Global Foodborne Infections Network (GFN)

Strategic Plan 2011-2015

Contents
1. 2. 3. 4. 5. 6. 7. 8. 9. Introduction ................................................................................................................... 3 The Global Foodborne Infections Network .................................................................... 3 2010 GFN Situational Assessment ................................................................................. 5 Vision and Mission ......................................................................................................... 6 Goals and Strategies ...................................................................................................... 6 Monitoring and review................................................................................................... 8 Annual workplans .......................................................................................................... 8 Annex: Working activity plan for 2010-2015 ................................................................ 10 Annex: SWOT Analysis ................................................................................................ 14

1.

Introduction

The Global Foodborne Infections network (GFN) is a capacity-building program that promotes integrated, laboratory based surveillance and intersectoral collaboration among human health, veterinary and food-related disciplines. Since its inception in 2001, GFN operations were guided by five-year strategic plans (20012005, 2005-2010). The third five-year strategic plan was discussed and developed during the Strategic Planning Meeting in Lyngby, Denmark, from 27-28 August 2010. The focus of the discussions around the new strategic plan was on ensuring that the future needs for capacity building in this field will be addressed, forming strategic partnerships and avoiding duplication of efforts. To gain insight in the needs and current training offers available, GFN organized its first stakeholder meeting one day prior to the strategic planning meeting. The outcome of the stakeholder meeting provided valuable input for the discussions during the strategic planning meeting.

2.

The Global Foodborne Infections Network

Laboratory-based surveillance of animals, food and humans is important, both to detect and prevent foodborne pathogens from entering or spreading through the food chain, as well as to identify foodborne disease outbreaks so that appropriate control measures can be taken. Many countries still lack the necessary surveillance capacity for foodborne disease outbreak detection and response. In addition, many foodborne disease outbreaks go undetected, in part due to lack of communication between the human, veterinary, and food sectors. Due to the globalization of animal and food trade, national food safety issues can have global implications. It is imperative that countries are able to detect and deal with clusters of foodborne pathogens and disease for the benefit of their own population as well as the global community. The World Health Organization (WHO) estimates that each year over two million people die from diarrheal diseases, many of which are acquired from eating contaminated food. In response to the impact of foodborne and other infectious enteric diseases, WHO, in collaboration with other partners created The Global Foodborne Infections Network (GFN), formerly known as WHO Global Salm-Surv (GSS). GFN is part of WHO's endeavors to strengthen the capacities of its Member States in the surveillance and control of major foodborne diseases and to contribute to the global effort of containment of antimicrobial resistance in foodborne pathogens. GFN has six main programme components: 1) international training courses, 2) a passive Salmonella surveillance system, 3) an annual External Quality Assurance System (EQAS), 4) focused regional and national projects, 5) reference testing services and 6) communications. 3

GFN is truly a collaborative network bringing national centres of excellence from WHO Member States (laboratory and epidemiology). Coordinated by WHO, the current WHO GFN Steering Committee Members are as follows: Danish National Food Institute (DTU Food) United States Centers for Disease Control and Prevention (CDC) International Network Institut Pasteur (IP) United States Food and Drug Administration (FDA) Public Health Agency of Canada (PHAC) Utrecht University (UU) European Centre for Disease Prevention and Control (ECDC) OzFoodNet PulseNet International (PNI) National Institute of Public Health, Japan

Institutions with demonstrated technical competency and leadership in foodborne disease surveillance and outbreak detection and response may serve on the WHO GFN Steering Committee. The WHO GFN Steering Committee Membership is designated by WHO in consultation with existing members of the Steering Committee. The Steering Committee provides to GFN strategic direction, technical assistance, coordination of training as well as contributing resources, both human and financial. Steering Committee meetings are held annually, hosted by one of the partners. The purpose of these meetings is to review GFN accomplishments and to discuss the strategic plan for the future. Dedicated GFN subcommittees work on specific areas such as curriculum development for epidemiology and laboratory exercises, funding, web development, marketing and strategic partnering. These subcommittees conduct regular telephone conferences and have face-to-face meetings during the annual Steering Committee meetings. In addition to the Steering Committee, GFN relies on a network of GFN regional centres and training sites around the world. These are located in Argentina, Brazil, Cameroon, China, Costa Rica, Egypt, Fiji, Guam, Guatemala, India, Kenya, Madagascar, Mozambique, Papua New Guinea, Poland, Russian Federation, South Africa, Thailand, Trinidad & Tobago, Tunisia.

3.

2010 GFN Situational Assessment

Participants at the stakeholder and strategic planning meetings discussed GFNs strengths, weaknesses, opportunities and threats (SWOT analysis) impacting GFNs ability to fulfill its mission. The outcomes of the SWOT analysis were used to formulate new strategic direction and goals for 2011-2015. Strengths of GFN: The fact that GFN is a large network, led by an informal and familiar group with a great deal of expertise, was identified as a strength. GFNs dedication, focus and resourcefulness were also regarded in the same manner. Additional strengths included GFNs global mandate from WHO to build capacity and GFNs focus on integrating public health, animal agriculture and food sectors. Weaknesses of GFN: Weaknesses of GFN included a lack of stable funding sources, incomplete follow-up after training, a lack of continuity of trainers, and a lack of local champions in some regions. Other identified weaknesses included imperfect metrics to better measure the impact of training and the need for increased integration of the network and its activities into WHO Regional Office Plans. Opportunities for GFN: Opportunities included renewed global attention on zoonoses through One Health approaches to public health (promoting potential new partnerships for GFN); recognition of globalization, the importance of food safety, the possibility for private-public sector collaborations, and the need for surveillance to detect foodborne outbreaks; and increased emphasis on global health by specific Steering Committee Partners (i.e, CDC). The occurrence of foodborne disease outbreaks was also viewed as an opportunity to draw attention to the need for increased capacity for laboratory based surveillance. Threats to GFN: Threats identified for the network included having few financial resources, the global economic downturn, other competing projects/health issues/priorities (e.g., H1N1), and the dependence of the network on a volunteer workforce. Also noted was the potential loss of political support in partner institutions. The increasing number of partnerships would subsequently require more management and coordination. Therefore consideration of formally engaging more partners would need to be assessed with due attention.

4.

Vision and Mission

Vision A world where all countries have more capacity to prevent and control foodborne and other enteric infections. Mission To enable countries to detect, control, and prevent foodborne and other enteric infections by: Building capacity for integrated surveillance; and Fostering collaboration among human health, veterinary, food and other relevant sectors.

5.
Goal 1:

Goals and Strategies1

Strengthen national and regional capacities for surveillance, investigation, prevention and control of foodborne and other enteric infections

Rationale This is considered a continuation of the core business of GFN since its inception. It aims to build laboratory capacity to strengthen the network of institutions and Regional Centres of Excellence that form the backbone of integrated laboratory surveillance of foodborne pathogens and disease. Needs assessments are conducted to determine region-specific priorities for enteric diseases so that the training curriculum is relevant to the priority public health challenges. One major addition to this goal is an increased focus on initiating country projects to understand the epidemiology of high priority enteric diseases. These projects must be feasible to complete at reasonable expense, and be able to help understand the burden of a specific illness in a region. These studies can also raise awareness around the importance of foodborne infections and advocate for sustainable integrated surveillance. Training should include train-the-trainer and adult learning aspects and explore other teaching methods such as e-Learning. Evaluation and impact assessment of training and projects are essential elements of the activities under this goal. Strategic actions: Conduct a high-quality and effective GFN training program suited to the needs and resources specific institutions, with an emphasis on building sustainable capacity. Support GFN regional centres and training sites through provision of technical expertise, financial and human resources. Promote systematic follow-up on GFN activities and build on already-established program successes. Promote connection with other foodborne disease networks to fill identified technical gaps, maximize impact and reduce duplication of efforts.
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See Annex 1 for a more detailed working activity plan for 2010-2015

Goal 2:

Foster partnerships relevant to regional and country goals

Rationale Goal Two is a direct response to the positive and valuable input from the stakeholders that attended the stakeholder meeting prior to the strategic planning meeting. It is dedicated to identifying strategic partners that can support or supplement the mission of GFN. GFN will map potential partnerships (e.g. financial, technical), determine gaps in GFN capacity that can be complemented through collaboration, and develop a strategy to engage partners. The establishment of a stakeholder group will ensure regular and transparent communication with stakeholders of GFN and other initiatives and networks with a similar vision. Strategic actions: Explore the establishment of a stakeholder group to strengthen external stakeholder engagement within GFN activities. Goal 3: Raise awareness of GFN outputs and activities and the benefits of integrated surveillance

Rationale Goal Three puts focus on highlighting the accomplishments of GFN and its members to 1) raise awareness of GFNs efforts among decision makers, potential partners and stakeholders, 2) showcase successes of GFN and the means for overcoming barriers to establishing integrated laboratory based surveillance GFN steering committee members and collaborators will seek out opportunities to present the network to various audiences that may benefit from this information. An advocacy package will be developed that will provide an overview of the scope of the network. The GFN website will provide key information in the six official languages of the UN. Strategic actions: Actively and strategically utilize the successes of GFN to promote the network and solicit further support. Promote the over-all public health benefits of integrated surveillance and how GFN contributes to this. Assist with the execution of focused projects and encourage publications of their outcome.

Goal 4:

Generate country and regional data that contributes to a global understanding of foodborne and other enteric infections

Rationale Goal Four focuses on the availability of high quality data for national, regional and global action. Through the EQAS, GFN will strive to continue to increase the quality of the laboratory output produced by its member laboratories. The existing structure for data capture within GFN, the GFN Country Databank (CDB), will be expanded to include more representative data from veterinary, food and public health sectors in more countries. GFN has been promoting the sharing of data with national counterparts that need to act upon it. In an interconnected world, sharing of reliable data and information is vital to address international food safety events and supporting Member States within the framework of the International Health Regulations (2005). A renewed effort to populate the CDB will also include the expansion to add other pathogens and data fields. In addition to the development of a user-friendly interface that will allow interested parties to generate comprehensive summary reports, the main trends of the data in the databank will be communicated via reports, publications and at scientific conferences. The outcome of these data should contribute to the improved knowledge of the burden of foodborne disease in countries. Strategic actions: Strengthen the CDB as a robust and a key tool for GFN members, participants and other stakeholders for data collection, management and assessment. Disseminate the information from the Food Safety Portal. Improve the quality of serotyping and AMR testing globally through EQAS. Publish information from GFN-supported projects (microbiological, enhanced surveillance, BOI, etc.).

6.

Monitoring and review

GFN will be undergoing a formal evaluation. The results of the evaluation will feed into refining this document and subsequent workplans. Evaluations of specific activities will be conducted on: training sites and regional centres; training courses; and membership EQAS can be considered as an indicator of successful implementation as participation in this system shows implementation of acquired knowledge and provides indicators of success through the EQAS results.

7.

Annual workplans

Annual workplans will be developed at steering committee meetings. They will be based on this strategic document as well as the experiences and lessons learnt of the past year.

8.

Annex: Working activity plan for 2010-2015

Goal 1: Strengthen national and regional capacities for surveillance, investigation, prevention and control of foodborne and other enteric infections Strategic action Activities Conduct training needs assessments Indicators Conduct a training needs assessment for each Region (or nation, as determined) through WHO Regional Offices and GFN Regional Centers and Training Sites every two years (beginning 2011) Complete seven national or regional training courses annually For each training course, curriculum assessment completed

Conduct training courses Broaden scope of training (technique, pathogens, etc) in accordance with regional needs assessments

Conduct a high-quality and effective GFN training program suited to the needs and skills of specific audiences, with an emphasis on building institutional capacity

Create modules for training curricula

Materials as of 2010 in module format, developed and reviewed by December 2011; validated by June 2012 Develop and validate the train the trainer plan and curricula by May 2011 Conduct at least one train the trainer activity every two years, beginning by November 2011 Identify three Training Sites with near capacity to meet the "2005 Regional Center Terms of Reference" (including creation of a regional strategy for technical and financial support)by December 2011 Confirm status of WHO GFN Regional Centers or Training Sites by June 2011

Develop a train the trainer plan (including lab and epi) Develop a train the trainer plan (including lab and epi) Transition Training Sites to Regional Centers

Acknowledgement of WHO GFN Regional Centers and Training Sites Status Evaluation of Regional Centers and Training Sites

Develop the instrument for a biannual evaluation of Regional Centers and Training Sites by May 2011

Evaluation of Regional Centers and Training Sites Support GFN Regional centres and Training sites through provision of technical expertise, financial and human resources Regular meeting of the Regional Center and Training Site Coordinators

All Regional Center and Training Site Evaluations submitted by December 2012 and subsequently, every two years Biannual Meeting of all Regional Centers and Training Sites to be conducted

Regular communication of the Regional Center Coordinators

Representation of Regional Centers in the Steering Committee Assessment of Regional Center Needs

All Regional Centers conduct routine communication (e.g. teleconferences, listserv, online discussion group) with each other every three months annually, beginning by January 2011 To have Regional Center Representation in the Steering Committee All Regional Centers report needs, including financial, staff, and status biannually, beginning in 2011

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Develop a regional strategy in collaboration with WHO Regional Offices

100 % of Regional Centers with a Regional Strategy by December 2011

Advocacy at national and regional levels on foodborne disease prevention and control

For every training course, assess the possibility of including decision makers and stakeholders at the course

Plan for follow-up and evaluation post training Promote systematic follow-up on GFN activities and build on already-established program successes Promote integrated, national laboratory networks (food, vet and human) and epi-lab collaboration

By March 2011, develop a follow-up and evaluation plan to be implemented after each training course National plans for integrated, laboratory networks developed

Regional and National Projects

At least one Regional and/or National Project (originating from GFN Training) conducted per WHO Region between 2011-2015 Each national reference laboratory participating in EQAS and entering data in the CDB annually 100% of Regional Centers send updated information to the GFN Steering Committee for the GFN Annual Report, website, newsletters, and publications, as requested All Regional Centers contact the points of contact for the other related foodborne disease networks and share GFN information by December 2011

EQAS and CDB

Document Regional Accomplishments

Promote connection with other foodborne disease networks to fill identified technical gaps, maximize impact and reduce duplication of efforts

Collaboration and communication between GFN and other international networks

Goal 2: Foster partnerships relevant to regional and country goals, including veterinary public health, food industry, and other microbiology and epidemiology training programs
Strategic action Activities Map potential partnerships (banks, industry, national institutions, related international groups) Indicators Map created by June 2011

Determine gaps in partnerships Explore the establishment of a stakeholder group to strengthen external stakeholder engagement within GFN activities Prioritize and pursue partnerships Establish stakeholder group Hold first stakeholder council meeting

Gaps assessed by October 2011 Prioritize partnerships by December 2011 Establish stakeholder group by February 2012 First meeting of council to be held by June 2012

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Goal 3: To raise awareness of GFN outputs and activities and the benefits of integrated surveillance Strategic action Activities
Publish journal supplement on GFN

Indicators
Published supplement by 2015

Publish peer reviewed articles from 9 or more training sites GFN Presentations to private sector

9 peer reviewed articles from training sites by 2015 5 or more GFN presentations to private sector per year reported to Steering Committee Complete package by August 2011; in multiple WHO languages by August 2012 Distribute Annual Report by May 1 annually Review and update GFN Website by August annually Translate GFN website in all WHO official languages by December 2011 3 or more GFN presentations to decision makers (MOH/MOA) per year

Actively and strategically utilize the successes of GFN to promote the network and solicit further support.

GFN Advocacy Package -slides, handouts, 1 pagers, video Publish GFN Annual Report Maintain and update GFN Website

Maintain and update GFN Website GFN Presentations to high-level decision makers at MOH or MOA

Promote the over-all public health benefits of integrated surveillance and how GFN contributes to this

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Goal 4: Generate country and regional data that contributes to a global understanding of foodborne and other enteric infections

Strategic action

Activities Countries contribute top 15 Salmonella serotype and other pathogen data into CDB annually

Indicators A total of 75% of all member countries submit data annually into the CDB by December 2015

All labs participating in EQAS contribute to CDB

Ensure member list updated annually and reconciled with EDG

A total of 75% of labs participating in EQAS enter top 15 Salmonella serotypes or other specified pathogen data into CDB annually by December 2013 100% of member contact information verified by regional centers annually; EDG and CDB reconciled yearly Antimicrobial susceptibility testing data to be included in the CDB or other database by December 2012 and Shigella by December 2014; transition to top 50 serovars by December 2015

Strengthen the robustness of the CBD and demonstrate it as a key tool for GFN members, participants and other stakeholders.

Expand CDB to include other pathogens, other types of data (e.g., antimicrobial susceptibility testing), and expand Salmonella data from top 15 serovars to 50 serovars

Expand source categories in CDB Rename portal to promote better understanding of what the portal contains

New source categories to be implemented in the CDB by September 2012 Changed name by June 2011

Annually analyze Food Safety Portal data and disseminate data via reports and publications Disseminate the information from the Food Safety Portal

Summary of Food Safety Portal data in GFN Annual Report and cited / acknowledged annually in publications; a new Food Safety Portal data peer-reviewed publication by 2014

Ensure Regional Centers follow up on EQAS results in their regions Improve serotyping and AMR testing globally through EQAS

Increase the number of participating labs meeting the serotyping quality control threshold in EQAS to 80%

Assist laboratories which do not pass EQAS

Corrective action implemented in 50% of laboratories which do not pass EQAS annually

Publish information from GFNsupported projects (microbiological, enhanced surveillance, BOI, etc)

Analyze data and write a manuscript and/or section for a report

At least one publication annually; project description and results to be included in GFN Annual Report

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9.

Annex: SWOT Analysis

Strengths People involved are very informal and there is a familiarity in the group People are focused We have resources to make an impact Huge network Global mandate through WHO Local interest in GFN Experience (10 years) Diversity, multi-sectorial Expertise and dedication from the people working in the GFN Resources fullness of the GFN group Integration of food, vet and public health parts Opportunities Recognition of the need for food surveillance Re-organization of the CDC with more emphasis on global health Focus on new partners (e.g. FAO and OIE due to the one health momentum) GFN to get prepared for future events (like predict possible outbreaks) Globalization Expand the hazard list (e.g. contaminants) Current political momentum there is an increased awareness for food safety and surveillance Food outbreaks More partnerships between private and public sector One-health momentum Weaknesses Lack of follow up No metrics to measure achievements Lack of customization of our work Instable funding Visibility (e.g. the changing the name) Lack of regional champs Limited follow-up of the trainings Lack of continuity of the trainers Limited scope of the CDB Better integration of GFN and regional offices

Threats Low resources Outbreaks non-food related (e.g. flu) By increasing the partnerships, we also lose our informality and start to have more bureaucracy Economic crisis Loss of political will Competitive health issues Loss of focus on too many projects (internal threat) Competing priorities The high level of voluntarism which is a strength is also a threat Competing or confusing other initiatives

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