Pandemic Preparedness: Analyzing National Plans for Respiratory Pathogen Pandemics in the Americas Region

Background: To identify gaps and define priority actions to strengthen national pandemic preparedness and response plans, we assessed the concordance between national plans for respiratory pathogens against the World Health Organization (WHO) pandemic checklist and the States Parties Annual Report (SPAR) in the Americas.

Methods: In this retrospective, semiquantitative study, we reviewed the most recent respiratory pandemic plans for 35 Pan American Health Organization (PAHO) member states and assessed their concordance with (1) actionable guidelines in WHO pandemic checklist and (2) International Health Regulations (IHR) (2005) core capacities using the latest SPAR tool. We developed 25 tracking questions to identify gaps, strengths, and opportunities for improvement using a 5-point scale. We compared the average SPAR score and the Pandemic Plans score to assess areas of convergence and variance between preparedness and capacities.

Results: We analyzed 35 respiratory pandemic plans (2005-2024): 29 were influenza specific, 5 were COVID-19 specific, and 1 was not pathogen specific. Most national plans showed limited alignment with the content recommended in the pandemic checklist. The lowest concordance between plans and checklist was in public health and social measures (80% of plans with score of 1); emergency, logistics and supply chain management (74%); and research and development (71%). Conversely, the strongest subcomponents were policy, legal, and normative instruments (45% of plans with score 4 or 5); coordination (46%); and surveillance: early detection and assessment (43%).

Conclusions: 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.