 | Ducks have been in high demand during Vietnam's Lunar New Year celebrations, despite avian flu outbreaks |
February 28, 2008––A 22-year-old Chinese man, and another in his early forties, along with a 27-year-old Vietnamese man in Ninh Binh have become the latest victims of avian flu. The three men died after developing headaches and fevers from the highly pathogenic avian flu virus. A seven-year-old child in Vietnam is also under surveillance after testing positive. The disease has now killed 234 people worldwide and cost countries, commercial poultry operators, and families billions of dollars in economic losses. In West Bengal, the Indian government has reported no new cases of avian flu after a dramatic surge in infected poultry led to the culling of some 3.9 million birds. In neighboring Bangladesh, nearly a million birds have been culled, but the disease continues to spread. The Bangladeshi poultry industry has already suffered some 45 billion taka ($650 million) in losses, and 60 percent of the country’s chicken farms are out of business. In the Middle East, Egypt has discovered new cases in chickens in two towns in the Nile Delta provinces of Gharbia and Kafr el Sheik. As many as 19 of the 43 Egyptians known to have caught avian flu have died over the last several years, making Egypt the hardest-hit country outside Asia, which has long been the world’s avian flu epicenter. A Growing Threat Avian flu (H5N1) has faded from newspaper headlines since the period 2003–2006, when media attention was at its height, but the threat of H5N1 to national and global health and financial systems is still serious. The disease has now been reported by 61 countries, compared to just 17 at the end of 2005. Should a human pandemic virus emerge—one capable of being spread from human-to-human just like seasonal flu—the subsequent shock to economies and communities everywhere could be catastrophic. The potential cost to the global economy could be in the order of $2 trillion, with the heaviest impact likely in developing countries. A recent study published in the New England Journal of medicine points out that bird flu symptoms—from fever and cough to diarrhea and vomiting— have been mistaken by doctors for pneumonia, typhoid, and at least four other diseases in Southeast Asia, causing treatment delays that might have worsened their patients' chances of survival.  | The UN's David Nabarro |
“It’s still out there, and we can’t afford to be complacent for a minute,” Dr. David Nabarro, the UN system influenza coordinator at UNSIC, said on a layover between flights as he shuttled between affected countries, donors, and technical agencies. Nabarro says the world’s response so far has been patchy. “Certainly we’re better off today than we were three years ago, but we still have a lot of work left to strengthen animal health surveillance, and have veterinarian systems in place that let us contain avian flu outbreaks in poultry, which is essential for preventing its cross-over into a human flu pandemic.” Regional Avian Flu Teams The Bank’s Regional avian flu teams are relaying the same message to their counterparts in countries and partner agencies alike. Since December 2007, Bangladesh, Benin, China, Egypt, Germany, India, Indonesia, Iran, Israel, Myanmar, Poland, Russia, Ukraine, Turkey and Vietnam have all confirmed new H5N1 outbreaks. Most of the confirmed outbreaks occurred in domestic poultry, including chickens, turkeys, geese and ducks. “On the plus side, the response by the development community to avian flu has been a good example of global cooperation,” says Olga Jonas, an economic adviser in OPCS, who coordinates the Bank’s avian flu response with Networks, Regional teams and outside partners on a regular basis. “But within countries themselves, we see too little operational readiness, especially at the local level, and not enough pandemic planning between neighboring countries. We’re also worried that people may be seeing this as purely a health concern, and not the development and disaster-preparedness challenge it really is,” Jonas added.  | A veterinarian in Vietnam examines a duck for signs of avian flu |
Report to the Delhi Summit A progress report written by the Bank and UNSIC for the Delhi International Ministerial Conference on Avian and Pandemic Influenza noted that, “the virus is considered to be entrenched (or enzootic) in parts of Indonesia, Egypt, Nigeria, and possibly parts of Bangladesh and China. “Given the potential of poultry trade and wild birds to carry the virus over long distances, continued transmission of Highly Pathogenic Avian Influenza among poultry in any one country represents a threat to the world,” The report added. The report goes on to say that while “substantial progress has been made in the initial-emergency phase of the global response and threats to public health…a national, regional, and international three-to five-year response to these challenges should be mapped out and agreed by governments.” Financing the Fight Nearly all of the external assistance announced at international pledging conferences—some $1.3 billion of grant funding for 2005–2008—has already been spent. Developing countries are increasingly mobilizing their own scarce finances to defend against avian flu. As a result, the New Delhi summit asked the Bank and partner agencies to jointly craft a medium-to long-term avian flu strategy, which could be tabled at the next ministerial meeting on avian and pandemic influenza in Cairo in mid-October this year.
One aim is to mobilize additional support for developing countries, which have been fighting avian flu as a global public good on behalf of the rest of the world.
In 2006, when the Bank’s response to avian flu was launched, each of the Bank’s Regions appointed a representative to a Bank-wide task force on avian and human influenza (AHI—See box above).
With the Cairo summit coming up this autumn, the task force is now working at speed on the new strategy. Teams from the Human Development and Sustainable Development Networks, together with OPCS and EXT’s development communications team, have already launched a review of experience gained from implementation of the Bank’s portfolio of emergency avian and human influenza projects. Forty-eight projects have been approved to date, and 38 more are in the pipeline. A Real Threat As a key member of the strategy group, the Bank’s Director of Health, Nutrition, and Population Julian Schweitzer, says the Bank’s ongoing vigilance around H5N1 is essential as the world enters a new age of animal-borne viruses ready to jump the divide into the human population. “Even if we manage to dodge the threat from H5N1 specifically, we know with great certainty that another mutated form of it, or perhaps another animal virus altogether, will spark an influenza pandemic sooner or later,” says Schweitzer. “Zoonotic diseases represent an increasing threat to health and development worldwide.”  | | Highly pathogenic avian flu (in brown ) invades cell tissue, seen under an electron microscope |
The Nipah virus, SARS, HIV, avian flu, Ebola, and West Nile are just some of the ‘zoonotic’ or animal viruses that have crossed over from the animal world into the human population, to deadly effect. Schweitzer says that strengthening human and animal health systems in low-income countries is a vital step towards shoring up national and global defenses against emerging health threats from the animal world, while containing those—like avian flu—that have now made themselves a permanent fixture in animals in large parts of the world. For more on the Bank’s work on avian and human influenza, including an overview of projects, their PADs/Technical Annexes, and lists of Bank Regional and Network contacts, go here. For the latest news on avian flu outbreaks, see the UN's avian influenza and pandemic threat site here. Contributed by Phil Hay, communications adviser for the Human Development Network, and a member of the Bank’s avian and human influenza taskforce |
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