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China

At the chicken market in Xining, Lanzhou Province, China (photo on Flickr by Padmanaba01).

By Matthew Davis

The initial news reports were slim on details but the reaction was swift. There were at least three people dead in China after apparently contracting influenza from birds. Prices of soybean—a major ingredient in livestock feed—immediately took a dive.

Then the death toll rose to five, virus samples were detected in pigeons, and in Shanghai authorities began slaughtering poultry flocks. Within a few days the death count was up to seven, then nine. And people started to wonder about a connection to all those pig carcasses floating down Shanghai waterways.

Such is the confusing swirl of information emanating from the latest incident in which a worrisome disease has passed from animal to human, a phenomena—and a quite common one at that—known as zoonoses. In this instance, it’s an influenza virus called H7N9 that appears to have originated in wild or domestic bird populations, but much about its source remains murky.

For Delia Grace, a veterinary epidemiologist at the International Livestock Research Institute (ILRI) who spends most of her waking hours studying zoonotic events around the world, there are two essential facts to keep in mind as the situation in China evolves. And they embody how difficult it can be to craft a proper response.

One: the vast majority of zoonoses outbreaks do not escalate to crisis proportions. But, two: every now and then, as happened with Spanish flu in 1918 and AIDS in more recent times, an animal disease jumps to human hosts and causes a ‘civilization altering event’.

Grace suggests the appropriate reaction is to ‘panic slowly’. In other words, be prepared to move quickly if things get worse, but don’t over-react to the early reports. Also, keep in mind that, just based on what gets reported, a new disease emerges somewhere in the world about every four months.

For example, Grace noted that epidemiologists in the United Kingdom, Germany, and the Middle East are probably more concerned right now about a new and deadly corona virus that as of late March had killed 11 of the 17 people known to have been infected. There is evidence that at least one of the infections may have originated in racing camels.

Grace advises decision-makers in the public and private sector to channel the impulse to take action toward addressing conditions that are intensifying zoonotic threats.

We know that in certain parts of the world, livestock intensification is being pushed well beyond the limits of anything we have done in agriculture in the past’, she said. ‘There are hundreds of thousands of animals packed together and little transparency about how they are being managed. And that’s making disease experts pretty nervous.’

But Grace cautions against focusing solely on the risks posed by certain livestock practices and ignoring the fact that livestock are a major source of food and income for 1 billion of the world’s poorest people. She worries that misguided reactions to emerging zoonotic diseases can end up doing significant harm to their lives and livelihoods.

For example, in 2009, the Egyptian government ordered the mass slaughter of pigs tended by Coptic Christians on the mistaken belief that the pigs were linked to the H1N1 flu pandemic. Also, the possible link in Asia between a different, and also deadly, form of avian influenza called H5N1 and ‘backyard’ poultry farming has prompted a shift to more industrial-scale production. Yet, as Grace points out, given the problems plaguing industrial operations in the region, this shift could actually increase the risk of zoonotic diseases while imperiling the food security of livestock keepers.

‘The proper reaction to the risks posed by emerging zoonotic diseases is not to indiscriminately slaughter animals. That could threaten the health of far more people by depriving them of their primary source of protein and other nutrients’, Grace said.

What we need to do is look at the many ways livestock production has gone wrong—lack of diversity in animals, using drugs to mask signs of diseases, dirty conditions—and put them to right.

Matthew Davis is a Washington DC-based science writer and policy analyst; he also serves as a senior consulting writer for Burness Communications.

Mozambique, Chokwe, Lhate village

Cows standing in the compound after grazing in Chokwe, Mozambique. A new study calls for improved integration between epidemiology and economics to understand economic and poverty impacts of animal diseases (photo credit: ILRI/Mann)

A new study by researchers working with the International Livestock Research Institute (ILRI) is recommending use of ‘bottom-up’ approaches that use the strengths offered by value chain analysis and information economics in assessing the impacts of animal diseases and their interaction with socio-economic and institutional factors in developing countries.

Authors Karl Rich, from the Norwegian Institute of International Affairs (NUPI) and on joint appointment with ILRI and Brian Perry, an honorary professor of veterinary medicine at the Universities of Edinburgh and Pretoria and formerly a leader of ILRI’s research team on animal health and food safety for trade, say economists and epidemiologists need to work more closely in assessing the impact of animal diseases. They recommend use of ‘participatory disease surveillance’ approaches that feature models of disease assessment that consider the context in which animal diseases occur and how they affect markets, livelihoods and poverty reduction especially in developing countries where livestock serve diverse commercial and cultural roles which affect disease control efforts.

In a paper ‘The economic and poverty impacts of animal diseases in developing countries: New roles, new demands for economics and epidemiology’ published in the 15 September 2010, online edition of the Preventative Veterinary Medicine journal, the scientists say both value chain analysis and information economics hold particular promise and relevance towards animal disease impact assessment.

They note that ‘normative’ approaches that try to guide how agents affected by diseases should behave (for example by emphasizing elimination of disease while relegating issues of disease mitigation, equity, gender and poverty) have had limited success in reducing poverty and disease prevalence in developing countries. The scientists suggest that new models that consider the context decision makers, farmers and value chain actors face in the event of animal disease outbreaks and what they actually do (not only what they should do) will contribute to more effective pro-poor policymaking.

The paper also recommends harmonizing divergent incentives among different stakeholders in developing countries noting that, for example, integrating the views of political economy and institutions engaged in animal health research will help to focus more broadly and systematically on incentives and the behaviour of those institutions and political actors, thereby helping researchers to better understand the economic impact of diseases.

The paper reviews the livelihoods and poverty impacts of animal diseases in the developing world, with a focus on Rift Valley fever, highly pathogenic avian influenza (HPAI) and foot and mouth disease. The paper also analyses the effects of these diseases through a poverty and value chains perspective and highlights ways that lessons from these perspectives can be aligned with disease control initiatives.

Rift Valley fever outbreaks are common in eastern Africa, especially after heavy rains, which lead to rises in numbers of mosquitoes that spread this viral zoonotic disease. Rift Valley fever affects cattle, sheep, goats and camels but also infects and kills humans. A recent outbreak of the disease between 2006 and 2007 killed more than 100 people in Kenya and led to significant loss of animals and livelihoods, especially for pastoralist livestock keepers.

Rich and Perry say the response of different stakeholders to diseases is based on their unique circumstances and constraints and their incentive for compliance also depends on such contexts. Their paper stresses the importance of ‘improved integration between epidemiology of disease and its relationships with economic behaviour.’

The authors call for a holistic look at the livestock sector as a system of interacting actors, each with their own values and constraints. They say that frameworks such as those offered by value chains can help identify the impacts that animal diseases generate. The value chain framework’s emphasis on relationships, characteristics and dynamics among actors, can help identify not only who is impacted by animal disease but also how and why they are affected and how different actors might behave and adjust in response to disease outbreaks.

To read the complete paper and its recommendation, click here

This piece is adapted from an original story posted on the Market Opportunities Digest blog written by Tezira Lore, communications specialist for ILRI’s Markets Theme.

Poultry seller in Indonesia

Poultry seller in Indonesia (photo by ILRI / C Jost)

To reduce risks faced by poor communities to outbreaks of bird flu (highly pathogenic avian influenza), experts in Indonesia say poultry farmers, traders and transporters, as well as the general public, need to be better educated about the disease and its control. They also recommend strengthening the capacity of Indonesia’s institutions to control the country’s bird flu pandemic.

These recommendations were made during a workshop held in Bogor, Indonesia, 5–6 August 2010, that concludes the research activities of an Indonesian component of a project to develop strategies for reducing the risks of bird flu among poor communities in countries of Asia and Africa.

The two-year project is supported by the UK Department for International Development and is implemented in Cambodia, Indonesia, Thailand, Vietnam, Ethiopia, Ghana, Kenya and Nigeria.

About 40 participants attended the Bogor workshop, some drawn from the key partners in the project: the Food and Agriculture Organization of the United Nations, the Indonesian Ministry of Agriculture, the International Food Policy Research Institute, the International Livestock Research Institute (ILRI), and the Royal Veterinary College. Other participants represented a variety of stakeholders in better control of bird flu in poor communities. These included local universities such as Gadjah Mada University, in Yogyakarta, and Bogor Agricultural University; local poultry farmer groups and members of the poultry industry; and international researchers and donor agents conducting similar projects in the country.

The workshop participants made 5 key recommendations regarding better control of bird flu in poor communities:

  1. widen uptake of basic biosecurity measures through education
  2. provide targeted subsidies
  3. develop professional actor associations with certification schemes
  4. find ways to encourage prompt reporting of outbreaks of bird flu
  5. build public awareness campaigns to promote changes in public behaviour that reduce risks to the disease

Ad hoc institutions set up after the initial outbreaks of bird flu in the country played a key role in the subsequent dissemination of information on bird flu. The Indonesia National Committee for Avian Influenza Control and Pandemic Influenza Preparedness is one such institution, which usefully brought together animal and human health authorities in a joint response to the pandemic. The workshop members recommended that these institutions be integrated into relevant government departments throughout the country’s administrative units. These recommendations will be further developed in consultation with the Indonesian Ministry of Agriculture.

This piece is adapted from an original story posted on the Market Opportunities Digest blog drafted by ILRI staff members Fred Unger and Bernard Bett, scientific members of the project who attended the Bogor workshop, and Tezira Lore, communications specialist for ILRI’s Markets Theme.

Read more on the website of the collaborative research project: Pro-poor HPAI Risk Reduction

Chicken

Risk assessment shows Avian Influenza still a threat to poultry production in Kenya

The risk of avian flu on poultry production continues to be a threat to the livelihoods of many poor and livestock-reliant farmers in developing countries such as Kenya, researchers say.

Scientists from the International Livestock Research Institute (ILRI) and the International Food Policy Research Institute (IFPRI) have found that poultry farmers in Kenya are ‘highly susceptible to the introduction and spread of the highly pathogenic avian influenza (HPAI)’ because of the country’s location along key wild birds’ migratory routes and the absence of strong mechanisms to deal with a possible outbreak of the disease.

Like in many developing countries, poultry production is an important livelihood activity in Kenya. Most poultry is kept by small-scale farmers in non-commercial settings, who depend on income from the sale of eggs, animals and meat to sustain their livelihoods.

Results from a 2009 impact assessment conducted by ILRI, IFPRI and the Royal Veterinary College in London with support from the Department for International Development (DFID) on the ‘Role of Poultry in Kenyan Livelihoods and the Ex Ante Impact Assessment of HPAI on Livelihood outcomes’ show that farmers in the key poultry producing regions of the country are not adequately prepared to deal with an outbreak of avian influenza.

Though the country has not had an outbreak of avian flu, there were two scares in 2005 and 2005. The scares led to a slowdown in the industry as farmers, in fear of making losses, reduced flock sizes by up to 40 per cent. The two scares also led to a depressed market for poultry and poultry products and lowered the prices which negatively impacted farmers. The assessment showed that farmers in Kenya are still at risk especially because the country’s human and animal health services are not adequate. Coupled with the fact that most of the poultry farming in the country is a ‘backyard poultry system’ preventing and controlling disease outbreaks would be significantly difficult.

Among others, the results of the assessment also showed, like other studies had confirmed, that poultry production is largely done by women and children to support livelihoods and that most of the poultry in Kenya is produced in the country’s western and eastern regions. Farmers in these places are most at risk of loses in the event of a HPAI outbreak. Kenyan farmers keep an average flock size of 18 birds across the country but there are significant variations across regions mostly determined by ease of access to markets. Nairobi province, for example, has large producers (though fewer in number compared to other regions) with an average of 158 birds per flock because of access to ready market for their animals.

The assessment found that ‘households with “larger” small-scale flocks as well as those located in high risk areas (Western, Nyanza and parts of Eastern provinces) are vulnerable to HPAI. In the event of an outbreak, the disease would cause ‘significant reduction in livestock income and wealth (asset value) and total annual household income would be reduced.’

The results of this assessment were first published as ‘The role of poultry in Kenyan livelihoods and the ex ante impact assessment of HPAI on Livelihood outcomes’ by the International Food Policy Research Institute (IFPRI). A full report of the assessment can be found in the following link http://www.ifpri.org/sites/default/files/publications/hpairb11.pdf

For more information visit www.hpai-research.net

To get serious about controlling emerging human disease, we’re going to have to get serious about understanding and controlling their origin in animal disease, often in developing countries


As the world’s governments raced to deal with a looming flu pandemic starting some two weeks ago, in late April 2009, World Health Organisation (WHO) officials confirmed that the world is better prepared than ever before to deal with a pandemic, thanks largely to six years of research and preparations to battle bird flu and SARS. Nearly 150 countries are now known to have drawn up contingency plans covering everything from the response of health services to travel restrictions and international co-operation.

Although it contains animal genetic components, the current influenza A(H1N1) virus has not been diagnosed in animals before and has spread from person to person, threatening an influenza pandemic which, according to scientists, is inevitable, even though no one can predict the timing. Three serious influenza pandemics occurred in the 20th century, with each new virus eventually infecting up to a third of the world over the course of one to two years: the 1918 ‘Spanish flu’ responsible for more than 40 million deaths, followed by the 1957 ‘Asian’ and 1968 ‘Hong Kong flu’, which killed between 1 and 3 million people worldwide,

The history of flu epidemics and pandemics, which can be traced back with some accuracy for the past 300 years, tells us that outbreaks occur somewhere in the world in most years and pandemics, which are epidemics that spread worldwide, at 10- to 50-year intervals. Despite influenza and its causative organism being the most studied of viral diseases and pathogens until the advent of HIV/AIDS two decades ago, little has been done in the past century to change the pattern of influenza infections.

2009 June 11 Swine flu update:

  • WHO on 11 June raised the pandemic alert level from phase 5 to 6, indicating a global pandemic outbreak
  • This will trigger drug makers to speed production of a swine flu vaccine and prompt governments to devote more money to containing the virus.
  • Although appearing less deadly than seasonal flu, experts worry the virus could mutate into a more lethal strain during the Southern Hemisphere’s coming flu season.
  • Experts also worry that poorer countries could be overwhelmed with cases they do not have the capacity to treat.
  • The last pandemic, the Hong Kong flu of 1968, killed 700,000 people worldwide. Ordinary flu kills 250,000 to 500,000 people each year

11 May 2009 brief from the World Health Organisation

For more information, we encourage our readers to read the WHO brief copied below and linked to here:
http://www.who.int/csr/disease/swineflu/assess/disease_swineflu_assess_20090511/en/index.html

This WHO brief of 11 May 2009 provides much useful background information for understanding expert concerns about the current new flu virus, particularly how it may affect the developing countries of the southern hemisphere, where the flu season is about to begin. These expert concerns include the following.

  1. The influenza A(H1N1) could mutate into a more lethal form in a subsequent wave of this pandemic, as the virus causing the 1918 pandemic flu did.
  2. Having not appeared in humans or animals before, scientists anticipate that pre-existing immunity to the virus will be low or non-existent, or largely confined to older population groups that have had flu vaccinations and therefore striking down more people of a younger age group, than viruses causing normal so-called ‘seasonal flu’.
  3. This new flu virus, although as yet causing generally mild illness in the 29 countries outside Mexico where it has so far been confirmed, could cause severe illness in developing countries, particularly:
    • people suffering malnutrition
    • poor communities with inadequate health care
    • the greatly increased numbers of people now afflicted with chronic conditions such as heart disease and diabetes, conditions that can greatly increase the severity of illness this flu causes (although these chronic conditions afflicted mostly affluent populations until a few decades ago, a full 85% of people suffering them today live in low- and middle-income countries)
  4. As this new influenza A(H1N1) virus spreads to the southern hemisphere with the start of the flu season here, it may meet the H5N1 bird flu virus that is widely circulating among the poultry populations of some developing countries; no one knows how, under pressure of the new A(H1N1) human-to-human transmitted flu virus, the H5N1 bird-to-bird transmitted flu virus might change, including whether the latter, more lethal, bird flu virus could be helped to mutate into a form transmitted easily among people. (The more lethal H5N1 bird flu virus, now endemic in many areas, has thankfully to date been transmitted only rarely directly from person to person; almost all the people infected have received the virus from handling infected poultry, which has helped keep the virus from spreading widely among human populations.)

11 May 2009 Update

11 May 2009 Update As reported in Time Magazine this week (11 May 2009), ‘new research suggests that the WHO acted wisely in raising the pandemic alarm — and that the threat of H1N1 may not have passed. In a study released May 11 in the journal Science, researchers from Imperial College London, along with WHO staff and Mexican scientists, conclude that H1N1 is transmitted considerably easier than the regular seasonal flu and is about as deadly as the 1957 Asian flu, which killed about 2 million people worldwide. A World Bank study last year found that a pandemic of similar severity today might kill 14.2 million people around the world, and cut 2% from the global economy.’

7 May 2009 Update

As of 7 May 2009, there were 2,371 confirmed cases of swine flu in 24 countries and 46 deaths from this infection, all but 2 of the deaths occurring in Mexico. Scientists described 11 cases of Americans who were infected before the current outbreak with swine flus that partly matched the new epidemic strain that emerged in Mexico in March 2009. The first case was in December 2005. In articles published online in The New England Journal of Medicine, virologists from the US Centers for Disease Control and Prevention (CDC) described those cases, most of them in young people in the Midwest who touched or were near pigs. All had a ‘triple reassortant’ virus that combined human, swine and avian flu genes. The H1N1 flu now spreading out from Mexico also has those genes, as well as genes from Eurasian swine. The CDC reports that the pandemic does not appear to be petering out, that we appear to be still on the upswing of the epidemic curve, and that only about 10% of those infected had a travel history to Mexico.

The role of livestock scientists in the developing world
Livestock scientists have a vital role to play in helping to predict, prevent and control zoonotic diseases, which are all those transmitted between animals and people. Remarkably, zoonoses make up more than 60% of all human infectious diseases and more than 70% of all emerging infectious diseases. These diseases occur most frequently in Asia and Africa, where limited resources hinder both surveillance and response. The growing threat of emerging diseases such as Nipah and SARS, and re-emerging diseases such as Rift Valley Fever and avian influenza, has served as a wakeup call to animal health and public health services that their collaboration is necessary if these threats are to be minimized. There is increasing recognition that, for a number of zoonotic diseases, the most effective way to protect the health of the public is to control disease in the animal host.

The work of livestock scientists working in and for developing countries has special relevance in tackling these animal-human diseases, because within developing countries today, fast changes in food systems wrought by skyrocketing demand for, and production of, livestock foods is creating new niches and transmission pathways for pathogens, with unprecedented numbers of diseases emerging and re-emerging in recent decades. New tools and approaches for managing diseases in developing countries are urgently needed.

The animal-human disease interface
Most pathogens (61%) that affect people also affect animals; such shared infecting organisms and infections are known as ‘zoonotic’. A full 71% of all the world’s emerging infectious diseases are zoonotic, or transmissible between people and animals. In addition to swine flu, bird flu and SARS, these diseases include such devastating plagues as BSE (mad cow disease), HIV/AIDS, ebola and Rift Valley fever. The bugs that cause these diseases are notorious for their ability to evolve. Flu viruses, for example, can change both from severe to mild and from mild to severe.

Researchers at ILRI have been working at the livestock-human disease interface, supporting better integration of veterinary and public health surveillance programs, for three decades. ILRI’s particular interests are aspects of zoonotic diseases that impact the world’s poorest communities, where animal husbandry is a way of life and a central means of livelihood for more than half a billion people. ILRI and its partners, for example, make evidence-based assessments of the different impacts on the poor of employing different disease-control methods, thereby helping policymakers determine optimal pro-poor strategies for different regions and agricultural production systems of the developing world.

ILRI works with many research institutions within developing countries to better control zoonotic diseases at local, national and regional levels. It works with WHO and its international network of institutions to bolster disease surveillance. It works with the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) on participatory epidemiology, a grassroots approach to disease surveillance and control that is being successfully applied in the battle against bird flu in Indonesia. And it works with regional agencies such as the Africa Union / Inter-African Bureau for Animal Resources to improve laboratory testing and diagnosis of bird flu and other infectious livestock diseases.

ILRI and its partners are also investigating risk-based approaches that focus on key hazards and maximize benefits with available resources. With case studies in Africa and Asia, and concepts derived from ‘one medicine’ and ‘one health’, ILRI scientists argue that a ‘risk-analysis framework’ both can and should be extended to integrate risks to animal, human and environmental health.

The role of policy
ILRI also works with the International Food Policy Research Institute (IFPRI) and other institutions on providing evidenced-based policy support so that we don’t fall into the trap of doing more harm than good in our efforts to control infections, particularly in poor countries which can least afford such mistakes.

Some of the most profound consequences of disease threats are economic rather than medical, with inappropriate policies devastating local and national economies. Egypt’s on-going culling of its entire population of some 300,000 pigs, for example, is reported to be reigniting religious and economic tensions, and may end up doing more harm than good. The pigs are kept not by Egypt’s majority Muslim population, which views the animals as unclean, but by Egypt’s Coptic Christians, many of whom maintain pigs on the rubbish heaps of shantytowns, where entire families pick out organic waste to feed their pigs. On the other hand, Egyptian authorities may be trying to prevent a repeat of events two years ago, when they were criticized for not responding swiftly enough to an outbreak of bird flu, which killed 26 people in the country, three in just the last month.

‘Misconceptions and inappropriate responses can spread quickly during the early stages of a new disease outbreak,’ says John McDermott, a veterinary epidemiologist and ILRI’s director of research. ‘This “swine flu” is spread by people, not by pigs,’ he said. ‘So most authorities are appropriately focusing their current attention on stopping the spread of swine flu among people.’ (Bird flu, in contrast, is spread by birds, so authorities focus on controlling that disease within poultry rather than human populations.) This new swine flu virus, and our reactions to it, like the more lethal bird flu and SARS before it, should provide us with many lessons for the future.

Research gaps
We still know little about the nature of this new influenza virus strain, other than its genetic makeup is a ‘mashup’ of human, bird and pig elements (making the name ‘swine flu’ something of a misnomer we shall probably have to live with; ‘Spanish flu’ didn’t originate in Spain, but the name stuck anyhow). We don’t know yet when it first made the jump from pig to person, why it has been so deadly in Mexico but not elsewhere, or how virulent it will eventually prove to be. The pathogenicity of a virus can become milder or more severe over time. Until now, the influenza A(H1N1) virus thankfully has proven relatively mild, with most of those infected responding well to usual flu treatments and recovering.

Our ignorance of this new strain of swine flu virus is partly due to our neglect of animal health matters. In rich as well as poor countries, veterinary health care and research remains chronically under-funded. And there is increasing need for disease control policymakers, agents and researchers to collaborate at the interface of the human-and-animal-health sectors, exchanging up-to-date information on disease outbreaks and transmission.

Controlling emerging infectious diseases
‘To get serious about preventing new zoonotic infections from spreading,’ says Carlos Seré, director general of the Africa-based International Livestock Research Institute (ILRI), ‘we need to get serious about veterinary resources. We need new ways to look for new pathogens infecting animals, new ways to assess those which may be most dangerous, and new ways to determine how they may be transmitted to people. We have just had a demonstration as to the danger of waiting for a new flu to emerge and begin spreading among people before trying to contain it.’

The influenza A(H1N1) virus is spreading rapidly because in our ever-shrinking, ever-globalizing world, pathogens are crossing species and borders with increasing ease. In such a world, says Seré, ‘we ignore veterinary health problems in developing countries at our peril.’ With high-quality collaboration among countries (rich and poor alike), scientific disciplines (e.g. socio-economics as well as genetics), and sectors (e.g. medical, veterinary, agricultural, environmental, wildlife), Seré argues, we can manage today’s emerging disease threats.

Because animals are the origin of most emerging diseases, they could play the same role that canaries did in the mines, in that case, alerting the coal workers to the presence of noxious gases or too little oxygen.

‘We should be spotting many infectious disease threats not in people, as we did in the case of this new flu virus,’ says Seré, ‘but rather in animal populations.’ That should give authorities more time to design and implement interventions to protect people from becoming infected. ‘But as we’ve seen in recent outbreaks of bird flu and Rift Valley fever, all too often it is people rather than animals that serve as our sentinels, sickening and dying after the disease has begun circulating in local livestock populations.’ That’s largely because in poor countries, livestock diseases tend to go unreported (it’s hard to tell one livestock disease from another in countries with spotty veterinary coverage) and/or underappreciated (people facing serious human health problems have little time to spare worrying about animal diseases), and/or ignored (it may be considered political suicide to report a disease outbreak that might have large economic consequences).

‘To find better ways of controlling human diseases,’ Seré concludes, ‘we’re going to have to find better ways of understanding and controlling diseases in both domesticated and wild animal populations. And we’re all going to have to work together, breaking down traditional barriers between organizations and scientific disciplines in the process. We need new thinking to tackle these new threats. And bringing diverse expertise together is the best way of staying on top of fast-evolving situations that threaten our global public health—as well as the well being of the world’s poorer livestock keeping communities.’

For more information contact

John Mc Dermott
Deputy Director General-ILRI
Nairobi, Kenya
Email: j.mcdermott@cgiar.org
Telephone: +254 20 422 3207

Substantial GTZ support provided to ILRI and AU-IBAR has provided 80 laboratory staff in 37 African countries with specialized knowledge in rapid detection of highly pathogenic avian influenza

This program of the German Technical Cooperation (GTZ) for early detection of bird flu in Africa did more than train people in advanced techniques for diagnosing a new disease. It invested in people, connecting them in a ‘who’s who’ of skilled African laboratory staff as well as a handful of international bird flu experts focusing on Africa. It united these laboratory experts in a common cause.

As Carola von Morstein, coordinator of the GTZ Task Force on Avian Influenza, puts it, ‘This—remarkably the first regional training in Africa to diagnose avian influenza—is helping to improve transparency, communication and information exchange in bird flu campaigns. We will publish in print and on the web a training manual so we can widely share the lessons learned in this training. One of those lessons is the great advantage to be gained in coordinating work to prevent and control bird flu across the continent.’

Staff at the International Livestock Research Institute (ILRI) and the Africa Union’s Interafrican Bureau for Animal Resources (AU-IBAR), who organized the series of intensive training courses conducted over the last year across the continent, are interested in continuing their work with GTZ to sustain this cooperation among agricultural, veterinary and medical experts. Such inter-sector cooperation in disease control is regrettably unusual in all countries but particularly so in those lacking resources to bring together experts from different ministries and disciplines.

ILRI’s research director John McDermott is excited about this cooperative aspect of the project. ‘The network of African veterinary and human diagnosticians created by this training over the past year has great potential. It has fostered “diagnostic champions” in Africa who are being consulted by their colleagues. The benefits of this will go beyond avian influenza to other important infectious diseases of both people and animals.’

ILRI’s director general Carlos Seré also sees opportunity to build on the momentum that has been created. ‘We’re interested to explore with others how this regional emergency training might be transformed into long-term indigenous capacity-building for better control of infectious diseases in Africa.’

Other partners involved in organizing the training courses or providing training materials were the Food and Agriculture Organization of the United Nations (FAO), the World Animal Health Organization (OIE), the World Health Organisation (WHO) and the U.S.-based Centres for Disease Control (CDC). ILRI and AU-IBAR worked closely together to conduct a basic 10-day training course that they held in three countries: Cameroon, Kenya and Senegal. They drew trainers from OIE/FAO/WHO avian influenza reference laboratories, ILRI, AU-IBAR, CDC-Kenya, the Institut Pasteur, the Centre Pasteur and African universities and research organizations.

These courses revealed that most African countries have the capacity to collect samples of bird flu virus, including the highly pathogenic H5N1 avian influenza virus, and ship these to designated laboratories for analyses. Some of these labs can also perform basic serological tests for bird flu virus. But few of them are equipped with the advanced diagnostic tests in molecular diagnosis and virology or with the BL3 facility (a laboratory built to a secure biosafety level 3) needed to handle the deadly live H5N1 virus. ILRI and AU-IBAR staff organizing the training courses targeted the few labs that did have these facilities to serve as regional reference laboratories and provided 20 of their staff with two advanced training courses (one in English, the other in French) conducted at South Africa’s ARC-Onderstepoort Veterinary Institute (OVI), in Pretoria, which is equipped with all the facilities needed for diagnosis of avian influenza. (OVI had previously trained staff in southern African countries.)

Funding for this project was provided by Germany’s Federal Ministry for Economic Cooperation and Development (BMZ) and implemented by GTZ within its ‘Poverty Reduction in Rural Areas’ project. The latter works to boost—in a sustained manner—the capacity of developing countries to prepare for and respond to outbreaks of bird flu. With uncommon foresight, this German project further helps countries implement preventive measures that help their farming communities maintain their livestock, the mainstay of livelihoods of the rural poor. Among the farm animals at risk from zoonotic diseases and conventional programs implemented to control them are many local poultry breeds kept by the poorest of the poor.

Carola von Morstein, leader of the GTZ Task Force conducting this pro-poor work fighting avian and human influenza, visited Nairobi this week to consult with ILRI and AU-IBAR directors and scientists who organized the training and tailored the English and French courses to suit African circumstances.

In early July, the first follow-up training took place in three veterinary laboratories in Ghana. Staffs of the laboratories in Accra, Pong Tamale and Kumasi were trained by the German Friedrich-Löffler-Institute (FLI). This Federal Research Institute for Animal Health has a Task Force for Epidemiology. GTZ and FLI are together providing training to affected countries such as Ghana. GTZ also procured for these laboratories equipment, such as Quick Tests Influenza Kits, V-bottomed Microtest-Plates and Pipettes, to ensure that the country is equipped for diagnosis of bird flu.

For more information about this GTZ project, email the GTZ task team:
carola.morstein-von@gtz.de> or
kerstin.schoell@gtz.de

or the Rene Bessin at AU-IBAR:
rene.bessin@au-ibar.org

or Duncan Mwangi or Roger Pellé at ILRI:
d.mwangi@cgiar.org and r.pelle@cgiar.org

A GBP3.9 million (USD7.8 million) study, launched today by the UK’s Department for International Development (DFID) to develop better ways of controlling bird flu aims to help the world’s poorest farmers tackle avian flu and safeguard their livelihoods.

The DFID-funded research programme will examine the best ways to control avian flu and also how to reduce the impact of the disease on poor peoples’ livelihoods. The programme focuses on Africa and Southeast Asia, with initial research to be conducted in Thailand, Vietnam, Indonesia, Cambodia, Kenya, Ethiopia, Mali and Nigeria. The International Livestock Research Institute (ILRI) and International Food Policy Research Institute (IFPRI) will manage the research in Africa, while in Southeast Asia the research will be managed by the United Nation’s Food and Agriculture Organisation (FAO), the Royal Veterinary College and the University of California at Berkeley.

John McDermott, ILRI’s Deputy Director General for Research, says ‘In global avian influenza discussions there are many different perspectives. This project seeks to provide evidence on the impacts and control of avian influenza from the perspectives of developing country farmers, technical staff and policy makers, to allow them to effectively make decisions of importance to them.’

New Approach
The DFID-funded research programme marks a new approach as previous work has largely focused on eradicating Highly Pathogenic Avian Influenza (HPAI) from poultry populations and preparing for a potential human pandemic.

Launching the programme today, the UK’s International Development Secretary, Hilary Benn, said: ‘As well as claiming lives, avian flu – and the measures taken to control it – is damaging the livelihoods of farmers in the developing world. It is important to investigate how best to protect them when avian flu strikes.

‘This pioneering research will help find ways of helping the poor while also ensuring appropriate control measures are followed so that farmers do not hide, slaughter or eat infected birds. The first results of the study are expected within a year and will be discussed with policy makers in Africa and Asia.’

The potential impact on agriculture of the continuing spread of HPAI and the fear of this developing into a human pandemic are very great. The World Bank recently estimated that a pandemic could reduce the world’s GDP by five per cent, with a higher proportional loss in developing countries. To date, HPAI infections have claimed more than 170 lives in 12 countries since 2003 and, in South East Asia, led to the culling of more than 140 million birds with a total estimated economic loss to the region of more than $10 billion.

Jeff Mariner, senior epidemiologist at ILRI, says, ‘Although the potential of HPAI to adapt to man and cause a global pandemic is the primary concern motivating much of the donor response to this disease in the world, human disease is as yet a rare event. Very few farming communities have actually experienced human cases. The primary concern of farmers today is the negative impact that repeated waves of poultry mortality due to HPAI have on their livelihoods. Understanding the impact of HPAI in poultry on peoples’ livelihoods will provide entry points to motivate and drive effective control programmes. Enhanced control of HPAI to reduce the risk of a human pandemic is only possible through win-win scenarios that address the present effects of HPAI.’

Further information:
Click here for the DFID press release

Click here
for the IFPRI press release

‘Participatory epidemiology’ – an approach to controlling livestock diseases pioneered by ILRI’s Jeff Mariner and colleague Christine Jost – is being used to improve control of bird flu in Indonesia.

Indonesia has the worst bird flu problem in the world. Experts fear that the country provides the perfect setting for the highly pathogenic form of avian influenza, H5N1, to evolve into a form easily passed among humans, touching off a global pandemic. Through an approach known as ‘participatory epidemiology’, teams of veterinarians are tapping into local knowledge of where and when bird flu outbreaks are occurring and then enlisting villagers’ cooperation in control efforts.

The H5N1 virus is endemic among poultry throughout much of Indonesia. ‘You simply couldn’t get more virus in the environment,’ says Jeffrey Mariner, a veterinarian at the International Livestock Research Institute (ILRI), in Nairobi, who is helping train surveillance teams under the auspices of the Food and Agriculture Organization (FAO) of the United Nations.

To establish a systematic control program, officials will have to track where and when outbreaks of bird flu are occurring, especially among the estimated 300 million chickens kept in backyards by 60% of all Indonesian households. That’s the challenge for a new approach called ‘participatory epidemiology’ pioneered by Jeff Mariner and his colleague Christine Jost, an assistant professor at Tufts University, in Massachusetts. By talking to villagers and about disease incidences and symptoms, researchers can gather valuable epidemiological data on how disease is spreading and kept in circulation, which in turn informs control strategies. Mariner and Jost pioneered participatory epidemiology to help control rinderpest in Africa. This approach enabled authorities in Sudan to target vaccination programs that eradicated rinderpest from the country. Although participatory approach has never been tried for avian influenza and has never been tried on such a large scale for any disease, international and Indonesian animal health officials believe that this approach will be a key component for bringing the H5N1 crisis under control, both in Indonesia and elsewhere in the developing world.

Early in 2006, with USD1.5 million in funding from the United States Agency for International Development (USAID), a pilot program was established in 12 districts in Java comprising two teams of publicly funded vets specializing in either participatory disease surveillance or participatory disease response. The teams ‘turned up much more avian influenza than anyone expected,’ Mariner says. ‘Poultry populations were fully saturated with the disease.’

Those alarming results persuaded Indonesian authorities and international experts to push for a rapid expansion of participatory epidemiology. Even though coverage of the country is still fairly limited, the data being accumulated are providing clues to what keeps the virus in circulation.

Participatory response is an important part of the program. Mariner says that until recently the standard response was for government vets to indiscriminately cull all poultry around the villages where infected birds were found and then vaccinate widely. This mass culling, known as ‘stamping out’, causes resentment among smallholders, who may correctly believe that their birds have not been exposed to the virus. Delays in compensation exacerbate the ill feelings. The participatory approach aims to involve villagers in decisions—ideally, to cull all poultry directly exposed to infected birds, with immediate compensation, and then vaccinate other birds in the vicinity. Mariner says that even smallholders can be convinced of the need to cull birds that have been directly exposed to H5N1-infected chickens.

At the same time that Indonesia is verifying the effectiveness of participatory epidemiology, the country, with FAO support and financing from the United States, Australia and Japan, is planning to extend the program to all of Java and Bali and parts of Sumatra by next May.

This article was taken from a longer article published in Science on 5 January 2007 titled: Indonesia Taps Village Wisdom to Fight Bird Flu.

Download article (subscription required): http://www.sciencemag.org/cgi/content/full/315/5808/30

Fighting deadly bird flu in the developing world is more complex and difficult than in the industrialized west. To be effective, global control strategies must take developing-country contexts and perspectives into account.

A recent consultation on highly pathogenic avian influenza (HPAI) highlighted the complexities of fighting bird flu in the South. The consultation, held in Nairobi 14–16 June 2006, was organized by the International Livestock Research Institute (ILRI) and the International Food Policy Research Institute (IFPRI). Participants worked towards identifying how the research community can best assist developing countries and frontline personnel in the fight against bird flu both now and in the medium to longer terms.

The consultation report, How Research Can Support Efforts to Control Avian Influenza in Developing Countries: First Steps Toward a Research Action Plan, is now available. The report contains a comprehensive list of service and research needs identified by participants. The next step will involve validating and prioritizing these lists in a broader email-based consultation.

Battling Bird Flu: Developing Country Context & Perspectives
Developing countries have large numbers of widely dispersed small-scale and backyard poultry keepers. This makes detecting and controlling the disease difficult. In addition, these countries generally have insufficient numbers of professional in disease control and communication work and insufficient institutional support for controlling disease. All of this makes it difficult to communicate the risks of the disease and to get people to comply with control efforts. ‘Stamping-out’ (mass culling of poultry infected or suspected to be infected) is routinely adopted in industrialized countries, but this approach is likely to be impractical in developing countries. If our strategies to fight bird flu don’t take developing-country contexts into account, we will fail to control bird flu globally.

As important, John McDermott, ILRI’s Deputy Director General for Research, warns, ‘In the battle against bird flu, the world’s poorest people could become the main victims of the disease. They have little voice in how we control the disease and the burden of controlling it falls disproportionately on the rural poor, who both consume their own poultry and rely on it for their livelihoods.’

McDermott and his colleagues at ILRI and partner institutions in Africa and Asia are saying, in effect, that ‘one size does not fit all’. What works in the North will not necessarily work in the South. To fight bird flu successfully, we must attend to social as well as to economic and technical issues, we must learn from frontline experience, and we must understand the developing-country context for disease control. If we do these things, we will help develop control strategies that countries can tailor to their conditions and circumstances.

The Consultation: Experiences from the Front Line
The Nairobi Consultation opened with interviews of scientists with direct field experience in Asia and Africa. These experts with first-hand knowledge of fighting the disease identified illegal cross-border trade and live bird markets as key vehicles for the spread of bird flu within and between countries. Constraining early notification of disease outbreaks and subsequent control of the disease, they reported, were insufficient or total lack of compensation for lost birds, lack of trust in governments, and the common farmer experience of losing lots of birds to Newcastle Disease and other, endemic, diseases.

Key Issues Highlighted
Compensation

  • Well-publicized and carefully thought out compensation plans are critical to achieving early notification of outbreaks and effective control of bird flu. Lessons from the front-line tell us that compensation plans should consider more than just direct compensation for birds lost to the disease or culling operations. While some countries have provided poultry owners with compensation, others have not done so or do not intend to offer any form of compensation. A key message from the experts at this consultation was that compensation matters, and it matters a great deal to millions of poor small-scale farmers.
  • In India, for example, although farmers received compensation within a few hours of their birds being culled, they were compensated for no associated investments. Many farmers had cash tied up in grain bought to feed their chickens and had no other use for the grain once their chickens were gone. India’s experience suggests that a broader view of compensation is required. The bird flu scare in India caused people to panic, poultry prices plummeted, and those directly and indirectly involved with poultry and grain lost their livelihoods as their industry crashed.
  • Implementing different compensation levels for different sizes and/or ages of birds lost could create new problems. Farmers might be tempted, for example, to hide their young birds until they grew to a size that would attract the highest price, thus putting people and animals at greater risk of the disease.


Major threats

  • Migrating birds: Many participants believed that migrating wild birds were not the greatest threat to the spread of bird flu in developing countries. Although southern Africa had not at the time of the consultation had any confirmed cases of the highly pathogenic H5N1 virus, different forms of bird flu have been present there for some years, typically infecting ostriches. Experts there are concerned about possible introduction of new strains from ostriches and introduction by illegal cross-border movement of people, birds, and avian products, as well as the wild birds who migrate from nothern Europe to this region.
  • Trade: Illegal cross-border transfers of both live poultry and carcasses was identified as one of the biggest threats to the spread of bird flu and a key route for transmission within and between countries. Live birds and poultry carcasses are already being smuggled across borders and this is likely to increase if widespread culling is implemented and little or no compensation is offered. The borders of many developing countries are large and porous with only certain parts patrolled, making illegal cross-border transportation of birds relatively easy.
  • Markets: Live bird markets represent another key route for transmission of bird flu. In some countries, farmers are being advised not to take home any live birds that they are unable to sell at market to avoid infecting flocks at home, but what they should do with their live unsold birds is not specified. And where live bird markets are being made illegal, some are simply going underground.


Diagnosis and control

  • Poor farmers are familiar with dead and dying chickens – this is a fairly regular occurrence for them. Newcastle disease is endemic in many developing countries and can kill many birds fast. Confusion in the diagnosis of poultry diseases – notably in distinguishing the Newcastle disease from HPAI and other diseases – is a further obstacle to early notification and identification of bird flu. Needed are clear communication and information about the physical signs and symptoms of poultry diseases, what to do if the farmer sees these, and the risks the farmer faces if he or she does nothing about the disease.
  • People’s lack of trust in their governments and/or promises of compensation were identified as key constraints to implementing emergency response and control procedures such as mass culling. The utility of employing mass culling as a means to control the spread of bird flu in developing countries was also questioned by these experts.
  • Most smallholders keep only a few birds in their backyards. Mass culling of all poultry infected and suspected to be infected would be impractical. If no incentives are provided to the smallholders for complying with culling operations, and if most of the smallholders do not recognize the risks of not culling, it is likely that many of them would simply hide their chickens or try to sell them quickly. The incentives provided to poultry keepers have to be sufficient to encourage people to be extra vigilant and to report any suspected cases of bird flu immediately.


Poultry to human transmission

  • Many poor people live close to their livestock, with household members and their chickens often sharing the same small dwelling at night. This increases the potential for transmission of bird flu from poultry to humans. How do you educate people about the dangers of poultry-to-human transmission when practices such as sleeping in the same room with your chickens are widespread? What alternatives do people living in great material poverty have that will ensure their poultry are safe from predators or theft?


The value of chickens to the poor

  • For many small farmers, chickens are ‘coins’ in the bank used for small emergencies: the birds can be sold quickly to raise money for such essentials as food, school fees and medicines.
  • Chicken and eggs are relatively cheap sources of animal protein for the poor. If eggs and chicken become unavailable to the poor, the nutrition and health of many children, women of childbearing age, and other vulnerable groups will be put at risk.
  • Poor people value chickens for more than their market value. For many, chickens represent the first step on the ‘livestock ladder’ out of poverty. Compensation schemes based on market rates are thus unlikely to satisfy farmers or provide them with sufficient incentive to report suspected cases of bird flu.


Alternative investment strategies

  • If chickens are culled and people advised not to restock, what livestock can replace the chickens? Larger livestock are out of the reach of many poor people. And even financial compensation at market values for a small number of chickens would be insufficient to enable the poor to reinvest in other types of livestock. Thus, the living assets of the poor would be liquidized with few alternative (livestock) reinvestment options on offer; other livelihood options would have to be explored.


Information, education and communication

  • Information, Education and Communication has been the mantra working well in Vietnam, one of the first countries to suffer from bird flu. Vietnam has been continually developing, refining and improving its communications to make them relevant to the local communities.
  • Many communications concerning bird flu have been written in English and/or other European languages and do not translate well into local languages. To be effective, communications must consider social and cultural contexts and be open to continual revisions.
  • The bird flu outbreak in Laos highlighted the lack of basic science education and lack of veterinary infrastructure. No veterinarians had been trained there since 1975, leaving only nine veterinarians to serve the whole country. Laos is now working hard, however, to build capacity. The bird flu outbreaks in Laos were largely in commercial poultry farms in urban areas and there were only a few commercial poultry farmers with large numbers of birds. This is in stark contrast to other developing countries in Asia and Africa, where the poultry structure is made up of very large numbers of widely distributed small commercial operations.
  • Community and religious leaders were identified as key players to raise awareness of the dangers of bird flu. Having a series of clear, simple messages conveyed in local languages to communities by trusted sources was viewed as vital to preparedness, emergency response and control. Community action worked well in communities that were relatively stable, and where people were regularly informed and involved and had a vested interest in working together to protect the community as a whole.


According to Dr Carlos Seré, ILRI’s Director General: ‘The global fight against bird flu has to equitable as well as effective – protecting the livelihoods of the world’s poor as well as lives worldwide.

‘To be more effective, efficient and sustainable, bird flu control technologies and strategies must be adapted to the particular realities and constraints of developing countries, including the need to balance public health and poverty reduction objectives. Otherwise, bird flu control will not work in developing countries, and poor control there will continue to threaten the North.’

Short Movie
Robyn Alders of the Kyeema Foundation on The difficulties of diagnosing bird flu in developing countries.

ILRI and IFPRI are convening a consultation in Nairobi from 14 to 16 June 2006 to determine how the research community can best assist developing countries in the fight against bird flu.

The International Livestock Research Institute (ILRI) and the International Food Policy Research Institute (IFPRI) are convening a consultation to explore how research can support efforts to control the highly contagious avian influenza, with special emphasis on the needs of developing countries and the poor. The consultation is a response to requests from donors on priorities for targeting their research investments for Asia and Africa.

The consultation has four main objectives:

  1. To share the experiences of those in the front-line of avian influenza outbreaks to provide a realistic, objective, and up-to-date backdrop for the consultation.
  2. To identify and prioritize immediate service needs that research can provide in support of preparedness and emergency responses.
  3. To identify and prioritize medium-and long-term research needs.
  4. To develop an action plan and decide how to put it in place, including the possibility of forming an inter-institutional task force.

Much of the present effort in fighting bird flu is focused on immediate actions – emergency preparedness and response. The research community, however, also has a critical role to play in anticipating and addressing medium-and longer-term issues associated with bird flu in developing countries.

One of the greatest concerns is that bird flu could eventually become endemic in developing countries due to large poultry populations, weak infrastructure, scarce veterinary expertise and a general lack of resources. Poor poultry keepers in developing countries are also at a high risk of contracting bird flu, because they live in such close proximity to their livestock. Those who keep poultry and are desperately poor have the most to lose – and many may choose to save or eat sick chickens. This could put all family members and their other livestock at risk of contracting the deadly bird flu. The impacts on poor livestock keepers in Africa are highlighted in a recent article in the New Agriculturist.

New Agriculturist news article


Falling fowl of avian flu? New Agriculturist 1 May 2006

Members of the international development community wishing for more information about the ILRI-IFPRI Avian Influenza Consultation should contact Keith Sones ksones@africaonline.co.ke.

Further information about bird flu is available at ILRI’s Livestock in the News: Bird Flu page.

ILRI and Uganda experts have just produced a series of poultry density maps for Uganda, which will provide information on potentially threatened areas in the event of bird flu reaching the country.

Africa is on red alert for bird flu, with five states – Egypt, Nigeria, Niger, Cameroon and Burkina Faso- now having confirmed cases of the deadly H5N1 strain in poultry.

Uganda, located in eastern Africa, has an estimated population of 25.3 million and an annual population growth rate of 2.7%. Despite Uganda’s progress and concerted poverty reduction efforts, poverty is still widespread, with an estimated 38% of the population living below the national poverty line. The latest figures show the average life expectancy of a Ugandan is 43 years (47 years in 1990), infant mortality is 83 per 1000 live births, and under 5 mortality is 141 per 1000 children. The annual number of births is 1.3 million, but an estimated 184,000 children under 5 die each year.

(Data sources: World Bank; UNICEF.)

Agriculture is the most important sector of Uganda’s economy, contributing over 32% of GDP and employing over 80% of the work force. The poultry maps give a visual representation of poultry density in Uganda, including total poultry density, local chicken, exotic/cross-bred chicken, turkeys, ducks, guinea fowl and geese. The maps reveal that almost 50% of agricultural households keep local chicken, but only a tiny proportion (0.7%) keep exotic/cross-bred chicken. Most local chicken are reared in the eastern and northern regions. For households rearing local chicken, 80% had less than 10 birds.

The maps also show high densities of exotic chicken can be found around major urban centres like Kampala, Jinja, Entebbe, Masaka, Mpigi and Mbarara. In these densely populated areas, demand for chicken has outstripped supply of local chicken. Many are now rearing exotic chicken mainly for economic gain. Of the households that rear exotic chicken 56% have less than 10 birds, with the vast majority (80%) having less than 100 birds.

Uganda 2002:
Total Poultry Density

Uganda 2002:
Duck Density

Uganda 2002:
Local Chicken Density

Uganda 2002:
Exotic Chicken Density

Uganda 2002:
Geese Density

Uganda 2002:
Turkey Density

Uganda 2002:
Guinea Fowl Density

Uganda 2002:
Livestock Density Per Household

Uganda 2002:
Ownership of Welfare Assets

These maps complement poverty maps published earlier this year.
See Where are the Poor in Uganda?

For more information on bird flu, go to Livestock in the News

The deadly H5N1 virus claims its first victim in Iraq while Africa girds itself for a battle against a new pandemic.

BirdFluThreatLive guinea fowl and eggs for sale in a market outside Kano, NigeriaAt the end of January has come news the world was dreading—a preliminary positive report from a US Navy medical laboratory in Cairo of the first death of a person from avian fly in Iraq, a country fighting an insurgency and perhaps in the early stages of civil war. The victim, a girl from Iraq’s Kurdistan region, died two weeks ago in a household that had sick birds; an uncle of hers died later with similar symptoms. With four confirmed deaths of people from avian flu in neighbouring Turkey, where the victims also became infected from sick birds, the fear is that this lethal virus could mutate into a form that can pass from human to human, rather than bird to human as it is normally transmitted now, provoking a flu epidemic that could kill millions of people in a short space of time.

While the fear of avian influenza is keeping some African farmers watchful for sick birds in their flocks, most smallholders are too poor and are facing too many other risks to pay much attention to this flu threat as of yet. African governments, however, are readying themselves. This January, 140 experts from 43 African countries met in Congo’s Brazzaville to draft a blueprint for tackling an outbreak in the world’s poorest continent, already battling AIDS and tuberculosis.

There are fears that avian influenza could spread to the continent via populations of migrating wild birds now residing in eastern Africa to escape the European winter, with the peak of migration being January to March. An outbreak of the lethal H5N1 virus anywhere in Africa’s Horn could spell disaster. More than three-quarters of the people in this region farm for a living and almost all households outside cities keep some chickens. Existing high rates of mortality among domestic birds here will make it hard to detect the virus. Unaware of the risks, villagers would tend to eat birds showing symptoms of the disease. And few African governments would have the resources to pay for culling bird populations and compensating farmers for their losses.

Avian influenza has not been detected in Kenya or any other African country yet. Kenya is close to completing a National Preparedness Plan after a series of weekly meetings by experts, including ILRI immunologist David Mwangi, which started late last year. Kenya has formed a National Avian Influenza Secretariat hosted by the Ministry of Health (MOH) and manned by that Ministry and the Directorate of Veterinary Services (DVS). Dr Mwangi participated in an Avian Influenza National Taskforce meeting in early January, where Kenya’s six-level response system was outlined. Kenya is now in Alert Phase I, which involves surveillance, laboratory support, infection control measures, case management, preparedness and communication and education. A Cabinet paper has been submitted to request funds from the Kenyan Government for this Task Force and donor funds are being sought.

Activities are being conducted now using the limited budgets of the MOH, DVS, Kenyan Museums (whose ornithologists are helping to check wild bird populations for diseased or dead birds), and an office of the US Centers for Disease Control (CDC), whose laboratories at the Kenya Medical Research Institute (KEMRI) include a Biosafety Level-3 Laboratory, the only kind in the country capable of carrying out diagnosis of avian influenza in conjunction with a CDC laboratory in Egypt. Kenya’s frontline national laboratories, KEMRI and DVS, have joined hands in this fight with the Kenya Agricultural Research Institute (KARI) and ILRI to form sub-committees responsible for various work. ILRI is represented on the coordination and resource mobilization team; the surveillance and monitoring team, which are exploiting ILRI’s expertise in epidemiology and geographic information systems; and laboratory support, particularly diagnosis and DNA sequencing and database work.

To read more about ILRI and Kenya plans and activities on this task force, read ‘Bird flu threat still hovers over Kenya’ in the Sunday Nation, 15 January 2005.

The good news is that so far the bird flu virus has remained hard for people to catch. Most human cases acquired their infection during the home slaughtering and subsequent handling (defeathering and eviscerating) of diseased or dead birds before cooking them. The bad news is that in Africa as in Asia, birds are often marketed live, with home slaughtering common, increasing the risk of human infections in areas with outbreaks in poultry. Those buying poultry meat, however, are in no danger because chickens and other poultry are safe to eat if cooked properly.

ILRI agrees with other international organizations that key elements in helping developing countries cope with avian flu outbreaks among animals is strengthening surveillance systems and veterinary laboratories and services, improving people’s access to veterinary services, and providing proper compensation to poultry farmers and marketers for culled birds. World Bank Vice President Jim Adams says that, ‘Experience shows if you get the animal side right, one substantially reduces the risk of a human pandemic.’

With the continuing spread of avian flu beyond its stronghold in Asia, it is clear that combating the disease requires a long-term, internationally coordinated and well-funded effort. That’s why it is good news that donor and international health organizations meeting in Beijing January 17 and 18 pledged US$1.9 billion over the next 3 years to fight bird flu. About $1 billion will be disbursed as grants, the rest as loans. The donors of this massive new program—which include the European Union, United States and World Bank—have set up an Avian Influenza Multidonor Financing Framework to coordinate it.

Read a CGIAR news release and briefing on how the threat of avian flu impacts the developing world.

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