22 December 2005
Africa Faces Bird Flu, Pandemic with Special Challenges
Continent's most pressing need is rapid mobilization, economist says
By Charles W. Corey
Washington File Staff Writer
Washington -- As the world faces the further spread of avian influenza and the possibility of human pandemic influenza, Africa will encounter special challenges preparing its own defense, says development economist Asif M. Shaikh, president and chief executive officer of the International Resources Group (IRG).
Rapid mobilization is most needed to fight a possible bird flu outbreak among animals, in order to prevent escalation into a human disease pandemic, Shaikh told the Washington File December 13. Broadly speaking, he said, a direct response requires attention to four key areas: awareness, capacity building, prevention and mitigation.
"When you compare those four needs to Africa's capabilities," he said, "the first finding is Africa has a very weak infrastructure" both institutional and physical. "So it is going to be a challenge to build response systems quickly enough. A great deal depends on if and when" pandemic may occur, he said.
Avian influenza is an animal infection caused by influenza (flu) viruses. These influenza viruses occur naturally among birds. Wild birds worldwide carry the viruses but usually do not get sick from them. However, avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick, sometimes fatally.
The H5N1 virus is just one strain of avian influenza, but a dangerous one because of its proven capability to infect humans and its potential to cause a pandemic. The World Health Organization has documented almost 140 human cases of H5N1 infection since January 2004. Most of these cases have occurred as a result of people having direct or close contact with infected poultry or contaminated surfaces.
Of the few avian influenza viruses that have ever crossed the species barrier to infect humans, H5N1 has caused the largest number of detected cases of severe disease and death in humans, according to the U.S. Centers for Disease Control and Prevention (CDC).
In Asia, H5N1 has caused the broadest outbreak of avian influenza among humans ever seen since its first appearance two years ago. Now the disease has moved west, appearing in flocks in Russia, Kazakhstan, Turkey, Croatia and Romania. Some experts predict that migratory flocks will carry the disease to African birds in their seasonal movements.
DISEASE DETECTION AFRICA
Shaikh, who has been professionally involved with Africa since 1972, explained that most poultry in Africa is raised on small farms or in remote villages, with 80 percent of Africa's poultry production being noncommercial.
"The ability to get the message to farmers on how to identify a sick bird in the first place is limited," he said, due often times to their remote location. "The capacity for farmers to do that identification and to get the information back to a relevant authority is limited" as well, he said, because of the region's poor communication infrastructure.
Hong Kong in one day slaughtered 1 million birds in an effort to contain and prevent a spread of the virus, he said. "That is not going to be possible in a dispersed situation in Africa -- so the containment capacity" will be limited there, he said.
The financial capacity to respond to a possible pandemic in Africa is another challenge, he said.
"Does Africa have the resources to mount a massive retaliation to contain," a pandemic, he rhetorically asked? Answering his own question, he said, "Containment will be a problem because it will be difficult to get those resources" on such a massive scale.
International donors now are planning how to expand laboratory and disease surveillance capabilities in developing nations so that they are better able to monitor animal diseases that could burst into human populations.
Another key issue to consider, Shaikh said, is that "relative to any other part of the world, African governments are very heavily dependent on donors for their finances, for their institutional capacity and their technical expertise. So to a large extent, Africa's response to avian flu will be influenced by what the international community supports as Africa's response to the avian flu.
"If we imagine a pandemic at a time when the whole world is preoccupied with its own situation rather than thinking about other parts of the world -- that could be negative for Africa. Part of the goal is to help assure that that does not happen because we are all in this together. It is a global issue. If it breaks out anywhere it can spread everywhere."
ONE BURDEN TOO MANY
Comparing a potential human influenza pandemic to what Africa already is enduring with regard to HIV/AIDS, Shaikh noted, "HIV/AIDS is … chronic and … continues to build with each year …. It has a permanent long-lasting impact. Avian flu would be different," he added, as pandemic influenza typically unfolds in human populations over a period of a few years.
Shaikh again stressed however, that presently, "there is no certainty that we will have a pandemic."
Pandemic influenza would be similar to HIV/AIDS is that it could affect many of those same vulnerable populations who live in nations with chronic health problems and poor health care.
"The great danger is that this could affect Africa across the board and really exacerbate everything that HIV/AIDS has done," he said.
Modeling must be done, he said, if one is to try to understand the full potential impact that an influenza pandemic could have on Africa. "Africa loses a great deal of people already from … malaria, infectious diseases, diarrheal diseases, HIV/AIDS, civil war, famine, so we have to understand it in the context of all of those things and assure that we have response strategies that are realistic and founded on what this thing might actually do and that work to protect Africa's economic growth.
"If we look 10 years out, if we do not protect economic growth," he speculated, "then we are more likely to have many, many more people die from the secondary causes" of pandemic influenza.
Summing up, Shaikh said, the most important thing to do to contain the spread of bird flu and prevent a human influenza pandemic is to help bring about a coordinated response. Multiple sectors would be involved, he said.
"This is fundamentally an environmental, economic and health problem, and so there needs to be a capacity to work across sectors and to coordinate responses" to confine the virus to animal populations and prevent its crossover into humans.
Shaikh noted that it is fortunate that a large number of agencies of the U.S. government already are involved in mounting a response to a possible influenza pandemic: the U.S. Department of State, CDC, the U.S. Agency for International Development (USAID) and the U.S. departments of Defense and Agriculture.
"Coordinating that response is going to be one of the biggest challenges this country (the United States) faces …. so response coordination is probably the most important thing we are working on right now."
Shaikh said the United States already has "tremendous capabilities" and "huge assets" on the ground in Africa that could help marshal a response in the event of pandemic influenza. That is especially important, he said, "Because to start from scratch … would be a terrible mistake."
For additional information on avian influenza and efforts to combat it, see Bird Flu.
(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)
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