Bhutan boosts pandemic influenza readiness with Pandemic Influenza Preparedness Framework Partnership Contribution (PIP PC)-supported training and simulations

Building national influenza preparedness capacities

Originally developed in 2012, the National Influenza Pandemic Preparedness and Response Plan (NIPPRP) has long served as Bhutan's guiding framework for managing influenza threats. In 2024, it underwent a comprehensive update to incorporate evolving global and regional guidance, lessons learned from the COVID-19 pandemic, and new capacities developed under the PIP Framework. The revised plan is now more explicitly aligned with Bhutan's broader emergency and disaster risk management frameworks, ensuring a coordinated, whole-of-government approach to pandemic response.

As an effort to strengthen national pandemic preparedness, Bhutan organized three national-level training sessions followed by simulation exercises on influenza pandemic preparedness and response at five sentinel hospitals between April and May 2025, with support from the PIP PC. The training brought together more than 140 health professionals and partners from across the country, focusing on operationalizing the NIPPRP.

Over three days during each training session, participants engaged in interactive sessions on key components of pandemic response, including infection prevention and control, clinical case management, activation of rapid response teams and risk communication. The training underscored the importance of multi-level coordination, timely communication, and robust legal and policy frameworks to enable swift and effective outbreak response. A key highlight was a full-day simulation exercise, during which participants applied standard operating procedures in a mock influenza outbreak scenario. This hands-on exercise strengthened clarity of roles and enhanced coordination across agencies - critical elements for real-world emergency response.

Testing preparedness in sentinel hospitals

Following the trainings at the national level, simulation exercises were conducted in May 2025 at five sentinel hospitals in Paro, Trashigang, Punakha, Samdrup Jongkhar, and Tsirang. These exercises tested the practical application of influenza preparedness protocols and revealed operational gaps. Common challenges included insufficient clarity in staff roles and responsibilities, weak internal communication mechanisms, inadequate crowd management practices, and infrastructure limitations such as the lack of designated triage areas.

To address these gaps, hospitals were advised to develop micro-plans clearly outlining staff roles and responsibilities, strengthen internal communication channels, and invest in basic emergency infrastructure. Furthermore, regular refresher training and simulation exercises recommended annually will be critical to sustaining influenza pandemic preparedness and ensuring a coordinated and effective response during future outbreaks or epidemics.

Bhutan's efforts reflect the broader objectives of the PIP Framework to strengthen regional and global readiness for pandemic influenza. By aligning with the Global Influenza Strategy (2019-2030) and the International Health Regulations (IHR), PIP PC-supported activities continue to deliver tangible results in enhancing influenza preparedness and response capacities in the country. Importantly, Bhutan's progress also contributes to efforts in the South-East Asia region as well as globally, demonstrating how targeted investments and capacity-building can translate into stronger pandemic preparedness systems, particularly in newly designated PIP PC recipient countries.