The Islamic Republic of Iran’s new national influenza pandemic preparedness plan (IPPP) is comprehensive, multisectoral and multidisciplinary. It reflects lessons learnt from the COVID-19 pandemic, which were integrated in real-time, and includes other respiratory viruses with pandemic potential for a holistic approach.
In early 2019, the Iranian Ministry of Health and Medical Education (MOH&ME) began drafting its national IPPP, using the three-phased approach defined by WHO’s essential steps in developing or updating a national pandemic influenza preparedness plan. When the COVID-19 pandemic struck, the MOH&ME team continued developing the IPPP and expanded the planning process by analysing the gaps and challenges faced during the response and developing a real-time roadmap and implementation plan. Ultimately, this will help secure the plan’s endorsement by stakeholders and policy-makers.
Phase 1. Preparation and situation analysis
The team reviewed national guidelines and emergency preparedness plans for a landscape analysis. It also did a thorough review of national capacities related to the pandemic response, including through face-to-face interviews with 39 stakeholders and provincial counterparts of 15 ministries. International guidelines and COVID-19 pandemic response experiences of other countries were also reviewed, and lessons learnt were continuously documented.
The team then established the following ten pillars, or building blocks, for the plan: 1) national laws and regulations; 2) planning, coordination, budget, and support; 3) surveillance, rapid response and risk assessment; 4) clinical management system; 5) health system response; 6) points of entry; 7) risk communications and community engagement; 8) maintenance of essential services; 9) supply of medical countermeasures; and 10) monitoring and evaluation of the control measures. By the end of phase 1, the first draft of the plan was created.
Phase 2. Developing the plan
The first step in Phase 2 was to hold three consultative workshops between 25 and 30 June 2022 for identified stakeholders and key organizations under each pillar. These workshops were supported through WHO’s Pandemic Influenza Preparedness (PIP) Framework Partnership Contribution. During these two-day workshops, participants – who held both executive and technical positions in their organizations – discussed strategic actions for each pandemic phase (interpandemic, alert, pandemic, and recovery). They also planned tangible activities with timelines, responsible agency and budget.
The MOH&ME team is now starting the second step of Phase 2, which involves consolidating the outputs of the June workshops through a series of consultative meetings with strategic ministries and agencies, including the Ministry of Interior. The team then intends to share the consolidated plan with the national steering committee for COVID-19 and influential policy-makers to get their support for implementation.
Phase 3. Evaluating, finalizing, and disseminating the plan
During Phase 3, the plan will be tested through a national tabletop simulation exercise, during which participants will propose tangible recommendations to revise and edit the plan. Finally, the plan will be endorsed by high-level policy-makers, then disseminated to all stakeholders and sectors that contributed to the process.
Overall, this multi-sectoral and multidisciplinary approach towards drafting and updating the Islamic Republic of Iran’s IPPP is an example of how a national plan can be devised through a well coordinated and structured mechanism focusing on multi-level capacity strengthening.