Avian Flu Resurgence Raises Concern in Asia, Middle East

March 10, 2011
Source: worldbank

In Cambodia, health authorities recently reported that Prak Sophorn, 19, and her 11-month-old son died of avian flu (H5N1) infection, contracted while handling dead chickens in Prey Veng province.

They are the world’s latest casualties of the H5N1 virus, which since January has re-emerged in Hong Kong (SAR PRC), Japan, Myanmar, and South Korea, and has been circulating in Egypt, Indonesia, Bangladesh, and other countries.

The surge in new infections in commercial poultry flocks and among wild birds is reminding governments and communities of the potential threat of H5N1 to national and global health, financial systems, and the livelihoods of poor farmers and families.

Epidemics like SARS in 2003, sporadic outbreaks of the H5N1 flu since 1997, and the H1N1 flu pandemic of 2009 racked up enormous economic costs around the world. While SARS cost between $50 billion to $100 billion, a World Bank estimate has pinned the potential costs of a severe flu pandemic at $3 trillion.

Animal Surveillance Needed

With 75% of all new human diseases since 1945 originating in the animal kingdom, there’s a growing urgency to strengthen both human and animal health systems to detect these infections before they start a new pandemic. Investing in stronger surveillance and preparedness has a high pay-off and can be thought of as low-cost insurance, experts say.

According to a new report by the Nairobi-based International Livestock Research Institute (ILRI), 700 million people keep farm animals in developing countries, generating up to 40% of household income.

"Wealthy countries are effectively dealing with livestock diseases, but in Africa and Asia, the capacity of veterinary services to track and control outbreaks is lagging dangerously behind,” said ILRI researchers John McDermott and Delia Grace.

"This lack of capacity is particularly dangerous because many poor people in the world still rely on farm animals to feed their families, while rising demand for meat, milk and eggs among urban consumers in the developing world is fueling a rapid intensification of livestock production," they said.

Latest Outbreak

South Korea is facing an especially difficult time. Authorities there recently declared a state of emergency to stop the rapid spread of avian flu after migrating wild birds infected poultry flocks in four provinces. Counting the new cases, the country has reported 46 outbreaks since the first was confirmed on Dec. 31, 2010. More than 5 million birds have been culled so far.

In Egypt, where people are living through an extraordinary new political era, a 25-year-old woman from Qena has become the 39th bird flu fatality, with others testing positive for the virus, including young children. The Egyptian government is running public service announcements to show people how to avoid avian flu.

‘Recurrent Emergencies’

“Unfortunately the H1N1 pandemic of 2009-10 was probably not the last, and we know that these communicable disease outbreaks from the animal world are likely to occur again and again,” says World Bank Vice President for Human Development Tamar Manuelyan Atinc, whose team coordinates the Bank’s avian and human influenza task force.

“The problem is one of recurrent emergencies, and so the international community has to invest more in preventing the spread of these diseases at their animal source. Better prevention and preparation will help us to avoid the illness, lives lost, and financial costs associated with ad hoc, unplanned, emergency responses.”

As an advocate for One Health―an approach that calls for stronger human and animal health systems to improve the health of both―Manuelyan Atinc says it’s vital that animal and human health experts and their systems work together to avoid new pandemics.

Global Program for Preparedness and Response

Since 2006, the Bank has supported the Global Program for Avian Influenza and Human Pandemic Preparedness and Response, which has provided $1.3 billion for projects in 60 countries. Financing has included $109 million in the form of grants from a multi-donor trust fund (which received contributions from 10 donors, led by the European Commission).

Despite the success of many of these operations, not all countries are interested in follow-up borrowing for improving infectious disease prevention and control. And with the emergence of other priorities, grant funding from donors has diminished.

Although investment has been insufficient, one of the program’s lessons has been that increased spending on animal and public health systems have reduced risk from animal-borne diseases.

Brian Bedard, a senior livestock specialist on the Bank’s Europe and Central Asia team, says, “We have to step up our analysis of the costs of these disease pandemic outbreaks to win the support of Finance Ministers to fund ‘One Health’ projects. Too little is understood about the substantial costs of neglecting animal health and how it’s one of the important determinants of public health in low-income countries.”

Science may partly compensate for the lack of government attention. In a promising new development reported by Science magazine, scientists have genetically modified chickens to prevent the transmission of avian influenza, an innovation that could cut the risk of a lethal strain crossing into the human population and could also boost the poultry industry.

But vigilance is needed, says Bank human development operations adviser Olga Jonas. “Policymakers now pay less attention to preventing and preparing for pandemic influenza than they should, and yet we know we have to stay alert and boost preparedness for the next pandemic outbreak.”