This report was drafted by a multi-institutional and interdisciplinary Task-Force involving staff from the Inter-African Bureau of Animal Resources of the Africa Union (AU-IBAR), the Food and Agriculture Organization (FAO), the World Organisation for Animal Health (OIE), the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO).
Objective of the Paper
African countries have shown a high degree of commitment and put in place policy instruments to facilitate the prevention and control of avian and human influenza since avian influenza first hit the continent in February 2006. Some countries have invested a substantial amount of funds to deal with this animal and public health threat and the potentially disastrous effect on people’s livelihoods. The start made by countries is recognized and it is in this direction that further international donor assistance is solicited to sustain the initial gains made by countries to improve the Veterinary Services and put in place public health structures and communication that, in the short, medium and long term, can provide the basis for sustainable control of highly pathogenic avian influenza and help prevent the potential for a human flu pandemic.
The proposals presented are therefore aimed at boosting the operational and technical capacity for Highly Pathogenic Avian Influenza (HPAI) prevention and control, human influenza pandemic preparedness and harmonization of communication strategies in Africa. They are designed to help African countries to improve the effectiveness and governance of their Veterinary Services in order to build the necessary capacity to efficiently prevent and control HPAI, as well as to detect and respond rapidly to other emerging and re-emerging trans-boundary animal disease outbreaks as soon as they occur. In view of the zoonotic nature of HPAI and the occurrence of human cases in Africa, it is essential to reinforce human influenza surveillance and response systems, strengthen collaboration between animal and human health institutions and improve communication elements of HPAI awareness, prevention and control with decision makers, poultry producers and consumers and the general public.
This Paper is intended to serve as a technical and financial support for the Bamako International Conference on Avian and Human Influenza (AHI).
Introduction
Africa recorded its first outbreak of Highly Pathogenic Avian Influenza (HPAI) when Nigeria officially reported an outbreak of the disease on February 8, 2006. The source of the Nigerian outbreak is still speculative as no concrete evidence of disease introduction has been documented. It is widely believed that legal and illegal trade in infected poultry and poultry products might have precipitated the outbreaks, although the possibility remains that the outbreaks may have resulted from interaction between infected wild birds and domestic poultry. Since the Nigerian outbreaks of HPAI, Egypt, Niger, Cameroon, Burkina Faso, Sudan, Côte d’Ivoire and Djibouti have reported outbreaks of the disease in poultry and human cases have been confirmed in Egypt and Djibouti. The threat of further spread in Africa is real and could occur from the legal or illegal movement of poultry or poultry products, and/or the interaction of domestic poultry with infected wild bird populations. The potential for infection occurs within a context where acute malnutrition and food insecurity often exceeds emergency thresholds, and in a region that is already dealing with other complex emergencies, displaced populations, conflicts, short-term economic disruption and poverty. In the present situation of few cases of human illness and few deaths (Egypt), avian flu is not viewed by many decision-makers as a priority given the burden of disease that countries are already facing.
Insufficient financial and logistical resources, weak Veterinary Services, lax border controls on animal movements, conflicts and inappropriate governance, constitute an environment in which the spread of the HPAI and other trans-boundary animal diseases could be facilitated. The direct consequences of HPAI outbreaks and particularly the loss of poultry production capacity and socio-economic impacts are likely to be worse in Africa than in any other part of the world. Moreover, the risk of the disease becoming enzootic in domestic poultry or wildlife has to be considered as a serious threat to the national economies and public health. The occurrence of human cases, even when sporadic, creates enormous new challenges for health systems and services that are already fragile and overburdened. The continent could equally become a reservoir for the virus from where re-emergence of the disease could pose recurrent risks to African countries and internationally. The prospect that, in this environment, the virus may mutate/reassort and initiate a human pandemic remains a distinct possibility. The rapidly evolving HPAI situation therefore, necessitates an adaptation of the global strategy to fit Africa’s specific challenges.
In this regard, the actions to be taken in the short-term are aimed at putting in place emergency measures to rapidly control the regional and global spread of highly pathogenic avian influenza and to protect populations at greatest risk of infection. These short-term measures, addressing both the human and animal health dimensions of HPAI, are guided by the global strategies defined by FAO and OIE and by the WHO Regional Pandemic Influenza Preparedness and Response Plan. The leadership provided by the global technical agencies for animal and human health represented in ALive recognizes the need for a response that, at the country level, in particular, is integrated and truly multi-sectoral. The measures outlined by the ALive partnership reflect this objective, and the recommendations presented emphasize the importance of an integrated response that brings to bear the strengths of all actors and stakeholders.
The progressive strengthening of official Veterinary Services is a priority both in the short- and medium-term phases of the response and the ability of Veterinary Services to discharge their responsibilities as regards effective HPAI disease control and prevention will also better equip countries to face other emerging or re-emerging zoonoses should these occur in the future. They need to be able to meet their mandate for the effective prevention and control of diseases, which fall within the concept of “Global Public Good”. Bringing the quality of the Veterinary Services in line with the international technical standards defined by OIE will have a significant and lasting impact on the countries concerned (and on the international community as a whole) in a range of areas including the agricultural economy, public health (including food safety and the supply of animal protein) and access to international markets. For these reasons, actions proposed hereafter should be considered eligible for the concept of global/international Public Good.
A series of international conferences organized since the emergence of HPAI have assisted the international community in the elaboration of a global strategy (Geneva, November 2005), for the mobilization of funds for avian influenza control and human pandemic preparedness (Beijing, January 2006), and in the systematic review of emerging practice and reporting of collective global progress (Vienna, June 2006). It is a measure of the rapid spread of HPAI that, at the time of the first two conferences, Africa had not been infected and, as a result, only a very low level of funds had been specifically targeted to assist Africa in the prevention and control of avian and human influenza (AHI).
Upon the invitation of the Commission of the African Union, it was agreed to hold the fourth international conference on avian influenza and human pandemic preparedness in Bamako, Mali. The main objectives of the Bamako conference are to:
- Establish systematic monitoring of progress made at the country, regional and global levels in the prevention and control of AHI (following the principles established at the Geneva, Beijing and Vienna Conferences), with a special focus on Africa;
- Call for financing that specifically targets African countries, based primarily on well-coordinated mobilization of all actors involved in AHI and submission to donors of a shared and realistic assessment of the needs facing African countries and on the AHI operational strategies that will be implemented.
An assessment of the financing needs and gaps is therefore essential in order to mobilize the donor assistance necessary to contain the outbreaks, prevent the spread of disease and to protect the lives, livelihoods and health of the many at risk of AHI infection.
Pursuant to the Vienna meeting of June 2006, the ALive Partnership received a mandate to take the lead in the preparation of a technical document that will support the pledging session for Africa at the Bamako Conference. A Multi-Institutional Task-Force composed of experts from AU-IBAR, FAO, OIE, WHO and UNICEF was therefore created to execute this task.
The proposals presented hereafter, are aimed at (i) boosting the operational and technical capacity for HPAI prevention and control, (ii) human influenza pandemic preparedness, and (iii) coordination of communication strategies. They are designed to help countries facing the greatest threats to improve the effectiveness and governance of their Veterinary Services in order to make them capable of efficiently preventing and controlling HPAI, as well as detecting other emerging and re-emerging trans-boundary animal disease outbreaks as soon as they occur and in responding to them rapidly. In view of the zoonotic nature of HPAI, it is also essential that human influenza surveillance and response systems are reinforced, that systematic efforts are undertaken to strengthen collaboration between animal and human health institutions, and that comprehensive communication programs are launched to ensure that key stakeholders including poultry producers, consumers, and the general public are informed of the status of the disease and the measures that they can take to reduce the risk of infection.
Go to the site of the 4th International Conference on Avian Influenza, December 6-8, 2006 in Mali ALive - Partnership for livestock development, poverty alleviation and sustainable growth