Stamping out H5N1 avian influenza could take decades

Long-term commitments required to eliminate virus in countries where it persists

Rome - Eliminating the highly pathogenic H5N1 avian influenza virus from poultry in the six countries where it remains endemic will take ten or more years, according to a new FAO report.

The report makes specific recommendations for each country regarding measures that should be taken over the next five years to move them towards virus elimination, and calls for a sustained commitment to eradication efforts both by governments where the disease remains endemic and by international donors.

At its peak in 2006, the H5N1 strain of highly pathogenic avian influenza (H5N1 HPAI) was reported in 60 countries. Today most have managed to stamp it out — but the virus remains firmly entrenched in Bangladesh, China, Egypt, India, Indonesia and Vietnam due to a combination of three factors, according to the report.

The first relates to the structure of their national poultry sectors. Endemically infected countries usually feature complex production and market chains, with poultry reared and sold under conditions that afford little protection from influenza viruses, and weak producer and service provider associations for supporting farmers.

The second factor is the quality of public and private veterinary and animal production services, which are not always able to detect and respond to infections — or identify and correct underlying structural problems in production and marketing systems.

The final factor relates to the level of commitment to dealing vigorously with H5N1. "The fear of H5N1 does not necessarily translate into concrete plans for virus control and elimination" the report notes.

Country-specific recommendations

"Approaches to Controlling, Preventing and Eliminating H5N1 HPAI in Endemic Countries" closes with detailed sets of recommendations targeted to each country where H5N1 HPAI remains endemic.

They contain a mix of measures aimed at outbreak control and response, gathering and analysing information, and disease prevention and risk reduction.

"The recommendations, which are based on lessons learned over the last seven years, are tailored to account for local differences in the poultry sector of each country, the stage of development of the country’s H5N1 HPAI programme, and national socio-political characteristics" said FAO chief veterinary officer Juan Lubroth.

"Each activity has clear objectives to enable measurement of progress and to ensure that countries remain focused on the goal of virus elimination. And it should also be noted that all the activities proposed develop capacity for handling other emerging and re-emerging diseases" he added.

The FAO/OIE Global Strategy on H5N1

A Global Strategy for Prevention and Control of H5N1 HPAI developed by FAO and the World Organisation for Animal Health (OIE) cautions that elimination of infection from countries where the H5N1 virus is endemic will require consistent engagement and support, and advocated a medium- to long-term approach — rather than just an emergency response.

This approach should include:

Continued building of capacities in key institutions, including better functioning veterinary services with the necessary powers to implement essential control measures and regulations
Sustainable adjustments to the poultry sector to reduce the risks of disease and infection in settings where commercial poultry production and marketing practices carry high risks of HPAI
Effective engagement of private-sector stakeholders (including industrial poultry producers) in risk reduction efforts
Sustained political commitment
The application of appropriate interim control measures, including vaccination, to contain infection.

The strategy also stresses that all points in the production and marketing chain should be examined to assess areas of risk, and that special attention must be paid to alleviating the impact of control measures on vulnerable human populations.

FAO’s HPAI Global Programme

Over the past seven years, FAO’s collaborative HPAI Global Programme has contributed significantly to limiting the impact of the disease, establishing stronger national systems, and strengthening regional coordination for disease preparedness, prevention and control.

The programme has been implemented through 170 projects, actively involving more than 130 countries that have benefitted in terms of inputs for direct disease control, laboratory and farm detection systems, capacity building, vaccines, vaccination strategies and prevention measures that have kept the disease out.