Indonesia struggles to contain H5N1 bird flu
Coordinated donor funding plays major role in the fight against bird flu
6 December 2006, Rome – It has been almost ten years now since the H5N1 bird flu virus was first isolated from a goose in China, and people are still dying from the disease while the deadly virus has spread to wild birds and poultry farms across Africa, Asia and Europe.
This week donor countries around the world meet in Bamako, Mali, to decide how much more funding is needed to combat bird flu, particularly in Africa where H5N1 outbreaks in poultry continue in Côte d’Ivoire, Egypt, Nigeria and Sudan.
Africa is not the only region still struggling with bird flu, and indeed there may be valuable lessons to be learned from other parts of the world, where the battle against bird flu has raged for some time.
In Asia, victory against the disease has eluded Indonesia, where the death toll from H5N1 for 2006 stood at 44 people at the end of November. This is cause for serious concern, because every new case presents an opportunity for the virus to mutate into a form that can pass easily from person to person. That could lead to a global pandemic which, many health experts believe, could kill millions of people.
Insuring against a pandemic
Agriculture and health authorities agree that the best insurance against a global human pandemic is to contain bird flu at its origin – in poultry. This has been FAO’s goal since the first wave of the disease swept across Asia in 2003.
To help Indonesia come to grips with the threat from bird flu, officials from FAO are training government veterinarians and community animal health workers in the latest bird flu surveillance and response techniques. Called participatory disease surveillance and response training, the course enables animal health workers to become part detective, part diplomat.
After a few basics in the classroom, they fan out to villages near the training centres to get to know the local people who raise chickens in their yards and on small suburban farms.
Economic concerns can cloud concern about bird flu
The idea behind FAO’s training is that building trust leads to the discovery of more sick birds. Farmers are often afraid to admit there are sick birds in their village for fear of losing a source of food and sometimes their livelihoods.
Progress comes in small steps as ideas and old ways of doing things are rethought. Amilia, a young woman vet from Bandar in Sumatra, who completed the FAO training course in September, says: “I think this training will bring many changes in our work, because here we are asked to be active in finding the disease while in the past we were just passive and filed a report.”
Pajiyo, another vet who recently completed the FAO course, says: “What we learned here will help us work better and closer with the community, so efforts to stop the spread of avian influenza will be improved. It will help us to mobilize the community and work with them to better contain the disease.
With 300 million birds, bird flu is almost everywhere
Finding bird flu is the easy part, according to Dr Jeff Mariner who was training Indonesian vets for FAO: “Indonesia has a very large poultry population. There are about 300 million backyard poultry and what we found, in all the areas where we look, is that bird flu is fully endemic and basically you couldn’t get any more bird flu occurring in the country. At the community level farmers are very receptive, they’re aware of bird flu.”
Mariner explained that Indonesia is a very highly decentralized country and very democratic. “Decision-making is decentralized so it is very difficult to set a policy at the national level. It’s not automatic that all the different districts and so forth will automatically pick up that policy.”
Beating bird flu in Indonesia will not be cheap
With the problem so widespread, veterinary services are strained to their limits as they find infected birds and safely cull and disinfect village after village, while mounting surveillance operations that must continue indefinitely.
All this is expensive. Experts estimate that a full-scale vaccination programme alone would cost US$88 million in Indonesia just for one year.
That’s why Indonesia and the international community are working together.
But they’re being held back by the nature of donor funding, which is often short term and comes with restrictions on how and where it can be used.
Changes in funding needed for better planning
According to Dr John Weaver, FAO Senior Technical Advisor on avian influenza in Indonesia, “One of the problems we face is that a lot of the funding support that FAO and Indonesia are getting is short term. And that’s a concern because we are really looking at a situation in Indonesia that is not short term.”
The battle against bird flu in Indonesia will not be won in a year or two. Dr Christine Jost, a Tufts University veterinarian working for FAO, said: “If you look at a map of Southeast Asia, there is Indonesia and it’s about 50 percent of the map. This is a huge country and avian influenza is a widespread problem.”
While progress in Indonesia has been slow, in Viet Nam, 3 000 kilometers to the north, there is a very different story. (read more...)
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