Vietnam: Emergency Response to Avian Influenza

Published: Tue, 15 Sep 2009 14:38:35 GMT

In December 2003, Vietnam experienced its first cases of Highly Pathogenic Avian Influenza (HPAI) H5N1. Within four months the disease had spread to 57 of 64 provinces, and 44 million poultry—17 percent of the nation’s stock—had died from the disease or been culled to prevent further outbreak. Veterinary health and disease surveillance systems were rapidly overwhelmed, and with 15 human deaths recorded in 2004, the specter was raised of a potential global influenza pandemic.


The Avian Influenza Emergency Recovery Project (AIERP) was the world’s first comprehensive HPAI emergency response operation. It was fully implemented in less than three years in the 10 provinces worst hit by the virus and helped enhance national disease surveillance and diagnostic capacity, strengthened mechanisms in the poultry sector to contain serious outbreaks, and safeguarded public health by raising awareness of risks and how to mitigate them. The project provided a platform for action, allowing the government to articulate and lead a concerted response with donors, international technical agencies and civil society. A complementary effort supported by the Government of Japan helped low-income stakeholders recover from losses caused by the epidemic.

A core team—including Bank staff and experts on animal health, veterinary epidemiology, poultry vaccination and poultry production from the UN’s Food and Agriculture Organization (FAO)—worked alongside government counterparts to fashion measures to control the outbreak. Close attention was focused on ensuring that the response (for example, in designing, testing and monitoring a poultry vaccine) kept pace with the rapidly evolving threat, while enabling the government to craft a longer-term strategy through investments to upgrade capacity, institutions and key health systems.


The project catalyzed a sustainable medium-term reform agenda emphasizing investments in critical systems to mitigate the threat of HPAI. The approach developed in 2004 has informed the design of 59 operations currently under way in 57 countries under the Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response. The project’s focus on containing the disease at the source is internationally recognized as the most effective way of reducing socioeconomic damage and the risk of widespread contagion among human populations.

Highlights:
- The national Emergency Contingency Plan developed by the government and adopted in December 2005 has become a model for many developing countries in containing a disease outbreak.

- Disease control measures have prevented direct losses in the poultry sector estimated at more than US$58 million, and improved veterinary services have yielded the added benefit of better controlling several other animal diseases.

- Regular joint supervision missions by IDA/FAO facilitated quick fine-tuning in the disease control strategy. For instance, around midterm, the project helped design and monitor the world’s first large-scale poultry vaccination program against the virus, coordinating some 100,000 vaccinators. Subsequently the strategy was adjusted to gradually replace blanket vaccination by ring vaccinations targeted to contain incipient outbreaks.

- Community-based early warning disease response systems were established in 30 districts of the 10 heaviest-hit provinces.

- Critical equipment and training provided to Vietnam’s key diagnostic laboratories, including the national veterinary laboratory and four regional facilities, enabled complex sample testing to be completed within a week of an outbreak.

- Biosecurity was upgraded in all 12 poultry-stocking facilities throughout the country.

- Public awareness and information campaigns were launched in 1,700 communes and reached 51,000 villagers in the provinces most affected by HPAI. Communications training for veterinary and livestock extension staff was provided at the central, provincial, district, commune and village levels.

- Under restocking operations supported through the Japan Social Development Fund, 8,366 poor households received 1.22 million poultry that were bred and raised in biosecure conditions and vaccinated against avian influenza and other diseases. The overall mortality of restocked poultry from delivery to market was 7.7 percent, versus a background mortality rate of 47 percent for backyard poultry.

- Using the project to expand dialogue on coordinating donor assistance, the World Bank in April 2006 coordinated a government-donor joint-assessment mission—with 32 representatives from 11 bilateral and multilateral organizations as well as relevant ministries/agencies (including the Asian Development Bank, Denmark, France, Australia, New Zealand and the United States)—to finalize the Government Operational Program for Avian and Human Influenza.

- A follow-up donor meeting in Hanoi in June 2006, attended by representatives from 30 donor countries and international agencies, pledged more than US$60 million for a global avian influenza response in 2006–08.


IDA provided US$5.0 million for this project, which was part of the much broader government program that cost US$127.5 million (funded by US$60 million in donor pledges and the lion’s share by Vietnam). The project also catalyzed significant counterpart and partner resources to strengthen critical veterinary health systems against a range of emerging, reemerging and endemic animal diseases, helping to prevent substantial economic losses.


The project mobilized direct support from FAO and the World Organisation for Animal Health (OIE) to provide technical advice to the government as it defined its response strategy. A Japan Social Development Fund (JSDF) grant helped restock poor households that had lost their livelihood from poultry as a result of avian influenza.


The emergency project undertaken in the rush to cope with a rapidly evolving threat was designed as a pilot to develop and test a comprehensive strategy to control avian influenza in Vietnam. The project achieved its goals and laid the ground for a broader follow-up effort in 2007, the Vietnam Avian and Human Influenza Control and Preparedness Project (VAHIP) with an estimated cost of US$35 million, of which US$20 million is covered by IDA. Close partnership between the government and IDA with United Nations specialized agencies, primarily FAO and the World Health Organization, as well as with the World Organisation for Animal Health will help insure that successful interventions are sustainable.

Successful implementation of the emergency response project also provided the basis for preparation of the Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI), which was approved by the World Bank on January 16, 2006, merely 18 months after approval of the pilot effort in Vietnam. Numerous lessons learned from the emergency project were readily applicable to other countries threatened by the disease, and have been incorporated in GPAI program design to mitigate the H1N1 pandemic.


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