More than 400 representatives from more than 72 countries gathered in Bamako from December 6 to 8 to evaluate the progress in fighting avian and pandemic influenza, and to increase financial support for prevention and response efforts, with a special focus on Africa.The deadly highly pathogenic Avian Influenza H5N1 virus remains a potent threat around the world, and the failure of one country to contain the disease can lead to the infection of many other countries, creating a domino effect and undoing all prevention efforts already in place.
In Segou, a small town, three hours away from Bamako, Moussa rides his bicycle to sell chickens that he raises in his backyard. The income from selling the birds is the only cash he earns to support his family. Moussa represents many poor families in Africa who rely on chickens as a major source of income as well as a main source of protein.
Moussa has heard on national TV that there was no sign of avian flu in his country, Mali. He knows that in case of sudden and massive death of his poultry, he must inform the local veterinary services. But he is convinced that this extreme situation will not happen.
“Poor people rely increasingly on poultry, duck, and other birds to earn income, and as a major source of protein in their diet, so stamping out avian flu is very much a key development challenge,” said John McIntire, Special Representative of the World Bank to the Fourth International Conference on Avian Flu.
The Bamako conference, which was open to all countries, was part of a series intended to keep a high-level of attention on avian flu and to review the adequacy of the international response (the Beijing Pledging Conference in January 2006, followed by the Vienna Senior Officials Meeting in June 2006).
The Bamako meeting was especially needed because world media has shifted its reporting away from avian flu. There is now a risk that programs to prevent and mitigate the costs of the potential catastrophe are receiving a lower priority, even though the virus has spread substantially since the time of the Beijing conference in January 2006.
Africa a priority
According to Francois Le Gall, the World Bank's lead livestock specialist for Africa, avian flu is just one of many diseases impacting Africa:
“The experts are telling us that other diseases are going to emerge or re-emerge. Almost every year there is a new disease appearing, and 75 percent of these emerging or re-emerging diseases are coming from animals; 80 percent of those have the potential to be transmitted from animal to human. These could come together to create what the experts are calling 'the perfect microbial storm."
Africa Avian Flu
Since March 2006, the World Bank has set up a new cross-sector task force on avian flu for Africa. The sector directors and sector managers for ESSD and HD have nominated a focal point person for each unit in ESSD and HD to serve on the task force. In addition, QK and LEGAF designate one person to provide advice and support on procurement, financial management, and legal issues.
The Avian Influenza Task Force has several objectives:
- Manage the information, communication, and coordination aspects of the response to avian influenza
- Support country teams in preparing individual country operations
- Help coordinate the region’s response with the global and Bank-wide funding programs, with donors, and mobilize additional funding as necessary.
Le Gall said that progress is being made now to tackle the current bird flu outbreak by strengthening veterinary and human health monitoring systems around the world. This, he noted, would temper the risk of an apocalyptic conflagration of diseases. "All the measures we are using now are going to be useful to control all these emerging or re-emerging diseases — like veterinary services, public health services."
Socio-economic vulnerability, impact of already existing diseases such as malaria, TB and HIV/AIDS, and poor capacity of veterinary services combine to make a complex situation in Africa.
In 2006, eight countries ─ Nigeria, Egypt , Niger, Cameroon , Burkina Faso, Sudan, Côte D’Ivoire, and Djibouti ─ reported outbreaks that resulted in sixteen confirmed human cases with seven fatalities.
The first outbreak was in Nigeria in January, 2006 and the presence of the virus was officially confirmed in February; then between January and April seven other countries were infected. The virus still circulates in Nigeria and Egypt, and Côte d’Ivoire recently reported an outbreak.
The current risk remains largely at the poultry level. Alpha Koumare, chairperson of the African Union has stated: “Since the introduction of the disease in February 2006 in the continent, Africa has suffered untold reversals of over US$60 million due to poultry mortality and culling of infected flocks and significant public health risks.”
But the greater concern is that the virus might take root in some regions, thus expanding its presence across the continent and raising the risk of genetic changes that cause a human pandemic. Migratory birds play a key role in spreading the virus, but large movements of animal and human populations, as well as trade in products and animals, contribute to its expansion. The recent outbreak in Côte d’Ivoire seems to indicate that the bird flu is slowly becoming endemic in the Africa region. Ok Pannenborg, Senior Health Advisor for the Bank’s Africa region, notes that
“While endemicity, so far, primarily remains an animal health problem, it does add to the human health risks. Up to now, there is no human-to-human transmission; however, the deeper the endemicity, the larger is the risk that the virus will mutate into a type that will be able to be transmitted from person to person. Once that happens, you have a completely different situation, and you cannot start preparing once it happens, because that will be way too late. Arguing for resources to prevent a risk from happening will always be difficult, but is crucial if we are not collectively all to be very sorry later.”
Preventing the spread of the disease and coping with outbreaks will require strengthening human and animal health systems and building capacity to communicate about risk, prevention, and compensation.
A coordinating platform: ALive
The World Bank, together with the World Organization for Animal Health (OIE), the FAO, and the African Union, has created the ALive platform, www.ALive-online.org. ALive is a multi-institutional and interdisciplinary partnership created as a coordinating mechanism not only for the fight against avian influenza, but also for the prevention of future emerging and re-emerging animal diseases.
The ALive group now counts 24 members, representing donors, research and training bodies, and international organizations as members of the partnership.
The group has produced a comprehensive paper assessing the financial needs for the continent. The paper presents the short, medium and long-term needs at the national, regional and global levels. ALive estimates that the financial needs for an integrated prevention strategy focusing on communication and animal and human health would be around US$720 million over 3 years. At the Bamako conference, the European Commission signed an agreement to provide US$ 10.5 million additional funding to the ALive Partnership.
Donors pledge $475 million
According to a World Bank assessment presented at the conference, $1.2 billion-$1.5 billion are urgently needed to sustain avian and human influenza programs over the next 2-3 years. In response, fourteen donors pledged over $475 million in grants to support developing countries and international technical institutions to respond to the avian and human influenza threats.
The funding pledged at the Bamako conference augments the nearly $1.9 billion already mobilized at the Beijing pledging conference in January 2006. Together with financing from multilateral development banks, the funding will be able to cover priority programs at the country, regional, and global levels during the next twelve months.