Technical Workshop on Highly Pathogenic Avian Influenza and Human H5N1 Infection

From the foreward:


"This technical workshop was organised jointly by FAO [Food and Agriculture Organization of the United Nations], OIE [World Organisation for Animal Health], and WHO [World Health Organization] in collaboration with UNICEF and the UN System Influenza Coordinator (UNSIC). It was attended by technical experts from these agencies, independent experts, representatives of regional organisations, senior veterinary officials from countries leading control measures for this disease, representatives of donor agencies in both national and international institutions, as well as those in the private sector. It aimed to consolidate information and opinion derived from earlier work on the disease, examine contentious technical issues relating to disease control and, where possible, achieve consensus on the technical issues surrounding the prevention and control of H5N1 highly pathogenic avian influenza and human pandemic influenza preparedness. It also aimed to highlight areas where further work should be focused or refocused to progressively reduce the threat of the disease to poultry and humans.


The technical workshop... pointed to some shifts in emphasis that the concerned countries, supporting international agencies, and donor community need to adopt in order to tackle the disease, especially in countries with entrenched infection or at high risk of infection." These include the following, as assessed by the document:

• A reduction of levels of infection is both achievable and crucial for reducing the risk of human H5N1 infection and securing safe poultry production and trade.
• Commitment from governments, providers of external assistance (donors), and the poultry sector would include facilitating the longer-term adjustments in commercial poultry production and marketing identified through objective risk analysis.
• Effective preparedness for an influenza pandemic results in increased resilience of local and national health systems, of national economies, and of communities’ capacity to respond to major crises.
• It leads to the creation of national infrastructure capable of reporting suspected incidences of novel influenza viruses and other threats under the WHO International Health Regulations (IHR 2005).
• Work similar to that done on national action plans should be extended to community and provincial preparedness.
• There is a particular need for capacity to communicate relevant information to the public, systematically, at these subnational levels – before and during an influenza pandemic.
• Systematic planning beyond the health sector (in sectors such as finance, transportation, communication, and energy) is needed as preparation for a possible influenza pandemic.

The document contains a broad range of technical disease control analysis in both animal and human disease transmission prevention. In the area of communications alone, a survey of achievements and recommendations include:

1. Achievements: active inter-sectoral partnerships including national inter-agency communication taskforces, advocating with relevant ministries to develop and implement communication plans; recommendations: better communication for understanding needs a focus on vulnerable populations.
2. Achievements: advance outbreak communication preparations, including supporting the management of media and promoting public trust and compliance in prevention/control efforts, to rapidly stamp out the disease; recommendations: a stronger distinction between human zoonotic influenza and bird flu would clear confusion; better mid- to long-term communication with ministries is called for, as well as multi-disciplinary research to build more effective communication strategies.
3. Achievements: discussions among communication professionals and technical partners underscoring that controlling HPAI requires an understanding of issues and barriers to change, as well as particular attention to animal health communication issues; recommendations: particularly in resource-poor settings, actions for risk reduction by poultry farmers, transporters, and marketers are complex, and communication strategies and interventions need to be crafted specifically for different occupational groups.

In conclusion, because entrenchment of infection reinforces the need for a strategic communication framework, guided by epidemiological data and knowledge of production and marketing practices, the document calls for a formal, global-level, trans-disciplinary and inter-agency Technical Advisory Group on HPAI communication to coordinate and guide communication action research, analysis, and the development of a unified vision and long-term strategic communication framework/plan for the prevention and control of HPAI among animals and subsequent transmission to humans. This plan needs to address the animal health aspects of HPAI H5N1 transmission and include communication tools to sustain behavioural change among those in 'at source' occupational groups. Public understanding of pandemic risk and preparedness must be clarified and monitored as national preparedness is strengthened.