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Best practices for prevention and containment of highly pathogenic avian influenza

14 June 2010 - Since onset of the highly pathogenic avian influenza A subtype H5N1 (H5N1 HPAI) epidemic in 2003, a total of 62 countries have reported cases of disease in poultry and wild birds. Of these, 26 are located in Europe, 25 in Asia and 11 in Africa. Up to date the cumulative number of confirmed human cases of H5N1 HPAI reported to international health authorities is 498, of which 294 have died. As a whole, this zoonotic disease has proven to be detrimental to animal and human health, with significant impacts on food security, economic progress, social stability and livelihoods.

Over the past seven years, most countries have successfully managed this disease, however a handful continue to recurrently report cases in animal and humans despite continuous and dedicated efforts to bring this disease under control. In this context, and in response to calls for participatory approaches, from 29 March to 1 April 2010, the United States Agency for International Development (USAID) and the Government of Indonesia organized jointly a "Technical Discussion on Best Practices for Prevention and Containment of Highly Pathogenic Avian Influenza" in Bali, Indonesia.

The main reason to organize this event was to hold technical discussions with institutional partners and key stakeholders on relevant issues that needed to be addressed in five countries considered endemic for H5N1 HPAI (i.e. Bangladesh, China, Egypt, Indonesia and Viet Nam) in relation to their constraints and successes when dealing with avian influenza infections in poultry and human populations. The outcomes of these discussions were presented at the 7th International Ministerial Conferences on Animal and Pandemic Influenza (IMCAPI) held in Hanoi, 19-21 April 2010.

The event was attended by high level technical and policy officers from the ministries of agriculture and health from Bangladesh, China, Egypt, Indonesia and Viet Nam, as well as by a number of international partners including officials from USAID Headquarters and Missions at regional and country levels, the World Health Organization (WHO), the United Nations System Influenza Coordination (UNSIC), the United States Centers for Disease Control and Prevention (USCDC), the United Stated Department of Agriculture (USDA) and the Food and Agriculture Organization (FAO).

The discussions were structured to provide ample opportunity for the five endemic countries to share positive and negative experiences, lessons learned, best practices, and constraints and successes encountered while addressing H5N1 HPAI under their particular circumstances. Key outcomes of this event included (a) the realization that mass or targeted vaccination against avian influenza is one of the many measures from a disease control portfolio that needs to be implemented in tandem with others, such as biosecurity enhancements, public awareness raising and public-private partnerships; (b) that control or mitigation of avian influenza can only be successfully attained with appropriate and sustained availability of resources (e.g. human, physical, economic) and strong political support at the highest echelons of power; and (c) that building on the added value of combining and coordinating the existing and functional mechanisms at national, regional and international levels to predict, identify, prevent and prepare for animal disease threats may have exceedingly positive cost-benefit outcomes.

Lastly, there was an expressed need for establishment of a platform to support inter-country information sharing, including a repository for documents related to best practices or lessons learned that could serve as a tool to foster continuing communication among infected countries. The plans to adopt these and other best practices for prevention and containment of HPAI by each country require refinement and finalization. A final report with recommendations is soon forthcoming.

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