Influenza experts in WHO’s South-East Asia and Western Pacific regions participate in the 16th bi-regional meeting of the National Influenza Centres (NIC) and Influenza surveillance in Dhaka, Bangladesh

COVID-19 pandemic negatively affected influenza related (a) sentinel surveillance, (b) laboratory diagnosis, (c) evidence-based interventions, (d) data reporting for national, regional, and global decision making and (e) virus sharing.

This situation presents a threat to the regional and global health security due to the possibility of missing detection and reporting of influenza viruses of pandemic potential (IVPP) through the international health Regulation (IHR) mechanism and inability to identify and respond to seasonal influenza surges promptly.

Despite WHO’s guidance on maintaining influenza surveillance and monitoring of SARS-CoV-2 through national “Influenza Like Illness (ILI)” and “Severe Acute Respiratory Infection (SARI)” sentinel surveillance systems, joint national and international surveillance reviews have demonstrated the low uptake of this guidance in the region.

Various reviews have also indicated multi-faceted challenges to laboratory diagnosis of both influenza and SARS-CoV for surveillance at the country level. These challenges have affected virus sharing with the Global Influenza Surveillance and Response System (GISRS) and molecular characterization of circulating influenza and SARS-CoV 2 viruses.

Based on the lessons learned in the Covid-19 pandemic, globally attempts are underway to expand the GISRS to expanded GISRS (eGISRS) with a view to addressing detection of preparedness for and response to multiple respiratory pathogens of epidemic and pandemic potential. However, countries in Asia-Pacific have their own challenges with Influenza surveillance that will be further multiplied with addition of more respiratory pathogens for surveillance.

In this context, to understand and find collective solutions to key issues related to strengthening influenza preparedness with specific focus on integrated surveillance (of influenza, SARS CoV-2 and other respiratory viruses of pandemic potential), laboratory diagnosis for public health surveillance and expansion of GISRS , WHO’s regional offices for South-East Asia (SEARO) and Western Pacific(WPRO ) conducted the 16^th Bi-Regional meeting of Influenza surveillance and national influenza Centres (NICs) in Bangladesh from 1^st to 3^rd August. The meeting was inaugurated by Prof. Dr. Abul Bashar Mohammad Khurshid Alam, Director General of Health services of the government of Bangladesh, Dr Bardan Rana, the WHO representative for Bangladesh and Dr Babatunde Olowokure, the Regional Emergency Director of the WHO’s Western Pacific Regional Office. Dr Bardan Rana represented the Regional Director for WHO’s Southeast Asia Region and delivered the opening remarks on behalf of her.

The hybrid meeting was attended by 126 participants (55 face to face and 71 online). These included participants from (1) Member States in South-East Asia and Western Pacific Regions (2) WHO Collaborating centres ( United States Centres for Disease Control and Prevention (US CDC), Victorian Infectious Diseases Reference Laboratory -Australia, The National Institute of Infectious Diseases (NIID)-Japan, Chinese Centre for Disease Control and Prevention, St Jude Children's Research Hospital, Memphis, Tennessee, USA), ( 3)”One health” partners from The World Organization of Animal Health (WOAH) and Food and Agricultural Organization (FAO ) (4) partners such as US CDC, AFRIMS, Hong Kong university, Pasteur institute -Cambodia among other multiple stakeholders

The meeting consisted of 7 technical sessions. The technical sessions were as follows

1. Influenza surveillance: situation, progress, gaps, and challenges
2. Role of public health laboratories in Surveillance:
3. Expansion of GISRS (GISRS to eGISRS)
4. End to end integrated surveillance of influenza and SARS-CoV-2 by leveraging national ILI/SARI sentinel surveillance systems.
5. Group work on Country challenges in integrated surveillance and specific challenges and identifying appropriate strategies for operationalizing the GISRS to eGISRS
6. New global developments and new initiatives pertaining to Influenza preparedness
7. Feedback from group work: integrated surveillance and eGISRS

In addition to technical sessions, laboratory experts visited the NIC at Institute of Epidemiology, Disease Control and Research (IEDCR) at Dhaka, Bangladesh for a site visit and a laboratory session. Meeting was also utilized by the Preparedness and Resilience for Emerging Threats (PRET) secretariat to introduce the PRET framework to participants.

The meeting concluded with drafting of conclusions and recommendations to strengthen influenza preparedness, better implement WHO recommended standards for laboratory diagnosis in public health surveillance, integrate sentinel surveillance of influenza and SARS-CoV-2 using end-to-end approach and effectively roll out of eGISRS taking into account the ground realities in both WHO regions.

Sixteenth Biregional Meeting of National Influenza Centres and Influenza Surveillance in the WHO South-East Asia and Western Pacific Regions, 1–3 August 2023, Dhaka, Bangladesh