Avian Influenza and the Pandemic Threat

Agencies’ Achievements (against outputs and activities indicated in the log-frame)

1.1 Cohesive response to avian influenza in poultry related to international (OIE) standards

12. The increased understanding of the disease and the success of various control approaches have allowed to refine strategies, at the global, regional and national levels. In response to these developments, FAO and OIE released in March 2007 an updated version of their Global Strategy for prevention and control of H5N1 HPAI.

13.  Between December 2006 and June 2007, FAO focused on the strengthening of the structure of its Emergency transboundary animal diseases (ETAD) and the Crisis Management Center Animal Health (CMC/AH) to ensure an efficient global response to HPAI. The CMC/AH has successfully deployed rapid assessment and response capacity missions for HPAI outbreaks in Togo, Ghana, Saudi Arabia,   Bangladesh, Afghanistan, Nigeria and the Republic of Korea . In addition to these missions, the CMC/AH has been put on alert on several occasions and has advised FAO in-country teams, without deploying its own teams, in Azerbaijan, Pakistan and Myanmar.

14.  FAO has been working with countries affected and at risk to strengthen capacity for early detection of HPAI outbreaks through community-based field surveillance and effective disease outbreak investigations. Efforts have been centered on developing sound national preparedness plans, enhancing the capacity for rapid and effective response to outbreaks of HPAI and promoting public awareness and education on HPAI and safe poultry rearing practices to groups in close contact with poultry.  Although the incidence of overt disease is declining in a number of the affected countries, there are now strong indications that avian influenza is endemic in some countries such as Indonesia and Egypt. There FAO and partners have made great strides in assisting containment of HPAI outbreaks which will persist for some time to come. In both countries strategic plans have been developed.

15.  Regionally FAO further strengthened its ability to monitor the disease situation, build capacity, take pre-emptive steps to prevent infection, and help countries to manage outbreaks. In addition to FAO’s presence in Bangkok from where it coordinates the regional programme in Asia, four Regional Animal Health Centers in Africa have been established through a joint initiative of OIE-FAO and AU IBAR building on the complementarities of the mandates of the three institutions within the framework of the FAO/OIE GF-TADs initiative, the PACE programme and the ALive Partnership Platform. An additional joint FAO/OIE Regional Animal Health Centre has been set up in Beirut to cover the Middle East countries and arrangements are being made to create regional centers for Eastern Europe and Central Asia.

16. OIE, the World Bank, FAO and WHO are currently finalizing agreements to implement Avian Influenza Rapid Assessments in 15 African countries. Avian Influenza Rapid Assessment procedures (Standards of Operation and Terms of Reference) are now ready and operational and will feed into the preparation of Integrated National Action Plans (INAPs).

17. UNHCR is working with animal health partners to build on existing surveillance, reporting and response capacity for use in refugee camps and communities so as to avoid the creation of parallel systems.

1.2 Biosecurity up to standard and capacity for scaling up veterinary services

18. OIE has received 51 official country requests from governments for OIE-PVS evaluations of their national veterinary services. Forty-six evaluations have already been carried out or are currently ongoing. FAO has conducted missions to laboratories in West Africa and other parts of the continent to assess their capacity and capabilities for diagnosis of avian influenza. It also provided logistical assistance for shipping samples or isolates to OIE/FAO reference laboratories

19. FAO and OIE, in close collaboration with regional organizations have expanded and strengthened data collection and reporting, regional epidemiology and laboratory networks. The enhanced quality of data and these networks are designed to improve the quality of disease surveillance and disease diagnosis in countries by establishing harmonized epidemic-surveillance and diagnostic tools and methods and providing training and technical support to national staff engaged in laboratory and surveillance activities. They also support coordination and harmonization of regional approaches for early warning, efficient detection and early response to HPAI. The Joint FAO/OIE/WHO platform for Global Early Warning System (GLEWS) established at FAO headquarters was reinforced with expertise in epidemiology, disease ecology and mapping for data integration, disease analysis and monitoring for early warning purposes. A GLEWS taskforce meeting was held in January 2007 to establish the terms of references for working groups covering early warning, the GLEWS electronic platform and GLEWS response. The first two working groups were organized in April 2007 in Rome (FAO) and Paris (OIE).

20. FAO assisted a number of countries in formulating strategies and technical guidelines for a safe poultry production across various farming systems, marketing and processing facilities. It has also been conducting trainings of national government counterpart staff at different levels. These include participatory surveillance and response training at the community level, training of trainers (TOT) on disease surveillance and response at the provincial and regional level, laboratory training on equipment use, analysis and procedures, and use of standard operating procedures. FAO has also been providing technical support to governments in the development of national strategic plans for HPAI control with expert advises on poultry disease, epidemiology, bio-security, laboratory diagnosis, socio-economics, virology and communications as well as financial and procurement support for project operations and management (including purchases of highly sophisticated laboratory equipment to upgrade national laboratories and polymerase chain reaction (PCR) machines to test and detect the H5N1 virus in diagnostic samples, rapid test kits, reagents, and other field surveillance supplies as well as PPE, vehicles and motorcycles for rapid surveillance and response). OIE-AI Vaccine Bank is now in place and fully operational and 21,300,000 doses of H5N2 vaccines for adult poultry have been delivered as of July 2007.

21. UNHCR is working with FAO and national veterinary networks on ensuring that protocols and pathways for laboratory and veterinary services in refugee camps and communities are in place.

1.3 Relevant international expertise with regard to the evolution of the new emerging HPAI H5N1 virus

22. Great efforts by FAO and partners have been invested in increasing the understanding of the epidemiology of the disease and its control by promoting and supporting applied research on issues of a global nature to improve the quality of technical tools, methods and strategies available to decision makers for combating HPAI and rehabilitating poultry industries. To this end, FAO and OIE co-organized, together with the Instituto Zooprofilattico Sperimentale delle Venezie and the European Commission, an international conference on poultry vaccination in Verona, Italy (March 2007), where technical issues and vaccination options and strategies for control of HPAI in animals were extensively discussed with all stakeholders, including national governments, international organizations financial institutions, private sector, research institutions and scientists. Results of a vaccination cost model being used in countries planning wide-scale vaccination programmes, such as Vietnam, were also presented.  

23. FAO is carrying out, through a collaborative effort with partners a large training programme for about 150 national officials from more than 80 countries in the Americas, Africa, Eastern Europe, Asia and the Middle East on wildlife surveillance including wild bird captures restraint and proper sample collection for the purposes of conducting H5N1 HPAI testing. A second round of wildlife surveillance (following the first one in 2006) was conducted from September 2006 to April 2007 in Africa, the Middle East and the Caucasus.  Approximately 18,000 samples were collected and of at least 10,000 samples analyzed, to date none tested positive for HPAI H5N1. This surveillance programme was coordinated by FAO and implemented by the Centre de Coopération Internationale de Recherche Agronomique pour le Développement (CIRAD) in collaboration with Wetlands International. FAO has taken a lead role at developing, writing and publishing a training manual titled, “Wild Bird AI Surveillance- A Manual for Sample Collection from Healthy, Sick and Dead Birds”. This manual is available online and is used in all of FAO’s wildlife training.

24. The support provided through the FAO/OIE OFFLU network has greatly improved the diagnostic capability of national veterinary laboratories in many countries, significantly contributed to monitoring the course of HPAI and ensured that the plans for disease control in infected countries – and surveillance and preparedness in non-infected countries – are based on sound scientific knowledge. The OIE/FAO OFFLU network :

• -    exchanges scientific data and biological materials (including virus strains) within the network, and shares such information with the wider scientific community;
• -    offers technical advice and veterinary expertise to countries to assist in the diagnosis, surveillance and control of AI;
• -    collaborates with the WHO influenza network on issues relating to the animal-human interface; notably early detection of new strains for human vaccines by sharing with WHO Reference Laboratory animal virus strains to be used in the early preparation of human vaccines; and
• -    highlights avian influenza research needs, promotes their development and ensures co-ordination.

Remaining gaps and challenges

25. A rapidly increasing number of countries in Asia, Africa, Eastern Europe and the Middle East is requesting assistance for assessing risks, surveillance systems and national laboratories and for providing technical support for emergency planning and simulation exercises as assessment missions reveal critical gaps in laboratory diagnostic capacity in affected and at risk countries. There is a need to conduct further epidemiological studies to clarify risk factors and back up decision making in Avian Influenza control strategies in selected countries were the disease is enzootic. In particular, the evolving situation of the disease and wide spread of the virus in most parts of Indonesia and Egypt require substantial resources to ensure the progressive control of the disease and ultimately the eventual elimination of HPAI. The occurrence of the disease in Bangladesh as well as Nigeria and other countries in Africa is also of concern.

26. FAO, OIE and partner organizations would require more funding than currently available to face these challenges: the CMC/AH needs more resources to cover the cost of its operations and the OIE/FAO OFFLU network would benefit from greater support to further improve the diagnostic capability of national veterinary laboratories in countries and monitor in a sustainable way the course of HPAI.  Also, support is needed for the OIE laboratory twinning programme which is building national scientific communities in those countries lacking expertise and/or capacity in order to enable them to prepare and negotiate standards so that laboratories in some of these countries could become international OIE Reference Laboratories in their own right. Finally, it would be important that the OIE-PVS evaluations be financed in full (40 remain unfunded) as these will lay the ground for gap analysis and investment priority setting. The first round of OIE-PVS evaluations carried out in more than 40 countries has already identified the following deficiencies/concerns leading to inabilities to comply with international standards:  

• -    Overall, legislations and regulations related to animal disease prevention and control are very often outdated, very incomplete, obsolete or even non-existent in some cases. This undermines any programme directed towards early detection and rapid response mechanisms.
• -    Public-Private partnerships are often still in their infancy, or non-existent. Complementarities and synergies between official veterinarians, private practitioners and farmers offer a positive way to improve implementation of early detection and rapid response.
• -    Sustainable operational budgets for Veterinary Services are insufficient and very far below the pro rata contribution of animal farming activities to the national GDPs, or inadequate when compared to the livestock population of the country.
• -    Staff resources and staff education and training (initial training as well as continuing education) are a source of concern in almost every country evaluated. In some countries the length of initial veterinary education is less than 2 years (world standards being 6 years on average).
• -    Laboratory capacity is also a weak point, both at national and at regional (sub-continental) level. This is not only due to a lack of adequate equipments but is also a management, personnel training and budgetary issue. The procurement of modern equipments which are often not adapted to local conditions (no water, no electricity), rarely solves all the problems. Conditions of collection and of shipment of biological samples to the laboratories are also a limiting factor working against early detection and confirmation of animal diseases.