VIRGo helps Mongolia plan for pandemic
Mongolia’s remoteness and sparse population are no barriers to an influenza pandemic, as VIRGo (Vaccine and Immunisation Research Group) researchers discovered in 2010.
Associate Professor Jodie McVernon and research fellow Dr James McCaw visited Mongolia when the Melbourne School of Population and Global Health’s VIRGo was commissioned by the World Bank to take part in an avian and human influenza pandemic preparedness project.
Ulaanbaatar, one the world’s coldest capitals with winter lows of -16 degrees Celsius, was swathed in a 37 degree summer heat wave when the pair arrived in July 2010 for an intensely busy two weeks. Health authorities were still regrouping from the impact of a H1N1 pandemic and a severe outbreak of Influenza B, which were both over by the time the VIRGo team visited.
Mongolia’s health authorities already had an excellent epidemiological surveillance system that revealed a surprising story, says Associate Professor McVernon. “Among the challenges unique to Mongolia, the big thing is space. Australia has two people per square kilometre, Mongolia has one,” she says. “In this enormous country, most of the population live in three cities.
“Before we went we thought it would take ages for flu to spread but what we found from the surveillance data was that yes, it was a bit slower in the provinces but once there was a flu outbreak in Ulaanbaatar, the flu was all over the country in a couple of weeks.
“This is because there is huge mobility of people and Ulaanbaatar is a really important hub, with a major east-west road, and another north-south road going down to China and that is how the flu mostly got in.
“You could see quite clearly how important geography was to the flu’s spread.”
The project’s emphasis on bird flu was due to the large migratory bird populations that pass through the country’s north en route to Lake Baikal in Siberia. Avian flu-infected birds had been detected in Mongolia. “Our part of the project was to help plan what to do if the avian flu got into the human population,” Associate Professor McVernon says. “How could we reduce the impact? And what interventions were needed to reduce its spread.
“We visited hospitals, family medicine clinics, and spoke to people in the health department and in flu surveillance, and we were based in the National Emergency Management Agency which coordinates a whole of society response.”
VIRGo’s track record in helping Australian governments to deal with pandemic preparedness had prompted the World Bank to enlist VIRGo’s expertise. “This project fit our own emphasis on developing pragmatic and feasible strategies that suit the limited resources available and the setting,” she says. “The World Bank was very pleased with the detail and the quality of our work and they felt that it set an important precedent because the WHO (World Health Organisation) tends to apply a ‘one size fits all’ approach to pandemics in developing countries. But this was something where we worked with the people on the ground to identify their specific strengths and capabilities and built on that.”
Caption: Associate Professor Jodie McVernon and research fellow Dr James McCaw in national dress.