The Avian Influenza Emergency and Other Transboundary Animal Diseases

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The Avian Influenza Emergency and Other Transboundary Animal Diseases Powered By Docstoc
					   Avian Influenza and Other Transboundary Animal
                       Diseases

                  Charles H. Riemenschneider
           Director, Liaison Office for North America
    Food and Agriculture Organization of the United Nations

                          Presentation at
              “Health in Foreign Policy Forum 2005”
                          Washington, DC
                         4 February 2005



      It is not often that a conference on health and national security
includes a presentation on animal diseases, and I admit that my topic
may seem misplaced between presentations on HIV/AIDS and
bioterrorism. However, I would like to thank AcademyHealth for
recognizing the important connections between transboundary animal
diseases and our national security and for giving me the opportunity to
address you today.

       Let me start by outlining why we are concerned about
transboundary animal diseases (TADs) and their implications for
national security. First and foremost, many TADs are zoonoses—they
affect human health as well as animals. BSE (Mad Cow Disease), Rift
Valley Fever, West Nile Virus are all animal diseases in the news
recently that affect humans. Highly pathogenic avian influenza (HPAI)
is the latest example to be featured prominently in the media. Human
mortality of HPAI in SE Asia has been on the order of 75%--12 dead in
Vietnam in the past five weeks alone. The distinct threat of HPAI
becoming easily transmissible to and among humans has medical
professionals very concerned about a major influenza pandemic.

      Second, TADs can also have dramatic economic impacts—
obviously a concern for national security. The direct and indirect costs
of the Foot and Mouth Disease (FMD) outbreak in the United Kingdom
in 2001 were estimated to be over $9 billion. Classical Swine Fever in
the Netherlands in 1997-98 had economic impacts of $2.5 billion.
Over 150 million chickens died or were culled in an attempt to control
HPAI in SE Asia last year. At one point last year, with HPAI, BSE and
other animal diseases, the Food and Agriculture Organization of the




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United Nations (FAO) estimated that nearly one-third of the world
meat trade was facing import bans due to animal diseases.

       Third, the risk of animal disease outbreaks likely will only grow
in the future as higher incomes in developing countries continue to
stimulate more demand for meat and animal products. As a result
livestock industries are growing larger, production is more intensive,
and international trade is increasing. The number of animals raised for
meat is growing very rapidly. During the 1990s, poultry production in
East Asia rose nearly 12% per year—a doubling every 5 to 6 years.

      Evidence suggests that threats from transboundary animal
diseases are increasing. We are familiar with the relatively new
human diseases like AIDS, Lassa Fever, SARS, and Ebola which seem
to have developed over the past 30 to 40 years without warning. At
the same time new animal diseases have also been appearing at an
alarming rate – HPAI, Nipah, BSE, hendra virus as well as new
biotypes or antigenic forms of existing infectious diseases, such as a
hypervirulent strain of infectious bursal disease in poultry in Europe.
Vector-borne pathogens like West Nile Virus, bluetongue and Rift
Valley Fever are also spreading to a much wider area.

      Let me lay out some key reasons why we see an increasing
threat from transboundary animal diseases. First, globalization and
trade have increased risks. Both higher levels and more rapid trade
have led to more host material, more packaging, and more
opportunities for long-distance “hitchhiking” of diseases. Increased
trade is occurring in fresh—as opposed to processed—foods which are
more likely to carry diseases. At the same time, new trade and travel
routes have developed, as from South Africa to SE Asia and SE Asia to
South America which create new pathways for disease.

       Second, increased conflict and civil unrest have raised the threat
of TADs. These conflicts lead to difficulty in enforcement of quarantines
due to military and refugee movements. Conflict and civil unrest often
also lead to a breakdown of institutional support for quarantine,
increased smuggling, inflows of food aid (which can contain
contaminants) and increased difficulty in gaining access to border
areas because of landmines, etc., making disease surveillance more
difficult.

   Third, the rising demand for meat with rising income/population in
developing countries has led to intensification of production resulting
in more animals in one place. This increased production is often in


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peri-urban areas near large populations and too often under sub-
optimal husbandry practices. Disease outbreaks in high-density
production areas spread to greater numbers of animals faster and
often lead to socially unacceptable control measures. The mass
slaughter of pigs in the Netherlands in 1997-98 to control classical
swine fever led to a backlash from the non-farm population which
probably has limited the stamping-out option as a future disease
control strategy.

    Fourth, the conversion of tropical rain forests and wilderness to
livestock ranching exposes livestock to a completely new range of
infectious agents and vectors previously only circulating in wildlife
reservoirs. In these cases, disease spreads more rapidly as domestic
livestock are fully susceptible hosts

   Fifth, global warming trends seem to be changing rainfall/weather
patterns. This will likely shift the global distribution of insect vectors
for Rift Valley Fever, bluetongue, African horse sickness and similar
vector-borne diseases.

   Sixth, in the post 9-11 world most experts agree that the threat of
bioterrorism or the intentional introduction of diseases has also
increased. In this regard, animal diseases may be an even greater
threat than human diseases—less danger to a terrorist— along with
the ability to create significant economic disruptions.

   Couple these increased risks with the fact that the response is often
slower for animal diseases when compared to human diseases, and
one can see why TADs can pose a serious national security threat.
This slowness in response results from a combination of technical
capacity and perverse economic incentives. Public Veterinary Services
in developing countries are usually much weaker than Public Health
Services. At the same time animal disease reporting systems are
usually based on passive reporting rather than active disease
surveillance.

       There is often a lack of farmer awareness of high-threat
epidemic animal diseases in developing countries coupled with poor
contact between field veterinary staff and farmers. Diagnostic
capabilities of new or exotic diseases in developing countries are also
generally poor due both to training of veterinarians and inadequate
laboratory capacity to identify and confirm new strains. It was only
after the avian influenza outbreak last year in Laos that the first
laboratory was created there (with FAO support) which was capable of


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rapidly diagnosing the H5N1 avian influenza strain circulating in the
region.

        With rising trade, producers have less incentive to report
diseases like HPAI due to the potential loss of export markets. The
typical policy response by importing countries to an animal disease
outbreak in an exporting country is to impose a complete ban on
trade. BSE has cost US cattle producers over $1 billion in lost exports
to Japan. HPAI has cost over $1 billion in poultry exports for
Thailand. The threat of these potential lost markets is a deterrent to
timely reporting of diseases. A leading provincial politician in Canada,
recognizing the potential economic damage, went as far as to suggest
initially that a good farmer who fears he has a cow with mad cow
disease, should take the animal to the back of the farm, shoot it and
bury it—not a recipe for early reporting of disease.

       Trade concerns have also discouraged use of preventive
vaccinations for certain types of diseases like HPAI and FMD. Disease-
free countries are normally reluctant to import from countries using
corresponding vaccines. Importers often cannot distinguish vaccinated
animals from sick animals with blood tests alone. Under international
rules a country usually must wait longer or face more hurdles to be
declared free of a disease if vaccination is used to control outbreaks
rather than stamping-out. For HPAI, Thailand -–a major exporter--has
been reluctant to use vaccination as part of its control strategy most
likely in order to re-enter export markets more quickly. The same
rationale was used in the United Kingdom against vaccination for FMD
in 2001. From a public health standpoint, a good vaccination program
might reduce the viral load circulating in a country and thus reduce the
risk of HPAI spreading to humans.

      Compensation schemes in developing countries for animals
slaughtered to control a disease outbreak are usually poor; farmers
can easily lose life savings. This is a further disincentive to report sick
animals. Even when compensation schemes exist, disparities in value
of animals can cause problems, e.g. fighting roosters are much more
valuable than common chickens. In SE Asia these roosters were often
hidden from state veterinary services trying to kill all chickens to
control the spread of HPAI and remained as a reservoir for the disease.
The same problem occurred in California with schemes to control the
spread of Newcastle Disease in poultry.

     This failure for timely reporting also hastens the spread of TADs
between countries. Many have suggested that HPAI might have been


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circulating for months in the region before it was reported to
international authorities leading to its introduction in a wider number
of countries. An ex ante study of 2001 FMD outbreak in the United
Kingdom shows that the FMD virus was likely introduced 3 to 4 weeks
before it was reported and a ban on livestock movements occurred.
Earlier reporting and a movement ban would have cut the spread by
over 40%--possibly eliminating the spread to other European
countries.


      In conclusion, TADs are a growing threat to human health and
economic growth in the world. Any number of these diseases could
rapidly escalate into a national security threat. As a result of rising
meat demand, we are putting humans and animals together in
numbers never seen before in the world, particularly in East and South
Asia. At the same time, biosecurity on farms in places where meat
production is growing most rapidly is often poor. This creates great
potential for animal diseases to jump species to create human health
problems.

       The key to meeting this threat is early detection and early
response to transboundary animal diseases. To accomplish this we
need to invest in veterinary public health services along with
traditional human public health in developing countries. Without a
strong veterinary service, even the best national public health
strategies are jeopardized. We need better training and laboratories.
Preparedness plans for human diseases are weak in many developing
countries—yet they are even weaker for animal diseases.

      We also need to improve incentives to report animal diseases
with better compensation for farmers and more risk management
tools. Import bans in response to an animal disease outbreak must be
based on sound science to assure that countries also have incentive to
report internationally.

      Public health and national security issues tend to fall in the realm
of national governments. Yet to address the growing threat of
transboundary animal diseases we need to strengthen decentralized
government structures as well as improve international coordination;
diseases do not respect either local or national boundaries. We need
government support at the lowest administrative level to assure early
detection. But this must be coupled with adequate coordination at
national and regional level to assure that sufficient response is given



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to avoid spread of disease through livestock movement controls,
closing of live markets, sharing of diagnostic services, etc.

       Finally, international coordination is also critical. In 1994, FAO
established the EMPRES program for the emergency prevention of
transboundary animal and plant pests and diseases to improve FAO’s
early warning and early reaction to disease threats. This effort has
greatly increased our ability to respond to emerging animal disease
risks.

      FAO, along with the World Health Organization (WHO) and the
World Organization for Animal Health (OIE), works on various aspects
of transboundary animal diseases. Coordination among these agencies
has strengthened in recent years but donor support for these efforts
tends to rise and fall from crisis to crisis. Responses to the avian
influenza epidemic in SE Asia have been very closely coordinated
among the three agencies. Virtually all of the training and meetings
occurring in response to HPAI have been organized jointly by the three
agencies.

      Donor interest was relatively high last year when the avian
influenza crisis received major media attention. The recent tsunami
has shifted media and donor attention in the region while perhaps
increasing the risks of further spread of HPAI as poultry movements
increase to meet the needs of those affected by the tsunami. If we
are to avoid an even more serious national security threat, we will
need to assure that both donors and governments in the region
continue to support these coordinated efforts to control HPAI even
when the spotlight is off this disease as a result of the tsunami.




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