progress and impact of efforts to control avian influenza and prepare for the next pandemic
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Progress and Impact of Efforts to Control Avian Influenza and Prepare for the Next Pandemic. David Nabarro United Nations System Influenza Coordination Peter C. Harrold Director, Operations Services, World Bank New Delhi International Ministerial Conference December 4, 2007. - PowerPoint PPT PresentationTRANSCRIPT
Progress and Impact of Efforts to Control Avian Influenza and
Prepare for the Next PandemicDavid Nabarro
United Nations System Influenza Coordination
Peter C. Harrold Director, Operations Services, World Bank
New Delhi International Ministerial Conference December 4, 2007
1. Looking back at the
outcomes of Bamako conference December
2006
2. Outcomes from the
Technical Workshop Technical Workshop in
Rome June 2007
3. Assessment of progress, gaps and remaining challenges
H5N1 in poultry & wild birds during 2007
During 2007 – 25 countries infected
H5N1 in humans during 2007
Looking back at the International Ministerial conference in Bamako
December 2006
Bamako: Outcomes and Actions
• Effective action needed especially in Africa• Incorporate avian influenza prevention into
existing animal health work• Incorporate pandemic preparedness into
existing health programmes – in all nations• Increased focus on non-health aspects• Better coordination of external assistance• Grants to the value of $474million were pledged
Rome: Technical Workshop
June 2007
Rome: What the workshop confirmed
• HPAI largely affecting poultry, occasionally spreading to humans and other mammals. H5N1 virus has not yet developed the capacity for sustained human-to-human transmission
• Control of the disease in poultry remains the priority intervention
• Un-infected countries need to prepare for possible virus incursions into poultry
• All countries need to improve human health capacity to deal with the emergence of a novel pandemic strain
Rome: The key lessons identified
• Reports of successful control and prevention of the disease in poultry as a result of efforts being made in many countries
• Reports of several locations where infection is enzootic likely to remain so for some time
• Field research reveals reasons for persistent infections: knowledge helps direct longer term measures (risk reduction, vaccination and surveillance) for sustaining gains
UN- World Bank:Assessment of Progress and impact of efforts to control Avian influenza and prepare for the next PandemicThird Global Progress report(Based on responses from 146 countries)
. Human Cases, Deaths from H5N1 and Countries Affected
46
98
115
71
32
43
79
47
60
9
16
55
0
20
40
60
80
100
120
2004 2005 2006 2007
Num
ber a
s re
porte
d to
WH
O
0
10
20
30
40
50
60
Num
ber a
s re
porte
d to
OIE
Human cases (per year, left axis)
Human deaths (per year, left axis)
Countries w ith H5N1 in animals (cumulative, right axis)
As of Nov. 5
Assessment of Progress (1)
• The H5N1 virus is considered enzootic in locations within at least 6 countries
• Countries report improved capacity to respond to Highly Pathogenic Influenza (HPAI) infection (more rapid and more effective): a movement of hundreds of thousands of people
• But veterinary capacity in many countries remains insufficient
Assessment of Progress (2)• Reports suggest insufficient coordination between animal
and human health surveillance and response networks within most regions
• Evidence indicates an improvement in human influenza virus diagnostic and surveillance capacity globally. However, capacity varies significantly between countries
• Over 90% of countries report that they have developed pandemic preparedness plans
• National preparedness for a pandemic responses is patchy
Assessment of Progress (3)• Few countries have (a) sufficiently tested their plans, (b)
included wider social and economic impacts or (c) considered vulnerable groups including migrants. These concerns apply to wealthy and poor countries.
• Humanitarian organizations and Red Cross Movement preparing for a pandemic at local level
• 73% of countries have implemented communication strategies to create awareness around the threat posed by HPAI H5N1 (with significant assistance from UNICEF).
• The impact varies: awareness does not always translate into behaviour change
Challenges: • Ensuring intensive responses where enzootic
• Long term maintenance of animal health (using FAO guidance on biosecurity) and functioning veterinary services (following OiE international standards)
• Integrated multi-sectoral pandemic preparedness– at local, national, regional and global levels
• Implementation of the International Health Regulations (IHR 2005) and capacity to detect, confirm and contain influenza-like illness
• Maintaining strong and continued political and financial commitments:
• Increase solidarity between countries
Key Messages:
• Underlying threat of a pandemic remains• Need to broaden focus to cover other zoonoses• Expand strategies to address medium and
longer term challenges• Maintain high level commitment • Encourage convergence of animal, human and
environmental health, as well as food safety and crisis management
Catastrophic Impact of a PandemicIn a moderately severe pandemic, high-income
economies lose the most income but developing economies are hardest-hit
0
200
400
600
800
1,000
1,200
High inco
me coun
tries
East A
sia an
d Pac
ific
Europe
and C
entral
Asia
Latin
Americ
a and t
he C
aribb
ean
Middle
East a
nd N
orth A
frica
South
Asia
Sub S
ahara
n Afric
a
US$
billi
on
2.0
2.5
3.0
3.5
4.0
4.5
Loss
of i
ncom
e as
% o
f GDP
Loss of income Decline in GDP
Global Response to Threat
• Guidance from OIE, FAO, and WHO -- and support from other technical experts
• Donors pledged more than $2.3 b to assist developing countries to respond to avian influenza and to prepare for pandemic
• As of June 30, 2007, $1.7 b of pledges already committed, of which more than $1.0 b already disbursed
Challenge as of end-2007 (1)
• Threat of avian influenza better understood, but fundamentally undiminished
• Focus on prevention and rapid response and containment and control of AI in emergency response in 2005-2007 was appropriate – and should continue … but
• Also need medium- and long-term strengthening of capacity of animal and human health systems
• Investments in AI response have wider benefits, beyond AI
Challenge as of end-2007 (2)
• Some countries are now preparing for their third (or even fourth) “avian flu season”
• Less concern with how to respond – and more with how to sustain a response:e.g., Vietnam experienced resurgence of AI
outbreaks (despite extensive control measures with good results)
Addressing Threat of Zoonotic Diseases
• Medium-term and long-term investments in animal and human health systems so as to improve capacity for rapid response to control diseases
• Coordination across institutional, sectoral, and territorial boundaries
• Sustain successes achieved to date by promoting long-term systemic changes
Thank you.
www.un-influenza.orgwww.worldbank.org/avianflu