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Avian Influenza Prevention and Control and Human Influenza Pandemic Preparedness in Africa Assessment of Financial Needs and Gaps Fourth International Conference on Avian Influenza Bamako - Mali - December 6-8, 2006

Avian Influenza Prevention & Control, and Human Influenza Pandemic Preparedness in Africa – Assessment of Financing Needs and Gaps

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CONTENTS Page

ACKNOWLEDGMENTS LIST OF ABBREVIATIONS & ACRONYMS OBJECTIVES OF THE PAPER

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APPROACH FOLLOWED FOR THE ELABORATION OF THE PAPER 9

1. INTRODUCTION 112. HIGHLY PATHOGENIC AVIAN INFLUENZA IN AFRICA: EPIDEMIOLOGICAL SITUATION AND POTENTIAL CONSEQUENCES 13

2.1. Epidemiological Situation of HPAI in Africa 13

2.2. Impacts on national economies and social capital 15

2.3. Impacts on population nutritional status 17

2.4. Compensation/Indemnity 17

2.5. Impacts on biodiversity 18

2.6. Impacts on environment 18

3. STRENGTHS, WEAKNESSES AND OPPORTUNITIES FOR THE PREVENTION AND CONTROL OF AVIAN INFLUENZA AND HUMAN PANDEMIC PREPAREDNESS IN AFRICA 19

3.1. Strengths 19

3.2. Weaknesses 21

3.3. Opportunities 23

4. STOCKTAKING OF CURRENT INTERVENTIONS IN AFRICA – BEST PRACTICES AND LESSONS LEARNED

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4.1. International and Regional Advocacy/Mobilization 25

4.2. International assistance to Africa 28

4.3. Lessons Learned – Steps forward 305. STRATEGY TAILORED TO AFRICA FOR THE PREVENTION AND CONTROL OF AVIAN INFLUENZA AND HUMAN PANDEMIC PREPAREDNESS 33

5.1. Main objective of a control Program 34

5.2. Expected outputs 34

5.3. Operational principles 34

5.4. Implementation plan 355.4.1. Implementation plan at country level 35

5.4.1.1. Immediate and short term national actions 385.4.1.2. Medium and longer term national actions 39

5.4.2. Regional support for national activities 40

5.4.3. International support for national and regional activities 41


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6. ASSESSMENT OF THE NEEDS AND GAPS 43

6.1. Communication component 43

6.2. Animal health component 45

6.3. Human health component 49

7. ESTIMATED BUDGET FOR AFRICA 51

Table 1: Overall Estimated Budget 52

Table 2: Estimated Budget of African Countries 54

ALive 56


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ACKNOWLEDGMENTS This report was drafted by a multi-institutional and interdisciplinary Task-Force involving staff from the Inter-African Bureau of Animal Resources of the Africa Union (AU-IBAR), the Food and Agriculture Organization (FAO), the World Organisation for Animal Health (OIE), the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO). The Task-Force consisted of Bouna Diop (AU-IBAR), William Amanfu (FAO), Alain Dehove (OIE), Misse Misse (UNICEF-Dakar) and Adamou Yada (WHO-AFRO). The respective five institutions reviewed the document internally. For the provision of data in the preparation of this report, the ALive Secretariat acknowledges with thanks the following institutions and organizations not directly involved in the task force: Africa RECs: ECOWAS/CEDEAO, CEMAC/CEBEVIRHA, IGAD, SADC, UEMOA and UMA; UNSIC, OCHA Regional Office (UN Office for Coordination of Humanitarian Assistance-Dakar); Veterinary Services especially those in countries visited such as Botswana, Burkina Faso, Chad,

Djibouti, Morocco and Nigeria; as well as all the participants in the regional consultations which took place in Nairobi (November 10, 2006) and in Ouagadougou (November 13, 2006). Very helpful written reviews were provided by Members of the Executive Committee of the ALive platform and by Piers Merrick, Mario Bravo, Jacqueline Dubow, Pauline Zwaans, Monique Vledder, Veronica Schreiber, Ok Pannenborg and Jean-Philippe Tre (WB). Although every attempt was made to incorporate fully all suggestions received, the Secretariat of ALive accepts responsibility for the views expressed in this report and for the choices made when several different suggestions were put forward on a given topic. Guidance and coordination was provided by François Le Gall (Program Manager of ALive) and Nadège Leboucq (Secretariat of ALive). Funding was provided by the ALive Multi-Donor Trust Fund and the five International Technical Agencies.


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LIST OF ABBREVIATIONS & ACRONYMS

AfDB African Development Bank

AHI Avian and Human Influenza AHIF Avian and Human Influenza Facility

AI Avian Influenza AIDS Acquired Immunodeficiency Syndrome ALive ALive Platform, Partnership for Livestock Development, Poverty Alleviation & Sustainable Growth in Africa

AU African Union CEBEVIRHA Commission Economique du Bétail, de la Viande, et des Ressources Halieutiques

CEDEAO Communauté Économique des États de l'Afrique de l'Ouest (les 8 pays ouest-africains de la Zone franc CFA + Cap Vert, Gambie, Ghana, Guinée, Libéria, Nigeria, Sierra Leone)

CEMAC Communauté Économique et Monétaire de l'Afrique Centrale (Cameroun, Congo, Gabon, Guinée Équatoriale, Centrafrique, Tchad)

CMC (FAO/OIE) Crisis Management Centre EC European Commission

ECOWAS Economic Community of West African States (CEDEAO in French) ECTAD Emergency Centre for the Control of Transboundary Animal Diseases

EIA Environmental Impact Assessment EISMV Ecole Inter-Etats des Sciences et Médicine Vétérinaires (Bénin, Burkina-Faso, Cameroun, Côte

d'Ivoire, Congo, Gabon, Mauritanie, Niger, République Centrafricaine, Rwanda, Sénégal, Tchad, Togo) ESARO (UNICEF) East and Southern Africa Regional Office

EU European Union EUR Euro (currency) FAO Food and Agriculture Organization (of the United Nations) GDP Gross Domestic Product

GF-TADs (OIE/FAO) Global Framework for Transboundary Animal Diseases GLEWS (FAO/OIE/WHO) Global Early Warning System

GIS Geographic Information Systems GPAI Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response

GPS Global Positioning System H5N1 Haemagglutinin type 5; Neuraminidase subtype 1 (Influenza Virus) HPAI Highly Pathogenic Avian Influenza IAEA International Atomic Energy Agency

IAH Institute of Animal Health ICPs Integrated Country Plans

IATA International Air Transport Association IBAR Inter-African Bureau of Animal Resources

IDA International Development Association IDSR Integrated Disease Surveillance and Response IGAD Intergovernmental Authority on Development IICA Inter-American Institute for Cooperation on Agriculture IHR (WHO) International Health Regulations ILI Influenza-like Illnesses

LPAI Low Pathogenic Avian Influenza MAE Ministère des Affaires Etrangères (France)

MDGs Millennium Development Goals MDTF (ALive) Multi Donor Trust Fund


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NADEC

National Animal Disease Emergency Committee

NCD Newcastle Disease NGO(s) Non Governmental Organization(s) OCHA (UN) Office for Coordination of Humanitarian Assistance

OFFLU OIE/FAO Network on Avian Influenza OIE World Organisation for Animal Health

PACE Pan-African Programme for the Control of Epizootics PANVAC Pan-African Veterinary Vaccine Centre

PARC Pan-African Rinderpest Campaign PPE Personal Protective Equipment PVS (OIE) Performance, Vision and Strategy: A Tool for Veterinary Services

RAHC (OIE/FAO/AU-IBAR) Regional Animal Health Centre RECs (Africa) Regional Economic Communities SADC Southern African Development Community

SFERA (FAO) Special Fund for Emergency and Rehabilitation Activities SPS Sanitary and Phytosanitary

TCP (FAO) Technical Cooperation Programme ToRs Terms of Reference

UEMOA Union Économique et Monétaire Ouest Africaine (Bénin, Burkina Faso, Côte d'Ivoire, Guinée Bissau, Mali, Niger, Sénégal et Togo)

UMA Union du Maghreb arabe UN United Nations

UNICEF United Nations Children’s Fund UNDP United Nations Development Program

UNSIC United Nations System Influenza Coordination USA United States of America

USAID United States Agency for International Development USD/US$ US Dollar (currency)

USDA United States Department of Agriculture VS Veterinary Services

WB World Bank WAHWF (OIE) World Animal Health and Welfare Fund WCARO (UNICEF) West and Central Africa Regional Office

WHO (UN) World Health Organization WTO World Trade Organization


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OBJECTIVES OF THE PAPER

African countries have shown a high degree of commitment and put in place policy instruments to facilitate the prevention and control of avian and human influenza since avian influenza first hit the continent in February 2006. Some countries have invested a substantial amount of funds to deal with this animal and public health threat and the potentially disastrous effect on people’s livelihoods. The start made by countries is recognized and it is in this direction that further international donor assistance is solicited to sustain the initial gains made by countries to improve the Veterinary Services and put in place public health structures and communication that, in the short, medium and long term, can provide the basis for sustainable control of highly pathogenic avian influenza and help prevent the potential for a human flu pandemic. The proposals presented are therefore aimed at boosting the operational and technical capacity for Highly Pathogenic Avian Influenza (HPAI) prevention and control, human influenza pandemic preparedness and harmonization of communication strategies in Africa. They are designed to help African countries to improve the effectiveness and governance of their Veterinary Services in order to build the necessary capacity to efficiently prevent and control HPAI, as well as to detect and respond rapidly to other emerging and re-emerging transboundary animal disease outbreaks as soon as they occur. In view of the zoonotic nature of HPAI and the occurrence of human cases in Africa, it is essential to reinforce human influenza surveillance and response systems, strengthen collaboration between animal and human health institutions and improve communication elements of HPAI awareness, prevention and control with decision makers, poultry producers and consumers and the general public. This Paper is intended to serve as a technical and financial support for the Bamako International Conference on Avian and Human Influenza (AHI).


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APPROACH FOLLOWED FOR THE ELABORATION OF THE PAPER

This document is a synthesis report of an ALive mission carried out by a Multi-Institutional (AU-IBAR/FAO/OIE/UNICEF/WHO) Task Force. The Task Force visited and held discussions with Regional Economic Communities (RECs) in Africa in two stages. Visits were made i) to UEMOA-Burkina Faso, ECOWAS-Nigeria and IGAD-Djibouti in May 2006 and ii) to UMA-Morocco, CEMAC/CEBEVIRHA-Chad and SADC-Botswana in October 2006. The aim of these missions was to collect relevant data from countries and regions for avian influenza control, human influenza pandemic prevention and preparedness, assess needs and gaps and prepare a continental action plan for the prevention and control of HPAI disease at the source in order to prevent and minimize exposure of humans to HPAI viruses.

In addition, consultations on the draft of this paper were organized in November 2006 through the ALive platform as well as during two sub-regional workshops in Nairobi, Kenya and Ouagadougou, Burkina Faso, attended by representatives from countries and RECs, so as to obtain a common continental consensus on the various elements of this proposal. This report also received the World Bank support in the review and consolidation of its technical and financial aspects.

The paper draws on:

(i) the analysis of data collected from countries and RECs and from AU-IBAR, FAO, OIE, UNICEF and WHO initiatives geared towards control and prevention of HPAI in poultry and human influenza pandemic preparedness. These institutional initiatives are targeted at assisting African countries to prepare for the potential spread of HPAI to other parts of the continent and to provide effective control strategies through the design of emergency plans, early response programs for avian influenza control and to mitigate the socio-economic impacts of a potential human flu pandemic;

(ii) the FAO/OIE HPAI strategy paper1 “A Global Strategy for the Progressive Control of Highly Pathogenic Avian Influenza (HPAI)”;

(iii) the FAO strategy document2, “Highly Pathogenic Avian Influenza in Africa: A Strategy and Proposed Program to Limit Spread and Build Capacity for Epizootic Disease Control”;

(iv) the OIE/FAO publication3 on “Ensuring Good Governance to Address Emerging and Re-emerging Disease Threats – Supporting the Veterinary Services of Developing Countries to Meet OIE International Standards on Quality”. This document, which provides guidelines on limiting the spread of building capacity for the control of epizootic diseases, formed the main background for elaboration of strategies for the progressive control of HPAI in affected African countries and prevention of the propagation of the disease to unaffected countries in Africa and elsewhere;

(v) the WHO Africa Region document on Regional Pandemic Influenza Preparedness and Response Plan, 2006-2007, and the Report of the WHO Regional Director of Africa to the Regional Committee for Africa (56th Session);

(vi) the mission report of the UN inter-agency rapid assessment mission on HPAI (16 Feb. – 4 March 2006); and

(vii) the documents from the OCHA Regional Office in Dakar and AU-IBAR.

1 FAO/OIE, November 2005, revised in November 2006 2 FAO, July 2006 3 Last updated in August 2006


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1. INTRODUCTION Africa recorded its first outbreak of Highly Pathogenic Avian Influenza (HPAI) when Nigeria officially reported an outbreak of the disease on February 8, 2006. The source of the Nigerian outbreak is still speculative as no concrete evidence of disease introduction has been documented. It is widely believed that legal and illegal trade in infected poultry and poultry products might have precipitated the outbreaks, although the possibility remains that the outbreaks may have resulted from interaction between infected wild birds and domestic poultry. Since the Nigerian outbreaks of HPAI, Egypt, Niger, Cameroon, Burkina Faso, Sudan, Côte d’Ivoire and Djibouti have reported outbreaks of the disease in poultry and human cases have been confirmed in Egypt and Djibouti. The threat of further spread in Africa is real and could occur from the legal or illegal movement of poultry or poultry products, and/or the interaction of domestic poultry with infected wild bird populations. The potential for infection occurs within a context where acute malnutrition and food insecurity often exceeds emergency thresholds, and in a region that is already dealing with other complex emergencies, displaced populations, conflicts, short-term economic disruption and poverty. In the present situation of few cases of human illness and few deaths (Egypt), avian flu is not viewed by many decision-makers as a priority given the burden of disease that countries are already facing. Insufficient financial and logistical resources, weak Veterinary Services, lax border controls on animal movements, conflicts and inappropriate governance, constitute an environment in which the spread of the HPAI and other transboundary animal diseases could be facilitated. The direct consequences of HPAI outbreaks and particularly the loss of poultry production capacity and socio-economic impacts are likely to be worse in Africa than in any other part of the world. Moreover, the risk of the disease becoming enzootic in domestic poultry or wildlife has to be considered as a serious threat to the national economies and public health. The occurrence of human cases, even when sporadic, creates enormous new challenges for health systems and services that are already fragile and overburdened. The continent could equally become a reservoir for the virus from

where re-emergence of the disease could pose recurrent risks to African countries and internationally. The prospect that, in this environment, the virus may mutate/reassort and initiate a human pandemic remains a distinct possibility. The rapidly evolving HPAI situation therefore, necessitates an adaptation of the global strategy to fit Africa’s specific challenges. In this regard, the actions to be taken in the short-term are aimed at putting in place emergency measures to rapidly control the regional and global spread of highly pathogenic avian influenza and to protect populations at greatest risk of infection. These short-term measures, addressing both the human and animal health dimensions of HPAI, are guided by the global strategies defined by FAO and OIE and by the WHO Regional Pandemic Influenza Preparedness and Response Plan. The leadership provided by the global technical agencies for animal and human health represented in ALive recognizes the need for a response that, at the country level, in particular, is integrated and truly multi-sectoral. The measures outlined by the ALive partnership reflect this objective, and the recommendations presented emphasize the importance of an integrated response that brings to bear the strengths of all actors and stakeholders. The progressive strengthening of official Veterinary Services is a priority both in the short- and medium-term phases of the response and the ability of Veterinary Services to discharge their responsibilities as regards effective HPAI disease control and prevention will also better equip countries to face other emerging or re-emerging zoonoses should these occur in the future. They need to be able to meet their mandate for the effective prevention and control of diseases, which fall within the concept of “Global Public Good”. Bringing the quality of the Veterinary Services in line with the international technical standards defined by OIE will have a significant and lasting impact on the countries concerned (and on the international community as a whole) in a range of areas including the agricultural economy, public health (including food safety and the supply of animal protein) and access to international markets. For


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these reasons, actions proposed hereafter should be considered eligible for the concept of global/international Public Good. A series of international conferences organized since the emergence of HPAI have assisted the international community in the elaboration of a global strategy (Geneva, November 2005), for the mobilization of funds for avian influenza control and human pandemic preparedness (Beijing, January 2006), and in the systematic review of emerging practice and reporting of collective global progress (Vienna, June 2006). It is a measure of the rapid spread of HPAI that, at the time of the first two conferences, Africa had not been infected and, as a result, only a very low level of funds had been specifically targeted to assist Africa in the prevention and control of avian and human influenza (AHI). Upon the invitation of the Commission of the African Union, it was agreed to hold the fourth international conference on avian influenza and human pandemic preparedness in Bamako, Mali. The main objectives of the Bamako conference are to:

Establish systematic monitoring of progress made at the country, regional and global levels in the prevention and control of AHI (following the principles established at the Geneva, Beijing and Vienna Conferences), with a special focus on Africa;

Call for financing that specifically targets

African countries, based primarily on well-coordinated mobilization of all actors involved in AHI and submission to donors of a shared and realistic assessment of the needs facing African countries and on the AHI operational strategies that will be implemented.

An assessment of the financing needs and gaps is therefore essential in order to mobilize the donor assistance necessary to contain the outbreaks, prevent the spread of disease and to protect the lives, livelihoods and health of the many at risk of AHI infection. Pursuant to the Vienna meeting of June 2006, the ALive Partnership received a mandate to take the lead in the preparation of a technical document that will support the pledging session for Africa at the Bamako Conference. A Multi-Institutional Task-Force composed of experts from AU-IBAR, FAO, OIE, WHO and UNICEF was therefore created to execute this task. The proposals presented hereafter, are aimed at (i) boosting the operational and technical capacity for HPAI prevention and control, (ii) human influenza pandemic preparedness, and (iii) coordination of communication strategies. They are designed to help countries facing the greatest threats to improve the effectiveness and governance of their Veterinary Services in order to make them capable of efficiently preventing and controlling HPAI, as well as detecting other emerging and re-emerging transboundary animal disease outbreaks as soon as they occur and in responding to them rapidly. In view of the zoonotic nature of HPAI, it is also essential that human influenza surveillance and response systems are reinforced, that systematic efforts are undertaken to strengthen collaboration between animal and human health institutions, and that comprehensive communication programs are launched to ensure that key stakeholders including poultry producers, consumers, and the general public are informed of the status of the disease and the measures that they can take to reduce the risk of infection.


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2. HIGHLY PATHOGENIC AVIAN INFLUENZA IN AFRICA: EPIDEMIOLOGICAL SITUATION AND POTENTIAL CONSEQUENCES

2.1. Epidemiological Situation of HPAI in

Africa Highly Pathogenic Avian Influenza (HPAI), caused by avian influenza virus subtype H5N1 (haemagglutinin type 5 and neuraminidase subtype 1), has severely affected poultry populations in Southeast Asia since 2003. Initial outbreaks were confined to Indonesia, Vietnam, Thailand, Lao PDR, Cambodia and China. However, from late July 2005, the HPAI virus spread in a north-westerly direction, causing outbreaks in wild birds and poultry in eastern, central and western Russia, Mongolia and central Kazakhstan. Within the last year, the disease has spread progressively to Europe, the Middle East and Africa. To date, 55 countries4 have reported outbreaks of H5N1, of which 36 saw outbreaks among their poultry populations5. On a global scale, it is estimated that within the past two years more than 250 million6 poultry have died or been culled as a result of avian influenza, causing severe socio-economic damage in affected countries. In addition, the zoonotic nature of the H5N1 avian influenza virus has resulted in a rapidly rising number of humans infected with the disease. As of November 13, 2006, the total number of human infections reported was 258, of which 153 people died7, representing a case-fatality rate of 59.3%. In Africa, Egypt has recorded 15 human cases with 7 fatalities. In Djibouti, a young girl fell ill after she became infected with the H5N1 virus. The development of highly pathogenic avian H5N1 influenza viruses in poultry in Eurasia and Africa accompanied with the increase in human infection

in 2006 suggests that the virus has not been effectively contained and that the pandemic threat persists. In Africa, especially this poses serious animal and human health risks, as well as

4 Data as recorded by OFFLU, the OIE/FAO Network of Expertise on Avian Influenza on October 25th, 2006 www.offlu.net 5 Data as recorded by the OIE on October 26th, 2006 www.oie.int 6 FAO estimate as at end of October 2006 7 Data as reported by the WHO on November 13th, 2006 www.who.int

potentially devastating consequences for the continent and the world as a whole. Africa recorded its first outbreak of H5N1 when Nigeria first reported outbreaks of HPAI in domestic poultry on February 8, 2006. Seven other African countries (Egypt, Niger, Cameroon, Burkina Faso, Sudan, Côte d’Ivoire and Djibouti) subsequently reported H5N1 infection and disease in their poultry flocks. In Burkina Faso, Cameroon, Djibouti, Niger and Côte d’Ivoire the disease has remained relatively localized, with the spread and impact of the disease being greatest in Egypt, Nigeria and Sudan. Given the deficiencies in surveillance systems in many African countries, it is possible that the apparent localization of reported cases might not reflect the actual distribution of the virus and further spread of HPAI in Africa, by way of migratory birds or through trade, is thus very likely. Investments are urgently needed for science-based active disease surveillance to clarify the true epidemiological situation in the affected countries and prevent the spread of avian influenza to non-infected areas on the continent. Surveillance should focus in particular on those countries in Central and Western Africa at immediate risk of H5N1 infection due to their close proximity to, or active trading relations with, currently infected countries. Previous examples have shown that especially the dynamic coastal trading networks of West Africa provide a high risk of continued spread of the virus along the Atlantic coast, as happened during the late 1990s and early 2000 when the African Swine Fever spread rapidly through this route. The need for control and elimination of HPAI infections in this sub-region, as well as elsewhere on the continent must therefore seriously engage the immediate attention of the international donor community if we are to avoid large-scale outbreaks and contain the virus.


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The table below summarizes the HPAI outbreaks and related human cases in Africa:

Summary of confirmed HPAI H5N1 outbreaks in Africa

Country Date of First Reported Outbreak/Location

Latest Outbreak

Affected Animal Population

Human cases officially reported (Cases/Deaths)

Burkina Faso April 3, 2006; Gampéla May 20, 2006; Bobo Dioulasso, Ouagadougou

Domestic poultry and wild birds No

Cameroon March 12, 2006; Maroua March 28, 2006; Malapé

Domestic poultry and wild birds No

Côte d’Ivoire March 31, 2006; Anoumabou

June 10, 2006; Grand Bereby, San Pedro Domestic poultry No

Djibouti April 6, 2006; Boulaos First outbreak Domestic poultry Yes (1/0)

Egypt February 17, 2006; 5 Upper Egypt Districts

Sept. 30, 2006; Damietta and Giza

Domestic poultry and wild birds Yes (15/7)

Niger March 2, 2006; Magaria June 1, 2006; Boko Maigao Domestic poultry No

Nigeria February 8, 2006 Jaji - Kaduna State

October, 2006; Lagos State Domestic poultry No

Sudan March 25, 2006; El Gezira August 4, 2006; Juba Domestic poultry No

Source: OIE, FAO and WHO records as at November 13, 2006 In none of these countries has the original source of the virus been confirmed. Despite the constant presence of wild birds in Africa and migratory patterns which involve species migrating from infected northern land masses, there is no firm evidence to incriminate wild birds in the genesis of HPAI outbreaks in Africa. Human activities, specifically illegal trade in live birds, are conceived to be the more likely cause of the spread of the disease between and within countries. Notwithstanding the threat of the introduction and spread of the highly pathogenic avian influenza virus by wild birds and the need for continued monitoring of migratory fowl, the risk of avian influenza spreading across national borders through legal or illegal import of live birds or poultry products represents a major

national and international concern. Recent sequencing of avian influenza virus genomes of Nigerian strains has led to hypothesis that at least three different introductions of the virus occurred almost simultaneously. Furthermore, in Africa, as in Asia, the poultry production and marketing systems involve close contact between humans and birds. This gives rise to increased risks of transmission of the virus from birds to humans, with the possibility of virus reassortment and mutation that could result in the facilitation of human to human transmission - a prerequisite for a human influenza pandemic. A clear link has been established between the concentration of domestic birds, and therefore trade, the spread of the disease and endemicity.


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In the conditions prevailing in many African countries, with prolonged hot dry seasons and extensive low-density poultry populations primarily in dispersed village production systems, it is possible that the virus will spread more slowly than it has in several Southeast Asian countries. This seems to have been the case in Niger, Northern Cameroon and Burkina Faso. However, the situation in Egypt and Nigeria proves the contrary and the evolution of the African HPAI situation is therefore impossible to predict. Furthermore, it is envisaged that HPAI is approaching enzootic status (endemicity) in some countries in Africa. Since potential wildlife reservoirs are many, in the worst-case scenario the HPAI H5N1 virus could become permanently established within wild bird reservoirs, in African waterfowl and perhaps shorebird species, and thus pose a continued threat to domestic poultry and people. The situation in those countries recently affected with H5N1 in Africa suggests that:

- although the preferred measures of control, where feasible, are culling and the control of movement of live poultry, poultry products and equipment, they are mostly difficult to implement in African countries due to limited infrastructure;

- the response to new outbreaks is not immediate, and the rapid spread to many parts of an affected country has thus usually occurred before control capacity is rendered operational;

- in hot arid countries, such as Niger, the spread from an initial introduction to other regions in the country seems not to happen as easily when movement control is applied;

- the implementation of vaccination campaigns can be very difficult in village production systems. Therefore, without strong political commitment and appropriate investments, the vaccination coverage could be too small to provide sufficient flock immunity across broad areas, but may be reached in specific farms and in specific areas for the control of the disease.

The presence of the H5N1 virus in Africa is of great concern for human and animal health alike. As in Asia, a large number of African households keep domestic birds in their houses and backyards. These birds often mingle freely with

wild birds that enter households and share outdoor areas where children play, creating extensive opportunities for human exposure to H5N1. The widespread practice of home slaughtering, de-feathering, and butchering of poultry poses an additional risk as avian influenza can be transmitted by inhalation of infectious droplets and droplet nuclei through direct contact or indirectly. So far, the majority of the human H5N1 infections have been linked to close contact with infected domestic birds while engaging in the above-mentioned daily activities. To diminish the risk to humans and prepare African countries for a possible pandemic, urgent action is needed at the country level to improve communication, strengthen weak health systems and services, provide greater human resources for health crises, and develop early warning systems and pandemic preparedness response plans. A weak surveillance system, leading to late detection of initial clusters of human influenza infection, would delay rapid containment and increase the likelihood of the disease spreading to other foci. Other major challenges are to improve collaboration, cooperation and coordination within and across the various sectors; to update existing health personnel on avian influenza; and to ensure timely sharing of information with all who need to know. The lack of relevant standard operating procedures; weak transport and communication infrastructure; weak general public services and logistics systems; high illiteracy rates; widespread poverty; food insecurity: and potentially huge economic losses due to the possible disruption of trade, further emphasizes the urgency of the situation. Immediate action, with support from the international donor community, is required to adequately address these challenges. 2.2. Impacts on national economies and

social capital Economic losses due to death and culling of domestic poultry, market closures and trade restrictions, have been considerable. The direct and indirect impact of an influenza pandemic would likewise be enormous, affecting the economy as a whole, and in particular health


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systems, health-care services, political machinery, trade, tourism, biodiversity and essential services such as public transport, education, police and general administration. Estimates of global HPAI losses since the start of the outbreaks at the end of 2003 run into billions of dollars8. Therefore, in planning and executing a comprehensive HPAI control program in a country or a region, the social and economic dimensions of the entire process need to be taken into account. Decisions made at each stage of a HPAI program, from prevention of the disease through the entire control and eradication response, have the potential to significantly affect peoples’ livelihoods from the poorest to the richest members of society, and to impact the long term sustainability of the poultry sector. Four key factors have been identified as contributing to the potential social and economic impact of HPAI, namely i) the zoonotic nature of the disease and the potential for large-scale human deaths, ii) the severe impact of outbreaks on local, and especially vulnerable, populations due to considerable livelihood and production losses, iii) the prolonged financial drain for control costs as the disease becomes endemic, iv) the simultaneous outbreaks across countries and regions as the disease spread rapidly across central Asia to Europe and Africa. If widespread outbreaks persisted without rapid and adequate control measures global production and trade could be severely disrupted. The impact of a single animal outbreak of HPAI on national GDP would depend on the speed with which the disease was controlled, the size and structure of the poultry sector and its relative contribution to GDP. The 2003 and 2004 outbreaks in Asia took Veterinary Services by surprise. As a result the avian influenza virus was not easily controlled, spread widely, often re-emerged and resulted in the death or destruction of millions of birds. Direct losses were highest in Vietnam (44 million birds, amounting to approximately 17.5% of the poultry population) and Thailand (29 million birds, 14.5% of the poultry population)9, with long-lasting effects on their respective poultry industries due to lost market share. 8 European Commission: “Impact Assessment Avian Influenza” (COM(2005)171). 9 http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/cd/documents/Economic-and-social-impacts-of-avian-influenza-Geneva.pdf

Recent studies by UNDP Nigeria provided an assessment of the impact of HPAI on the Nigerian economy and its implications for the achievement of the Millennium Development Goals (MDGs)10. The HPAI outbreaks not only created general panic among the public, but revealed an inadequate coordination among relevant government agencies and stakeholders in livestock sub-sectors. The panic led to an initial boycott of poultry products, resulting in a sharp decline in sales and prices. Egg and chicken sales declined by 80.5% within 2 weeks following the announcement of avian influenza outbreaks in Nigeria. Likewise, poultry feed sales dropped by 82% as a result of the government’s announcement in February 2006. The livelihoods of poor households particularly in the rural areas, where many depend on income from poultry to meet pressing economic, social, and dietary needs, were further depressed by the economic shocks induced by the HPAI outbreak. In countries where there had been no outbreaks of HPAI, negative reporting caused panic, and fear of consumption of poultry products caused indirect economic losses. The duration and overall extent of the market impact of AI risks and outbreaks will heavily depend on consumer perceptions about human health risks. These concerns will be greatly influenced and shaped by risk communication strategies. To limit the market impact, there should thus be an effective and well-informed education and communication campaign. Poultry production plays a key role in the build-up of social capital as well as in ceremonies and social gatherings, where poultry is often consumed or presented as a gift. Avian influenza outbreaks thus have a direct impact on the socio-cultural fabric of African society and could contribute to the deterioration in living standards of the rural population whose livelihoods are affected. Economic, political and social issues have a significant impact on the choice and implementation of HPAI disease prevention, control and eradication strategies. Analysis of the costs and benefits of different approaches emphasizes the need for a well-informed choice of control strategies, because it can provide guidance on whether a proposed approach 10 UNDP Nigeria: Socio-Economic Impact of Avian Influenza in Nigeria. July 2006


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would be economically viable, the potential financing source, the risks of non-compliance with regulations, and the best means to provide exit strategies for producers and processors who cannot afford to comply with more stringent measures. Consideration needs to be given to social support and rehabilitation of communities or poultry owners whose livelihoods have been adversely affected by HPAI. This may extend to a much larger group of people than those who may have obtained compensation/indemnity for culled infected and at-risk birds. It is important to distinguish between compensation/indemnity for culled birds, which is believed to encourage compliance with stamping out, and the rehabilitation of the poultry sector after an outbreak, which may include other kinds of financial and technical support to farmers to promote safer poultry production in the long term. 2.3. Impacts on population nutritional

status Deaths of large numbers of poultry, whether due to disease or culling for control purposes, would deprive already impoverished populations of an important - and at times the sole - source of dietary protein from chickens and eggs. The nutritional impact of culling domestic birds would further deteriorate the health of the population and negatively impact progress towards the attainment of the MDGs. Children tend to suffer greatest from losses of dietary animal protein. 2.4. Compensation/Indemnity Compensation/indemnity is critical to control strategies for HPAI, because it provides an incentive to the producer to report suspected HPAI disease outbreaks and to comply with culling procedures. Poorly designed schemes, however, can hasten the spread of the disease as poultry farmers resort to salvage tactics through movement and sale of infected birds. Compensation dampens the effects of critical social and political shocks, where large numbers of farms are depopulated through culling of stock and should be regarded as an international public good. This is derived from the potential for serious international spillovers from HPAI outbreaks and the strong possibility of affecting human health. Compensation remains a key tool in support of both stamping-out strategies for

animal disease control and communication. Compensating/indemnifying rural farmers is a complex operation involving funds disbursement, extension services, trust in governments, transparency, good governance and overall institutional challenges due to the need for rapid response and compensation. Guidelines for good practices are needed to set prices and predict funding needs for compensation during emergency culling, in order to avoid loss of credibility from not having sufficient resources at hand for adequate or timely payments. The effective provision of funds for compensation/indemnity should be clearly addressed by governments and donors. The Senior Officials Meeting on Avian and Human Influenza held in Vienna, June 6-7, 2006, identified the need for guidelines based on best practices for compensation of producers of culled birds under developing country conditions as a top priority in the fight against avian influenza. Guidelines on good practice have been drafted for the 4th International Conference on Avian Influenza to be held in Bamako, Mali, and these should be useful to countries and partner agencies when designing compensation/indemnity schemes and packages for both backyard and industrial poultry11. Schemes that provide funds for needy countries should be put in place to allow the implementation of a compensation/indemnity policy with the requisite guidelines to operationalize the administration of the scheme. In addition, the involvement of insurance firms could be explored, in particular for the intensive production sector, either to introduce it or to strengthen it where it already exists. In general, there is a lack of interest in insurance by the majority of poultry farmers, including some commercial producers, who often reject insurance as a strategic option for risk management. The unwillingness of farmers to insure their poultry business stems from the fact that the conditions for paying relief are highly exploitative as far as agriculture or poultry farming is concerned.

11 Enhancing Control of HPAI in Developing Countries through Compensation – Issues and Good Practice. World Bank, FAO, IFPRI and OIE, 2006.


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2.5. Impacts on biodiversity

Comprehensive programs of HPAI disease management should increasingly be based on strong biodiversity programs and the appropriate use of HPAI control tools such as vaccination. It is necessary to build inventories, including spatial information of breeds and valuable breeding stocks within a country. This may include isolation, protection and compartmentalization of valuable stocks, precautionary cryo-conservation of their genetic material, or other measures to ensure that in the case of an outbreak, genetic material can be conserved if birds have to be culled. In view of the paucity of data on the H5N1 virus and poultry genetic diversity, disease ecology, the interaction of the virus with host genetic make-up and the wider host habitat; investments in research may be required in order to clarify issues and provide a sound basis for HPAI control actions that takes into account, biodiversity considerations. 2.6. Impacts on environment

Disposal of dead or culled birds as a result of outbreaks of HPAI poses a great threat to environmental integrity and must be approached with a great deal of caution. Wild birds have been implicated in the spread of HPAI in other parts of the world.

However, the destruction of wild bird populations or their habitats is scientifically and ethically unjustified as a method to prevent HPAI outbreaks or as a control strategy. These activities could contribute to environmental degradation and reduce biodiversity.

Biosecurity measures should include aspects of environmental safety and considerations pertaining to the handling and disposal of potentially infective material. This includes collection of samples from birds or collection of environmental samples, and the storage and shipping of samples. Training in this area should not only be conducted for veterinarians but encompass game/wildlife officers, hunters, farmers, bird watchers and the general public.

Resources need to be allocated towards research that will provide more baseline information and identify environmental factors that contribute to the occurrence of the disease, and factors that enable transmission between poultry, wild birds and humans. Other areas of research should include ecological studies of wild bird migratory routes, important areas of interaction between wild birds, domestic birds and humans, and the identification of susceptible bird species.

Strategies for developing public awareness should also be considered.


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3. STRENGTHS AND WEAKNESSES IN AFRICA FOR THE PREVENTION AND CONTROL OF AVIAN INFLUENZA AND HUMAN PANDEMIC PREPAREDNESS

The strengths and weaknesses in Africa for the prevention and control of avian influenza, human influenza pandemic preparedness and the dissemination of the correct messages to relevant stakeholders are analyzed here to provide a sound basis for international concerted action. 3.1. Strengths • National political commitments Following the emergence of avian influenza in Nigeria, a sub-regional meeting was held in Dakar, Senegal, on February 22 and 23. A decision was made to establish a sub-regional mechanism for coordinating prevention and response efforts in West Africa. A pan-African meeting (at which 45 countries were represented), attended by various United Nations agencies, took place in Libreville in March 2006. The goals of this meeting were primarily technical and consisted of assessing the outcomes of the Beijing conference: namely the development by countries of their Integrated Country Plans and the reiteration of the importance of animal health issues while the disease is still confined to animals. The Libreville Declaration issued at that meeting emphasizes the importance of heeding the recommendations of the international technical agencies (in terms of drawing up Integrated Country Plans), and of developing hubs of expertise on animal and human health. The United Nations System for Avian and Human Influenza (UNSIC) also explained its role as coordinator of the UN agencies and programs involved in the response and emphasized the need to improve coordination at the country level. ALive recognizes the strong political will and commitment in the fight against AHI that many African countries have shown in this and many other meetings and continued support for activities of the kind characterized below will be essential to the success of the response in Africa.

• Establishment of crisis management centres Many countries infected by HPAI have established Crisis Management Centres to manage and coordinate disease control efforts. In view of the multi-sectoral nature of HPAI, centres typically

involve representatives from all Ministries or national agencies involved in the response and are managed under ministerial supervision (and sometimes under the leadership of the Head of State or an immediate appointed representative). • Intersectoral collaboration Avian influenza outbreaks or threats of outbreaks in Africa have provided the platform for the animal and public health sectors to work together in seeking common solutions to the avian influenza threat, as demonstrated by the Integrated Country Plans. This essential collaboration has been unprecedented and should continue to be strengthened for a lasting collaboration between Human Health Services and Veterinary Services in the fight against emerging and re-emerging zoonotic diseases. • Animal disease surveillance systems Progress made in developing national surveillance systems by programs aimed at controlling epizootic diseases (PARC and PACE programmes) in Africa over the last 20 years gives an indication of what can be achieved if initiatives receive sustained funding and technical support. It was in fact the PACE surveillance programme that first alerted Africa to HPAI infection. In January 2006, FAO launched a series of Regional TCPs in West/Central, East/Southern and North Africa, which are intended to establish HPAI disease and epidemiological surveillance networks. • Existing wildlife expertise Wildlife surveillance systems have been established by AU-IBAR through the PACE programme. This network of expertise in East, West and Central Africa is able to work with the Veterinary Services and Public Health systems to enable early detection of disease in wild birds and other susceptible fauna. Further capacity building can be provided to existing wildlife personnel to equip them to address AI. These trained personnel can then be used to adopt a ‘trainer training’ approach.


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• Human disease surveillance systems Opportunities for effective implementation of an integrated avian influenza plan at the country level include the need to develop avian influenza surveillance and response capacity (within the Integrated Disease Surveillance and Response framework and in compliance with the legal basis provided through the International Health Regulations 2005), to adapt and use the polio surveillance infrastructure, and to improve the collaboration between human and veterinary public health services. • African Regional Economic Communities’

involvement Africa Regional Economic Communities (RECs) have existing coordinating mechanisms for animal disease control that have been effectively used in the HPAI response to date most notably by CEMAC, ECOWAS, SADC, UMA and others whose sub-regional technical committee on animal health was established for the surveillance and control of transboundary animal diseases prior to outbreaks of HPAI on the continent. RECs are also playing a significant role in supporting the implementation of national avian and human pandemic preparedness and response plans by developing initiatives, organizing ministerial and technical meetings, drafting regional plans, and developing institutional mechanisms to coordinate activities. SADC countries will also establish a Joint Technical Committee (JTC) and a Coordination Unit whereas in ECOWAS, a sub-regional AI prevention and control coordination mechanism has already been created. Similar coordination mechanisms exist in the IGAD, UMA and CEMAC-CEBEVIRHA regions. In addition, sub-regional organizations have an important role to play in raising awareness raising, capacity building and the implementation of integrated national plans within the continent. The existence of initiatives such as ALive, the PACE Programme and the establishment of a Regional Animal Health Centre in Bamako, Mali, with proposals to establish similar centres in Nairobi, Kenya; Gaborone, Botswana and Tunis, Tunisia, will provide avenues for improved and strengthened animal disease control structures. The RECs are well positioned fora to ensure proper collaboration between animal and human health.

• Regional and international cooperation International institutions, notably AU-IBAR, FAO, OIE, WHO, UNICEF, UNDP, UN country teams and others, have provided technical guidelines, human expertise (hiring of consultants and recruitment of staff), material and financial assistance and coordinating mechanisms in controlling and preventing HPAI in poultry and ensuring human pandemic influenza preparedness. The FAO has established the Emergency Centre for Transboundary Animal Diseases (ECTAD), which makes both operational and technical assistance on HPAI immediately available to countries. In addition joint actions with the OIE have been undertaken in the preparation of technical documents on HPAI control, establishment of Animal Health Centres and a Crisis Management Centre (Rome) designed to respond rapidly to requests for technical and operational assistance to countries in relation to transboundary animal diseases in general and AI in particular. A strategy for the control of avian influenza in Africa was initially defined in September 2005 by AU-IBAR in collaboration with FAO and OIE and subsequently endorsed at the Ministerial Meeting in Kigali, Rwanda, in November 2005. This document has evolved to reflect the rapidly changing epizootic situation of HPAI in Africa. The threat posed by AHI to human health was discussed at the Fifty-sixth World Health Assembly (May 2005), during which Member States agreed12 to draw up and implement integrated national preparedness plans and requested the organization to continue to provide leadership in pandemic preparedness. Prior to this, the Fifty-fifth session of the WHO Regional Committee for Africa, held in Maputo, Mozambique (September 2005), expressed concern about the potential impact of the pandemic in countries of the Region and proposed setting up a technical advisory group (October 2005). In addition, the Regional Office convened a Regional Meeting on Pandemic Influenza in Brazzaville, Congo (January 2006) and collaborated in holding the Joint UN Meeting on Avian Influenza in Libreville, Gabon (March 2006).

12 By WHO Resolution WHA56.19


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UNICEF has provided technical guidance for behavior change communication for avian influenza at national, regional and global levels. Technical assistance is being provided to countries for the design of communication plans and to UN country teams in finalizing their contingency plans. To ensure that public awareness campaigns appropriately reflect national and cultural differences, UNICEF’s Regional Office for West and Central Africa has hired an international NGO to carry out participative action research in coastal and Sahelian regions to map out the perception of avian influenza and human health risks in communities, and the overall extent of its socio-economic and overall extent of market impact. The knowledge produced will support the design of sound risk communication strategies. • Bilateral and multilateral support There are many bilateral and multinational institutions that are providing human, financial and material support to African countries and various regional and technical agencies including NGOs and civil society assisting in the control and prevention of AI and in human pandemic preparedness planning. The African Development Bank (AfDB) has provided emergency financial assistance through its Special Relief Fund to at least eleven countries affected or at high risk of infection to assist in their response activities or to support preparedness and contingency planning. The AfDB has also provided development assistance through its projects to strengthen the human and animal health services and prevent future outbreaks. 3.2. Weaknesses • Inadequate or under-funded official

Veterinary Services The restructuring programs in the recent past have done little to overcome institutional weaknesses in national veterinary systems. Many countries continue to face difficulties in designing effective prevention and control programs for major epizootic diseases, particularly as regards establishing an effective chain of command. A recent survey13 has indicated that 25 per cent of African countries have no program for control of transboundary animal diseases despite the high incidence of zoonotic and non-zoonotic epizootic

13 “Economic and Social Justification of Investment in

Animal Health and Zoonoses “, Dr François G. Le Gall, World Bank, presentation to 74th General Session of OIE, Paris, May 2006.

diseases. Capacities for disease reporting with epidemiological investigation and differential diagnostic follow-up actions as well as data analysis, are generally deficient. • Management of public health system National health system capacity and human and financial resources are already overwhelmed by the demands of diseases such as HIV/AIDS, tuberculosis and malaria and laboratory confirmation of human H5N1 infections is technically challenging, expensive, and demanding of these scarce human resources. Management of H5N1 patients is also resource intensive and infection control measures required in most hospitals are difficult to introduce and sustain. Sporadic cases of H5N1 infection and the frequent reluctance of residents to comply with recommended reporting and isolation measures during outbreaks of severe disease threaten to push already fragile health systems close to the brink of collapse. Surveillance systems are, with rare exceptions, not sufficiently sensitive to pick up clusters of human cases - a critical early warning signal that the virus is improving its transmissibility. Africa has some well-equipped laboratories, but these facilities would be inadequate in the event that large numbers of samples needed to be tested rapidly. • Weak linkages between governments and

the private sector In many countries, official Veterinary Services do not enjoy close relationships with livestock owners (including their associations) or the private veterinary sector. Consultation and coordination mechanisms with the private sector (livestock owners and veterinarians) to perform comprehensive surveillance activities (early detection) and rapid response have generally not been put in place and there is generally little basis for public sector teams to rely on the support of their private sector counterparts in the event of an emergency. • Difficulties in implementing biosecurity

measures In Africa, 80 per cent of the farmers keep poultry in village/backyard production systems, characterized by local indigenous breeds adapted to scavenging habits. Private entrepreneurs are emerging but small commercial farms often lack adequate biosecurity measures and operational capacity


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to prevent HPAI spread. Requirements to increase biosecurity measures have an impact on the livelihoods of various stakeholders in the market chain. Village and backyard poultry production is often carried out by women, so that the closure of markets as part of disease control measures may have gender implications as well. • Difficulty of implementing a ‘stamping-out’

policy Small farmers tend to lack faith in compensation/indemnity payments and are therefore often reluctant to submit to culling of their flocks (stamping-out policy). It is important to distinguish between compensation/indemnity for culled birds, which is believed to encourage compliance with stamping out, and the rehabilitation of the poultry sector after an outbreak, which may include other kinds of financial and technical support to farmers to promote safer poultry production in the long term. Price differentials on either side of national boundaries influence poultry movements. Lack of transparency from government at national level and poor cooperation on the part of various stakeholders makes the implementation of a stamping-out policy difficult. • Lack of adequate communication programs Few African countries have designed AHI integrated development communication policies and operational strategies, with the exception of Eastern and Southern Africa countries that were supported by UNICEF in developing AHI communication strategies that were integrated into the UN and government Emergency Preparedness and Response plans. Too often, the communication models are still vertical, from expert to communities. The experiences already encountered in HPAI control in different countries of Africa as well as from earlier animal and human disease control campaigns and other development issues have shown the importance of ensuring that communication strategies and messages are targeted at carefully identified groups. Where communication campaigns have been developed, lack of funds prevents their implementation and resources are sought as a matter of urgency. There is also a need to develop evidence-based approaches and improve the monitoring and evaluation of communication interventions to gauge the impact of the campaigns.

• Weak inter-sectoral linkages Stronger inter-sectoral collaboration, particularly between the animal health and public health sectors as well as other relevant government sectors is crucial for influenza prevention and pandemic preparedness. Currently, the links between the animal health, public health, wildlife authorities and communities in monitoring zoonoses in Africa could be further improved. However, good progress has been made since the avian influenza outbreaks. The program envisages the forging of closer links and interactions between these key role players. There is considerable scope for sharing elements of the surveillance and reporting systems at village level and in molecular epidemiological analysis of virus evolution through using the OIE/FAO-OFFLU and WHO networks • Lack of considerations for biodiversity Conservation of biodiversity both of domestic livestock and wildlife must be taken into consideration when implementing control measures for HPAI. Breeding stocks and zoological birds should be considered among the first priorities. Another priority is endangered rare poultry breeds. For these rare breeds, vaccination should be the primary means to control and culling considered only as a last resort. As regards poultry diversity, the hypothesis that chicken breeds differ in their susceptibility to HPAI needs further investigation as there is no definitive proof that the breeds differ in their resistance to HPAI. However, there is no evidence that natural selection for resistance against H5N1 HPAI, a new virus, has taken place. • Lack of research on avian influenza in

Africa Operational research on avian influenza is very limited and particularly as regards the epidemiology (circulation of the virus among different domestic species and between domestic and wild species; short and long distance virus propagation modalities within a country or among countries, etc.), the socio-economic impacts of the disease, possible vaccines and antiviral drugs. Therefore, countries are encouraged to facilitate collection


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of strains, testing of vaccines, medicines and diagnostics in accordance with international ethical standards. This will create an opportunity for the transfer of technology and for access to scientific knowledge on the disease. It also implies the need for collaboration between doctors and veterinarians to study the zoonotic aspects of the virus. 3.3 Opportunities • The willingness of donors and development

partners to support African countries in strengthening the institutional capacity to enhance the continent’s preparedness and responses against AHI offers an opportunity for international cooperation on support for socio-

economic well being and improvements in public health infrastructure.

• Systems put in place to control AHI provide

a unique opportunity for the control of emerging and re-emerging transboundary animal diseases.

• The willingness to shift from individual agency interventions to more integrated and coordinated planning, programming mechanisms at global, regional and national levels.


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4. STOCKTAKING OF CURRENT INTERVENTIONS IN AFRICA – BEST PRACTICES AND LESSONS LEARNED

Regarding HPAI, the obvious link between animal health and human health has, for the first time, spurred a joint mobilization of international scientific and technical organizations (i.e. OIE, FAO, WHO, UNICEF and others) together with the international donor community and others interested in addressing an epizootic in an integrated and coordinated manner. 4.1. International and Regional

Advocacy/Mobilization In November 2005, an International Conference on Avian and Human Influenza (AHI) took place in Geneva and led to the preparation and adoption of a joint FAO/OIE/WHO strategy supported by the World Bank and other donors. In January 2006, a second International Conference in Beijing generated donor commitments totalling US$1.9 billion and the establishment of a financial framework to bridge the financing gaps. The components of the joint intervention strategy unveiled in Geneva were also strongly endorsed at this conference. In June 2006, a third international Conference on AHI was held in Vienna, and provided an opportunity to monitor the financial

commitments made in Beijing and the progress made through collective response in terms of prevention and control of AHI worldwide. The FAO’s SFERA funding mechanism also provides flexible donor-supported funding systems that facilitate rapid response to HPAI emergencies and has been instrumental in assisting a number of African countries with immediate needs and technical assistance in preparing contingency plans and improvements in diagnostic capacities of laboratories for HPAI. During these conferences, the following principles were agreed and received strong endorsement from the national governments and the international community: In terms of strategy and general principles of intervention

The prevention of a potential pandemic requires, first and foremost, the prevention and control of avian influenza at its animal source, implying early detection and rapid response linked to the general precept of good governance (see text Box 1 below);

Box 1 - Towards Good Governance, Early Detection and Rapid Response

To limit the spread of newly emerging or re-emerging epizootic diseases, including avian influenza, there is a need to strengthen the capacity of States to rapidly detect their presence and take the appropriate emergency actions to immediately eliminate the pathogen(s) in question. It implies good cooperation between livestock owners, private veterinarians and public Veterinary Services, which together constitute an important tripod for early detection of animal diseases. Immediately eradicating an emerging disease as soon as it occurs will reduce the pathogen load as well as the cost of eradicating it several times. For this reason, steps must be taken to ensure the efficacy of the specialised public services responsible for formulating the relevant legislation and effectively controlling its application (core public functions). For this purpose, countries should have efficient Veterinary Services (this means the Veterinary Administration, all the Veterinary Authorities, and all persons authorised, registered or licensed by the veterinary statutory body; i.e. including public and private veterinarians). The OIE convinced the countries and the main international multilateral organisations concerned, including the World Bank, that the core functions of Veterinary Services are a “Global Public Good’’. One of the OIE’s main objectives, in its Fourth Strategic Plan, is to strengthen the capacity building of the National Veterinary Services, encouraging the improvement of legislation and resources, in order to assist the Member Countries in complying with the (OIE) international standards and guidelines for animal health (including zoonoses) and welfare, and for safe international trade in animals and animal products. The necessity to strengthen Veterinary Services has also been reaffirmed at the last G8 Summit held in St. Petersburg on July 16, 2006 (http://en.g8russia.ru/docs/10.html: Conclusion 13. in “Fight against infectious diseases”). Building and maintaining good (epidemio-)surveillance networks and territorial meshing covering the entire national territory potentially for all animals and for all animal diseases, including zoonoses, is an international obligation of all OIE Member Countries.


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If one country fails, all others will be at risk. This implies a permanent and very close collaboration with all partners and stakeholders, including the private sector (that includes livestock owners, their organizations, private veterinarians, traders, exporters, processing/transformation industry, major retailers and catering industry). The OIE Member Countries have adopted quality standards for the evaluation of Veterinary Services (http://www.oie.int/eng/normes/update2006_chap_1.3.3.pdf) and guidelines for their evaluation

(http://www.oie.int/eng/normes/update2006_chap_1.3.4.pdf), which are the world reference for the countries, regarding the surveillance, prevention, control and eradication of animal diseases, as well as for safe trade in animals and animal products. These standards help countries, in particular developing countries and countries in transition, to justify contributions requested from national governments and international donors for the development of their capacity building and compliance with OIE standards. Capacity building of National Veterinary Services is a key factor for creating and reinforcing effective legal frameworks including in particular early detection networks, notification of suspected cases of diseases, quick and reliable diagnosis, rapid answer, national chain of command and public-private partnership (animal owners organisations and private veterinarians). This allows a rapid response, controlling and containing the diseases at their initial stages. For this purpose, the OIE and the Inter-American Institute for Cooperation on Agriculture (IICA) have joined forces to develop a useful tool to asses the Veterinary Services: the Performance, Vision and Strategy (PVS) Instrument, in accordance with the relevant OIE standards, under the Chapters 1.3.3. and 1.3.4 of the Terrestrial Animal Health Code. This important tool was democratically adopted by OIE International Committee. Formal reference to the PVS in the OIE Terrestrial Animal Health Code has already been adopted by the 167 OIE Member Countries during the last OIE General Session held in May 2006.

(http://www.oie.int/downld/PVSI_update_%202006.pdf) This PVS instrument is not only an assessment tool. It is also a development tool that collaborates with the Veterinary Services, identifying gaps and deficiencies, facilitating the elaboration of national investment programmes and their follow-up overtime, and thus providing a framework and justification for obtaining funds from international donors, including from the World Bank as well as from developed countries, which have pledged funds to assist developing countries and countries in transition in the strengthening of their Veterinary Services. These identified gaps and deficiencies will also provide detailed references for Governments to make policies directed at investments and improvement of governance and the capacity building of their Veterinary Services. Source: Communication of OIE to CAHP Conference, Brussels, 7 November 2006 Coordination among the key stakeholders is a

key element in the successful prevention and control of AHI and should be ensured from the international level (coordination among international agencies in the definition of priority interventions and of a common approach; the role of UNSIC has been pivotal in this regard) to the national level (setting up of National Coordination Committees in charge of leading the response);

All interventions aimed at combating avian influenza should proceed from a multi-sectoral approach, integrating animal health, human health and communication aspects. In this regard, the elaboration of an Integrated Country Action Plan across all sectors has been recommended to provide the basis for coordinated technical and financial support (see text box below);

Partnership should be developed between public and private sector (profit and non profit), and with communities;

While immediate and short-term activities are clearly the priority, medium and longer term activities need also to be envisaged to prevent and control AHI in a sustainable manner, since there is the potential for the virus to emerge or re-emerge at any time;

While fighting AHI remains the priority in the short term, prevention of all other emerging and re-emerging animal diseases (and in particular zoonoses) should also be targeted as an explicit objective of the medium- to long-term strategy;


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Box 2 - General principles of interventions for Africa:

Recommendations for Integrated Country Plan based operations. The Integrated Country Plans (ICPs) must be requested and steered by the countries (via their National Coordination Committees) and drawn up with the help of international technical experts provided either directly by the international and regional technical organizations through their multidisciplinary teams (AU-IBAR, FAO, OIE, UNICEF, WHO) and through the OIE/FAO/IBAR Regional Animal Health Centres (already implemented in Bamako and planned to be established in Gaborone, Tunis and Nairobi) in close collaboration with the Regional Economic Communities. In the case of human health WHO/AFRO and African Union decided to work closely on this issue. The ICPs must be based on a reliable diagnostic analysis of the national situation. To this end, the ALive Partnership has validated the Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI) Terms of Reference for a Rapid Assessment of the situation with regard to avian influenza. These TORs now constitute a recognized and standardized basis for analysis in Sub-Saharan Africa. In accordance with the goals set by the international community at the Beijing and Geneva meetings, the immediate, as well as medium- and long-term needs must be identified so that country capacities can be sustainably enhanced, particularly in the area of animal health and link with human health and communication needs, and the capacity to prevent and combat not only avian influenza but also the major emergent and re-emergent animal diseases. The diagnostic must take into account the achievements of the previous projects/programs notably the PARC and PACE programs and FAO programs notably the laboratory and epidemiological sub regional networks (in particular regarding epidemio-surveillance) and any new support should be built on these existing achievements. While the Rapid Assessments are generally funded by the country itself or a specific donor, its results are meant to be shared with all actors and be the basis for any interventions on AHI, who ever the implementer may be. The countries will then submit the ICPs to the various financial/ development partners with a view to developing jointly the ICP’s Financing Plan that will allow the activities to be adequately distributed, in a simultaneous effort to both address all needs and avoid redundant financing. In summary, interventions to prevent and combat avian and human influenza should, whenever possible, be preceded by a three-step process: Rapid Assessment Integrated Action Program Bilateral and/or Multi-Donor Financing Plan. Once these steps are completed, the donors activate their own intervention mechanisms and procedures for the design and implementation of activities that they will finance. Access and mobilization of international funds by the low income countries must be based on this intervention scheme, as agreed at the AFR meeting. Source: AHI Operational Task Force, World Bank, 2006

Considering the transboundary nature of

HPAI, efforts should be made at both the country and sub-regional levels in terms of coordination. The RECs should ensure that all their member countries have put in place the minimum measures so that one country may not jeopardize the status of the whole sub-region;

All African countries are at high risk.

In terms of financing framework and mechanisms During the Beijing International Conference on AHI, a flexible financial framework was put in place to address the needs of the countries, regions and institutions with regards to the prevention and control of AHI.

In particular, a Multi-Donor Trust Funds AHIF (Avian and Human Influenza Facility) hosted by the World Bank was created to assist developing countries in meeting financing gaps in their Integrated Country Plan to minimize the risk and socio-economic impact of avian and possible human pandemic influenza. The governance of the AHIF is composed of the contributing donors with, as observers, OIE and the UNSIC system. This facility is aimed at financing stand-alone as well as co-financed operations on AHI (national level only). So far, about US$75 million has been pledged, with the European Commission being the largest donor so far. As all developing countries—some 145 of them—are at risk of avian flu and need to prepare for a possible human pandemic, the amount expected to be available for any one developing country’s program is highly constrained.


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Bilateral funding is also an option for financing for AHI operations. It is crucial that these funds be planned and disbursed in coherence with the other sources of financing. Since some financial mechanisms were already in place in Africa, it was recommended that the various existing funding sources be exploited on the basis of comparative advantages. In this regard, the ALive Multi-Donor Trust Fund, dedicated to supporting up-stream and up-scaled interventions to ensure quality operations at national level in the livestock sector, has been identified to also support interventions on AHI. Activities funded under the MDTF of ALive are clearly meant to be complementary (up-stream) to those financed by bilateral funds and/or in addition to those financed by the AHIF. Eight (8) million euros have been allocated in the MDTF of ALive for this purpose. Finally, AfDB and ECOWAS have put in place an emergency fund to be able to provide any country of the sub-region with immediate financial assistance, should an outbreak occur. Further information on available funds and mechanisms for AHI is detailed in the Financing Framework Paper that was prepared for the Beijing Conference and has been consolidated for the Bamako Conference. 4.2. International assistance to Africa

• At the national level Upstream interventions to quality operation preparation (Rapid Assessment report) To date, 9 rapid assessments based on the ToRs promoted by ALive have been performed in Burkina Faso, Burundi, Cameroon, Democratic Republic of the Congo, Ethiopia, Kenya, Malawi, Niger, and Zambia. It is expected that European Union will finance a rapid assessment in Chad and that two others (Liberia, Sierra Leone) will be rapidly conducted by the World Bank, funded by the AHI Facility (USD 95,000 per country). All other African countries should be covered (elaboration of the national ICPs or their review when they already exist) through the ALive funds dedicated to AHI and specifically targeted at providing up-stream support (analytic and advisory assistance) to donors and development agencies operations. Initial experience has identified the translation of the

diagnostic provided by the Rapid Assessment into an action-oriented plan (ICP) as a particular obstacle to progress. Strategic operational framework The World Bank has designed a Global Program for Avian Influenza control and human pandemic preparedness and response (GPAI), which provides not only a financial facility (allows for the use of up to US$ 500 million in loans, credits or grants from the Bank’s concessional lending arm IDA, upon accelerated preparation and Board approval mechanisms) but also a technical framework/umbrella, drawn on the integrated approach jointly developed by FAO, OIE, UNICEF and WHO. It is aimed at framing a common approach to the Bank and other donor operations so as to provide a comprehensive and common technical framework for AHI operations. Operations at the country level From the main donors present in ALive14, major findings are:

Donors Total on-going portfolio in Africa

African Development

Bank

US$ 5,500,000; national support (11 countries covered)

European Commission

US$ 90,600,000 (incl. 28,100,000 tbc15); national (all Sub-Sahara African countries covered) and regional support

France/MAE US$ 9,750,000; national (11 countries covered), sub-regional (West Africa and Indian Ocean) and regional support

USA/USAID US$ 6,500,000; national (16 countries covered) and sub-regional support (East and West Africa)

World Bank US$ 111,000,000; national (9 countries covered + 7 in the pipeline, amount tbc)

AHIF (MDTF) US$ 5,420,000 ; national (8 countries)

14 Without prejudice to contributions from African Governments and other bilateral and multilateral Donors which are not part of the ALive governance 15 tbc: to be confirmed


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Overall, a majority of the 53 African countries have received assistance (technical or financial) from donors regarding AHI. In particular, all infected countries have received strong support from donors, mainly to cover the immediate needs, demonstrating that donors are able to quickly mobilize funds, through emergency packages (AfDB, France/MAE, USAID) or reallocation of funds (EC, WB).

While most interventions are cross-sectoral (and address the animal health, human health and communication dimensions) and in that sense comply with the Beijing conference recommendations, very few of them are actually based on an ICP sensu stricto (based on a rapid assessment - see Box 2) which ensures a comprehensive identification of the needs and gaps at the country level, with a technical/scientific validation by the International Technical Agencies. Furthermore, few detailed resource estimates have been designed and circulated among donors to ensure coherent coverage of needs and avoid gaps or overlaps in and/or duplications of interventions, although the portfolio cross-analysis shows that most of the countries have received multi-donor support (2 or more donors). While a lack of consultation among stakeholders can be understood in a crisis situation (suspected or confirmed outbreaks), it should not occur in other non-emergency situations. It is noted that coordination among donors is a responsibility that clearly rests with National Committees.

Most interventions (75%) are less that US$ 1 million, implying that assistance has addressed immediate needs in the first instance although countries have indicated that the support provided has been insufficient to establish fundamental early detection and rapid response measures.

Medium and longer term support has been taken into consideration mainly by the World Bank, which systematically ensures that an in-depth PVS (long-term VS capacity building) will be implemented in the course of the project. Long-term support to human health services is also provided.

The African Development Bank (AfDB) has, in addition, provided support through its on-going operations in its regional member

countries to strengthen both their human and animal health services. The total commitment among the ongoing projects targeting both human and animal health services in its regional member countries stands at about US$950.72 million and US$53.89 million, respectively. About 29% of these funds have so far been disbursed.

• At the sub-regional and regional levels

Coordination The office of the UN System Influenza Coordination (UNSIC) has been created within the UN Development Group to help ensure coordination and cooperation within the UN System so that, as a whole, it can effectively respond to national, regional and global challenges posed by the avian flu epidemic and the threat of a human pandemic.

The ALive platform has been instrumental in gathering the main stakeholders involved in the prevention and control of AHI in Africa and ensuring knowledge sharing (AHI portfolios, videoconferences, physical meetings) and coordinated country preparation. Strategy Policy and technical guidelines for a common approach in dealing with AHI has been adopted and provided by UNSIC, FAO, OIE, AU-IBAR, WHO, UNICEF and UN Country teams in Africa. ALive has supported IBAR in the definition of a strategy of regional coverage. Operational support Three FAO regional projects (TCP) for East/Southern Africa, Western/Central Africa and North Africa have been implemented and have provided the basis for disease recognition, epidemiological, laboratory and wild bird surveillance training. Training of field and laboratory personnel, provision of laboratory equipment and diagnostic kits to countries in Africa for HPAI interventions have also been provided. Supplemental support from donors has enabled these projects to be extended. While these projects ultimately benefit the countries, this sub-regional dimension ensures a similar level of preparation within countries of the sub-region.


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WHO has provided all African countries with personal protective equipment and a small quantity of antiviral drugs. WHO has also developed training modules and trained participants (epidemiologists, laboratory technicians) from 42 countries. The Regional Economic Communities have received support from donors, mainly for communication and coordination aspects or provision of technical assistance. AU-IBAR, together with the OIE, FAO, and the EISVM, have organized HPAI regional training programs and have supported simulation exercises organized by Senegal with the participation of French-speaking countries of West and Central Africa (both desktop and field) to test the effectiveness of contingency and emergency preparedness plans of countries. A similar program is foreseen for English-speaking countries in Lilongwe, Malawi. Various regional workshops on avian influenza were organized by different international organizations (FAO, OIE, OCHA, UNDP, UNICEF, WHO). The African sub-regions and region received the support from donors and Development Agencies through the on-going PACE Programme, SFERA, GF-TADs, OFFLU networks, and will receive support from the Regional Animal Health Centres as soon as they are fully operational. A virtual vaccine bank has been put in place by IBAR (identification of needs) and OIE (ordering of vaccines from to a pharmaceutical firm) at the regional level to provide countries with vaccines of quality (in compliance with OIE standards) within a very short time-scale (to avoid each country needing to have its own stock of vaccines). 4.3. Lessons Learned – Steps forward From recent experience in Africa (less than a year, since avian influenza struck Africa), key lessons learned so far include:

o International organizations working together, have achieved far more progress in HPAI control globally than each organization going it alone. It has brought about an harmonization of plans, policies and strategies, sharing of resources and avoided duplication of efforts and confusion.

o Inter-sectoral collaboration between the animal and human health sectors has greatly improved (most countries have put in place an ICP) although there is still room for further improvements.

o Political commitment to the ideals of AHI control has been unequivocal (at the regional, sub-regional and national levels) and will need to be sustained if the AHI response is to be successful.

o While most of the African countries have made efforts in terms of preparedness for AHI (elaboration of emergency and contingency plans), technical support from the international community has not been forthcoming to ensure conformity with international standards, technical quality (recourse to a rapid assessment to prepare or consolidate ICPs should ensure such quality – see Box 2) and the financing of these plans.

o Ensuring early detection and rapid response should clearly remain the priority for all countries. The establishment of compensation/indemnity schemes for culling should be studied and put in place as a matter of priority (see the guidelines recently published on compensation).

o In countries affected by HPAI in Africa, follow up action reports to the FAO, OIE and WHO by countries have not been frequent. This affects the monitoring of progress of control actions.

o Communication messages have to be prepared by qualified personnel with the relevant expertise and skills and should be informed by relevant survey and rapid assessment data. Communication messages should emphasize the significance of poultry-to-poultry as well as poultry-to-human transmissions and the need for the adoption of biosecurity measures and best poultry production practices to prevent the spread of HPAI;

o Political commitment has not been matched with allocation of resources by governments and contingency and emergency preparedness plans remain largely under-funded: additional funding to cover the minimum needs in terms of early detection and rapid response is urgently needed.


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o Only a few donors have allocated funds so far to finance projects that would ensure the sustainable and long-term reinforcement of Veterinary Services and human health services. Additional funds are also required in this regard.

o Complementarity of funds is not ensured among donors; and a comprehensive and detailed national funding estimate, identifying resources and funding gaps should be drawn up and shared as a pre-requisite for any donor support.

o It has been recognized that the perception of AI in some countries has had negative socio-economic effects, even in countries where the disease has not occurred, by instilling fear in the consumption of poultry and poultry products. Therefore, appropriate communication strategies and messages at all stages (prevention and control) are essential to success in dealing with AI spread and prevention.

o Concerns related to exposure to HPAI infection through cross-border trade have resulted in the imposition of trade bans where this may not be warranted or cannot be justified. This needs to be addressed at both political and technical levels.

o Newcastle disease (NCD) and Gumboro disease (infectious bursal disease) in particular take a heavy toll on the poultry industry in Africa and should therefore be addressed to further improve the differential diagnosis and reporting of HPAI. In addition to the differential diagnosis issue, this is also perceived as adding to public confusion (misinterpretation on the reason/origin of high poultry mortality in some villages). In some countries, efforts have been made to control NCD, and prevention and control of AI should build on the experience gained from NCD control. This will further sharpen the case definition for HPAI and decrease the level of ambiguity in high poultry die-offs.

o Risk-based epidemiological analysis should be consolidated at national level and discussed at regional/ sub-regional levels to assist in strategy formulation for HPAI control.

o Environmental impact assessments (EIA) have not featured in control programs for HPAI. Avian influenza impact assessments could identify environmental consequences of outbreaks, including possible environmental contamination/spread of the disease agent, loss of biodiversity of species through mortality/culling and impact from incineration and burial of carcasses.


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5. STRATEGY TAILORED TO AFRICA FOR THE PREVENTION AND CONTROL OF AVIAN INFLUENZA AND HUMAN PANDEMIC PREPAREDNESS

The fundamental principle of HPAI control globally is to break the virus transmission cycle by progressively reducing the amount of circulating virus in poultry populations. Infected areas must be contained as far as possible by control of movements of people and poultry and measures applied to eliminate infection. These include stamping out, cleaning, disinfection and targeted or poultry in and around infected area mass vaccination. Official movement controls on poultry, market control, enhanced biosecurity at all levels, culling and vaccination are implemented to create barriers between uninfected poultry and foci of infection, thus limiting the chances of disease spread in poultry and human exposure to the virus.

In general, global strategies from FAO, OIE, WHO, UNICEF and the overarching coordinating mechanisms of UNSIC, have played a pivotal role in shaping the overall response to HPAI globally. For Africa in particular, the FAO strategy document, provided the relevant technical information for HPAI disease control. Additional work and investments are, however, needed in terms of strategy development as the disease evolves in Africa.

• Animal health

This strategy prepared by FAO and OIE in collaboration with the WHO aims to minimize the global threat and risk of influenza at source in domestic poultry and prevention of exposure of humans, through progressive control of HPAI. This global strategy has been adapted by AU-IBAR in collaboration with FAO/OIE to suite African specificities. The strategy is implemented over three time-frames namely: immediate to short term (1-3 years), short to medium term (4-6 years) and medium to long term (7-10 years). This strategy is complemented by the elaboration of detailed country specific HPAI control plans often prepared with collaboration between national governments and international technical agencies.

• Human health

The WHO global strategy recognizes five critical actions needed to address an influenza pandemic. These are i) reduce human exposure to H5N1 viruses, ii) strengthen early warning systems, iii) build capacity to cope with a pandemic, iv) intensify rapid containment operations and v) coordinate research and development efforts to help accelerate the development and the production of human influenza vaccine. The activities proposed by WHO/AFRO are summarized in its Regional Pandemic Influenza Preparedness and Response Plan, 2006-2007. FAO, AU-IBAR and OIE contributed to the elaboration of this plan with the African countries participating in the meeting in January 2006.

• Communication

UNICEF (West and Central Africa Regional Office (WCARO) and East and Southern Africa Regional Office (ESARO) are actively engaged in international efforts to contain and lessen the impact of the virus. Along with multiple partners both regional Offices are therefore committed to addressing the global burden of avian influenza in close collaboration with global institutions (including WHO, FAO, OIE), regional structures (AU-IBAR and Africa RECs) and the Government of Japan whose contribution is enabling UNICEF to coordinate international global preparedness, prevention and control measures. Notwithstanding the support already provided by donors it is evident that significant further resources are required.

Considering the challenges identified so far, the UNICEF global strategy for addressing them is based on the following strategic orientations:

- Communicate the risks of avian influenza to the government and decision-makers, and the general public;

- Help to develop country ownership for avian influenza prevention and control interventions.


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5.1. Main objective of a control Program The objective of the control program is to safeguard human health, livelihoods of African families and the commercial poultry production sector from the threat of HPAI by controlling outbreaks quickly, building capacity in countries to be able to establish effective rapid detection and response capacity to combat future epizootic diseases. 5.2 Expected outputs The expected outputs would be an increase in the efficiency of the animal and human health surveillance and response systems as well as an efficient communication strategy from the high political to the grass-roots level, whilst enhancing regional integration in terms of strategic planning, operational coordination, up-scaling of capacity building efforts and exchange of knowledge and know-how across countries. The program will also encourage progressive compliance with international standards on surveillance, notification and appropriate governance on veterinary policies. Specifically, the following outputs are envisaged: (i) In affected countries, expansion of the

disease is limited and/or stopped through effective surveillance networks with community participation and adequate implementation of emergency preparedness plans through capacity building and improvement of Veterinary Services in Africa;

(ii) Non affected countries are kept free of disease through effective surveillance networks with community participation and adequate implementation of prevention components of preparedness plans;

(iii) A more robust and more bio-secure poultry sector supporting sustainable livelihoods in Africa can be developed;

(iv) Threat of human pandemic flu is mitigated and human health services and institutional capacities are strengthened.

5.3. Operational Principles The problem of HPAI in Africa will be addressed initially by a 10-year, four-component program, as follows:

- Component 1: Immediate and short term actions to initiate the fight against disease already present and the prevention of disease where it has not yet occurred, essentially through communication and community surveillance;

- Component 2: Medium and longer term national actions involving progressive capacity development facilitated by sub-regional units;

- Component 3: Regional support through AU-IBAR/FAO/OIE/WHO Regional Animal and Human Health Centres, networks of Laboratories and Epidemio-surveillance teams and socio-economic networks; and

- Component 4: International support being coordinated by FAO, OIE and WHO in collaboration with UNICEF and UNSIC.

While close linkages already exist with the members of the ALive Platform and Regional Economic Communities of Africa these should need to be further strengthened during the implementation of the program. Promotion of transparency and good governance must therefore be based on standards and guidelines relating to the quality and evaluation of AHI prevention and control as set out by the relevant international organizations (OIE, WHO, UNICEF, FAO, and others) and adopted by their Member Countries. These standards provide guidelines on legislation, technical infrastructure, human, material and financial resources. The countries should develop and fully implement the national multisectoral preparedness and response plans, taking into account the priority interventions recommended in this document, monitoring and evaluation of implementation of the plans, and timely sharing of information on influenza in accordance with the WHO International Health Regulations (2005). There is a need for a clear and strong political commitment, ownership and leadership of governments and for appropriate means to enforce the implementation of the strategies. Major international funding will be needed as the situation relates to an international public good, but this must be matched by local funding and a commitment to building effective veterinary and


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medical services capable of addressing statutory obligations of countries. 5.4. Implementation plan 5.4.1. Implementation plan at country level Integrated national plans need to be developed urgently and adapted to the country’ prevailing risk status: non-infected, recently infected, approaching endemicity, or infection status unknown. Emergency preparedness planning linked to risk analysis will feature highly for those countries that remain free from infection. Prevention is linked closely to enhanced surveillance and early response capabilities. Establishing these systems requires significant investment at the country level in support of the official Veterinary Services. In addition, a good prevention strategy needs to be based on a sound understanding of the social and economic factors that influence poultry farmers’ decisions related to their enterprises as well as issues related to culture that may eventually relate to human infection. The strategies need to reflect the reality of existing veterinary capacity and be subject to at least annual reviews. Culling and control of movement remain the interventions of choice to eliminate the virus in cases of isolated outbreaks. This needs to be the immediate response based on available emergency preparedness plans and adequate compensation/indemnity schemes. However, plans should be flexible, anticipating the need to vary the strategy based on the actual field situation. Vaccination will very likely have to be used especially in enzootic circumstances but most probably as a targeted, focused vaccination in most cases. The conditions could be:

Mass vaccination when there is a high concentration of farms (high poultry density) for example in peri-urban areas;

Containment of geographic spread through ring vaccination around outbreaks;

Pre-emptive vaccination when there is a specific risk factor such as in regions close to or linked to endemic regions through trade exchanges or in areas close to wild bird concentrations if such reservoirs are proven

to be an important factor of virus maintenance and spread.

Plans to implement vaccination campaigns require adequate preparation and strategic stocks of vaccines and equipment (syringes, needles, protective clothing). Logistical support needs to be established and operational funds have to be provided. It is important to build a robust poultry production sector on the continent that can deal with threats like HPAI and other poultry diseases. Assessment and guidance on measures for safer poultry production is therefore of great importance, especially for smallholders. Specific consideration should be given to measures that ensure a sustainable pro-poor approach. Better understanding of the specific situations of the different poultry sectors and market chains will help to develop appropriate control measures and improved biosecurity. It needs to be explored to what extent and in which way local communities should take responsibility in this. The implementation of good husbandry practices for safe poultry production requires joint efforts by national and local authorities and communities, animal health workers and general agriculture authorities, farmers and other stakeholders, including consumers. Improvement and upgrading of the poultry production sector for sustainable livelihood support through enhanced biosecurity along the poultry market chains should consider that:

(i) Communication interventions develop awareness on biosecurity;

(ii) Activities are related to ensure food security and food safety with particular emphasis on disadvantaged groups;

(iii) The cultural requirements of consumers are seriously taken into account while supporting improved ways of poultry production, marketing and processing.

All components of the program described here also have a function secondary to the direct needs of HPAI control: the structures and expertise created will contribute significantly to developing regional and national expertise and systems to address the issues of transboundary animal disease control. Such a developmental process would create an enabling environment for subsequent disease control initiatives


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employing structures and capability created for HPAI in the first instance. For the human health component of an effective avian influenza response it is important that countries put in place mechanisms for a rapid response to avian influenza outbreaks as well plan for a longer-term agenda addressing systemic shortcomings with respect to core public health functions. Work on both the short- and long-term fronts, therefore, needs to proceed in parallel, and efforts should be made to ensure that short-term responses are consistent with and contribute to proposed longer-term interventions. From a communication perspective, large-scale public information campaigns are needed to sensitize communities to the risks to human health and peoples’ livelihoods and the means of minimizing those risks. Communication should be conceived as a skilled process that requires expert knowledge and recognition of socio-cultural practices. Elements of communications that emphasize poultry-to-poultry transmissions

that could potentially amplify HPAI virus loads and therefore increase the chances of human exposure to the HPAI virus must be communicated to the relevant stakeholders. An integrated platform for communication planning should urgently be designed and made operational. These platforms should be strategized around three major components: o Advocacy to sensitize decision

makers/politicians o Social/community mobilization to sensitize

the general public, and o Communication for behavioral change at the

individual level. Integrated Country Plans need to ensure close functional linkages between national and international health and communication agencies (WHO and UNICEF in particular) in surveillance, investigation of suspicious events (human and animal), and in response.

Box 3 - General guidelines Communication

Efficient communication, a process for sharing information and building a common response between all relevant stakeholders, is a crucial component of the control program. In order to prevent and control HPAI, the general public and key groups of people need to have accurate information and relevant knowledge to act upon. Furthermore, relevant information and data on HPAI are critical to supporting advocacy, social mobilization and individual behavior change. Communication interventions will be undertaken to support the animal and human health components as well as countries’ preparedness. Animal health - Strengthening community-based surveillance, response and containment through social mobilization - Supporting prevention and control campaign management and compensation mechanisms - Supporting communication components of emergency preparedness plans. Human health - Strengthening health education and communication targeting communities at risk: This communication

strategy will deliver messages informed by improved understanding of animal disease, human behavior and risk of acquiring H5NI infection.

Country preparedness - Engaging all stakeholders from policy makers to individuals - Establishing clear communication links at the regional, national and community levels - Assessing adequate communication media, including information and communication technologies - Developing data-driven, result-orientated communication interventions - Setting up two-way communication/participatory mechanisms between all stakeholders - Tailoring and adjusting communication strategies in light of gained insights and new situations - Strengthening the communication and technical ability of frontline and intermediary countries to expand the

use of proven and cost-effective communication interventions such as the interpersonal communication and community-based approach

- Enhancing pandemic communication planning and preparedness at national levels - Encouraging transparency in reporting and investigating avian influenza occurrences.


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Animal Health

The country programs developed will take into account and supplement existing programs of assistance for HPAI control, particularly from the FAO/ECTAD, OIE and AU-IBAR co-ordinations and Regional Animal Health Centres. National strategic plans will adapt guidelines for control to local conditions and will comprise the following elements: Enhancement of outbreak control – area-wide disease management Surveillance (in particular active surveillance to determine the exact status of each country) and

epidemiology, including diagnostic services Compensation/indemnity mechanisms Animal quarantine services Legislation and enforcement Production system and marketing restructuring Socio-economic studies Epidemiological studies Migratory birds / domestic poultry interactions.

Human Health Control of H5NI diseases in animals is the principal way to reduce opportunities for human infection and thus reduce opportunities for a pandemic virus to emerge. Prevention of behaviors that expose humans to the virus is the second way. The major activities to help achieve these objectives are: Strengthen diagnostic capacity and increase surveillance in areas at high risk due to transboundary animal

movement through collaboration between the animal and public health sector Strengthen linkages between public and veterinary laboratories on surveillance for pandemic influenza Develop information materials for safe behaviors among high-risk population groups. Produce and disseminate guidelines and health promotion and information materials Promote barrier preventive measures in order to reduce the risk of transmission in humans Enhance capacity for timely detection of human cases Establish an early warning system Define influenza surveillance objectives and include in IDSR Expand existing sentinel virological surveillance for influenza Establish heightened vigilance for unusual deaths in wild & domestic birds Establish enhanced surveillance among special groups, e.g. people exposed to birds, animals or infected

patients Set up a surveillance coordination mechanism (include veterinarians) Involve the community (including schools and military personnel) in surveillance Record (using Log of outbreaks in IDSR guidelines) and investigate rumors Enhance surveillance of influenza-like illnesses (ILI) as part of IDSR, and weekly reporting and monitoring

of trends Improve identification of cases of pandemic influenza and monitor its spread in specific risk groups; Integrated influenza surveillance with ongoing provincial active surveillance activities (sentinel hospital

surveillance activities).


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5.4.1.1. Immediate and short-term national actions The components of emergency national actions shall be designed according to WHO internationally accepted step templates. These components are the following: o Intensive control in clusters of infected

countries This component is of pre-eminent importance and needs to be initiated immediately before all other structural deficiencies are addressed. The steps to be followed are:

Immediate appraisal of the epidemiological determinants of infection in the countries comprising the clusters concerned. This should be done by convening sequential national and cluster workshops, essentially for veterinarians, guided by international FAO and OIE experts and consultants to define as far as possible the likely extent of infection. The means of interrupting virus transmission will be defined and a strategy for virus elimination roughly mapped out.

Rapid development of national strategic plans to provide the ‘road maps’ to guide the national campaigns together with funding proposals to include national and international funding. Strategic plans will set out the control rationale and a program for its achievement.

Timely execution of control programs in which rapid and sensitive surveillance systems, supported by diagnostic services, elicit timely action from rapid response teams; aided by the provision of financial and technical assistance.

Demonstration of control of infection and progressive determination of freedom from infection, which is probably best achieved on a production sector basis.

Three clusters namely i) Egypt and Sudan, ii) Nigeria, Niger, Cameroon with Benin and iii) Burkina Faso, Cote d’Ivoire with Ghana and Togo, should be addressed immediately by AU-IBAR/FAO/OIE programs which will later be integrated within sub-regional (REC) initiatives.

Given rapid start-up, the prospects of success are relatively good for countries where infection appears to have remained localized in the areas of original introduction, and spread is relatively slow. In countries where this has not been the case - for example Nigeria, Egypt and Sudan - the challenge to control the spread of infection is likely to prove more complex. WHO, working closely with the National Health Authorities in these countries, should be looking at the human health aspects in accordance with the objectives and strategies defined in their national and regional Preparedness and Response plans. In preparation for a rapid response to an outbreak of influenza the following immediate steps are required: • Health promotion and community

mobilization to educate and inform the population on the risks of the disease and its transmission to humans.

• Strengthening of the National Public Health surveillance system including, in the case of an outbreak, active human case detection by a coordinated animal health - public health team. This requires strengthening of outbreak investigation teams to assess and verify events and support implementation of infection control measures.

• Upgrading of existing national reference laboratories (NRL), including design, renovation and upgrading to laboratory biosafety level 03, required for work with virus isolation and micro-neutralization diagnostic procedures for avian influenza. Strengthening of local level laboratories to collect and handle human influenza samples.

• Personal protective equipment for key health workers, laboratory personnel and outbreak investigation teams.

o Supportive actions in non-infected countries Emergency preparedness, rapid response capabilities and socio-economic and epidemiological studies will predominate in the focus of action to prevent avian influenza spreading into non infected countries and thereby exposing humans to the dangers of human infection.


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These actions should involve all stakeholders engaged in the productive sector and maintenance of animal and public health. National governments should consider pre-emptive actions to safeguard public health and the livelihoods of vulnerable groups. o Functional National Interministerial

Committees The national authorities could establish Inter-ministerial Committees to oversee the preparation and the implementation of the integrated national plan with the participation of representatives of poultry farmers’ associations. This Committee could be chaired by the highest authority level (e.g. from the Prime Minister, Vice President or Head of State’s Office). An operational secretariat staffed with adequate human resources could be established in order to assist the national Inter-Ministerial Committee in coordinating national efforts and to provide a point of contact for external partners and the media. The UN Country offices (FAO, WHO, UNICEF, UNDP), the OIE delegate and other key partners should provide support for the national Inter-Ministerial Committee and the donor community more broadly. They should also consider providing support for the national operational secretariats. It is proposed that Inter-Ministerial Committees comprise three technical sub-committees each responsible for a principal dimension of the integrated country plan: (1) animal health, (2) human health, and (3) communication. There is a need for strong central direction and local support for control campaigns. Chaired by the Minister in charge of livestock, the animal health sub-committee is required to guide national policy and actions in the control of HPAI and the risk of its introduction. Comprised of representatives from all relevant government agencies and private sector organizations the sub-committee will be charged with developing national policy and with leading national HPAI prevention and control programs. Experience has shown that a functioning National Animal Health Disease Emergency Committee (NADEC) empowers official Veterinary Services and creates an effective enabling environment for disease control.

All countries will be expected, and will be assisted, to develop Integrated Country Plans for AHI Prevention and Control with the guidance of the official veterinary and public health authorities’ Veterinary Services and with the active engagement of all departments involved in the response (Planning, Finance, Local Government, Police, Military, etc.). NADEC should serve to impress on Government departments the need for a dynamic national involvement of all government departments in the AHI emergency response. Matching this is a need since it is an international public good which is being addressed and failure to act promptly and decisively risks serious global repercussions. 5.4.1.2. Medium and longer term national actions The progressive strengthening of official Veterinary Services is a key objective in the medium to longer term. They need to be able to meet their mandates for the effective prevention and control of diseases which fall within the concept of “Global Public Goods”16. Bringing the quality of the Veterinary Services into line with international technical standards defined by OIE will have a significant and lasting impact on the countries concerned (and on the international community as a whole) in a range of areas including the agricultural economy, public health (including food safety and the supply of animal protein) and access to international markets. For these reasons, actions proposed hereafter should be considered eligible for the concept of global/international Public Good.

The World Bank and the main international donors have recognized the importance of ensuring compliance with OIE standards on quality of the Veterinary Services. The OIE is 16 OIE and FAO published proposals on “Ensuring Good Governance to Address Emerging and Re-emerging Disease Threats – Supporting the Veterinary Services of Developing Countries to Meet OIE international Standards on Quality” (last updated in August 2006) and also listed in their document “Global Strategy for the Progressive Control of Highly Pathogenic Avian Influenza (HPAI)” (November 2005).


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involved in the training of experts to carry out assessments of investment priorities, using the PVS17 instrument. Two training sessions have been carried out in close cooperation with OIE Collaborating Centres, in May and in July 2006. More than forty OIE certified PVS experts have already been trained, nearly a third (thirteen experts) of whom are from African countries. Thanks to the support of the World Bank and of the USA (USDA), an OIE pilot scheme for the PVS evaluation of 15 countries is ongoing; 5 of them will be in Africa. A third PVS training session is planned for February 2007. The reports of these evaluations, of evaluations in other African countries and of the corresponding gap analysis, will be used by national governments for the preparation of national action programs and by main donors for better use of international funds. Other issues that need to be addressed relate to enhancing biosecurity and facilitating disease control by restructuring the poultry industry and informal sectors together with rationalization of marketing systems.

From the human health perspective, in the medium to long-term there is a need to further strengthen public health management and planning and the capacity of the health system to effectively respond to a possible pandemic. This includes preparedness planning to provide optimal medical care and maintain essential community services, establishment of specialized units in selected hospitals, training and implementation of treatment guidelines and hospital infection control guidelines.

5.4.2. Regional support for national activities National programs and activities require the constant provision of technical guidance and this is most efficiently organized on a sub-regional basis to coordinate and build capacity for prevention, emergency preparedness planning and control of HPAI and channel funding assistance for control. • Sub-Regional Networks of laboratories and epidemiosurveillance teams established by FAO regional TCPs for HPAI, the OIE/FAO OFFLU network and by AU-IBAR/PACE for other

17 PVS: Performance, Vision and Strategy, a tool for the Evaluation of Veterinary Services

transboundary animal diseases, will be supported to provide an enhanced role in surveillance, diagnostic confirmation and early warning. WHO has set up a laboratory network for avian influenza and technicians have been trained to undertake HPAI diagnosis (PCR, RT-PCR). WHO should continue to support to these laboratories and ensure the provision of adequate reagents. WHO/AFRO elaborated training modules to build health workers capacity in the countries. Under this scheme, core staff (epidemiologist, clinician, laboratory experts) from 42 countries were trained in June 2006. It is hoped that this training can be repeated for other national health workers involved in the response. • Regional Animal Health Centres Four Regional Animal Health Centres are planned to be set up and one has already been created in Bamako, Mali. Others are planned to be created in eastern Africa, Nairobi, Kenya; southern Africa, Gaborone, Botswana and northern Africa, Tunis, Tunisia. Created on the joint initiative of AU-IBAR, OIE and FAO, these centres will help coordinate and harmonize actions taken to control HPAI and other transboundary animal diseases. The complementarities of these institutions’ mandates to improve animal health in Africa (OIE and FAO at global level, AU-IBAR at the level of the African continent) and therefore to contribute to poverty alleviation, provide a strong foundation for collaboration which is pursued within the framework of the PACE program, the ALive initiative and the GF-TADs. • Regional Economic Communities The main regional networks (CEMAC/CEBIVIRHA, ECOWAS, IGAD, SADC, UEMOA, and UMA) are needed to support countries and national projects with a coordinating platform and socio-economic inputs to disease control. They will have a coordinating and backstopping function that will promote consistency in methodology, enable local national institutions to share ideas and information and build capacity and assist in developing and reviewing strategic studies conducted by the institutes in the networks. Issues of compensation/indemnity, rehabilitation and safe and economically viable smallholder poultry raising all have regional as well as national dimensions, and these will be more clearly identified through regional linkages provided by the RECs.


41

National programs and activities will be supported by the RECs for sub-regional coordination and communication. Coordination of public health activities at regional level will be ensured by the WHO Regional Office for Africa, Brazzaville-Congo and the various United Nations agencies concerned. The experience of UNICEF will continue to be used in the coordination of communication activities. This will be done in coordination with the ALive partnership, FAO, OIE, the RECs and the other actors active in the sector. 5.4.3. International support for regional and national activities Regional organizations and countries will benefit from the support of the FAO/OIE Crisis Management Centre in Rome, the international network of experts OFFLU (OIE/FAO Network of Avian Influenza Reference Laboratories and Collaborating Centres), the Joint FAO/IAEA

Division in Vienna and WHO Influenza Collaborating networks. UNICEF will support the coordination of communication activities in synergy with FAO and the WHO. FAO will provide technical information pertaining to measures to limit the spread of HPAI in poultry emphasizing the importance of adhering to sound biosecurity principles. The Global Early Warning and Response System for major transboundary animal diseases including zoonoses (GLEWS) is a joint FAO, OIE and WHO initiative which combines the strengths of the three organizations to achieve common objectives. Through sharing of information on animal disease outbreaks and epidemiological analysis, the GLEWS initiative aims at improving global early warning as well as transparency among countries for the benefit of the international community. Other information packages will be effectively coordinated between the three organizations and others.


42


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6. ASSESSMENT OF THE NEEDS AND GAPS An assessment of resource needs for Africa and a brief explanation of the assumptions used in the calculation of indicative cost estimates for each priority area are provided. The financial needs assessment for countries was made by using the integrated plans for prevention and control of AHI which were available from a majority of African countries. These needs were analyzed and sometimes adjusted by taking into account: i) the size of the human population and poultry data; ii) the need to put in place national strategies to control AHI that are coherent with those recommended at the international and regional level; and iii) the necessity to control the virus H5N1 at its animal source and prevent its spread. Resource needs were evaluated at the

national level, sub-regional and regional level to support national activities and at the international level to support regional and national activities. Special emphasis was placed on immediate and short term needs. Medium and longer-term needs were also assessed to ensure that capability for dealing with the control of emerging and re-emerging zoonotic diseases is maintained. Funds already mobilized by countries from their national budgets and/or from donors were taken into account when such information was available. It was not possible to evaluate the cost of supports in terms of equipment received from donors and international technical agencies by countries and this is not included in the data on the funds mobilized by countries.

Note: References in [square brackets] before each paragraph below refer to the corresponding budget line in Part 7. Estimated Budget for Africa at the end of this document. 6.1. Communication component [I.1. – II.1. – III.] From the review of communication plans so far received from countries, the main requirements are budgeted for the following operations:

• [I.1.1.] Strategic and micro planning Resource allocations for communication planning (human, financial, and time for preparation) have been less than optimal, and thus, in the event of an outbreak, policy and decision-making within national governments still seem to be reactive in nature, and driven largely by political expediency. There is a strong need for developing guidance for adequate resource allocations for communication activities and interventions at national levels. • [I.1.2.] Strengthening public and farmer

awareness It is essential for the majority of the population in Africa to be able to correctly recall the “negative” health effects of avian influenza, know that AI is preventable and know the correct methods of AI prevention. There is also a need for those who keep backyard poultry or are involved in small/large-scale poultry farming and trading to

adopt the recommended AI prevention practices to ensure biosecurity. • [I.1.3.] Media engagement to promote

public awareness for prevention strategies and outbreak response during a human-to-human pandemic

All media persons (radio/TV/print journalists, etc) will have a comprehensive knowledge of AI prevention and will actively promote the adoption of those behaviors within their constituencies.

• [I.1.4.] Advocacy with community level leadership to promote and disseminate messages to households

There is an urgent need for the establishment of a strong, inter-disciplinary, technical advisory group, to provide leadership, technical guidance and oversight for the development of sound, evidence-based communication strategies, plans, monitoring and evaluation methodologies, and which is strongly focused on animal health issues and socio-economic aspects of AI prevention and control.


44

• [I.1.5.] Inter-agency multi-sectoral partnerships to leverage resources and harmonize approaches, such as school-to-home approaches to educate communities

UNICEF, FAO, WHO and OIE in partnership with AU/IBAR are uniquely positioned to provide guidance and leadership in strategic communication interventions for the prevention and control of HPAI in Africa. Additionally, besides the close linkages with UNICEF, FAO and WHO regional and country offices, as well as the various Regional Economic Commissions within Africa, the Regional Animal Health Centres can form the backbone for the roll-out of communication interventions. • [I.1.6.] Training of front-end staff (para-

veterinarians, veterinarians, extension workers) in inter-personal communication skills

Considerable effort and resources are being expended on developing and refining key messages, but disproportionately fewer resources on developing, establishing and strengthening sustainable outreach mechanisms and strategies to effectively deliver these messages to those who need it most. • [I.1.7.] Mobilization and piloting of a

community-based surveillance/reporting network

Capacities will be built/strengthened such that the time between field reporting of a suspected case/event and the roll-out of an outbreak communication response will be within 48 hours. • [I.1.8.] Establishment of an M&E

mechanism to track implementation and progress

Provision was made to establish of a monitoring and evaluation mechanism to track implementation and progress of communication activities. • [I.1.9.] Impact evaluation studies of

communication interventions in 25 countries Few country plans call for Knowledge, Attitude, Practices (KAP) or Risk Perception studies ahead of implementation of communication campaigns, with the result that ‘messaging’ continues to remain largely generic in nature and not adapted to real-life situations on the ground. Provision was

made to conduct rapid risk perception studies and/or KAPB surveys in selected high-priority countries to establish baselines for measuring progress and change and redefine national contingency and communication plans.

• [II.1.1.] Establishment of sub-regional

“Stop AI” partnership initiatives and secretariats to host the partnership

Based on technical guidance and oversight of the Africa Region Technical Advisory Group, these Sub-Regional platforms will focus on forging closer links with national authorities, regional/national media and specialized communication agencies, large-scale NGO networks with a strong grassroots-level presence, and the private poultry sector, for the systematic implementation and roll-out of communication interventions.

• [II.1.2.] Establishment/strengthening of

communication resource centres Establishing/strengthening a network of regional communication resource centres will facilitate the provision of on-going, hands-on technical assistance to country campaigns, development/adaptation of communication materials, training of country communication focal points, coordinate advocacy with regional/national media, and liaise with country-level counterparts of the Stop AI Partnerships (especially NGOs, the private poultry sector, media agencies, farmer associations, etc).

• [II.1.3.] Development, production,

translation and dissemination of communication guides/materials, tools, etc.

Provision was made to develop, produce, adapt, translate and disseminate communication guides, materials and tools for local contexts/languages.

• [II.1.4.] Strengthening outbreak and risk

communication capacities through 5 x Sub-regional, multi-country, civil society and media training workshops and on-going in-country technical assistance

Mechanisms to engage and establish partnerships with the media, the commercial/private sector, small-scale poultry producers associations, as well as civil society, have remained weak. News reporting has often tended to be sensational, confusing and inaccurate, fuelling rumors and loss of public trust and confidence in national authorities. This has generally precipitated large-


45

scale negative consumer reaction and poultry market shocks/disruptions. • [II.1.5.] Development and implementation of

regional media campaigns directed at policy advocacy and public education, using a strategic mix of national and community media, across 25 priority countries

• [II.1.6.] Conduct of one NGO Summit and

one Commercial Poultry Producers Summit in each Sub-Region

• [II.1.7.] Development and piloting of

country-specific, grassroots-level,

communication strategies in 10 countries, focusing on participatory disease surveillance/response, compensation, and socio-economic impact mitigation

The budgeting shall consider operational costs interventions at a regional level (UNICEF, WCARO and ESARO), interventions at central, peripheral and community/operational levels for each phase of the pandemic, pertaining to both animal and human health. Communication for resumption/recovery is to be budgeted after each WHO phase.

6.2. Animal health component [I.2. – II.2. – III.] • Immediate needs Based on the experience of countries already infected, it is essential that each country puts in place mechanisms for rapid response and removal of bottlenecks that hinder early reaction to animal disease emergencies. The lack of a rapid response in areas where there have been outbreaks facilitates undetected circulation of the virus and its spread to new areas. The requirements are as follows: Strengthening public and producers

awareness, mobilizing them so that they are able to recognize or suspect the disease, contribute to the prevention of its spread to other farms/areas and of its transmission to humans.

Short ad hoc training for upgrading and coordinating the technical veterinary personnel in charge of active epidemiosurveillance, sample taking and dispatch (field, laboratory and coordination).

Procurement of laboratory reagents and/or diagnostic tools (field kits or small laboratory equipment) for diagnostic tests that can be carried out at the local or national level.

Support for the packaging and dispatch of samples to regional laboratories and to the OIE reference laboratories.

Equipment for personal protection (overcoats, overalls, masks) for veterinary personnel so that they can intervene immediately, where there is an outbreak.

Funds for emergency compensation/indemnity so that stamping out or modified stamping out can be applied immediately in cases where there is a strong suspicion of an outbreak

Procurement of stocks of vaccines and minimum veterinary equipment (glass box, automatic syringe, needles, etc.) for the implementation of well targeted vaccination programs

Purchase of materials and products for disinfection to be used in sanitary policing and biosecurity operations.

• [I.2.1.1.] Preparation of emergency

preparedness plan The analysis of the plans worked out by countries at the beginning of the epizootics, showed that in many cases there was a need to improve the plans. For that purpose, provision was made to provide expert advice in the formulation of the emergency plans and to organize training in contingency planning and emergency preparedness for countries. • [I.2.1.2.] Strengthening disease surveillance

for early detection, diagnosis and reporting Appropriate design of surveillance networks, specialized training in laboratory techniques for AHI diagnosis and the involvement of the private sector, private veterinary practitioners and stakeholders active in the market chain for livestock and livestock products, should ensure


46

early detection, reporting of avian influenza and an early response. Provision was made for the medium and long term and was estimated at around seven times the amount budgeted for year 3. • [I.2.1.3.] Improving biosecurity Biosecurity constitutes an essential element of the AHI response. Biosecurity measures within the context of poultry production in Africa under traditional management systems must be strengthened and integrated into poultry production and processing of poultry products. For this purpose, knowledge of biosecurity principles for veterinarians, extension agents and major stakeholders in the field will be improved through training and the organization of awareness campaigns. Provision was made for medium and long term and it was assumed that the cost could represent 7 times the amount budgeted for year 3. • [I.2.1.4.] Retraining and continuing

education of Veterinary Services staff Retraining and continuing education of Veterinary Services staff on HPAI disease recognition, avian influenza virus biology, surveillance plans and modalities, public health and worker safety, effective prevention and response, are essential to ensure effectiveness of H5N1 control measures. Provision was made for the medium and long term and it was assumed that the cost could represent 3 times the amount budgeted for year 3. • [I.2.1.5.] Poultry census and mapping of

farming systems Technical capacity of epidemiologists and those responsible for data management will be reinforced by GIS and the use of GPS in order to improve animal disease surveillance and monitoring and the mapping of farming systems in each country. In addition, relationship of animal disease prevalence with particular reference to HPAI will be investigated. • [I.2.2.1.] Culling, disposal and disinfection The operational cost of the culling team activities, disinfection of premises and disposal of dead birds was evaluated taking into consideration the situation in Vietnam and Nigeria which were both affected by HPAI. In the case of Vietnam, it was estimated to cost about US$ 0.25 per bird to cull and dispose ~200 chickens per farm. In the case of Nigeria, teams were organized on an ad hoc basis

and the costs were estimated to reach about US$ 1.00 per bird, if the team culled 1,000 birds within a day18. In Africa, it is estimated that 5 percent (around 66,000,000 poultry) of the total poultry population (poultry population of South Africa not included) would be culled within three years and estimated to cost about US$ 1.00 per bird. • [I.2.2.2.] Epidemiological investigation to

define progress of the disease and effectiveness of control measures

Epidemiological investigation to define the progress of the disease and effectiveness of control measures through establishment of appropriate surveillance networks, field and laboratory staff training. • [I.2.2.3.] Expansion of vaccine emergency

funds Provision was made to provide African countries with readily available high quality avian influenza vaccine (compliance with OIE international standards) at competitive prices. Two funds: (1) emergency vaccine fund for Africa created under AU-IBAR/PACE Programme hosted by the OIE and managed through an agreement with the European Commission and (2) the FAO Special Fund for Emergency and Rehabilitation Activities (SFERA) will both be replenished to cope with the needs of African countries for the use of vaccines in the control of HPAI. It is estimated that 12.5 percent of the poultry population in Africa (around 165,000,000 birds; poultry population of South Africa not included) should be vaccinated in Year 1, in Year 2 and Year 3. • [I.2.2.4.] Operational cost of vaccination Apart from the cost of vaccines (see I.2.2.3), a vaccination campaign for HPAI also includes the logistical cost of vaccine administration in birds which includes the cold chain for appropriate storage of the vaccine, syringes and needles, allowances for vaccinators, transportation, protective clothing and cost of pre- and post-vaccination surveillance. In Vietnam, the unit cost of a dose delivered to poultry was estimated at US$ 0.038, assuming a vaccine cost of US$ 0.016. Based on prior rinderpest vaccination

18 Hinrichs, J., Sims, L., McLeod, A., 2006: Some directs costs of control for avian influenza. ISVEE Paper, 2006.


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campaign experience and considering the spatial distribution of poultry production units and small-scale backyard flocks in Africa, it was assumed that operational costs for HPAI vaccination could represent 4 times the cost of the vaccine. • [I.2.2.5.] Recovery and

compensation/indemnity Compensation/indemnity rates differed between species (chickens, ducks, ostriches, etc.) and between countries. In Thailand, compensation/indemnity rates were 70 and 100 percent of the market price of a bird, whereas in Vietnam the rates were only about 20 to 30 percent. In Nigeria, the compensation/indemnity rate was evaluated at US$ 1.95 per culled chicken. It was assumed that 5 percent of the poultry population would be culled and compensated at 50 percent of the market price (around US$ 1.50) within the next three years (40 percent for Year 1 and 30 percent for Years 2 & 3). The issue of poultry farmers’ recovery was not evaluated in the document because the conditions of implementation will first need to be carefully studied and defined. It is an important component for the revitalization of the poultry sector and governments will need to discuss with commercial banks to effectively address this issue. Provision was made for medium and long term and it was assumed that the annual cost could represent twice the amount budgeted for year and was estimated for three years. • [I.2.3.1.] Preparation or upgrading of

governance and legislation in line with international standards

Preparation or upgrading of governance and legislation in line with international standards to improve the organization and functioning of the Veterinary Services, so as to ensure rapid detection of emerging and re-emerging diseases especially those of zoonotic significance. Rapid response to outbreaks will be done through national seminars. Provision was made for the medium and long term and it was assumed that the total cost could represent 3 times the amount budgeted for year 3. • [I.2.3.2.] Audit and evaluation Veterinary

Services using the PVS tool This task will provide information about the deficiencies and gaps in Veterinary Services requiring legislative and regulatory adjustments

and will help to identify the investments needed to modernize their infrastructure. With the support of the World Bank and of the USA (USDA), the OIE has already obtained the necessary funds to implement a pilot scheme for the PVS evaluation in 15 countries, including 5 in Africa. Provision is made to carry out the audit and evaluation of 45 other African countries during the three next years at a rate of 15 countries per year. • [I.2.3.3.] Developing priority infrastructure

(technical material, logistics and technical investment)

The necessary funds to reinforce and/or rehabilitate priority infrastructure including veterinary quarantine services, laboratories, veterinary posts and equipment will be evaluated through audit and evaluation of Veterinary Services using the PVS tool and will be used by national governments for the preparation of national investment programs and by main donors for better use of international funds. Provision was made for the medium and long term and it was assumed that the annual cost could represent 4 times the amount budgeted for year 3 over a period of seven years. • [I.2.3.4.] Strengthening the capabilities of

public and private national actors Activities to strengthen the capabilities of national public and private actors will take the form of sub-regional seminars, designed to achieve economics of scale and create synergies and harmonized approaches between countries. Provision was made for the medium and long term and it was assumed that the annual cost could represent 4 times the amount budgeted for year 3 over a period of seven years. • [I.2.3.5.] Support for the organization of

producers and processors Support for the organization of producers and processors will be provided through training. Provision was made for the medium and long term and it was assumed that the annual cost could represent 4 times the amount budgeted for year 3 over a period of seven years. • [II.2.1.] Establishment/reinforcement of 4

Regional Animal Health Centres The creation of a joint OIE/FAO/AU-IBAR Regional Animal Health Centre (RAHC) to coordinate regional animal health activities is a


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major achievement and is expected to improve the coordination of control measures against avian influenza in Africa significantly. Provision was made to secure four expert posts and support staff in each RAHC. Provision was made for the medium and long term on the assumption that the total cost could represent 7 times the amount budgeted for year 3. • [II2.2.] Reinforcement of Africa RECs

coordination activities Support will be provided to the RECs to reinforce their role in the mobilization of stakeholders, in particular political actors and for coordination of activities in collaboration with the RAHC. Provision was made for the medium and long term on the assumption that the total cost could represent 7 times the amount budgeted for year 3. • [II.2.3.] Building/strengthening sub-regional

networks diagnostic and epidemiological surveillance

Provision was made to reinforce the sub-regional networks of laboratories and epidemio-surveillance teams established by FAO for HPAI and AU-IBAR/PACE for other transboundary animal diseases and to extend them for surveillance, diagnosis and early warning. Provision was made for the medium and long term and it assumed that the total cost could represent 3.5 times the amount budgeted for year 3. • [II.2.4.] Building sub-regional wild birds

surveillance Provision was made to build a sub-regional network for wild bird surveillance and to support investigations related to the role of migratory birds in the epidemiology of the disease. Provision was made for the medium and long term and it was assumed that the total cost could represent 7 times the amount budgeted for year 3. • [II.2.5.] Developing and implementing sub-

regional networks of socio-economics Provision was made to provide specialized expertise in countries, in particular those affected by the disease, and to implement monitoring and evaluation mechanisms at regional level. This is essential to refine compensation/indemnity mechanisms and to design recovery programs, exit strategies and alternative coping mechanisms, once outbreaks have been fully controlled.

• [II.2.6.] Developing applied research on avian influenza

Provision was made for resources for avian influenza research in veterinary laboratories, universities and other institutions, focused on defining the characteristics of the disease in Africa and interaction of the viruses with eco-climatic zones. Socio-cultural factors that influence the spread of avian influenza could be investigated to minimize the risk of human exposure to the viruses. Provision was made for the medium and long term on the assumption that that the total cost could represent 7 times the amount budgeted for year 3. • [II.2.7.] Coordinating and harmonizing

animal disease information systems This will be done during seminars to be held under the auspices of OIE, AU-IBAR, FAO and FAO-IAEA Joint Division to discuss the existence and implications of current animal disease information systems with a view to harmonizing the animal disease information systems in Africa.

• [II.2.8.] Assuring quality control of avian

influenza vaccines Provision is made to support PANVAC to take the necessary measures, including institutional upgrading, to assure quality control of avian influenza vaccines and to provide laboratory diagnostic reagents for avian influenza. Provision was made for the medium and long term under the assumption that the total cost could represent 7 times the amount budgeted for year 3. • [III.3.] Supporting laboratory twinning

arrangements On the basis of recent experiences with reference laboratories for rinderpest and taking into account recent recommendations from the ALive General Assembly and its Executive Committee (October 2006 in Nairobi, Kenya), technical twinning between reference laboratories for avian influenza could be encouraged. Such twinning arrangements may involve north-south twinnings with current reference laboratories. This may lead to proficiency ring tests and also to continuing education and exchanges of


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laboratory experts. The overall aim of the concept is to increase the number of reference laboratories based in Africa. Provision was made for the medium and long term and on the assumption that the total cost could represent 7 times the amount budgeted for year 3. • [III.4.] Supporting the OFFLU network Up to now, the international community and the main donors have tended to underestimate the importance of an exchange of information on virus strains. It is essential that this worldwide network is fully operational as soon as possible. African countries should be fully integrated in this network from the beginning and should therefore have the necessary resources to collect samples, to send samples and virus strains (following IATA biosecurity measures) to international reference laboratories. Provision was made for the medium and long term on the assumption that the total cost could represent 7 times the amount budgeted for year 3.

• [III.5.] Supporting global wild birds surveillance

Wild bird surveillance at national and regional levels needs to ensure close functional linkages with the global level in order to coordinate implementation of activities). Provision was made for the medium and long term on the assumption that the total cost could represent 7 times the amount budgeted for year 3. • [III.6.] Supporting studies on biodiversity

and resistance to HPAI Provision was made to support studies on biodiversity and resistance to HPAI, bearing in mind that, in Africa, there is a strong presence of indigenous breeds, which should be protected and used for restocking in village backyards systems. Provision was made for the medium and long term on the assumption that the total cost could represent 7 times the amount budgeted for year 3.

6.3 Human health component [I.3. – II.3. – III.] • [I.3.1.] Enhancing public health program

planning and coordination Provision was made to enhance public health program planning and coordination. • [I.3.2.] Strengthening national public health

surveillance systems Provision was made to strengthen national public health surveillance systems. Provision was made for the medium and long term on the assumption that the total cost could represent 7 times the amount budgeted for year 3. • [I.3.3.] Strengthening health system response

capacity Provision was made to strengthen the health system response capacity. Provision was made for the medium and long term on the assumption that the total cost could represent 7 times the amount budgeted for year 3. • [II.3.1.] Reducing opportunities for human

infection It is planned to carry out three main activities and seven subsidiary activities. The budget

corresponds to US$ 30,000 per country and per year, plus US$ 40,000 per year for the WHO Regional Office activities. • [II.3.2.] Strengthening early warning

systems It is planned to carry out six main activities and eighteen subsidiary activities. The budget corresponds to US$ 30,000 per country and per year, plus US$ 245,000 per year for the WHO Regional Office activities. Provision was made for medium & long term and it assumed that the total cost could represent 7 times the amount budgeted for year 3. • [II.3.3.] Building capacity to cope with a

pandemic It is planned to carry out two main activities and six subsidiary activities. The budget corresponds to US$ 10,000 per country and per year, plus US$ 31,650 per year for the WHO Regional Office activities. Provision was made for the medium and long term and it was assumed that the total cost could represent 7 times the amount budgeted for year 3.


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• [II.3.4.] Enhancing regional preparedness and response coordination capacity

Three main activities and twelve sub-activities will be carried out to enhance regional preparedness and response coordination capacity. The budget corresponds to US$ 30,000 per country and per year, plus US$ 467,000 per year for the WHO Regional office activities. Provision was made for medium & long term and it assumed that the total cost could represent 7 times the amount budgeted for year 3. • [II.3.5.] Conducting operational research

into human pandemic influenza It is planned to carry out three main activities and seven subsidiary activities. The budget corresponds to US$ 25,000 per country and per year, plus US$ 33,000 per year for the WHO Regional Office activities. Provision was made for the medium and long term and it was assumed that the total cost could represent 7 times the amount budgeted for year 3.

• [II.3.6.] Strengthening national health systems to effectively deal with diseases having epidemic and/or pandemic potential

It is planned to carry out five main activities and ten subsidiary activities. The budget corresponds to US$ 20,000 per country and per year, plus US$ 101,660 per year for the WHO Regional office activities. Provision was made for the medium and long term and it assumed that the total cost could represent 7 times the amount budgeted for year 3. • [II.3.7.] Reinforcing communication and

health promotion It is planned to carry out five main activities and twelve subsidiary activities. The budget corresponds to US$ 10,000 per country and per year, plus US$ 73,320 per year for the WHO Regional Office activities.


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7. ESTIMATED BUDGET FOR AFRICA


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Table 1: Overall Estimated Budget

Budget US$ Immediate & Short term N° Components & Item Immediate

needs Year 1 Year 2 Year 3 Total % Medium &

long term 4 - 10 years

I FUNDING AT NATIONAL LEVEL I1 COMMUNICATION COMPONENT

I11 Strategic et micro planning 1,600,000 1,600,000 I12 Strengthening public and farmers

awareness 2,000,000 2,000,000 4,000,000

I13 Media engagement to promote public

awareness for prevention strategies and outbreak response during human-to-

human pandemic 500,000 500,000 500,000 1,500,000

I14 Advocacy with community level

leadership to promote and disseminate messages to households

1,000,000 1,000,000 2,000,000

I15 Inter-agency multi-sectoral partnerships

to leverage resources and harmonize approaches, such as school-to-home approaches to educate communities

5,000,000 5,000,000 10,000,000

I16 Training of front-end staff – para-vets,

vets, extension workers in inter-personal communication skills

500,000 5,000,000 5,000,000 10,500,000

I17 Mobilization and piloting of a community-based surveillance/reporting network 2,500,000 2,500,000 2,500,000 7,500,000 17,500,000

I18 Establishment of M&E mechanism to track implementation and progress 2,500,000 2,500,000 2,500,000 7,500,000 7,500,000

I19 Impact evaluation studies of communication interventions in countries 1,000,000 1,000,000

TOTAL COMMUNICATION COMPONENT 4,600,000 18,500,000 17,500,000 5,000,000 45,600,000 25,000,000 I2 ANIMAL HEALTH COMPONENT

I21 Prevention I211 Preparation of emergency preparedness

plan 2,000,000 2,000,000 4,000,000

I212 Strengthening disease surveillance for early detection, diagnosis and reporting 700,000 7,000,000 6,000,000 6,000,000 19,700,000 42,000,000

I213 Improving biosecurity 3,000,000 2,500,000 2,500,000 8,000,000 17,500,000 I214 Retraining and continuing education of

veterinary staff 2,000,000 5,000,000 7,000,000 15,000,000

I215 Poultry census and mapping of farming systems 700,000 300,000 1,000,000

Sub total 4,700,000 17,700,000 8,800,000 8,500,000 39,700,000 74,500,000 I22 Response

I221 Culling, disposal and disinfection 2,640,000 26,400,000 19,800,000 19,800,000 68,640,000

I222 Epidemiological investigation to define

progress of the disease and effectiveness of control measures

350,000 3,500,000 3,000,000 3,000,000 9,850,000

I223 Expansion of vaccine emergency fund 520,000 5,200,000 5,200,000 5,200,000 16,120,000 I224 Operational costs of vaccination 2,080,000 20,800,000 20,800,000 20,800,000 64,480,000 I225 Recovery and compensation 3,960,000 39,600,000 29,700,000 29,700,000 102,960,000 178,200,000

Sub total 9,550,000 95,500,000 78,500,000 78,500,000 262,050,000 178,200,000 I23 Strengthening Veterinary Services

I231 Preparation or upgrading of governance and legislation into line with international

standards 200,000 160,000 160,000 520,000 480,000

1232 Audit and evaluation of Veterinary Services using PVS tool 750,000 750,000 750,000 2,250,000

I233 Development of priority infrastructure

(technical material, logistics and technical investments)

8,000,000 8,000,000 8,000,000 24,000,000 224,000,000

I234 Strengthening the capabilities of public and private national actors 900,000 700,000 700,000 2,300,000 19,600,000

I235 Support for the organization of producers and processors 1,100,000 900,000 900,000 2,900,000 25,200,000

Sub total 10,950,000 10,510,000 10,510,000 31,970,000 269,280,000 TOTAL ANIMAL HEALTH COMPONENT 14,250,000 124,150,000 97,810,000 97,510,000 333,720,000 521,980,000

I3 HUMAN HEALTH COMPONENT I31 Enhancing public health program

planning and coordination 589,200 5,892,000 5,892,000 5,050,000 17,423,200

I32 Strengthening of national public health surveillance systems 3,164,300 31,643,000 31,643,000 27,123,000 93,573,300 189,861,000

I33 Strengthening health system response capacity 35,208,000 35,208,000 30,178,000 100,594,000 211,246,000

TOTAL HUMAN HEALTH COMPONENT 3,753,500 72,743,000 72,743,000 62,351,000 211,590,500 401,107,000 TOTAL FUNDING AT NATIONAL LEVEL 22,603,500 215,393,000 188,053,000 164,861,000 590,910,500 81.8% 948,087,000


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II REGIONAL SUPPORT TO NATIONAL ACTIVITIES

II1 COMMUNICATION COMPONENT

II11 Establishment of Sub-Regional Stop AI

Partnership initiatives and secretariats to host the partnership

2,500,000 2,500,000 2,500,000 7,500,000 17,500,000

II12 Establishment/strengthening of communication resource-centers 3,000,000 3,000,000 3,000,000 9,000,000

II13 Development, production, translation and dissemination of communication

guides/materials, tools, etc 2,500,000 2,500,000 2,500,000 7,500,000

II14 Strengthening outbreak and risk

communication capacities through 5 x Sub-regional, multi-country, civil-society and

media training workshops 1,000,000 1,000,000 2,000,000

II15

Development and implementation of regional media campaigns directed at policy

advocacy and public education, using a strategic mix of national and community

media, across 25 priority countries

5,000,000 5,000,000 10,000,000

II16 Conduct of one NGO Summit and one

Commercial Poultry Producers Summit in each Sub-Region

1,000,000 1,000,000 2,000,000

II17

Development and piloting of country-specific, grassroots-level, communication

strategies focusing on participatory disease surveillance/response, compensation,

socio-economic impact mitigation

1,000,000 1,000,000 1,000,000 3,000,000 7,000,000

TOTAL COMMUNICATION COMPONENT 16,000,000 16,000,000 9,000,000 41,000,000 24,500,000 II2 ANIMAL HEALTH COMPONENT

II21 Establishment/reinforcement 4 Regional animal health centers 2,930,000 2,930,000 2,930,000 8,790,000 20,510,000

II22 Reinforcement RECs coordination activities 6,500,000 6,500,000 6,500,000 19,500,000 45,500,000

II23 Building/Strengthening sub-regional networks diagnostic & epidemiology

surveillance 6,320,000 6,720,000 6,720,000 19,760,000 23,520,000

II24 Building sub-regional wild birds surveillance 1,100,000 300,000 100,000 1,500,000 700,000

II25 Development and implementation sub-regional networks socio-economics 2,300,000 2,200,000 2,200,000 6,700,000

II26 Development operational research on Avian influenza 250,000 250,000 250,000 750,000 1,750,000

II27 Coordination and harmonization of animal disease information systems 300,000 120,000 120,000 540,000 840,000

II28 Assure quality control of avian influenza vaccines 100,000 100,000 100,000 300,000 700,000

II29 Monitoring and evaluation 190,000 190,000 190,000 570,000 1,330,000 TOTAL ANIMAL HEALTH COMPONENT 19,990,000 19,310,000 19,110,000 58,410,000 94,850,000

II3 HUMAN HEALTH COMPONENT II31 Reduce opportunities for human

infection with H5N1 2,850,000 1,250,000 1,250,000 5,350,000 II32 Strengthen early warming systems 4,475,000 200,000 200,000 4,875,000 1,400,000 II33 Build capacity to cope with the

pandemic 1,325,000 75,000 75,000 1,475,000 525,000

II34 Enhance regional preparedness and response coordination capacity 1,914,000 1,813,000 1,813,000 5,540,000 12,691,000

II35 Conduct operational research on human pandemic influenza 560,000 460,000 460,000 1,480,000 3,220,000

II36 Strengthen national health systems to

effectively deal with diseases of epidemic and/or pandemic potential

2,015,000 525,000 525,000 3,065,000 3,675,000

II37 Reinforce communication and health promotion 1,100,000 250,000 250,000 1,600,000

TOTAL HUMAN HEALTH COMPONENT 14,239,000 4,573,000 4,573,000 23,385,000 21,511,000 TOTAL REGIONAL SUPPORT 50,229,000 39,883,000 32,683,000 122,795,000 17.0% 140,861,000

III INTERNATIONAL SUPPORT TO REGIONAL AND NATIONAL ACTIVITIES

III1 Establishment of an Africa Region inter-disciplinary technical advisory group on

AI communication 1,000,000 1,000,000 1,000,000 3,000,000

III2 Regional media campaign on avian influenza 500,000 500,000 500,000 1,500,000

III3 Support to laboratories twinning 100,000 200,000 200,000 500,000 1,400,000 III4 Support for OFFLU network 400,000 300,000 300,000 1,000,000 2,100,000 III5 Global wild birds surveillance 1,300,000 400,000 350,000 2,050,000 2,450,000 III6 Biodiversity and resistance to HPAI

studies 100,000 100,000 100,000 300,000 700,000 TOTAL INTERNATIONAL SUPPORT 3,400,000 2,500,000 2,450,000 8,350,000 1.2% 6,650,000

GLOBAL BUDGET 22 603 500 269 022 000 230 436 000 199 994 000 722 055 500 100% 1 095 598 000


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Table 2: Estimated Budget of African Countries

Estimated budgets Funds already available19

Countries Population 2004

Poultry population

2004

Domestic

poultry units per

capita

Communication

Animal health

component

Human health

component

Implement. &

management.

Total Govern- ment Donors Total

Gaps

Western Africa Benin 6,918,000 16,000,000 2.3 750,000 3,000,000 2,000,000 690,000 6,440,000 98,000 612,161 710,161 5,729,839 Burkina Faso 13,393,000 32,000,000 2.4 1,500,000 8,000,000 4,000,000 1,475,900 14,975,900 576,923 2,116,000 2,692,923 12,282,977 Cap Verde 473,000 450,000 1.0 200,000 500,000 250,000 114,000 1,064,000 14,036 14,036 1,049,964 Cote d'Ivoire 16,897,000 33,000,000 2.0 437,100 1,500,000 4,050,600 16,589,500 22,577,200 5,355,769 3,000,874 8,356,643 14,220,557 Gambia 1,462,000 1,200,000 0.8 200,000 500,000 500,000 144,000 1,344,000 35,000 103,256 138,256 1,205,744 Ghana 21,337,000 29,500,000 1.4 1,000,000 6,000,000 6,000,000 1,560,000 14,560,000 271,444 4,331,193 4,602,637 9,957,363 Guinea 8,620,000 12,700,000 1.5 1,000,000 3,500,000 2,500,000 834,200 7,834,200 55,976 55,976 7,778,224 Bissau Guinea 1,538,000 600,000 0.4 200,000 1,000,000 1,000,000 144,000 2,344,000 77,889 77,889 2,266,111 Liberia 3,487,000 6,000,000 1.7 500,000 1,500,000 1,000,000 360,000 3,360,000 420,252 420,252 2,939,748 Mali 13,409,000 30,000,000 2.2 1,250,000 10,000,000 3,750,000 1,508,500 16,508,500 620,385 3,816,853 4,437,238 12,071,262 Niger 12,415,000 30,000,000 2.4 1,100,000 11,000,000 3,500,000 1,691,500 17,291,500 307,692 2,211,300 2,518,992 14,772,508 Nigeria 127,117,000 175,000,000 1.4 5,000,000 40,000,000 36,500,000 2,768,800 84,268,800 16,168,624 52,778,780 68,947,404 15,321,396 Senegal 10,339,000 29,000,000 2.8 1,000,000 8,000,000 3,000,000 1,304,800 13,304,800 1,053,846 2,869,738 3,923,584 9,381,216 Sierra Leone 5,168,000 7,500,000 1.5 800,000 2,000,000 1,500,000 516,000 4,816,000 100,000 399,709 499,709 4,316,291 Togo 5,017,000 10,000,000 2.0 700,000 2,500,000 3,200,000 564,000 6,964,000 578,012 578,012 6,385,988 Central Africa Cameroon 16,296,000 45,000,000 2.8 1,500,000 12,500,000 4,500,000 2,085,200 20,585,200 6,132,858 6,132,858 14,452,342 CAR 3,912,000 4,770,000 1.2 800,000 2,000,000 1,000,000 456,000 4,256,000 41,859 41,859 4,214,141 Chad 8,854,000 24,000,000 2.7 1,400,000 8,000,000 2,500,000 1,417,300 13,317,300 5,608,070 5,608,070 7,709,230 Congo 3,818,000 1,060,000 0.3 662,000 1,772,300 3,570,000 228,900 6,233,200 561,225 43,762 604,987 5,628,213 Equatorial Guinea 507,000 320,000 0.6 100,000 250,000 250,000 72,000 672,000 32,700 32,700 639,300 Gabon 1,351,000 3,100,000 2.3 500,000 2,241,300 307,700 887,000 3,936,000 288,461 44,051 332,512 3,603,488 Eastern Africa Sao Tome & Principe 165,000 300,000 1.8 100,000 250,000 250,000 72,000 672,000 13,386 13,386 658,614 Burundi 7,068,000 4,300,000 0.6 600,000 2,800,000 2,000,000 540,000 5,940,000 71,674 71,674 5,868,326 Djibouti 712,000 3,000 0.0 500,000 1,000,000 1,000,000 162,000 2,662,000 2,175,583 2,175,583 486,417 Ethiopia 72,420,000 39,000,000 0.5 3,000,000 12,000,000 10,500,000 3,060,000 28,560,000 2,198,171 2,198,171 26,361,829 Eritrea 4,297,000 2,500,000 0.6 600,000 1,200,000 850,000 318,000 2,968,000 240,324 240,324 2,727,676 Kenya 32,420,000 30,000,000 0.9 1,375,700 45,746,700 15,950,000 6,319,700 69,392,100 489,597 2,372,376 2,861,973 66,530,127 Rwanda 8,481,000 2,943,703 0.3 600,000 1,200,000 1,100,000 348,000 3,248,000 219,338 219,338 3,028,662 Somalia 10,312,000 0.0 700,000 750,000 600,000 820,000 2,870,000 36,692 36,692 2,833,308 Sudan 34,333,000 40,000,000 1.2 3,000,000 13,000,000 10,000,000 2,916,000 28,916,000 8,814,161 8,814,161 20,101,839 Uganda 26,699,000 36,200,000 1.4 1,500,000 11,000,000 7,750,000 2,430,000 22,680,000 548,888 548,888 22,131,112 Southern Africa Angola 14,078,000 6,800,000 0.5 1,000,000 1,900,000 1,800,000 564,000 5,264,000 326,900 326,900 4,937,100 Botswana 1,795,000 4,000,000 2.2 300,000 1,000,000 500,000 216,000 2,016,000 34,423 34,423 1,981,577 Comoros 790,000 0.0 100,000 500,000 250,000 102,000 952,000 6,828 6,828 945,172 DRC 54,417,000 20,000,000 0.4 2,000,000 16,000,000 13,500,000 3,769,000 35,269,000 565,718 565,718 34,703,282 Lesotho 1,800,000 1,800,000 1.0 400,000 800,000 500,000 204,000 1,904,000 35,000 47,429 82,429 1,821,571 Madagascar 17,901,000 24,000,000 1.3 1,400,000 6,000,000 5,000,000 1,488,000 13,888,000 65,330 65,330 13,822,670 Malawi 12,337,000 15,200,000 1.2 1,000,000 3,500,000 3,500,000 960,000 8,960,000 1,137,013 1,137,013 7,822,987 Mauritius 1,233,000 9,800,000 7.9 800,000 2,250,000 500,000 426,000 3,976,000 6,854 6,854 3,969,146 Mozambique 19,182,000 28,000,000 1.5 1,500,000 6,000,000 5,500,000 1,560,000 14,560,000 655,600 655,600 13,904,400 Namibia 2,011,000 3,500,000 1.7 600,000 1,000,000 500,000 252,000 2,352,000 42,966 42,966 2,309,034 Seychelles 82,000 570,000 7.0 100,000 250,000 250,000 72,000 672,000 29,513 29,513 642,487 South Africa 45,214,000 121,000,000 2.7 0 0 Swaziland 1,083,000 3,200,000 3.0 600,000 1,000,000 500,000 252,000 2,352,000 34,929 34,929 2,317,071 Tanzania 37,671,000 47,000,000 1.2 4,140,800 14,655,300 9,793,500 10,260,000 38,849,600 1,655,128 863,094 2,518,222 36,331,378 Zambia 10,924,000 30,000,000 2.7 1,000,000 7,500,000 3,000,000 1,380,000 12,880,000 1,556,382 1,556,382 11,323,618 Zimbabwe 12,932,000 11,100,000 0.9 1,000,000 2,500,000 3,750,000 870,000 8,120,000 31,874 31,874 8,088,126 Northern Africa Algeria 32,339,000 125,139,000 3.9 1,800,000 13,000,000 9,500,000 2,916,000 27,216,000 3,750,000 79,885 3,829,885 23,386,115 Egypt 73,390,000 115,150,000 1.6 1,700,000 52,000,000 21,000,000 4,164,000 78,864,000 7,329,843 5,172,636 12,502,479 66,361,521 Libya 5,659,000 25,000,000 4.4 0 Mauritania 2,980,000 3,400,000 1.1 400,000 2,290,000 2,048,000 278,000 5,016,000 1,325,021 120,316 1,445,337 3,570,663 Morocco 31,064,000 137,000,000 4.4 1,800,000 14,000,000 9,000,000 2,976,000 27,776,000 77,833 77,833 27,698,167 Tunisia 9,937,000 62,000,000 6.2 1,200,000 7,000,000 3,000,000 1,344,000 12,544,000 74,150 74,150 12,469,850 Total 868,054,000 1,440,105,703 1.7 55,415,600 367,855,600 228,269,800 86,450,300 737,991,300 40,021,958 112,909,595 152,931,553 585,059,747

19 Non exhaustive data as some donors and/or national governments did not confirm their respective figures.


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56

ALIVE

The livestock sector in Africa has a critical role to play in poverty alleviation, in the promotion of sustainable economic growth and in the achievement of the Millennium Development Goals (MDGs). Bringing together African and international organizations, research and training institutions and the donor community, the ALive platform has been established to provide national, regional and international policy-makers with expert guidance on issues relating to the livestock sector. Drawing on its membership’s wide ranging policy and technical expertise, ALive provides the basis for a coordinated and effective response to HPAI and other emerging and re-emerging transboundary diseases that threaten human populations and the livestock sector in Africa. The current Executive Committee (decisional body) of ALive comprises the following member institutions:

African Union-Inter African Bureau of Animal Resources (AU-IBAR) Africa Regional Economic Communities (CEMAC, ECOWAS, IGAD, SADC, UEMOA,)

Food and Agriculture Organization of the UN (FAO) World Organization for Animal Health (OIE)

Centre International en Recherche Agronomique pour le Développement (CIRAD/France) Forum for Agricultural Research in Africa (FARA)

Institute of Animal Health (IAH-UK) Ecole Inter-Etats des Sciences et Médecine Vétérinaires (EISMV-Dakar, Senegal)

European Commission (EC) African Development Bank (AfDB)

Ministère des Affaires Etrangères / Agence Française de Développement (MAE-AFD/France) United States Agency for International Development (USAID/USA)

World Bank (WB)

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