The public health authorities of Guangdong Province and Hong Kong have agreed to strengthen four main areas of collaboration in response to the spread of avian flu around the world.

A delegation of 18 experts from Guangdong Health Department's Emergency Response Office made a two-day visit to Hong Kong to acquire a better understanding of the city's mechanism and operation of the emergency response system and its development plan in responding to public health emergencies.

They visited the Center for Health Protection (CHP), its infection control simulation ward, the Hospital Authority and Princess Margaret Hospital and met representatives of these institutions.

Dr Regina Ip, acting controller of CHP, announced that their meeting with the emergency response team has led to "four aspects of enhanced collaboration".

"First, we agree that we will heighten our surveillance, we will depend on the findings of our surveillance and share information between the two places," she said.

Based on the ongoing infectious diseases notification system, the two sides will inform each other as soon as possible and increase surveillance on diseases such as avian flu and SARS.

Surveillance has already been done on humans on the community level and on patients while more will be performed on animals.

In Guangdong, there will be more regular monitoring for "high-risk individuals" such as those involved with poultry farms, trade and transport.

If an outbreak were detected among animals, follow-up work would be done every 24 hours.

According to Ip, this would give an advantage of "knowing beforehand at an early stage" if there were any disease cases.

The second agreement was to conduct regular risk assessment of the situation. Ip explained that two departments will "invite each other to come together and conduct joint assessment" if necessary and they will sound the alert if there is a need.

In other words, an advance warning mechanism will be set up with more effort given to estimate the impact and development of public health issues.

The third aspect focuses on procedures if a health emergency occurs. The two sides agreed they would invite each other to take part in an investigation, which would include sharing experiences as well as laboratory support. Joint efforts to implement emergency response measures will be made.

Lastly, resources will be shared between the two places. This includes information together with technology and expertise. "We will also invite each other to join or observe drills and emergency response exercises," she added.

Concerning the supply of Tamiflu, an anti-flu drug, Ip reiterated that the stockpile of the government has not been affected although Roche, manufacturer of Tamiflu, has suspended provision to retailers.

"We understand there is still a certain number of Tamiflu available in the private market, but there is not a lot and availability will decrease with time," she stated.

She hoped that the medical sector could cooperate and use this "valuable medicine" under the most appropriate circumstances.

With regard to Guangdong Province, Wu Yueqi, head of the Emergency Response Office of the Guangdong Health Department, said that the province has kept stockpiles of flu medicine for a few years. "We have both Chinese medicine and Tamiflu," he said. "We have increased our stock according to our needs."

He noted that Guangdong currently has a stockpile of about 10,000 boxes of Tamiflu.

Ip warned that the problem should be viewed from "a more global perspective". Just focusing on the situation of Hong Kong is insufficient because "infectious diseases nowadays respect no borders."

She elaborated that their worry now is "people still remaining in close contact with infected birds may have a chance of being infected" and their current strategy is "to tell people how to stay healthy, and what measures they have to take to prevent getting the infection from infected birds".

Despite the fact that the government's stockpile of Tamiflu has not been affected, most retailers in Hong Kong are already out of stock.

A staff member of Fanda Pharmacy in Central stated that there has been "no supply" for two to three weeks, and they are completely out of stock right now.

A branch of Watson's pharmacy in the same district also did not have any Tamiflu. The staff there said approximately two to three people visit the store and ask for the medicine every day.

(China Daily HK Edition November 4, 2005)