longer transit times in the maritime environment may help to 

clarify public health risk when compared with air and land border environments, there are 

features of maritime travel that are important to consider. Spread of disease during maritime 

travel has been significant in past pandemics, and the close contact that occurs on board ships 

17 Annex 9 to the Convention on International Civil Aviation, paragraph 8.15 

41 
 

creates an environment where influenza outbreaks may occur. Overall, reducing risk in a 

maritime setting is an important component of comprehensive efforts to delay a pandemic in 

North America. The three countries intend to: 

	 Coordinate any potential implementation of a risk-based approach to the screening of 

passengers and crew in the maritime environment; and 

	 Establish criteria and protocols similar to those used in aviation for exit, en route and 

entry screening for all maritime travelers (passengers and crew) on ships bound for 

North America. 

Land Borders 

Once disease exists in one North American country, the others are likely to experience 

outbreaks soon thereafter. Canada, Mexico and the United States intend to coordinate on 

land border issues to enhance the North American approach and best serve their respective 

populations. An important consideration for these coordination efforts is the logistical 

challenges of substantial screening at land borders. The three countries intend to: 

	 Coordinate any potential implementation of a risk-based approach to the screening of 

travelers entering the North American region by land, consistent with entry screening 

in the aviation and maritime environments; 

	 Share and coordinate common triggers, criteria and protocols for screening of 

travelers at land borders when certain conditions are met. These triggers, criteria and 

protocols should be balanced against the necessity to maintain the flow of persons, 

cargo and trade across North American borders; and 

	 Coordinate public messaging to be employed at land border crossings once disease 

exists in North America. Messaging should be consistent among the three countries 

and may include information such as location of outbreaks, steps to reduce one’s risk 

of infection and advice on when to seek medical care. 

42 
CHAPTER 6: CRITICAL INFRASTRUCTURE 

PROTECTION 

Critical infrastructure sectors in Canada, Mexico and the United States are interconnected and 

all three countries recognize that private sector entities play key and interdependent roles in 

sustaining critical services, delivering essential commodities, and supporting public health 

recommendations. 

Although a pandemic threatens the health of workers, as opposed to causing physical damage 

to systems, worker absenteeism could disrupt the efficient flow of critical goods and services. 

For example, critical workers sustain the flow of electricity as well as natural gas and 

petroleum. These critical goods and services are part of a vast, interconnected system serving 

all of North America. Beyond energy and power, other critical infrastructure and key resource 

(hereafter, critical infrastructure) sectors, from manufacturing operations to transport, banking 

systems to food delivery service and the ability to provide trained medical personnel could 

also be affected. Moreover, a pandemic could significantly interrupt the ability of public and 

private sector entities to sustain critical infrastructure. Underserved populations could be 

disproportionately affected by disruptions in critical infrastructure. 

Canada, Mexico, and the United States share interdependencies among travel and tourism 

industries as well as transportation and commercial facilities sectors. The travel and tourism 

industry is important to the North American economy, as well as a major player in the 

movement of and communication with the traveling public. To reduce the negative effects of 

a pandemic on North American critical infrastructure, the three countries intend to make 

every reasonable effort to: 

	 Coordinate before, during and after a pandemic; 

	 Establish a mutually supportive operating environment; and 

	 Assist one another in improving the resiliency of critical infrastructure in the face of 

the pandemic threat. 

Once established, this operational framework is intended to be applicable to critical 

infrastructure sectors, as well as to all public owner/operators in general. 

Business continuity planning is recognized internationally as a key method of providing for 

the continuous delivery of essential services and products during disruptions and is vital to the 

building of resilient infrastructure. All critical infrastructure sectors, and indeed all enterprises, 

large and small, public and private, including government, and non-profit community, should 

strive to maintain critical operations during an influenza pandemic. The three countries 

intend to promote business continuity planning in their public and private sectors as a key 

method of mitigating the impacts of pandemic influenza, providing for continuous service 

delivery and laying the groundwork for rapid recovery. 

43 
 

 

 

 

 

While the impacts of an influenza outbreak can range from a seasonal flu equivalent to a more 

severe event similar to the 1918 pandemic, contingency plans should be developed to reflect 

this broad range of potential impacts and consequences. Planning for all degrees of severity is 

vital for resilience both at the local level and across our borders. 

Lessons learned from the Pandemic (H1N1) 2009 should be considered in future planning, 

which can be developed as scaled activities responding to an event similar to seasonal flu up to 

a more severe pandemic. For instance, surveillance systems that can facilitate early 

identification of the pandemic severity and infectious strain provide longer lead times and 

allow managers to plan accordingly. Indicators of absenteeism, such as school closings that 

require caregivers to stay home from work, are also important considerations for critical 

infrastructure owners and operators. 

The North American Framework 

A collaborative North American approach emphasizing and supporting critical infrastructure 

planning, preparedness, response and recovery processes is fundamental to the proper 

functioning of these essential systems within and across borders during a pandemic. This 

updated plan is intended to be consistent with the efforts made as part of the North American 

emergency management framework “to develop a common approach to critical infrastructure 

protection, [and] to coordinate responses to cross-border incidents.”18 

Cross-border assets such as transmission lines, pipelines, and dams, need to be understood 

when developing plans to support emergency management and coordinated responses to 

cross-border incidents. Further, there needs to be recognition of the major interdependencies 

among Canada, Mexico and the United States that include, but may not be limited to the 

following: 

	 Canada and the United States are each other’s largest trading partners, moving over 

$1.9 billion (USD) worth of goods and services across the border every day; 

	 Mexico is the United States’ third-largest trading partner, with over $300 billion 

annually in bilateral trade between the two countries;19 

	 In 2010, Mexico was Canada's third most important merchandise trading partner, with 

slightly over C$27 billion in two-way trade. According to Mexico's statistics, Canada 

was Mexico's sixth most important merchandise trading partner; 

	 Every year, the United States supplies Mexico with a large volume of water from the 

Colorado River basin, and Mexico supplies the United States with its proportional 

share from the Rio Grande;20 

18 http://georgewbush-whitehouse.archives.gov/news/releases/2006/03/20060331.html or 

http://www.pm.gc.ca/eng/media.asp?id=1085 19 www.census.gov/foreign-trade/balance/c2010.html#2010 

http://mexico.usembassy.gov/eng/eataglance_trade.html 

20 www.ibwc.state.gov/html/colorado_river.html 

44 
	 Canada is an important source of the United States natural gas supply; in 2008 Canada 

provided approximately 90 percent of United States natural gas imports and the 

United States and Canada supply nearly all of each other’s electricity imports; and 

	 United States imports of Canadian agricultural/food products total more than 20 

percent of total United States agricultural/food imports, while Canadian imports of 

United States food products account for more than 70 percent of Canadian food 

imports. 

Critical Infrastructure Sectors 

Critical infrastructure refers to the assets, systems and networks that are essential to the 

security, public health and safety, economic vitality, and way of life of citizens. Critical 

infrastructure disruptions can result in catastrophic losses, including human casualties, 

property destruction, economic effects, damage to public morale and confidence, and impacts 

on nationally critical missions. The risks are heightened by the complex system of 

interdependencies among critical infrastructure, which can produce cascading effects far 

beyond the initially impacted sector and physical location of the incident. Collaborative 

public-private sector efforts to enhance the resilience of critical infrastructure are essential for 

effectively managing disruptions and confronting the evolving threat environment. 

As sovereign nations, each country organizes its infrastructure and its critical infrastructure 

sectors differently, and each therefore has a unique relationship with the private and public 

critical infrastructure owner/operators within these sectors. The United States has formally 

detailed the identification and protection of what it refers to as critical infrastructure and key 

resource (CIKR) sectors. Canada’s National Strategy and Action Plan for Critical Infrastructure, 

announced on May 28, 2010, sets out a comprehensive approach among governments, 

industry and other stakeholders to manage broad scale protection efforts across identified 

critical infrastructure sectors. Currently, Mexico is finalizing a similar approach. Identification 

of critical infrastructure sectors is based on a practical understanding of how these systems 

work and their critical importance to a given country’s national economic and social stability. 

Canada 

The goal of Canada’s National Strategy for Critical Infrastructure (the Strategy) is to build a safer, 

more secure and more resilient Canada. While each jurisdiction structures its critical 

infrastructure program as it deems appropriate, at the national level, the Strategy advances 

more coherent and complementary actions among federal, provincial and territorial initiatives 

and among the ten critical infrastructure sectors listed below: 

Energy and utilities 

Information and communication technology 

Finance 

Health 

Food 

Water 

45 
Transportation 

Safety 

Government 

Manufacturing 

The Strategy fosters a comprehensive approach to risk-management and information sharing 

among key partners. This includes identifying risks to critical infrastructure, developing plans 

to address these risks, and conducting exercises to validate the plans. 

The majority of Canada’s critical infrastructure is owned and operated by the private sector, 

which bears the primary responsibility for strengthening the resilience of critical infrastructure. 

This includes the development and implementation of business continuity plans tailored to 

address pandemic-related impacts, such as potentially severe staffing shortages, supply-chain 

disruptions and the degradation of essential services. 

Mexico 

The United States-Mexico Border Partnership Declaration, signed on March 22, 2002, in 

Monterrey, Mexico, provided both countries with the basis to develop the Framework of 

Cooperation for Critical Infrastructure Protection (CIP). 

Under this framework, the governments of Mexico and the United States share the 

commitment to protect their populations and critical infrastructure from terrorist attacks, 

natural disasters and any another eventuality that may compromise their integrity and 

operation. The protection of the critical infrastructure network on the border – taking into 

consideration the interdependency between the two countries, and vulnerabilities – represents 

challenges and opportunities for both countries. 

Even though Mexico and Canada do not share a border, these two countries recognize that 

critical infrastructure protection is important in a North American context. For this reason, 

both countries intend to explore opportunities for collaboration through the Mexico-Canada 

Working Group. 

For the purposes of the Plan, Mexico defines critical infrastructure as those assets, services 

and networks that are indispensable to the support and maintenance of the well-being of the 

Mexican population. Following the concept stated by the United States-Mexico CIP, Mexico 

has established sectoral working groups to evaluate and improve the protection of critical 

infrastructure within its territory. 

In this context, Mexico’s approach includes eight sectoral working groups: Energy, 

Telecommunications, Transportation, Water and Dams, Public Health, Food & Agriculture, 

Cyber Security and Strategic Facilities. 

To protect its critical infrastructure and with an eye to taking advantage of existing programs 

and resources, the eight sectoral working groups correspond to each CIP sector identified. 

Energy (e.g., storage and generating facilities and distribution networks) 

46 
 

 

 

Transportation (e.g., ports of entry) 

Telecommunications (e.g., telecommunication networks) 

Water and Dams (e.g., hydraulic infrastructure and bridges) 

Cybernetic Security (e.g., communication and information networks) 

Public Health (e.g., epidemiological surveillance) 

Food & Agriculture (e.g., animal health and epidemiological surveillance) 

Strategic Facilities (e.g., physical protection of strategic facilities) 

United States 

In the United States, the private sector owns and operates the vast majority of the country’s 

critical infrastructure. Therefore, sustaining the operations of critical infrastructure during a 

pandemic, as well as the operations of those businesses that support the nation’s CIKR, is to 

depend largely on each individual organization’s development and implementation of business 

continuity plans tailored to pandemic-related impacts, including potentially severe staffing 

shortages, supply-chain disruptions and the degradation of essential services. 

The United States Government identifies 18 CIKR sectors that are essential to United States 

security as well as to economic and social stability:21 

Agriculture and Food (e.g., agriculture and food production, storage, and distribution) 

Defense Industrial Base (e.g., production, integration, and maintenance of facilities and 

systems that support United States military national defense requirements) 

Energy (e.g., electricity, oil, and natural gas production and distribution) 

Healthcare and Public Health (e.g., hospitals and healthcare facilities, public health 

agencies, pharmaceutical companies) 

National Monuments and Icons (e.g., buildings and structures of national or historical 

significance) 

Banking and Finance (e.g., financial institutions and systems) 

Water (e.g., drinking water and wastewater systems) 

Chemical (e.g., chemical manufacturing, storage, and warehousing and distribution) 

Commercial Facilities (e.g., stadiums and arenas, movie theaters, hotels, and office 

buildings)
 

Critical Manufacturing (e.g., primary metals and heavy equipment manufacturing) 

Dams (e.g., dams, hydropower facilities, navigation locks, and levees) 

Emergency Services (e.g., law enforcement, fire and emergency medical services, public 

works) 

Nuclear Reactors, Materials, and Waste (e.g., nuclear power plants, research and test 

reactors, radioactive materials and waste) 

Information Technology (e.g., information technology products and services) 

21 As part of the U.S. Government’s pandemic preparedness strategy, the Department of Homeland Security 

(DHS) helps support the public and private CIKR sectors in developing and implementing their essential 

pandemic contingency plans. The Pandemic Influenza Preparedness, Response and Recovery Guide for Critical Infrastructure 

and Key Resources was developed to assist business owner-operators and their contingency planners with enhancing 

their pandemic planning. The primary purpose of this CIKR guide is to encourage the U.S. private sector to act 

now. With this CIKR guide, DHS has provided a comprehensive tool for the CIKR sectors in the United States, 

and for business and industry in general. 

47 
 

Communications (e.g., communications systems, including wireless, satellite, and cable) 

Postal and Shipping (e.g., mailing and shipping facilities and carriers) 

Transportation Systems (e.g., aviation, highway, rail, mass transit, maritime, and 

pipeline) 

Government Facilities (e.g., facilities owned or leased by Federal, State, local, territorial, 

or tribal governments) 

Improving Critical Infrastructure Resilience 

Our resilience depends on our many partnerships, especially with other levels of government, 

private sector stakeholders and international allies. We recognize the importance of 

cooperation to strengthen the resilience of our critical infrastructure and enhance the safety 

and economic stability of our communities to ensure, for example, safe food, secure 

transportation and working electricity. 

Sustaining interdependent critical infrastructure operations demands commitment, mutual 

support and collaboration from all relevant public and private sector critical infrastructure 

partners. While businesses and local communities are at the forefront of the efforts to 

respond to and recover from a pandemic, governments should maintain situational awareness 

of critical infrastructure and its capabilities to respond and recover from this type of threat. In 

addition, stakeholders from the travel and tourism industries could be involved in discussions 

on pandemic response and recovery, as appropriate. Also, where appropriate, governments 

should coordinate timely national, regional and local support among public and private sector 

resources. 

In July 2010, the Government of Canada and the United States Government announced the 

Canada-United States Action Plan for Critical Infrastructure.

22 This Action Plan provides a crossborder approach to enhance critical infrastructure protection and resilience. The Action Plan 

is founded on the principle that officials from both countries should work together to ensure 

that our most important assets, networks and systems are better able to withstand the full 

range of hazards, including pandemic-related threats. It includes a commitment to share 

information, collaborate on risk assessments and conduct joint exercises. The Action Plan is 

also intended to support regional cross-border relations by promoting awareness of common 

critical infrastructure issues, and encouraging cooperation among State, Provincial, and 

Territorial authorities. While not specifically addressing pandemic influenza, implementation 

of the Action Plan – establishing a virtual Canada-United States Risk Analysis Cell to develop 

and share risk management tools and information; collaborating to ensure effective 

information sharing during and following an incident impacting critical infrastructure; and 

working together to assess risks and develop plans to address priority areas – provides a 

structure and mechanism for enhanced cross-border critical infrastructure planning and 

response during a pandemic. 

22 The Canada-United States Action Plan for Critical Infrastructure was announced by the Secretary of Homeland 

Security and Minister of Public Safety Canada on July 13, 2010. See 

http://www.dhs.gov/files/publications/gc_1278689065644.shtm or 

http://www.publicsafety.gc.ca/prg/em/ci/cnus-ct-pln-eng.aspx 

48 
 

 

Joint Assessments of Risks and Interdependencies 

Critical infrastructure is vulnerable to a range of risk and threats, which are continually 

changing and evolving. The challenge of protecting our vital assets and systems from these 

risks and threats is compounded because of the interconnected nature of critical 

infrastructure. For example, the delivery of food depends on transportation systems, which 

require a reliable supply of energy. The availability of energy in turn depends on the ability to 

make financial transactions, which are communicated over cyber networks. 

Critical infrastructure is not only interconnected across sectors, but also beyond borders. For 

this reason, the impacts of a critical infrastructure disruption can rapidly escalate within a 

sector (e.g., August 2003 North American blackout23) and may cause significant consequences 

from both a cross-sector and cross-border perspective. In a pandemic situation, 

understanding the risks and interdependencies is fundamental to providing a coordinated 

cross-sector response. 

The countries intend to share risk analyses, vulnerability assessments and prioritization 

methodologies as appropriate within classification guidelines and data sharing agreements. 

Where appropriate, the countries also intend to develop and produce collaborative analytic 

products with cross-border applicability, and undertake joint and/or coordinated risk 

assessments. An important output of these assessments is the identification of 

interdependencies, including potential chokepoints and single-point failures if such nodes exist 

within and across critical infrastructure sectors that could be affected by a pandemic. 

Occurring within individual or small numbers of similar critical infrastructure 

owner/operators, single-point failures can be triggered when a component on which a system 

depends fails and has no alternate component to back it up. Any number of vulnerabilities, 

including those caused by single-points of failure, may increase the probability for cascading 

effects across sectors. To the greatest extent possible, any joint risk, vulnerability and 

interdependency assessment should occur prior to a pandemic outbreak to enhance 

compatibility and to share information on each country’s approach to critical infrastructure 

protection. 

Public and Private Sector Entities with International Operations 

The three countries intend to make every reasonable effort to examine essential North 

American critical infrastructure owner/operators with international operations. With the 

entry into force of the NAFTA,24 the three countries formed a free-trade area with a total 

gross domestic product (GDP) of more than $16.8 trillion (USD). NAFTA has also resulted 

in growing numbers of companies located in the United States, Canada and Mexico operating 

key facilities within the borders of one of the other two countries.25 These North American 

businesses increasingly function as a “borderless” North American commercial network. 

23 The 2003 North American Electrical Blackout: An Accidental Experiment in Atmospheric Chemistry, 

www.atmos.umd.edu/~russ/BlackoutFinal.pdf 24 NAFTA: http://www.ustr.gov/trade-agreements/free-trade-agreements/north-american-free-tradeagreement-nafta 

25 NAFTA: A Decade of Strengthening a Dynamic Relationship, 

www.ustr.gov/assets/Trade_Agreements/Regional/NAFTA/asset_upload_file606_3595.pdf 

49 
 

 

They represent another element of strength and vulnerability, since disruptions of these 

businesses could lead to cascading effects across each country. 

Borders 

The three countries intend to make reasonable efforts to coordinate border actions to sustain 

critical infrastructure. The flow of goods and people across the border, and all of the 

processes and organizations that facilitate this border traffic, represent an integral part of each 

country’s critical infrastructure. Borders also represent a significant vulnerability to the 

countries’ interdependent critical infrastructure sectors because where cross-border movement 

is restricted, supply chain and personnel movements can be significantly disrupted. Thus, they 

may represent chokepoints that may negatively affect international commerce. Given the 

significant degree of North American integration, the food sector is particularly vulnerable to 

disruptions in cross-border trade, as there is significant cross-border movement in key farm 

inputs, intermediate agricultural products and final food products. 

Many industries, such as the travel and tourism industry are vulnerable to restrictions in crossborder movement and restrictions may have significant affects on the economies of all three 

nations. Ongoing engagement with these industries in planning and response to a pandemic is 

essential. 

Recognizing the need for a coordinated approach to border management, in May 2009, the 

Government of Canada and the Government of the United States announced the CanadaUnited States Framework for the Movement of Goods and People Across the Border During and Following 

an Emergency.

26 The Framework, which facilitates joint coordination and communication of 

border management efforts, is essential for maintaining economic stability during times of 

crisis and ensuring that first responders are not delayed at the border when cross-border 

emergency assistance is needed. 

Canada has also developed a domestic Plan for the Movement of People and Goods During and 

Following an Emergency, which complements the Framework and provides the platform for 

establishing national priorities and communicating results to public and private sector 

stakeholders. 

Impact of Disease versus Impact of Border Disruptions 

The three countries’ border actions should be well coordinated and communicated with 

critical infrastructure owner/operators, and should be carefully managed for the health and 

safety of citizens while minimizing economic disruption to the extent possible, given legal 

requirements relating to animal health, plant health and food safety. 

26 http://www.dhs.gov/xlibrary/assets/border_management_framework_2009-05-27.pdf or 

http://www.publicsafety.gc.ca/prg/le/bs/mgpfrm-eng.aspx 

50 
Pandemic Preparedness and Response Management for Critical 

Infrastructure 

The following are to be priority measures necessary to establish a mutually supportive 

environment and to improve the resilience of the three countries’ publicly and privately 

owned critical infrastructure during a pandemic: 

Interagency Information Sharing: Appropriate government agencies should develop a 

process and mechanism for sharing information on pandemic impacts and to also include 

clearly established communications roles and responsibilities during and following an 

incident affecting critical infrastructure. 

Risk Assessments: Develop and share risk management tools and information, and 

where appropriate, conduct joint risk assessments to enhance our collective ability to 

respond to and recover from a disruption in the most timely and effective way possible. 

Shared Pandemic Exercises and Training: To the best of their abilities, the three 

countries are to endeavor to include an array of relevant public and private sector critical 

infrastructure partners and appropriate public health officials in their respective pandemic 

preparedness training and exercises. 

51 
ANNEX I: TERMS OF REFERENCE FOR THE 

NORTH AMERICAN SENIOR COORDINATING 

BODY AND THE HEALTH SECURITY WORKING 

GROUP 

I. North American Senior Coordinating Body (SCB) 

Overview and Mission 

Under the North America Leaders Summit (NALS) cooperation framework, Canada, Mexico, 

and the United States established the SCB, composed of senior officials at the Under 

Secretary, Assistant Secretary, Assistant Deputy Minister level, or its equivalents from the 

Federal Departments or Ministries of health, animal/agriculture, homeland security/public 

safety, and foreign affairs. The SCB is established to: 

	 Serve as the senior level contact group in the event of an outbreak of animal influenza 

with human pandemic potential, and/or other novel strains of human influenza 

outbreaks; 

	 Create a high-level forum to discuss and facilitate trilateral collaboration on animal and 

pandemic influenza preparedness; and, 

	 Oversee the activities of the Trilateral Health Security Working Group (HSWG). 

Objectives 

	 Advise their respective Ministers or Secretaries on emergency preparedness for and 

response to pandemic influenza; 

	 Identify and prioritize activities, gaps or areas of collaboration to enhance North 

American preparedness for pandemic influenza; 

	 Serve as the senior level interaction group in the event of novel influenza outbreak or 

influenza pandemic; 

	 Promote cross-sectoral collaboration of preparedness activities (e.g. human health, 

animal health and agriculture, homeland security, and foreign affairs sectors); and 

	 Oversee the activities of the HSWG and ensure timely development, appropriate 

coordination, and completion of the NAPAPI Implementation Actions, to the extent 

consistent with applicable law. 

52 
Organizational Structure 

Membership 

Senior officials at the Under Secretary/Assistant Secretary/Assistant Deputy Minister level (or 

its equivalents) from the following departments and agencies: 

Canada: 

Public Safety Canada 

Public Health Agency of Canada 

Canadian Food Inspection Agency 

Foreign Affairs and International Trade Canada 

Mexico: 

Secretariat of Health (Secretaría de Salud) 

Secretriat of Governance (Secretaría de Gobernación) 

Secretariat of Agriculture, Liverstock, Rural Development, Fisheries and Food 

(Secretaría de Agricultura, Ganadería, Desarrollo Rural, Pesca y Alimentación) 

Secretariat of Foreign Affairs (Secretaría de Relaciones Exteriores) 

United States: 

Department of Health and Human Services 

Department of Homeland Security 

Department of Agriculture 

Department of State 

Ad hoc representatives from other departments or agencies such as the defense, commerce and 

transportation sectors may be invited to join meetings as needed. 

Chair 

The Chair of both the SCB and of the HSWG is held concurrently by the same country. The 

Department, Agency, or Ministry holding the chair should be determined according to the 

emergency management structures in each participating country. The chair rotates among the 

three countries annually, with each chair serving for one year. 

Administrative Support 

The chairs of the HSWG provide administrative and logistical support for the SCB. 

Frequency of Meetings 

Meetings should be held twice a year or as called by the chairs on an as-needed basis. The 

meetings may be held in person, by video conference, or by teleconference. 

53 
II. North American Health Security Working Group (HSWG) 

Overview and Mission 

The HSWG is established under the SCB and composed of policy and technical subject matter 

experts from the health, agriculture, security, and foreign affairs sectors from Canada, Mexico, 

and the United States. 

The HSWG is expected to develop and execute a comprehensive, coordinated and evidencebased approach to plan for and respond to public health emergencies caused by novel 

influenza outbreaks and pandemic influenza. 

Collective efforts under the HSWG should enable the execution of activities to improve 

public health capacities and facilitate information-sharing in North America based on the best 

available science, sound federal government policies, and the legal support needed to enhance 

cross-border mutual assistance arrangements, protocols, and/or agreements for response to 

public health emergencies of international significance or mutual interest. 

Objectives 

	 Advise the SCB on emergency preparedness for and response to pandemic influenza; 

	 Serve as the technical and policy level interaction group in the event of novel influenza 

outbreak or influenza pandemic; 

	 Develop and complete, to the extent consistent with the legal authorities of the 

participating Departments and Agencies, the NAPAPI Implementation Actions and 

coordinate with other Departments and Ministries, as appropriate, regarding the 

development and completion of implementation actions, particularly those that may 

affect matters within their areas of responsibility; 

	 Provide administrative and logistical support for the SCB; and 

	 Supervise the creation and activities of the animal health, border measures, and any ad 

hoc sub-working groups. 

Organizational Structure 

Membership 

Canada: 

Public Safety Canada 

Public Health Agency of Canada 

Canadian Food Inspection Agency 

54 
Foreign Affairs and International Trade Canada 

Mexico: 

Secretariat of Health (Secretaría de Salud) 

Secretariat of Governance (Secretaría de Gobernación) 

Secretariat of Agriculture, Liverstock, Rural Development, Fisheries and Food 

(Secretaría de Agricultura, Ganadería, Desarrollo Rural, Pesca y Alimentación) 

Secretariat of Foreign Affairs (Secretaría de Relaciones Exteriores) 

United States: 

Department of Health and Human Services 

Department of Homeland Security 

Department of Agriculture 

Department of State 

It is intended that ad hoc representatives from other departments or agencies such as the 

defense, commerce and transportation sectors be invited to join meetings when issue within 

their areas of expertise are being considered. 

Chair 

The HSWG is to be chaired or co-chaired by representatives of appropriate government 

departments/agencies or ministries as established according to each country’s emergency 

management structure. The chair rotates among the three countries annually, with each chair 

serving for one year. Where deemed appropriate by that country, the chair may involve cochairs established between more than one government department, agency, or ministry. 

Administrative Support 

The country holding the HSWG chair should provide a point of contact for administration of 

the SCB and HSWG. 

Frequency of Meetings 

The Working Group intends to meet initially every other month or more often as needed 

during the Plan implementation. HSWG meeting summaries are to be provided to all 

members and should include, at a minimum: participant lists, action items, and decisions or 

recommendations. 

55 
 

 

 

ANNEX II: AVIAN INFLUENZA27
 

Avian influenza (AI) is an infectious and contagious viral infection affecting most species of 

wild and domestic birds. Infrequently, the virus has been found to cross into and cause 

disease in unrelated species including pigs, cats, dogs, ferrets, martens and humans. 

Transmission of the virus from one bird to another occurs primarily through direct contact – 

typically through contact with respiratory secretions or feces. Airborne transmission may 

occur if birds are in close proximity and with appropriate air movement. Infection with the 

virus may result in asymptomatic birds, as is found in many waterfowl and shorebird species, 

or a diversity of disease manifestations, as seen in domestic poultry, varying from sub-clinical 

disease, mild respiratory disease and loss of egg production to an acute and highly fatal 

disease. Most AI viruses found in birds do not appear to pose any significant health risk to 

humans. 

Since 1955, virtually all highly pathogenic outbreaks in domestic poultry have been attributed 

to viruses of the H5 and H7 subtypes. These subtypes have repeatedly demonstrated the 

tendency to mutate from low pathogenicity strains to highly pathogenic forms while 

circulating within poultry populations. 

Since 2003, trade in domestic poultry and the movement of migratory birds has resulted in the 

spread of the H5N1 Eurasian strains to numerous countries in Asia, Africa, the Middle East 

and Europe. Although the number of human infections remains low, the mortality rate in 

those infected is high. To date, there has been no sustained, efficient human-to-human 

transmission of the H5N1 Eurasian strains, so direct contact with infected birds (mainly 

poultry) remains the greatest risk of human infection. Of particular concern is the possibility 

of reassortment of genetic material between human and avian influenza viruses when they 

simultaneously infect the same swine or human host. This reassortment could result in the 

formation of a new influenza virus subtype with pandemic potential. 

The World Organization for Animal Health (OIE) sets international standards for the 

prevention, control and eradication of animal diseases of significance. It manages the “world 

animal health information system” based on the commitment of member countries to notify 

the OIE of listed “notifiable” diseases. Canada, Mexico and the United States are OIE 

member countries. Consistent with OIE guidelines under the Terrestrial Animal Health Code, 

each country has a legal framework that requires the suspicion of a notifiable avian influenza 

(NAI) virus to be reported immediately to the competent veterinary authority. Veterinary 

infrastructure should be sufficient so that the competent veterinary authority can isolate and 

characterize the avian influenza virus, immediately investigate the suspicion of disease and 

respond to, control or eradicate the disease. The basis of response to any detection of NAI in 

poultry is contained within the OIE’s Terrestrial Animal Health Code. 

27 From the 2007 North American Plan for Avian and Pandemic Influenza; http://www.spppsp.gc.ca/eic/site/spp-psp.nsf/vwapj/pandemic-influenza.pdf/$FILE/pandemic-influenza.pdf 

56 
 

Notifiable Avian Influenza 

The conditions under which avian influenza viruses are subject to OIE notification are set out 

in the OIE Terrestrial Animal Health Code. The competent veterinary authority of a country 

may choose to include more AI virus subtypes within its domestic notification protocols, but 

is encouraged to follow the OIE notification conditions in its dealings with its North 

American trading partners. 

The competent veterinary authority of each country should notify its counterparts of any new 

NAI infections using pre-established contacts in the respective governments. 

Zoning and Compartmentalization 

In the event of an incursion of NAI virus into North American poultry, the three countries, as 

WTO Members, have agreed to comply with Article 6 of the Agreement on the Application of 

Sanitary and Phytosanitary Measures (WTO SPS Agreement), including Article 6.2 which requires 

that WTO Members “shall, in particular, recognize the concepts of pest- or disease-free areas 

and areas of low pest or disease prevalence.” This could entail the implementation of 

“zoning” or “compartmentalization,28” per OIE guidelines. 

When establishing a zone or compartment, the competent veterinary authority of the affected 

country should clearly define and document the basis for its claim that the subpopulation is a 

distinct zone or compartment. It should provide for sufficient human and financial resources 

for the maintenance of such a zone or compartment and see that the veterinary and industry 

infrastructures have the required technical capacity. The birds belonging to a zone or 

compartment should be clearly recognizable as such and measures taken for the identification 

of the subpopulation should be documented in detail. Confirmation of the disease-free status 

of a zone or compartment should be maintained through effective monitoring as well as active 

and passive surveillance. 

Where zoning or compartmentalization has been established for the purposes of maintaining 

international trade, the competent veterinary authority of the exporting country should 

provide the importing country with the necessary documentation to confirm that the zone or 

compartment is epidemiologically closed and that an appropriate surveillance and monitoring 

system is in place to verify its disease-free status. The competent veterinary authority of the 

importing country may then conduct a science-based risk assessment based on the 

information provided by the exporting country and provide, within a reasonable period of 

time, written notification to the exporting country of its recognition of the 

28 As stated in the current Chapter 1.3.5 of the OIE Terrestrial Animal Health Code – 2006, ‘Compartment’ means 

one or more establishments under a common biosecurity management system containing an animal subpopulation with a distinct health status with respect to a specific disease or specific diseases for which required 

surveillance, control and biosecurity measures have been applied for the purpose of international trade. 

‘Zone/region’ means a clearly defined part of a country containing an animal sub-population with a distinct 

health status with respect to a specific disease for which required surveillance, control and biosecurity measures 

have been applied for the purpose of international trade. 

(http://www.oie.int/eng/normes/mcode/en_chapitre_1.1.1.htm#terme_compartiment) 

57 
zone/compartment, a request for further information or its rejection of the 

zone/compartment. 

The following commercial poultry compartments have been identified in Canada and the 

United States. The commercial poultry compartments for Mexico are pending signature of 

the Chief Veterinary Officers’ Memorandum of Understanding Regarding 

Compartmentalization: 

	 Broiler, turkey or layer breeder production flocks; 

	 Duck breeder and upland game breeder flocks; 

	 Commercial (grow out) broiler and turkey flocks (meat-type birds); 

	 Commercial duck and goose meat-type production flocks; 

	 Pullet production flocks; 

	 Commercial layer (table egg) flocks; and 

	 Commercial poultry flocks used for the production of other commercial products 

such as feathers (down) and foie gras. 

Surveillance/Epidemiology 

Surveillance for NAI should be aimed at demonstrating the absence of NAI virus in the 

poultry sectors while also acting as an early detection system for incursions of NAI in poultry 

and highly pathogenic NAI (HPNAI) incursions in wild waterfowl. The competent veterinary 

authority of a country may choose to expand its surveillance program to include the 

identification of more AI virus subtypes than required by the OIE. The data collected should 

support the risk assessment process and substantiate the rationale for all biosecurity measures 

in place. The surveillance system should be under the direction of the competent veterinary 

authority in each country. 

The competent veterinary authority of each country should promote the establishment of a 

formal and ongoing system for detecting and investigating suspected NAI infection. 

Procedures should be established so that all suspected cases of NAI are sampled rapidly, that 

the samples collected are appropriate for the species under investigation, that there is a 

mechanism in place to rapidly transport the samples to an approved NAI diagnostic 

laboratory and that the integrity of the samples is maintained at all times. The competent 

veterinary authority should promote the establishment of an effective system in place for the 

recording, managing and analyzing of diagnostic and surveillance data. Access to real-time 

data is of particular importance in an outbreak situation, since it will drive the control and 

prevention strategies. Methodologies used should be based on the best available information 

that is in accordance with current scientific thinking and should be fully documented, 

referenced to the scientific literature and supported by expert opinion. All processes should 

58 
be transparent for the purpose of fairness, the rationality and consistency of decision making, 

and to facilitate ease of understanding. The surveillance systems used should be subject to 

periodic auditing so that all of the systems’ components are functioning according to the 

design criteria. 

Surveillance programs should include imported poultry and birds for the pet trade, as well as 

birds for research and zoological display purposes. 

Poultry Surveillance 

The surveillance program for poultry should include both active and passive data collection 

for all levels of the production, marketing and processing chain, and all compartments within 

the poultry population. Ideally, it should include all susceptible poultry species but may be 

targeted to poultry populations at specific risk due to types of production, contact with wild 

birds, trade patterns or other significant factors. Active surveillance should occur at a 

frequency of at least six months, or according to recognized and established national 

surveillance program requirements, e.g., USDA’s National Poultry Improvement Plan. 

Surveillance methods should include both random and targeted approaches using virological, 

serological and clinical methods with known and validated sensitivity and specificity. 

In countries, zones or compartments where vaccination has been used to prevent the spread 

of HPNAI, surveillance programs should utilize virological and serological testing regimens 

that verify the absence of AI virus circulation as set out in the OIE Terrestrial Animal Health 

Code. 

Wild Bird Surveillance 

Effective wild bird surveillance provides an early warning system for potential or real threats 

that may exist in the wild bird population. Surveillance would allow an appreciation of 

changes in the types of AI viruses circulating in wild birds and detect any H5/H7 subtypes 

present that could result in the emergence of a highly pathogenic strain in domestic poultry. 

Advance warning would enable the poultry sector to adopt enhanced biosecurity measures 

and allow poultry surveillance programs to be targeted to those populations or compartments 

at increased risk. 

The competent veterinary authority should collaborate with wildlife agencies, universities and 

others to increase surveillance of wild birds, with an emphasis on waterfowl and shorebirds 

migrating from other mainland continents. Wild bird surveillance should be conducted at 

least annually during the periods when the movement or entry of migratory wild birds may 

pose an increased risk to domestic poultry. Wild bird surveillance programs should include 

active and passive methodologies and should include live and dead bird sampling. 

59 
Border Control Measures Associated with Notifiable Avian 

Influenza 

Each country should apply proper and proportional import health measures when NAI is 

confirmed and reported. These measures are intended to maintain the animal health status of 

the importing country while minimizing the impact on the trade of poultry, poultry products 

and other products from avian species among Canada, Mexico and the United States. Import 

measures applicable to NAI should be based on the OIE Terrestrial Animal Health Code, 

including chapters on NAI and Zoning and Compartmentalization, and consistent with the 

WTO Agreements, particularly the WTO SPS Agreement and the NAFTA, particularly 

Chapter Seven, Part B (Sanitary and Phytosanitary Measures). 

To enable a common approach that is both consistent and uniform among the countries, 

Canada, Mexico and the United States recognize that conditions for regional trade should be 

established to minimize unnecessary trade disruptions among the three countries. This is 

reflected in the understanding entitled Guidelines for Providing “Assistance” under the North 

American Plan for Avian and Pandemic Influenza and was signed by the Chief Veterinary Officers 

of the three countries in 2010, contained in Annex III. 

The competent veterinary authorities in each country should establish links with their 

respective border control agencies to develop procedures to control legal imports and to 

detect illicit imports. 

When a highly pathogenic variety of avian influenza exists outside North America, each of the 

three countries should enhance inspection methods to detect illicit trade in animals and 

commodities from the affected countries. Regulatory enforcement information related to the 

detection of illegal trade should be shared among Canada, Mexico and the United States. 

Laboratory Practices 

The laboratories conducting testing for the avian influenza virus should be authorized or 

certified by the country’s Reference Laboratory to perform these test methods, and should 

follow the tests and procedures recommended in the OIE Manual of Diagnostic Tests and 

Vaccines for Terrestrial Animals. These include serological tests, virus identification/isolation and 

virus characterization. Reporting to OIE should be based on the “recognized standard,” 

which includes virus isolation, complete subtyping of any H5/H7, the genetic sequencing of 

the hemagglutinin (HA) cleavage site and Intravenous Pathogenicity Index (IVPI) testing in 

chickens. All viral isolations and characterizations should be confirmed at a Reference 

Laboratory. 

Procedures should be developed so that adequate supplies of diagnostic materials/reagents are 

available in the event of an NAI outbreak. These procedures should include provisions for 

the import/export of diagnostic materials/reagents among Canada, Mexico and the United 

States, as well as contingencies for the rapid cross-border movement of diagnostic specimens 

and isolates. 

60 
Harmonization efforts under the NALS among animal health, avian-influenza-virus testing 

laboratories in the three countries should continue to evaluate needs for diagnostic 

improvements in tests used for the diagnosis of avian influenza. Linkages should be 

established/strengthened between the animal health and the public health laboratory systems 

in each country to improve the exchange of information and to enhance public health 

surveillance. Information technologies should be examined to identify opportunities that 

would enhance rapid data transfer. 

Avian Influenza Vaccines 

Vaccination is recognized as a valuable tool and as part of an overall comprehensive 

management strategy to control and eradicate avian influenza in the affected and at-risk avian 

populations. Although vaccination has been shown to increase resistance to infection and 

reduce virus shedding, it is understood that the virus is still able to infect and replicate in 

clinically healthy vaccinated birds. Countries employing vaccination should be able to 

differentiate infected from vaccinated animals, or determine the absence of NAI virus through 

comprehensive surveillance programs that include environmental sampling, in accordance 

with the OIE Manual of Diagnostic Tests and Vaccines for Terrestrial Animals. 

Each country should develop and implement a vaccination strategy that is effective within the 

scope of its disease control methodologies. This strategy should include a reliable system of 

monitoring and surveillance to identify rapidly any serious problems arising from the use of 

vaccines. 

The competent veterinary authorities of the three countries intend to develop protocols to 

harmonize the circumstances under which vaccines would be employed. International 

arrangements or agreements should be developed to provide for an adequate supply of avian 

influenza vaccine in the event of a North American outbreak, including a mechanism for the 

rapid cross-border movement of vaccines. 

Personnel 

The three countries should regularly assess the capacity of their operational and laboratory 

systems provide for sufficient capacity for the performance of routine surveillance as well as 

of expanded surveillance during NAI isolation in domestic poultry or wild birds. The 

competent veterinary authority should have emergency disease response contingency plans in 

place and the capacity to deploy properly trained staff to manage and direct disease eradication 

and control measures when required. 

The three countries may seek the assistance of staff with skills and experience from 

international sources to respond to an avian influenza outbreak. Contingency plans to expand 

the available resource base should be in place in the event that current resources are exceeded, 

and should be shared among Canadian, Mexican and United States veterinary authorities. 

Procedures that would allow rapid entry and deployment of emergency responders across 

international, provincial and state jurisdictional boundaries should be considered within the 

contingency plans of each country. The competent veterinary authorities should identify and 

address barriers to the movement of animal health/veterinary personnel across international, 

61 
 

 

provincial and state jurisdictional boundaries. Countries should have well-developed health 

and safety protocols for personnel that may be exposed to the virus, including the use of 

influenza vaccines and antiviral medications where necessary. Contingencies should include 

the possibility of exposure to NAI strains, which have the potential to result in human-tohuman transmission. 

Avian Health Information Sharing and Notification 

The three countries should strive for open communication and sharing of information 

regarding the occurrence of NAI virus in domestic poultry so that proper, responsible and 

proportional import health measures can be applied by each country when NAI virus is 

confirmed and reported. When requested, Canada, Mexico and the United States intend to 

share with one another information on their isolates of NAI virus in poultry and highly 

pathogenic avian influenza (HPAI) virus in wild birds, and in birds other than poultry. 

Confirmation of NAI should include virus isolation, H5/H7 complete subtyping and genetic 

sequencing of the HA cleavage site of the HA protein. Notifications of any NAI should 

follow OIE guidelines as well as chief-veterinary-officer-to-chief-veterinary-officer formal 

arrangements, and should occur between the corresponding import/export staff of each 

country. These notifications should minimize the impact such measures would have on the 

trade of poultry, poultry products and other products from avian species among the countries. 

Avian and Human Health Interface 

The emergence of the highly pathogenic H5N1 viruses has demonstrated the potential 

zoonotic impacts of certain strains of HPAI viruses given a coincident combination of 

epidemiologic factors – susceptible host, agent and environment – according to the principles 

of the epidemiological triad. Two of the most effective methods of protecting human 

populations from exposure to NAIs are by prevention and control of any exposure to 

domestic poultry of NAIs and by rapid containment and eradication of NAI-infected birds 

should an introduction occur. Prevention of domestic poultry exposure can be best achieved 

through the implementation of comprehensive surveillance programs, biosecurity protocols 

and adoption of effective import controls. Prevention of human exposure can be best 

achieved by adopting procedures to protect the health of individuals working in environments 

where HPAI virus may be found and by organizing public education programs on the 

importance of good hygiene and sanitation practices. Human health authorities should 

develop contingency plans that identify the risk to human health of low pathogenicity and 

highly pathogenic avian influenza viruses in wild and domestic birds, and should adopt 

appropriate response measures to manage the potential risks for the human population at 

risk.29 

Human health authorities in Canada, Mexico and the United States should share best practices 

in occupational health, infection control and personal protective measures to reduce potential 

risk to human populations. 

29 The Public Health Agency of Canada has developed guidelines entitled “Human Health Issues Related to 

Avian Influenza in Canada,” available at http://www.phac-aspc.gc.ca/publicat/daio-enia/pdf/nat-ai-guide2006_e.pdf 

62 
The competent veterinary authorities in the three countries should establish the appropriate 

contacts within their respective public health sectors for the purpose of consistency in the 

approach to public communications. Regular meetings should be held to review the 

communications framework, to identify emerging issues and to share communication 

products, where appropriate. 

63 
ANNEX III: CHIEF VETERINARY OFFICERS 

AGREEMENT 

64 
 

GUIDELINES FOR PROVIDING "ASSISTANCE" UNDER 

North American Plan For Avian & Pandemic Influenza 

(A) CHIEF VETERINARY OFFICERS' ARRANGEMENT 

FOR SHARING OF AVIAN INFLUENZA VACCINE and 

(B) CONTINGENCY PLANS TO EXPAND PERSONNEL 

WHEN HIGHLY PATHOGENIC AVIAN INFLUENZA 

HAS BEEN CONFIRMED IN
 

CANADA, MEXICO OR THE UNITED STATES1
 

APRIL2009 

1 ANNEX l Chapter 3 Avian Influenza Tasks A + B from Major Tasks from North American Plan For Avian & Pandemic 

Influenza (August 2007), pg., 34 

65 
 

Forward 

The "North American Plan For Avian & Pandemic Influenza" was developed as 

part of the Security and Prosperity Partnership of North America in August 2007. 

Annex 1listed "Major Tasks"in accordance with the North American Plan for 

Avian and Pandemic Influenza and in furtherance of the goals set forth therein. 

The Governments of Canada, Mexico and the United States committed to continue to 

work together to accomplish actions. The Annex was developed to assist the SPP 

Coordinating Body for Avian and Pandemic Influenza to follow-up on efforts to put 

the "Plan" into action. 

Specific Tasks for the CFIA, USDA and Ministry of Agriculture for Mexico were: 

TASK A: 

	 Develop international arrangements or agreements to provide for and adequate 

supply of avian influenza vaccine in the event of a North American outbreak, 

including a mechanism for the rapid cross-border movement of vaccines 

TASKB: 

	 Put in place and share contingency plans to expand the available personnel 

resource base in the event a nation's current personnel resources are 

exceeded
 

TASKC: 

	 Share best practices in occupational health, infection control and personal 

protective measures to reduce potential risk to human populations
 

Only Tasks A & B are addressed in this document. 

The Deputy Administrator,Veterinary Services, USDA APIDS initiated an exchange 

of letters on April14, 2008 with the Chief Veterinary Officers for Canada and the 

USDA to make arrangements for the Sharing of Avian Influenza Vaccine when 

Highly Pathogenic Avian Influenza has been Confirmed in Canada, Mexico or the 

United States. Canada signed the Agreement on April 24, 2008 and Mexico on May 

8, 2008. This was TASK A, sharing of vaccine. The exact text and signatures have 

been copied into Part A of this document. 

In October 2008, the CVOs for Canada, Mexico and the United States tasked the 

NAAH Emergency Management Working Group to develop a mechanism to 

implement the sharing of personnel using the International Animal Health 

Emergency Reserve (IAHER) framework to which Canada and the USDA were 

signatories in Mary 2004. This framework has been adapted for use within North 

America to be agreed in October 2009. 

66 
 

 

 

(A) CHIEF VETERINARY OFFICERS' ARRANGEMENT FOR SHARING OF 

AVIAN INFLUENZA VACCINE WHEN HIGHLY PATHOGENIC AVIAN 

INFLUENZA HAS BEEN CONFIRMED IN CANADA, MEXICO OR THE 

UNITED STATES 

CANADA THE CANADIAN FOOD INSPECTION AGENCY [CFIA]; 

MEXICO	 MEXICAN SECRETARIAT OF AGRICULTURE, LIVESTOCK, 

RURAL DEVELOPMENT, FISHERIES AND FOOD [SAGARPA]; 

AND 

UNITED STATES DEPARTMENT OF AGRICULTURE, ANIMAL AND PLANT HEALTH 

INSPECTION SERVICE [USDA APHIS] 

Referred to as "the Countries" collectively and the "Country" individually 

PART I-INTRODUCTION 

1. The Security-Prosperity Partnership provides opportunity for the United States, Mexico, and Canada to 

share resources. To ensure appropriate resources are made available as countermeasures against an 

outbreak of highly pathogenic avian influenza that threatens the poultry industries, international trade, 

and economic health of North America, the Chief Veterinary officers of the United States,Mexico, and 

Canada developed a process for requesting, receiving,sharing and reimbursing each respective 

country's stockpiles of avian influenza vaccines. 

PART II- GENERAL GUIDELINES 

2. To ensure a common approach to sharing of avian influenza vaccines among and between the 

Countries, movement of vaccines across borders, and re-imbursement process to replenish the 

respective country stockpiles of avian influenza vaccines, the Chief Veterinary Officers of the United 

States,Mexico, and Canada will abide by the conditions presented in this document. 

PART III-REQUESTING STOCKPILED VACCINES 

3. The Chief Veterinary Officers of the United States, Mexico,and Canada will consult when a 

confirmed case of highly pathogenic avian influenza virus has been identified in a respective Country. 

The consultation will include discussions regarding a decision by the respective infected Country to 

vaccinate and if there will be a need for assistance2 from the other Countries. 

Each Country will consider the epidemiology of the spread of the disease as part of the criteria needed 

to make a decision to share stockpiled vaccine. The requesting Country should provide evidence such as 

the North American Disease Spread Model3 results as well as surveillance and other epidemiologic data 

that support containment of the virus and justifies use of vaccine to control and eradicate the remaining 

infection of the disease. 

Once a decision is made to share vaccines, the Chief Veterinary Officers will implement emergency 

operations to include rapid issuance of permits to export and waivers, if needed, to import the shared 

vaccines. Each Country will need to develop specific standard operating procedures for issuing 

permits and tracking movement of the vaccines. 

PART IV-REIMBURSEMENT OF COSTS FOR SHARED VACCINES 

2 Guidelines for providing assistance (human resources) are outlined on pg. 3 to 8 of this document 3 The actual name of the model is North American Animal Disease Spread Model 67 
 

 

 

 

 

 

4.	 Each Country holding avian influenza vaccines as an asset in responding to an outbreak of the disease 

in their respective Country must be reimbursed for costs of purchase, storage, and shipment of all 

shared vaccines. Details of how the infected and requesting Country will reimburse the donating 

Country will be discussed during the consultation. Following the agreed to method of reimbursement 

discussed in the consultation, the requesting Country will provide the donating Countries an official 

declaration of how the reimbursement will proceed including a time line for when stockpiles will be 

replenished. 

UNITED STATES OF AMERICA4 

ted States of America

 ef Veterinary Officer
 John R. Clifford
 Deputy Administrator
 

USDA, APIDS, Veterinary Services 

CANADA
 

Dr. Brian R. Evans 

Chief Veterinary Officer 

Executive Vice-President 

Canadian Food Inspection Agency 

59 Camelot Drive 

Ottawa, Ontario KlA OY9 

MEXICO
 

Municipio Libre No. 377
 

Santa Cruz Atoyac Delegacion Benito Juarez 

Mexico, D.F. CP03310
 

MEXICO
 

4

*Note: text is re-formatted verbatim from a letter sent by the USDA on April 14 signed by Dr JereL Dick for Dr 

Clifford; later signed by Dr Lord April 24 and Dr Velarde 13 May 2008 for which signatures were copied 

68 
 

 

 

 

 

 

 

 

 

 

 

 

(B) Guidelines for Implementing "ASSISTANCE" Under the CHIEF VETERINARY 

OFFICERS' ARRANGEMENT FOR SHARING OF AVIAN INFLUENZA VACCINE 

WHEN HIGHLY PATHOGENIC AVIAN INFLUENZA HAS BEEN CONFIRMED IN 

CANADA, MEXICO OR THE UNITED STATES 

RESPONSIBILITIES 

Each Country will: 

A. Designate an official representative, who will activate the CHIEF VETERINARY OFFICERS' 

ARRANGEMENT FOR SHARING OF AVIAN INFLUENZA VACCINE WHEN HIGHLY 

PATHOGENIC AVIAN INFLUENZA HAS BEEN CONFIRMED IN CANADA, MEXICO OR 

THE UNITED STATES [CVO HPAI ARRANGEMENT] by requesting assistance, acting as 

liaison and administering activities conducted under this Agreement. 

B. Implement emergency operations for dealing with highly pathogenic avian influenza. 

C. Assess the adequacy of their respective Country's veterinary resources available to deal with 

highly pathogenic avian influenza. 

D. Provide skilled and competent personnel to an infected Requesting Country on a mutually arranged 

basis. Skilled and competent personnel include, but are not limited to, Veterinarians and 

Veterinary Specialists, Animal Health Technicians, Laboratory Diagnosticians and Emergency 

Managers. Criteria for skilled and competent personnel are established by the Requesting Country. 

E. Make arrangements between the Requesting Country and the Donating Country as outlined in 

Annex A. 

F. Make arrangements as the Requesting Country as outlined in Annex B. 

G. Make arrangements as the Donating Country as outlined in Annex C. 

5. Personnel of Donating Countries are under the supervision of the Requesting Country's official 

representative and will abide by the public service code of conduct and all regulations brought to their 

attention by the responsible Requesting Country's official representative. The Requesting Country will 

provide full and effective briefings on these requirements. 

EXTENT OF COMMITMENT 

6.	 This CVO HPAI ARRANGEMENT is intended to serve as the framework for the mutual working 

relationship should an outbreak of highly pathogenic avian influenza occur. In the event of an 

emergency outbreak, a bilateral agreement will be entered into that will outline the funding and 

liability arrangements. 

7.	 Nothing in this CVO HPAI ARRANGEMENT is intended to preclude individual Countries from 

providing additional assistance outside of this CVO HPAI ARRANGEMENT. 

LIMITATIONS OF COMMITMENT 

8. The terms and conditions of this CVO HPAI ARRANGEMENT and any continuation thereof by any 

Country is contingent upon the availability of funds appropriated by the legislative body or bodies of 

such Country in declaring an emergency response. Nothing in this CVO HPAI ARRANGEMENT is 

to require the Countries to obligate or transfer any funds. If fiscal resources are to transfer, the 

Countries are to develop a separate arrangement. Specific bilateral arrangements that may be 
 

 

 

 

 

 

 

 

established in the future pursuant to this CVO HPAI ARRANGEMENT are to be contingent upon the 

availability of personnel and resources and funds appropriated by the legislative bodies of the 

Countries. Any monies allocated for purposes covered by this CVO HPAI ARRANGEMENT are to be 

expended i n accordance with its terms and the manner prescribed by the fiscal regulations and/or 

administrative policies of the Country making the funds available 

DISPUTE RESOLUTION 

9. Should there be differences of opinion and interpretation of this CVO HPAI ARRANGEMENT or the 

activities and work hereunder; the Countries will resolve such differences in an amicable manner. 

AMENDMENTS 

I 0. This CVO HPAI ARRANGEMENT may only be amended by agreement in writing of all the 

Countries, specifying the dates on which such amendments will enter into effect. 

DURATION 

11. This CVO HPAI ARRANGEMENT enters into effect on the date of its execution and will remain in 

effect for a period of five years, and will be automatically extended for a further five year period, 

unless the Countries agree otherwise. 

TERMINATION 

12. Termination of this CVO HPAI ARRANGEMENT will not terminate or affect completion of any 

activities or work being carried on under this CVO HPAI ARRANGEMENT at the date of 

termination 

13. If at any time this CVO HPAI ARRANGEMENT no longer reflects the intentions of a Country, then 

that Country is to promptly so notify the other Countries in writing. 
 

UNITED STATES OF AMERICA
 

Deputy Administrator 

USDA, APHIS, Veterinary Services 

CANADA
 

Dr. Francine Lord 

Chief Veterinary Office 

Executive Vice-President 

Canadian Food Inspection Agency 

59 Camelot Drive 

Ottawa, Ontario KIA OY9 

MEXICO
 

Santa Cruz Atoyac Delegacion Benito Juarez 

Mexico, D.F. CP 0331 0 

MEXICO 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANNEX A 

ARRANGEMENTS TO BE MADE BETWEEN THE REQUESTING COUNTRY AND 

THE DONATING COUNTRY
 

The Requesting Country and the Donating Country will work together to: 

A. Jointly, review the adequacy and availability of any health, travel and other insurance coverage for 

injury or loss to personnel while in transit to or while on assignment in the Requesting Country. 

B. Seek authorisation within their respective national legislative authorities for the transfer of funds 

and the use of personnel, equipment, or other items regarded as necessary to implement the 

activities anticipated under this CVO HPAI ARRANGEMENT. 

C. Develop an implementation plan to include the following specific details: 

(1) The proposed schedules for the temporary assignment of personnel, including the proposed 

commencement date and estimated duration. The estimated duration of each person's 

assignment, which would generally be a minimum of 4 weeks, is subject to the circumstances 

of the emergency disease outbreak prevailing at the time. 

(2) Arrangements for the Donating Country to pay the salary and overtime of animal health 

personnel provided by the Donating Country under this CVO HPAI ARRANGEMENT on the 

basis that such staff remains an employee of the Donating Country. 

(3) Recovery time/rest for personnel after extended travel to the temporary duty station in 

accordance with the Requesting Country's travel regulations. 

(4)	 Provision of stress counselling services for Donating Country personnel. 

(5) Amicable consultation between the Countries to resolve any difficulties in the administration 

of this CVO HPAI ARRANGEMENT. 

(6)	 A process by which the Requesting Country would determine the hours of work of the personnel 

provided by the Donating Country. The process would also specify that although the 

Requesting Country would determine the hours of work, the entitlement to payment for 

overtime would be the same as the personnel would be entitled to for overtime worked in the 

Donating Country. 

(7) A process explaining the terms for reimbursement of Donating Country by the Requesting 

Country for all travel costs (transportation, lodging, meals and living costs); overtime 

necessarily incurred in the Requesting Country; and associated costs, with appropriate 

documentation. Living costs include telephone, laundry, and incidentals and would be 

reimbursed at the rate determined by the Donating Country's travel regulations. Associated 

costs include, but are not limited to, those for arranging flights for personnel travelling to the 

Requesting Country and a r r a n g i n g for appropriate authorisation and registration of animal 

health personnel to operate in the Requesting Country. Where the Requesting Country is unable 

to pay entitlements directly to the animal health personnel , arrangements should be put in 

place to ensure that payments are made to the personnel expeditiously, if necessary by the 

Donating Country, with later reimbursement of those costs from Requesting Country to 

Donating Country. 

(8) Terms by which either: 

(a) the Requesting Country arranges for any necessary supplemental coverage for injury or loss 

incurred by the Donating Country's personnel while in transit or on assignment, including 

travel, medical, health, life, public liability, baggage loss or other insurance; or, 

(b) at the request of the Requesting Country, the Donating Country provides coverage for such injury or 

loss, and is reimbursed for the costs incurred in providing this coverage by the Requesting Country. 
 

(9) Confirmation that the Donating Country will, where feasible, arrange additional insurance to cover 

workers’ compensation in respect of any injury which may occur to Donating Country personnel during 

travel to, or duty in, the Requesting Country, and that the Requesting Country is to be responsible for the 

cost of that additional insurance, and for any other Donating Country costs incurred as a result of a claim 

being made in respect of any such injury. 

D.	 Establish minimum stand-down times for personnel who have participated in the emergency disease outbreak 

on a case-by-case basis. Stand-down time is the amount of time personnel would have to refrain from contact 

with animals after returning to Donating Country. 

E. Provide a separate listing of names, titles, and complete mailing address and telephone numbers for all key 

contact personnel for administrative and personnel liaison. 
 

 

 

 

 

 

 

ANNEX B 

ARRANGEMENTS TO BE MADE BY THE REQUESTING COUNTRY 

The Requesting Country will: 

A. Prior to the arrival of Donating Country personnel in the Requesting Country, 

(I) Assess the adequacy of its national veterinary resources available to deal with an outbreak of 

highly pathogenic avian influenza and whether to activate the CVO HPAI ARRANGEMENT. 

(2) Specify the number and selection criteria for skilled and competent animal health personnel, 

veterinarians, animal health technicians, emergency managers, laboratory staff, specialists 

(epidemiologists, pathologists, virologists) - in consultation with the Donating Country and 

negotiate a projected schedule for assistance including commencement date and estimated 

duration. 

(3) Forward the necessary material to the Donating Country for a pre-arrival briefing. This 

material would include technical information about the response (history, epidemiology, 

strategy) and administrative information (such as powers, lines of communication, cultural 

and behavioural expectations). Briefing notes and fact sheets would be prepared and provided 

to the Donating Country to provide to each individual prior to departure for their assignment. 

(4) Provide advice to the Donating Country on all work permits, visa, immigration, health 

insurance and other requirements of the Requesting Country. 

(5) Advise the Requesting Country's local immigration offices of the relationship anticipated 

under this CVO HPAI ARRANGEMENT with the Donating Country so as to ensure the 

efficient transition of personnel into the Requesting Country. 

(6) Advise the Donating Country of a preferred date for arrival of animal health personnel and 

proposed domestic itinerary for transport from the international airport to the Requesting 

Country's work site/office and lodging accommodations. 

(7) Provide for authorisation and registration of animal health personnel to operate in the 

Requesting Country, i.e. veterinary licensure, when required. 

B. After the arrival of Donating Country personnel in the Requesting Country, 

(1) Where possible, provide liaison staff to facilitate the movement of the Donating Country's 

personnel through the airport and to the operation site and/or headquarters. 

(2) Provide an entry briefing for animal health personnel to include training in the local public 

service code of conduct, regulations, proposed work program, instruments of authority, 

materials, manuals of procedure, and equipment required to carry out the work. At a 

minimum, topics covered would include orientation to the outbreak from a national 

perspective, personal disinfection,surveillance procedures, familiarisation with equipment, 

infected premises procedures including lines of authority; case reporting procedures,situation 

briefs on commencement in the local outbreak centre, and cultural and behavioural 

expectations. 

(3) Advise Donating Country and in-country personnel of any proposed cancellation, variation, or 

extension of visit. 

C. Prior to departure, conduct an exit briefing of Donating Country animal health personnel. The 

Requesting Country will consolidate responses and provide feedback to the CVO HPAI 

ARRANGEMENT Countries to improve future outbreak responses. 
 

 

 

 

 

 

ANNEX C 

ARRANGEMENTS TO BE MADE BY THE COUNTRY 

The Donating Country will: 

A. Continue to pay the salary and overtime of animal health personnel on "loan". 

B. Prior to arrival in Requesting Country, 

(1) Select animal health personnel and provide details of the animal health personnel 

competencies and professional qualifications for registration as required by the 

Requesting Country (i.e. for veterinarians). 

(2) Make the Requesting Country aware of any overtime restrictions pertaining to individuals 

on assignment. 

(3) Arrange for an official passport, international driver's license and any other 

entry documentation that may be required (e.g. work Visa).
 

(4) Provide animal health personnel with a pre-departure briefing including 

administrative details, travel claims, media restrictions, emergency contacts, and 

disease precautions (including biosecurity provisions for the return home). 

(5) Identify a team leader per contingent and communicate the team leader's name to the 

Requesting Country. The team leader could be a member of the contingent currently going 

to the Requesting Country or a separate person assigned to act as team leader for multiple 

contingents coming to the Requesting Country.