Exercise Global Mercury was an international exercise designed to test communications between national health agencies in the event of a possible smallpox incident. It was run under the auspices of the Global Health Security Initiative (GHSI), a collaboration between Canada, the USA, Mexico, France, Italy, Germany, Japan, the UK, the European Community and the World Health Organisation.
The exercise took place from 9-10 September and the attached evaluation report was agreed by the GHSI ministers in Berlin on 7 November. The report concluded that many aspects of the participating agencies' preparations worked well but also indicated areas where there is room for improvement.
Exercise Global Mercury was a command-post exercise involving the GHSAG nations plus the World Health Organization and the European Commission. Conducted over a 56-hour period between 8 and 10 September 2003, the exercise aimed to evaluate the communications protocols between and among GHSAG members in the face of an outbreak of an infectious disease.
The scenario for Exercise Global Mercury (which was designed to be biologically-plausible) depicted an attack using fictitious self-inoculated terrorists to spread smallpox internationally to target countries. The exercise was designed to elicit public health interventions rather than a full counter-terrorism response. The scenario was designed to introduce "live" cases of smallpox into some countries and contacts into others to develop the whole range of possible national responses. A comprehensive "script" supported by exercise injects generated player responses to exercise events.
Planning for the exercise began in October 2002, with the establishment of an exercise planning group chaired by Canada and comprising "trusted agents" from all player nations/organizations. The exercise was developed, delivered and evaluated by a contractor selected and paid by Canada - other players were responsible for contracting local support for exercise play and evaluation.
Some player countries capitalized on the exercise scenario to conduct parallel national exercises to practice and evaluate national smallpox contingency plans.
Communications were effected using email, telephone, facsimile and video-conferencing. Some significant issues were identified both in technological and process senses.
As a result of the evaluations conducted during the exercise, the following outcomes were noted:
The resulting recommendations from Exercise Global Mercury are:
Recommendation 1 - Members of the GHSI recognized the mandate of WHO places the Organization in a strong position to undertake information collection, dissemination and effective coordination of action in the event of a public health emergency of international concern and urges the Director General to keep under review the priority and resourcing of this activity.
Recommendation 2 - The GHSAG should establish a mechanism for rapid international communications between the exercise participants. Future tests should be scheduled (on an ongoing basis) to assure that technical challenges do not hinder communications between the countries/organizations likely to be involved in an international public health emergency.
Recommendation 3 - National smallpox plans should be reviewed and the critical international aspects enhanced.
Recommendation 4 - GHSAG members are encouraged to share emergency response guidelines, functions and structures to facilitate international communication.
Recommendation 5 - The GHSAG should refer discussions on common terminology to the Field Epidemiology Working Group.
Recommendation 6 - The Exercise Planning Group recommends that member countries / organizations periodically evaluate their infrastructure and systems for international information exchange during public health emergencies.
Exercise Global Mercury was described by all participants as being well coordinated, realistic and valuable as a test of international communications. Particpants believe that similar exercises should be scheduled regularly, possibly annually.