Les relations entre les intervenants et la réponse contre l'influenza aviaire hautement pathogénique en Indonésie
17 mars 2010 –Indonesia has been afflicted by highly pathogenic avian influenza (HPAI) more than any country in the world. Since 2003, when it was first detected in central Java, the disease has spread to 31 out of 33 provinces, caused over $500 million in economic losses, disrupted the livelihoods of over 10 million people who are reliant on poultry keeping, and killed 135 people out of 163 confirmed human cases, most of which have been children and young adults. Nowadays HPAI is endemic in Indonesia with disease entrenched in Java, Sumatra, Bali and South Sulawesi. Sporadic outbreaks continue to be reported in other areas.
Indonesia has also received the largest commitment from the international community to fight HPAI, totaling up to April 2007 over $128 million. With the Food and Agriculture Organization (FAO) at the forefront, responses have centred on working with the Indonesian Ministry of Agriculture to focus on the development of extensive disease surveillance and response systems, vaccination and culling programmes, and more recently, retail market adjustments. In parallel, a wide range of communication initiatives, led largely by UNICEF and USAID contractors, have taken the perceived dangers of the disease to the masses. Despite these determined, well-funded and technically justified initiatives, control of this insidious disease has proved elusive.
A wide range of socio-economic, environmental, geographical and cultural factors are involved in disease emergence and entrenchment. For instance, with more than 235 million inhabitants spread over some 6,000 islands in an archipelago that stretches over 5,000 km between mainland South East Asia and Australia, the size and geography of the country conspire against effective animal health responses.
In Java, around 100 million people live closely with remarkably high populations of birds, and the free-ranging ducks and paddy rice fields that have been indicated as disease drivers elsewhere in South East Asia are also present. Significant further complexity has been created by Indonesia’s decentralization legislation, which has included devolution of the responsibility for controlling animal diseases to more than 450 autonomous regions. These challenges are well known.
Surprisingly, what has received little attention are the delicate stakeholder dynamics related to the spread and persistence of the disease, and the challenges they create for effective delivery of animal health programmes. National and sub-national authority contestations are thorny issues for international actors to address, and tricky to capture given their diffuse, subtle and culturally located nature. Nevertheless, they can provoke complex and unexpected externalities, challenging the conceptual foundations and operational workings of global governance ideals and the best designed institutional frameworks.
Indonesia’s long awaited new law on Husbandry and Animal Health (Law 18/2009 replacing Law 6/1967), for example, has seen a set of complex and dynamic discussions. The initial drafts began in 1978, but the HPAI epizootic brought both the failings of the existing law, and the urgent need to revise it, into focus. Ratified by the national parliament on 12 May 2009, the new law has however stalled in the Constitutional Court, where three groups have raised objections. First, veterinarians object that their rigorous, science-based approach to animal health has been made subservient to flexible, commercially-oriented, animal husbandry regimes. Second, a number of local observers and small farmer associations have expressed their misgivings to the introduction of a ‘zone-based’ system, rather than a ‘country-based’ system associated with imports and exports, on the basis that widening the number of countries that may import beef and cattle into Indonesia will both risk its hard-won Foot-and-Mouth Disease free status, and the economic well-being of numerous small livestock farmers. Third, professional groups and farming organisations point out that the new law provides no compensation in the case of depopulation (culling) of apparently healthy animals.
Stakeholder relations are of considerable importance because Indonesia produces around one billion broilers a year, with 70 percent of poultry production reportedly controlled by three large integrated conglomerates. Poultry production, and its associated activities, is estimated to account for around one per cent of national gross domestic product. Economists note that since all production is consumed by a domestic market, there is little incentive to adopt international health standards and procedures, and within a weak and poorly enforced regulatory structure, reports have surfaced indicating overly cordial public-private rapprochement.
Separately, and at local levels, some detailed studies on poultry market chains in Indonesia have been completed, but none have examined the crucial role played by ‘brokers’ or ‘middlemen’ who provide liquidity for a complex system that sees large numbers of collectors and traders individually moving relatively small numbers of live birds to a large number of markets and poorly developed slaughterhouses. The incentives, interests and motivations of these stakeholders are important to understand disease spread.
The international community adds complexity to this picture. For instance, disease mitigation measures have changed now that the response has moved out of emergency mode, with the related imperative to act reactively and quickly on information that may be imperfect. Also, intergovernmental agencies were unable to early reconfigure the apportioning of blame directed towards ‘backyard’ farmers, who until now are increasingly seen as ‘disease sentinels’ and less as the ‘engine room’ of HPAI infection.
Despite evolving challenges on many fronts, positive outcomes have emerged including determined implementation of grassroots programmes aimed at small rural farmers, improved relations with national and regional governments, and the importance of strengthening veterinary services has been recognized. The latter represents one of the most important aspects of zoonotic disease control.
Without a doubt the dynamic interactions among a wide and complex range of stakeholders in Indonesia have affected the spread and persistence of HPAI, as well as the policies and practices associated with animal health responses. In turn, these dynamic interactions have key implications for the international community in terms of global public health security as articulated in the ‘One Health’ agenda.
This article is a synopsis from ongoing research work by Olivier Charnoz and Paul Forster under the auspices of the Agence Française de Développement’s research programme on ‘Global Public Goods and Local Practices’.