In 2024, Member States in the WHO South-East Asia Region (SEAR) continued implementing influenza preparedness measures in alignment with the WHO Global Influenza Strategy (2019–2030) and the Pandemic Influenza Preparedness (PIP) framework, in accordance with the International Health Regulations (2005). WHO’s efforts focused on achieving two key outcomes: ensuring the availability of improved global tools for prevention, detection, control, and treatment of influenza, and building stronger national capacities through evidence-based influenza programs grounded in universal health coverage principles.
The WHO Health Emergencies (WHE) Programme at SEARO played a critical role in strengthening pandemic response systems under the PIP framework. The new six-year Pandemic Influenza Preparedness High-Level Implementation Plan III (HLIP-III, 2024–2030) prioritized ten countries, including India, Nepal, Bangladesh, Timor-Leste, Indonesia, Myanmar, DPR Korea, Maldives, Sri Lanka, and Bhutan, for partnership contribution funding to enhance preparedness and resilience. These efforts also aligned with advancing Sustainable Development Goals through strategic objectives outlined in the Global Influenza Strategy.
Surveillance and monitoring were strengthened through the integration of influenza and SARS-CoV-2 into Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) sentinel surveillance systems. WHO facilitated Phase III of the pilot project to integrate Respiratory Syncytial Virus (RSV) surveillance into these networks, adding Sri Lanka, Bhutan, and Bangladesh to the existing Phase II countries. This initiative aims to generate evidence for decision-making regarding RSV vaccines and monoclonal antibody use within the expanded Global Influenza Surveillance and Response System (GISRS).
To provide policy and operational guidance, SEARO collaborated with the WHO Regional Office for the Western Pacific (WPRO) to conduct the Seventeenth Bi-regional Meeting of National Influenza Centres (NICs) and Influenza Surveillance in Manila. The meeting reviewed progress and challenges in influenza and respiratory pathogen surveillance, discussed integrated laboratory-assisted approaches for early detection of influenza and other pathogens, and outlined strategies for sustainable surveillance systems. In addition, the Annual SEAR Regional Meeting focused on operational planning, strengthening sentinel surveillance, enhancing pandemic preparedness plans, and promoting genomic sequencing and coordinated activities for 2025 and beyond.
Under the Pandemic Influenza Preparedness framework, the PIP Partnership Contributions (PC) were reviewed in New Delhi, India, assessing the implementation of HLIP-III, identifying challenges, and developing recommendations to strengthen pandemic influenza core capacities across recipient countries. Strategic support included capacity-building in influenza and SARS-CoV-2 testing, with SEAR Member States processing 55,357 samples by the end of week 49 in 2024, reflecting a modest increase over 2023, although still below the optimal threshold for regional targets.
The region monitored influenza transmission patterns, observing year-round circulation with a unimodal peak in the 25th week of 2024, dominated by Influenza A, followed by Influenza B (Victoria) and un-subtyped B strains. Nine countries regularly reported SARS-CoV-2 detection through integrated ILI/SARI sentinel surveillance to WHO’s global platform, with positivity rates ranging from 0.9% to 9.7% throughout the year.
Capacity-building efforts included influenza surveillance reviews, training on data management, and the Pandemic Influenza Severity Assessment (PISA) in Indonesia, Bangladesh, and Bhutan. By 2023, all 11 SEAR Member States had established WHO-recognized NICs, supported by revised Terms of Reference and participation in the External Quality Assurance Programme (EQAP) for influenza testing, achieving full scores across seasonal and non-seasonal virus panels. PIP contributions also strengthened laboratory biosafety and RSV surveillance capacity, with technical support provided to Maldives, Nepal, Sri Lanka, Bhutan, Bangladesh, India, and Thailand.
Zoonotic influenza risk reduction was addressed through the development of the High Threat Pathogens (HTP) Distribution Assessment and Ranking System (HDARS), a geospatial tool applied in Nepal to guide cross-sectoral, risk-based surveillance and inform targeted interventions. Research and innovation efforts examined barriers and enablers to seasonal influenza vaccine introduction across SEAR Member States, supporting evidence-based policymaking and vaccination strategies.
Preparedness for respiratory pathogen pandemics was further enhanced through strengthening medical oxygen systems and respiratory care infrastructure, alongside the operational implementation of the PIP framework and lessons learned from COVID-19. The Preparedness and Resilience for Emerging Threats (PRET) initiative, launched in 2023, facilitated a multi-country simulation exercise in New Delhi in October 2024, testing regional coordination, communication, and pandemic response plans. This exercise helped countries identify gaps in their national influenza pandemic preparedness plans and adapt them into comprehensive respiratory pathogen pandemic strategies, with ongoing plans to conduct similar exercises at the national level.
Overall, WHO SEARO’s 2024 activities significantly advanced influenza and respiratory pathogen preparedness across South-East Asia, strengthening surveillance systems, laboratory capacities, policy guidance, and regional coordination, while integrating emerging threats such as RSV and zoonotic influenza into the broader Global Influenza Strategy framework.
