The World Bank: Vietnam Avian and Human Influenza Control and Preparedness

Source: http://www.worldbank.org

 

The project enhanced national disease surveillance, diagnostic, response capacity, strengthened vertical and cross sector coordination mechanisms in the animal health and human health sectors by promoting a One Health approach. This project helped contain serious outbreaks of avian and human influenza as well and raised awareness that led to a behavior change in people including health workers, poultry traders, and students.

 

Challenges


In December 2003, Vietnam reported its first cases of Highly Pathogenic Avian Influenza (HPAI) H5N1. Within four months, the disease was detected in 57 of 64 provinces. Some 44 million poultry—17% of the nation’s stock—were culled to prevent further outbreaks or died from the disease. This cost farmers severely, and the economy more broadly. The economic toll was about 0.5% of Vietnam’s GDP, or $250 million.


By 2005 the H5N1 avian flu virus emerged as a global threat. By the end of 2006, the virus spread rapidly to 55 countries in Asia, Europe, Africa and the Middle East.



In Vietnam, animal health and disease surveillance systems were rapidly overwhelmed. Moreover, as 15 human deaths were recorded in 2004, there was increasing evidence that virus could infect humans.



Solutions



The project set clear, relevant objectives that were important to Vietnam’s economy, public health, and poverty-reduction goals.
-    To build medium- and long-term capacity for the country by combining continuation of the emergency response with extensive strengthening of the veterinary and public health systems. The capacities created by VAHIP are relevant not only to a particular strain of avian flu, but also to control of other disease outbreaks.
-    To enhance Disease Control at the sources, including upgrading poultry wholesale markets and slaughterhouses.
-    To strengthen preparedness through simulation exercises, training courses on rapid outbreak response, communication programs
-    To introduce innovations to the country’s surveillance system for infectious diseases in humans
-    To promote the One Health approach to ensure cross sector coordination in control and containing the AI outbreaks, especially between Human and Animal Health sectors
-    To raise awareness that could lead to the changes in behaviors for preparedness, control of AI outbreaks to wide range of population.

 

Results



-    All 39 reports of suspected highly pathogenic avian influenza (HPAI) cases in poultry reported and fully investigated in 2014.  
-    Reporting time of new outbreaks and return of laboratory confirmation to the affected commune was reduced for both veterinary and health sectors from 8.7 days for veterinary and 10 days for human health in 2006 to 2.4 and 3.4 respectively in 2014
-    Fatality rate of human H5N1 cases was reduced in all 11 provinces. By June 2014, all 44 provincial hospitals and 124 district hospitals have developed their preparedness plans for an influenza pandemic.
-    Eight laboratories were provided with equipment and staff trained for ISO 17025 standards for AI testing.
-    87 District Preventive Medicine Centers in 11 provinces fully equipped and have adequate capacity to implement their responsibilities and functions in compliance with MOH decisions on Preventive Medicine.
-    68 cross sector simulation exercises were organized by 2014 for key stakeholders: people's committees, animal and human health workers, army, police, youth and women unions to promote coordination and labor division
-    Good biosecurity practices were applied by all poultry traders in Ha Vy wholesale live bird market and in 76 upgraded markets and slaughterhouses in the 11 provinces
-    98.8% of target population can accurately identify and practice at least one key preventive behaviors
-    69,012 health staff were trained, more than three times the level initially envisaged
-    The communication program reached 367 primary schools and more than 500,000 students.

 

Bank Group Contribution



VAHIP and VAHIP AF were financed by an IDA Credits ($30 million), an Avian and Human Influenza Facility (AHIF) Grant ($23 million), a Japan PHRD Grant ($5 million), and the Government of Vietnam ($5 million)



Partners



VAHIP was developed and implemented by the Ministry of Agriculture and Rural Development and the Ministry of Health, other departments of the government and 11 selected provinces. It was highly decentralized for the implementation of the project activities. There was strong commitment and highly beneficial engagement from the Ministries and the Provincial People’s Committees which contributed critical support and also provided tangible assets such as buildings at the district level.

 

Beneficiaries


 “We’ve gained great benefits and support from VAHIP project. Our center has improved significantly  in terms of environment, hygiene and food safety” Mr. Nguyen Dang Phong, head of Tan Truong Phuc Waterfowl slaughter center, Can Giuoc, Long An Province.


“VAHIP provided us with effective prevention solutions. We are now more proactively in identifying avian influenza patients and able to provide the patients with timely and effective treatments. The skills of our medical staff from commune to district levels have been enhanced and our ability to contain the disease has been improved. As a result, our capacity for early detection of the disease and provision of timely treatment  has been increased and we can prevent an epidemic from spreading into a pandemic” Mr. Do Thien Khuyen, Director, District Healthcare Center, Vu Thu District, Thai Binh Province.


“I learnt about avian influenza prevention at the school. When I come home, I will tell my parents that it is necessary to use gloves and facemask when contacting or feeding poultry. They should notice the veterinary service staff when they suspect that their ducks or chicken may have influenza so that we can proactively prevent ourselves from influenza”, a school pupil under VAHIP communication campaign.


Moving Forward


With contributions from VAHIP and other projects, the Vietnamese authorities have improved the performance of core animal health and human health capacities and the coordination between the two systems. The IDA-financed Livestock Competitiveness and Food Safety project is providing relevant support in this regard.

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