At a Glance
- Since 2006, the World Bank has provided $1 billion in fast-track approval credits from the International Bank for Reconstruction and Development (IBRD) and the International Development Association (IDA) to help developing countries tackle animal-borne or “zoonotic” diseases that cause pandemics.
- The Avian and Human Influenza Facility, to which the European Commission is the largest contributor, made grants to developing countries to address the avian flu threat, complementing financing from IBRD, IDA, and other donors.
- 70% of diseases in humans are zoonotic, and 80% of potential bioterrorism agents are zoonotic, putting a spotlight on public veterinary systems for early detection and control.
- A severe pandemic would be catastrophic, costing 4.8% of GDP, or $3 trillion globally, causing widespread hardship, and putting progress toward the Millennium Development Goals (MDGs) at risk.
- Pandemic prevention can succeed through control of pathogens at their animal source, before the disease spreads into the human population and human and economic costs rise exponentially. Such control is the essence of One Health approaches that deal with diseases at the interface between animals, humans, and the environment.
The highly pathogenic avian influenza virus H5N1 has affected over 60 countries to date. Poultry deaths due to culling and disease are estimated at between 300 million and one billion, causing substantial losses to, and reducing the nutritional options of, the poor. Since January 2012, outbreaks afflicted several countries, including Bangladesh, China, Egypt, India, Indonesia, Israel, Myanmar, Nepal, and Vietnam. Human infections continue to be extremely rare; reported cases have declined in 2007-8, but increased again in 2009-11. As of April 12, 2012, the laboratory-confirmed human toll stood at 602 cases, including 355 fatalities, representing a case fatality ratio of 60 percent.
Economic Impact of Pandemic Influenza
Episodes such as SARS (2003) point to two types of impact. First, demand for services (tourism, retail trade, transport, entertainment, etc.) contracts. Second, there will be costs of illness (medication, hospitalization, etc.) and production losses as a result of reduced labor supply due to illness and death. In a moderate scenario, the labor supply shock in the first year of the pandemic could amount to 1.3 percent of GDP or more. Combined with preventive costs of close to 2 percent of GDP, total costs could exceed 3 percent of GDP. In a severe scenario, costs could reach 4.8 percent of world GDP or $3 trillion.
Health Systems Strengthening in the Global Fight against Animal and Pandemic Influenzas
The 2009 H1N1 pandemic has reinforced the need for health systems strengthening, which is central to the Bank’s 2007 Health, Nutrition, and Population Strategy. Health systems such as disease surveillance and response capacity have improved in many developing countries, but their human and animal health systems are not sufficiently strong to ward off future outbreaks. Donor financing for surveillance and control of infectious diseases at their animal source expanded substantially in 2006-9 when combating avian flu was a priority. But it has since declined as media and policymakers’ attention has shifted from pandemic prevention to other issues.
Though it cannot provide grant funding that would be most effective to encourage disease prevention, the Bank is well-positioned to help countries with the multisector (“One Health”) approach that is needed to ward off infectious diseases. In January 2006, the Bank’s Board endorsed a fast-track program of $1 billion from IBRD and IDA. To date, $1.3 billion has been approved, from IBRD/IDA and trust funds, for projects in 60 countries (Table 1). The Bank-administered multidonor Avian and Human Influenza Facility (AHIF) received pledges of $127 million from 10 donors, of which the European Commission is the largest. The program supports integrated programs that use “One Health” approaches to strengthen veterinary services (critical for disease prevention), animal and human disease surveillance (critical for timely diagnosis), and human health systems.
|Table 1. Countries Receiving Support under the Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response |
|Africa ||East Asia & Pacific ||Europe & Central Asia ||Middle East & N. Africa ||Latin America & Caribbean ||South Asia |
Egypt, Arab Republic of
Iran, Isl. Rep.
Syrian Arab Republic
West Bank and Gaza
Working with Partners and Support to Ministerial Conferences to Improve Coordination
The Bank is working closely with developing countries, donors, the United Nations (UN) System Influenza Coordinator, WHO, Food and Agriculture Organization (FAO), World Organization for Animal Health (OIE), and others. The Bank has supported a series of ministerial conferences, starting in 2006, by analyzing for the international community the financing needs and gaps, poultry sector bio-security, and compensation schemes. The Bank and the UN have prepared global progress reports for ministers, with the most recent one recommending a “One Health” approach to building systems for early and effective disease control. These core public health functions in developing countries will require adequate resources, for investments that will benefit the whole world. Investments in pandemic prevention and preparedness have very high rates of return.
For more about the Bank and the pandemic threat, please visit: www.worldbank.org/flu. Contacts: Melanie Mayhew, (202) 458-7891, firstname.lastname@example.org
Updated April 2012