Avian Influenza: Country Situations and Update and Implications

David NabarroUnited Nations System Influenza Coordinator

World BankMarch 28th 2006

1 H5N1 in Birds

An Epizootic moving rapidly across the world with the potential to

become a pandemic: 20 countries reporting H5N1 in last six weeks.

Why it matters?

• Impact of the Avian Influenza Epizootic and challenges for response: – 150 million dead poultry, – $billions economic consequences, – Extreme hardship for poor people– Sporadic human cases (Vietnam, Thailand,

China, Indonesia, Turkey, Azerbaijan, Egypt, Iraq….)

– Mounting public concern about what it all means

H5N1 OUTBREAKS IN BIRDS: CHRONOLOGY 1996 TO DATE

1996 to 2003June 2004December 2004June 2005December 2005March 2006

ChinaChinaSouth KoreaSouth Korea

IndonesiaIndonesia

VietnamVietnam

ThailandThailand CambodiaCambodia

JapanJapan

LaosLaos

MalaysiaMalaysia

KazakhstanKazakhstan

RussiaRussia

MongoliaMongolia

TurkeyTurkey

UkraineUkraine

RomaniaRomania

CroatiaCroatia

BulgariaBulgaria

AzerbaijanAzerbaijan

IraqIraq IranIran

NigerNiger

NigeriaNigeria

EgyptEgypt

FranceFranceSwitzerlandSwitzerland

GermanyGermanyItalyItaly

AustriaAustriaBosnia HerzegovinaBosnia Herzegovina

SlovakiaSlovakiaSerbia MontenegroSerbia Montenegro

HungaryHungary

SloveniaSlovenia

GreeceGreece PakistanPakistan

IndiaIndia

2000 miles2000 miles3000 miles3000 miles4000 miles4000 miles5000 miles5000 miles6000 miles6000 miles7000 miles7000 miles

Distance from Hong KongDistance from Hong Kong

Map compiled by WFP Emergency Preparedness and Response Branch (ODAP) 06.03.06

2 Threat of Pandemic

Why it Matters?

• Impact of Human Pandemic: – Local outbreaks: Global Impact (SARS - <1000

dead, $50 billion economic loss). – Significant loss of life – High short term absenteeism– Disrupted supplies (markets closed, access

reduced, unreliable utilities, shortages of cash, telecom outages

– Reduced demand (affecting travel and leisure, restaurant and food industry)

– Threats to Rule of law, Security, Continuity of Governance

Specific Impacts of Pandemic

LivelihoodsLivelihoods

Human HealthHuman Health

Rule of Law and Governance

Rule of Law and Governance

Humanitarian Needs

Humanitarian Needs

Economic SystemsEconomic Systems

• Food and income loss from poultry deaths/ culling & decreased economic activity

• High illness & potentially higher death rates• Overstretched health facilities• Disproportionate impact on vulnerable

• Increased demand for governance & security• Higher public anxiety• Reduced capacity due to illness & death

• Deterioration of coping & support mechanisms• Interruption in public services• Quarantine policies

• Trade & commerce disruptions• Reduced availability of key persons• Interruption of regular supply systems

3 Responses

Strategic Approach November 2005

1.Stop influenza in animals through stamping out the disease at the place where the infection starts

2.Prevent emergence of pandemic by limiting human exposure;

• if pandemic does start, contain it quickly;

• mitigate pandemic consequences if containment is not possible.

• Information campaign: people must know how to reduce risks• Early warning of disease in birds; rapid response when found• Prompt detection, containment and management of human

cases• International Biomedical cooperation and transparency• Stocks of human antiviral medicines, consumables and

vaccines; functional supply systems • Joined-up Government with private sector, non-profits and

media• Tuned up crisis response capacity: civ/mil contingency

planning• Radical reforms to poultry sector and veterinary systems:

long-term protection against pandemic threats

Critical Actions

National Plans: A range of Interventions

• Animal Health Services• Biosecurity• Human Public Health• Continuity of Governance

and Rule of Law• Sustaining Economic and

Social Systems• Assessing vulnerability

and providing humanitarian relief

• Communication and Coordination: Joined-Up informed efforts by all of Government, Business, Civil Society, Media, Military, international bodies

Animal

Health

Humanitarian& Relief

Coordination & Communication

Human

Health

Economy& Society

Governance& Rule of Law

4 Mechanisms for support tocountry actions

Financial support

1 Emphasis on national plans and execution with back-up by regional institutions and global standards

2 Extent of required international technical and financial assistance estimated during November and December 2005

3 Multi-pathway Financing and coordination framework4 Support pledged at Beijing conference mid-January

2006: overall value $1.9 billion; principles for implementation confirmed

5 Scaling up action• Rapid and well organized appraisal of national plans• Strategies for mobilizing pledged technical and

financial resources• Techniques for urgent resource mobilization• Systems to track the impact of funds and coordinate

responses

Quality of National Plans?

Desirable Processes include:• High level inter-ministerial direction• Risk analysis and capacity review with explicit concept

and strategy• Vital Sectors engaged: Risk communication, animal

health, human health, pandemic preparedness • Key actions prioritized – within and between sectors. • Implementing partners identified.• Communities fully involved • Triggers agreed for crisis “mode”; standard procedures• Inputs established : national, regional and international

Developmental Approach

• Development Partners work with Government on Preparation of Integrated Plan

• Explicit framework for Appraisal

• Shared Appraisal Process

• Rapid shift from appraisal to implementation

• Standardized sequence: programme negotiation, approval, project allocation and management

• Support through Regional Institutions

• Rapid: 8 weeks from appraisal request to cash

Developmental Approach

• National Plans• Development Partnerships• Work together on Preparation• Open framework for Appraisal • Shared Appraisal• Rapid movement from appraisal to

implementation• Standardized programme negotiation, approval

and management• Support through Regional Institutions

Regional Support in Africa

• Political Support – African Union• Animal Health – OiE, FAO, IBAR: • Human Health – WHO with Pasteur Institutes,

Medical Research Councils• Communication – Regional communication

initiatives, unicef• Continuity of Governance and Coordination –

UNDP with ….• Preparedness for Humanitarian impact of

Pandemic -

Implementation Assistance

For the 90 Developing Countries with Strong Implementation Capacity….

• In country implementation assistance, supporting national authorities (technical assistance by regional bodies, OiE, bilateral agencies, UN specialized agencies)

Technical cooperation at central level Implementation and coordination advisers at State and local level– Multi-agency concept: – Capacities of each agency mapped

Implementation assistance (2)

30+ Developing Countries with Fragile implementation Capacity

• In country execution, by contractors working (on behalf of international Community) in support of national authorities

• Direct involvement in execution, culling, compensation handling (emergency basis)

• NGOs (eg VSF), • UN peacekeepers and • Emergency and operational agencies (UNICEF, WFP)

• Need for emergency fund: Design time – 2 weeks• Engage with AU, sub-regional bodies

5 Coordinated Responses

Advantage of Coordinated Response

Animal

Health

Human

Health

Humanitarian& Relief

Economy& Society

Governance & Rule of Law

Direct UN System Interventions

Catalyse other actors to contribute

• National governments• Regional bodies• Civil society• Private sector

Coordination & Communicatio

n

Levels of Coordination

Coordination is active at three levels and practiced both regionally and globally

In Country

Inter Agency

Inter-country

Provide local leadershipJoin up government departments, civil

society and partners Jointly implement and monitor

Facilitate information exchangeSet global standardsPrioritize and implement Monitor achievements

Align strategyProgress assessment by peersFill gaps and surmount blocksResolve difficulties

6040317-GMH-FAO-Coordv05BOS

Coordination Framework

, ,

National Coordination Mechanism (Country Led)

International and Regional Influenza Partnerships

FAO OIE

Regional Organizations:

APEC,ASEAN ,AU

Regional Development Banks

Regional

WHOOther UN

Financing Partners:MDBs Bilaterals

etcPrivate Initiatives

Global

FAO OIE WHOOther UN System

UN System Needs and Resources Three years (05 - 08)

Animal

Health

Human

Health

Gov Economic Systems

Human & Relief

Risk Communica

tion

Request

For 05 - 06

Pledge Received

01/04/06

FAO 131.0* 65 35

WHO 138.0** 54 26

UNDP 9.5 0 0

UNICEF 9.0 ? (49***)

WFP 7.0 0 0

OCHA 4.2 0 0

ICAO -

UNWTO -

OiE

UNEP -

UN Monitoring and Coordination

(UNSIC)

* Global and Regional

** 2 years

*** Communication

and Supplies

4.0 1 1

6 Current Priorities

Current Priorities

• The Risks posed to African Nations by Avian Influenza– Keeping up to date on threats to livelihoods, to continuity, to health

• Information reaching different audiences– Ensuring that everyone knows what to do to reduce risk

• Continued efforts to maintain Animal Health– Improving surveillance and ensuring responsiveness

• Public Health and Pandemic Containment– Making sure that local and global Public Health Services work

• Continuity and well-being during Pandemic– Maintaining the Economy, Governance, Society and Humanitarian

support: planning for continuity amidst a range of eventualities

• New Products and Services – Harmonised production of key Vaccines and Diagnostics

FAMILIES WITH BACKYARD BIRDS

• Promote safe household behaviours

EVERYONE• Buy, prepare and

cook poultry safely

1. “Bird-wise”

campaign

Promote 4 actions now!

Wash hands thoroughly with soap frequently

Cover coughs and sneezes

Wear a mask if symptomatic Don’t spit!

2. ‘Street-wise’

hygiene campaign

david.nabarro@undp.orgwww.influenza.undg.org