Pandemic preparedness: analyzing national plans for respiratory pathogen pandemics in the Americas region
Authors: Villalobos Andrea Patricia , Wellington Iyanna , Moosavi Shoa , de la Garza Ana , Rodríguez Ángel , McMurren Britney , Almeida Leite Juliana , Méndez-Rico Jairo Andrés , Redondo Lidia , Blanco Miriam Esther , Astudillo Olaya , Couto Paula , Born Priscila , Hess Sara , Goldin Shoshanna , Lewis Hannah , Mancero Tamara ,   SARInet plus members, Jara Jorge , Balsells Evelyn , Quesada Luis Fernando , Vicari Andrea , Rondy Marc 
Published: February 2025

Abstract

Background
The International Health Regulations (2005) (IHR), requires that States Parties develop their capacities to detect, assess, and respond to public health threats and report to the World Health Assembly through the States Parties Annual Report (SPAR). The National Pandemic Preparedness and Response Plans (PPRP) contribute to countries capacities however there are some discrepancies between both tools. To identify gaps and define priority actions to strengthen pandemic plans, we assessed the concordance between national pandemic preparedness and response plans for respiratory pathogens against the pandemic checklist published in 2023 and the SPAR.

Methods
In this retrospective, semi-quantitative study, conducted in August 2024, we reviewed the most recent respiratory pandemic plans for 35 PAHO member states and assessed their concordance with (1) actionable guidelines in the World Health Organization pandemic checklist and (2) IHR (2005) core capacities using the latest SPAR tool. We developed 25 tracking questions to identify gaps, strengths, and opportunities for improvement in the pandemic plans, using the pandemic checklist built on the capacities and capabilities described in the WHO’s Preparedness and Resilience for Emerging Threats (PRET) Module 1. We used a five-point scale (from 1, when the subcomponent was not mentioned, to 5, when the subcomponent was described at all levels), and we calculated the average pandemic plans score (PP score) for each component. Data from pandemic plans (2005–2024) were compiled, selected, analyzed, and scored. We compared the average SPAR score and the PP score to assess areas of convergence and variance between preparedness and capacities. The analysis was carried out using R and Excel.

Results
We analyzed 35 respiratory pandemic plans: 29 were influenza-specific, five were COVID-19-specific, and one was not pathogen-specific. Most current national plans showed limited alignment with the content recommended in the PRET pandemic checklist. At regional level, the lowest concordance between plans and pandemic checklist was in the following subcomponents Public Health and Social Measures (80% of the plans had a score of 1); Emergency, Logistics and Supply Chain Management (74%); and Research and Development (71%). Conversely, the strongest subcomponents (≥40% of plans with a score of 4 or 5) were: Policy, Legal, and Normative Instruments (45%); Coordination (46%); and Surveillance: early detection and assessment (43%). In most countries, the SPAR scores tended to be higher than PP scores, except for Argentina (the newest plan reviewed) for which the pattern was reversed, and the PP scores exceeded the SPAR scores.

Conclusion
Given the gaps identified between current plans and the global standards espoused by the PRET Module 1 initiative, it is recommended that countries build on the strengths of their national pandemic preparedness and response plans and update them using PRET module 1. This will support countries advance the capacities required by the IHR.