1. Avian Influenza: Country Situations and Update and Implications David Nabarro United Nations System Influenza Coordinator World Bank March 28 th 2006

2. 1H5N1 in Birds An Epizootic moving rapidly across the world with the potential to become a pandemic: 20 countries reporting H5N1 in last six weeks.

3. Why it matters? Impact of the Avian Influenza Epizootic and challenges for response: –150 million dead poultry, –$billions economic consequences, –Extreme hardship for poor people –Sporadic human cases (Vietnam, Thailand, China, Indonesia, Turkey, Azerbaijan, Egypt, Iraq….) –Mounting public concern about what it all means

4. H5N1 OUTBREAKS IN BIRDS: CHRONOLOGY 1996 TO DATE 1996 to 2003June 2004 December 2004 June 2005 December 2005March 2006 China South Korea Indonesia Vietnam Thailand Cambodia Japan Laos Malaysia Kazakhstan Russia Mongolia Turkey Ukraine Romania Croatia Bulgaria Azerbaijan Iraq Iran Niger Nigeria Egypt France Switzerland Germany Italy Austria Bosnia Herzegovina Slovakia Serbia Montenegro Hungary Slovenia Greece Pakistan India 2000 miles 3000 miles 4000 miles 5000 miles 6000 miles 7000 miles Distance from Hong Kong Map compiled by WFP Emergency Preparedness and Response Branch (ODAP) 06.03.06

8. 2Threat of Pandemic

9. Why it Matters? Impact of Human Pandemic: –Local outbreaks: Global Impact (SARS - <1000 dead, $50 billion economic loss). –Significant loss of life –High short term absenteeism –Disrupted supplies (markets closed, access reduced, unreliable utilities, shortages of cash, telecom outages –Reduced demand (affecting travel and leisure, restaurant and food industry) –Threats to Rule of law, Security, Continuity of Governance

10. Specific Impacts of Pandemic Livelihoods Human Health Rule of Law and Governance Rule of Law and Governance Humanitarian Needs Humanitarian Needs Economic Systems Food and income loss from poultry deaths/ culling & decreased economic activity High illness & potentially higher death rates Overstretched health facilities Disproportionate impact on vulnerable Increased demand for governance & security Higher public anxiety Reduced capacity due to illness & death Deterioration of coping & support mechanisms Interruption in public services Quarantine policies Trade & commerce disruptions Reduced availability of key persons Interruption of regular supply systems

11. 3Responses

12. Strategic Approach November 2005 1.Stop influenza in animals through stamping out the disease at the place where the infection starts 2.Prevent emergence of pandemic by limiting human exposure; if pandemic does start, contain it quickly; mitigate pandemic consequences if containment is not possible.

13. Information campaign: people must know how to reduce risks Early warning of disease in birds; rapid response when found Prompt detection, containment and management of human cases International Biomedical cooperation and transparency Stocks of human antiviral medicines, consumables and vaccines; functional supply systems Joined-up Government with private sector, non-profits and media Tuned up crisis response capacity: civ/mil contingency planning Radical reforms to poultry sector and veterinary systems: long-term protection against pandemic threats Critical Actions

14. National Plans: A range of Interventions Animal Health Services Biosecurity Human Public Health Continuity of Governance and Rule of Law Sustaining Economic and Social Systems Assessing vulnerability and providing humanitarian relief Communication and Coordination: Joined-Up informed efforts by all of Government, Business, Civil Society, Media, Military, international bodies Animal Health Humanitarian & Relief Coordination & Communication Human Health Economy & Society Governance & Rule of Law

15. 4Mechanisms for support to country actions

16. Financial support 1Emphasis on national plans and execution with back- up by regional institutions and global standards 2Extent of required international technical and financial assistance estimated during November and December 2005 3Multi-pathway Financing and coordination framework 4Support pledged at Beijing conference mid-January 2006: overall value $1.9 billion; principles for implementation confirmed 5Scaling up action Rapid and well organized appraisal of national plans Strategies for mobilizing pledged technical and financial resources Techniques for urgent resource mobilization Systems to track the impact of funds and coordinate responses

17. Quality of National Plans? Desirable Processes include: High level inter-ministerial direction Risk analysis and capacity review with explicit concept and strategy Vital Sectors engaged: Risk communication, animal health, human health, pandemic preparedness Key actions prioritized – within and between sectors. Implementing partners identified. Communities fully involved Triggers agreed for crisis mode; standard procedures Inputs established : national, regional and international

18. Developmental Approach Development Partners work with Government on Preparation of Integrated Plan Explicit framework for Appraisal Shared Appraisal Process Rapid shift from appraisal to implementation Standardized sequence: programme negotiation, approval, project allocation and management Support through Regional Institutions Rapid: 8 weeks from appraisal request to cash

19. Developmental Approach National Plans Development Partnerships Work together on Preparation Open framework for Appraisal Shared Appraisal Rapid movement from appraisal to implementation Standardized programme negotiation, approval and management Support through Regional Institutions

20. Regional Support in Africa Political Support – African Union Animal Health – OiE, FAO, IBAR: Human Health – WHO with Pasteur Institutes, Medical Research Councils Communication – Regional communication initiatives, unicef Continuity of Governance and Coordination – UNDP with …. Preparedness for Humanitarian impact of Pandemic -

21. Implementation Assistance For the 90 Developing Countries with Strong Implementation Capacity…. In country implementation assistance, supporting national authorities (technical assistance by regional bodies, OiE, bilateral agencies, UN specialized agencies) Technical cooperation at central level Implementation and coordination advisers at State and local level –Multi-agency concept: –Capacities of each agency mapped

22. Implementation assistance (2) 30+ Developing Countries with Fragile implementation Capacity In country execution, by contractors working (on behalf of international Community) in support of national authorities Direct involvement in execution, culling, compensation handling (emergency basis) NGOs (eg VSF), UN peacekeepers and Emergency and operational agencies (UNICEF, WFP) Need for emergency fund: Design time – 2 weeks Engage with AU, sub-regional bodies

23. 5Coordinated Responses

24. Advantage of Coordinated Response Animal Health Human Health Humanitarian & Relief Economy & Society Governance & Rule of Law Direct UN System Interventions Catalyse other actors to contribute National governments Regional bodies Civil society Private sector Coordination & Communication

25. Levels of Coordination Coordination is active at three levels and practiced both regionally and globally In Country Inter Agency Inter-country Provide local leadership Join up government departments, civil society and partners Jointly implement and monitor Facilitate information exchange Set global standards Prioritize and implement Monitor achievements Align strategy Progress assessment by peers Fill gaps and surmount blocks Resolve difficulties

26. 6 040317-GMH-FAO-Coordv05BOS Coordination Framework,, National Coordination Mechanism (Country Led) International and Regional Influenza Partnerships FAOOIE Regional Organizations: APEC,ASEAN,AU Regional Development Banks Regional WHO Other UN Financing Partners: MDBsBilaterals etc Private Initiatives Global FAO OIEWHO Other UN System

27. UN System Needs and Resources Three years (05 - 08) Animal Health Human Health GovEconomic Systems Human & Relief Risk Communica tion Request For 05 - 06 PledgeReceived 01/04/06 FAO 131.0*6535 WHO 138.0**5426 UNDP 9.500 UNICEF 9.0?(49***) WFP 7.000 OCHA 4.200 ICAO - UNWTO - OiE UNEP - UN Monitoring and Coordination (UNSIC) * Global and Regional ** 2 years *** Communication and Supplies 4.011

28. 6Current Priorities

29. Current Priorities The Risks posed to African Nations by Avian Influenza –Keeping up to date on threats to livelihoods, to continuity, to health Information reaching different audiences –Ensuring that everyone knows what to do to reduce risk Continued efforts to maintain Animal Health –Improving surveillance and ensuring responsiveness Public Health and Pandemic Containment –Making sure that local and global Public Health Services work Continuity and well-being during Pandemic –Maintaining the Economy, Governance, Society and Humanitarian support: planning for continuity amidst a range of eventualities New Products and Services –Harmonised production of key Vaccines and Diagnostics

30. FAMILIES WITH BACKYARD BIRDS Promote safe household behaviours EVERYONE Buy, prepare and cook poultry safely 1. Bird-wise campaign

31. Promote 4 actions now! Wash hands thoroughly with soap frequently Cover coughs and sneezes Wear a mask if symptomatic Dont spit! 2. Street-wise hygiene campaign

32. david.nabarro@undp.org www.influenza.undg.org