Livestock goods and bads: Background and evidence

On Thursday 15 April, ILRI staff, Board members and partners gather in Addis Ababa for the first day of the annual program meeting. The first major plenary session mobilizes a range of speakers on different dimensions of the ‘goods and bads’ issue. The presentations are online:

See a short video interview with IFPRI’s David Spielman in livestock research priorities.

We also asked leaders of ILRI research groups to briefly present what each is doing in terms of livestock goods and bads, and which research gaps need to be filled.

This post is part of a series associated with the ILRI Annual Program Meeting in Addis Ababa, April 2010. More postings …

International Livestock Research Institute joins new Consortium of International Agricultural Research Centres

Knut Hove signs document, right Carlos SereKnut Hove, chair of the board of trustees of the Africa-based International Livestock Research Institute (ILRI), yesterday, 14 April 2010, signed an agreement on behalf of ILRI to join a new Consortium of International Agricultural Research Centres.

A ‘Resolution of the ILRI Board of Trustees Regarding the Agreement of the Consortium Constitution’, developed during the 33rd Meeting of the ILRI Board of Trustees, held on ILRI’s campus in Addis Ababa, Ethiopia, states that the ILRI Board ‘endorses the principles outlined in the Consortium Constitution and wishes to reiterate its support for the CGIAR [Consultative Group on International Agricultural Research] reform process’.

The ILRI Board noted the following in its resolution. ‘The livestock sector accounts for as much as 40 percent of agricultural gross domestic product in many developing countries and is the basis of livelihoods for hundreds of millions of poor people. Further, zoonotic diseases—i.e. diseases that spread from animals to humans—account for 70 percent of emerging diseases, and yet, in developing countries and internationally, investments in livestock research are not commensurate with its importance in the agricultural sector.

The ILRI Board is confident that the Consortium recognizes this inconsistency and that together we will be able to redress this imbalance.’

View the video:

New threats, new thinking at the animal-human disease interface

To get serious about controlling emerging human disease, we're going to have to get serious about understanding and controlling their origin in animal disease, often in developing countries

 


As the world's governments raced to deal with a looming flu pandemic starting some two weeks ago, in late April 2009, World Health Organisation (WHO) officials confirmed that the world is better prepared than ever before to deal with a pandemic, thanks largely to six years of research and preparations to battle bird flu and SARS. Nearly 150 countries are now known to have drawn up contingency plans covering everything from the response of health services to travel restrictions and international co-operation.

Although it contains animal genetic components, the current influenza A(H1N1) virus has not been diagnosed in animals before and has spread from person to person, threatening an influenza pandemic which, according to scientists, is inevitable, even though no one can predict the timing. Three serious influenza pandemics occurred in the 20th century, with each new virus eventually infecting up to a third of the world over the course of one to two years: the 1918 ‘Spanish flu’ responsible for more than 40 million deaths, followed by the 1957 ‘Asian’ and 1968 ‘Hong Kong flu’, which killed between 1 and 3 million people worldwide,

The history of flu epidemics and pandemics, which can be traced back with some accuracy for the past 300 years, tells us that outbreaks occur somewhere in the world in most years and pandemics, which are epidemics that spread worldwide, at 10- to 50-year intervals. Despite influenza and its causative organism being the most studied of viral diseases and pathogens until the advent of HIV/AIDS two decades ago, little has been done in the past century to change the pattern of influenza infections.

 

2009 June 11 Swine flu update:

  • WHO on 11 June raised the pandemic alert level from phase 5 to 6, indicating a global pandemic outbreak
  • This will trigger drug makers to speed production of a swine flu vaccine and prompt governments to devote more money to containing the virus.
  • Although appearing less deadly than seasonal flu, experts worry the virus could mutate into a more lethal strain during the Southern Hemisphere’s coming flu season.
  • Experts also worry that poorer countries could be overwhelmed with cases they do not have the capacity to treat.
  • The last pandemic, the Hong Kong flu of 1968, killed 700,000 people worldwide. Ordinary flu kills 250,000 to 500,000 people each year

 

11 May 2009 brief from the World Health Organisation

For more information, we encourage our readers to read the WHO brief copied below and linked to here:
http://www.who.int/csr/disease/swineflu/assess/disease_swineflu_assess_20090511/en/index.html

This WHO brief of 11 May 2009 provides much useful background information for understanding expert concerns about the current new flu virus, particularly how it may affect the developing countries of the southern hemisphere, where the flu season is about to begin. These expert concerns include the following.

  1. The influenza A(H1N1) could mutate into a more lethal form in a subsequent wave of this pandemic, as the virus causing the 1918 pandemic flu did.
  2. Having not appeared in humans or animals before, scientists anticipate that pre-existing immunity to the virus will be low or non-existent, or largely confined to older population groups that have had flu vaccinations and therefore striking down more people of a younger age group, than viruses causing normal so-called 'seasonal flu'.
  3. This new flu virus, although as yet causing generally mild illness in the 29 countries outside Mexico where it has so far been confirmed, could cause severe illness in developing countries, particularly:
    • people suffering malnutrition
    • poor communities with inadequate health care
    • the greatly increased numbers of people now afflicted with chronic conditions such as heart disease and diabetes, conditions that can greatly increase the severity of illness this flu causes (although these chronic conditions afflicted mostly affluent populations until a few decades ago, a full 85% of people suffering them today live in low- and middle-income countries)
  4. As this new influenza A(H1N1) virus spreads to the southern hemisphere with the start of the flu season here, it may meet the H5N1 bird flu virus that is widely circulating among the poultry populations of some developing countries; no one knows how, under pressure of the new A(H1N1) human-to-human transmitted flu virus, the H5N1 bird-to-bird transmitted flu virus might change, including whether the latter, more lethal, bird flu virus could be helped to mutate into a form transmitted easily among people. (The more lethal H5N1 bird flu virus, now endemic in many areas, has thankfully to date been transmitted only rarely directly from person to person; almost all the people infected have received the virus from handling infected poultry, which has helped keep the virus from spreading widely among human populations.)

 

11 May 2009 Update

11 May 2009 Update As reported in Time Magazine this week (11 May 2009), ‘new research suggests that the WHO acted wisely in raising the pandemic alarm — and that the threat of H1N1 may not have passed. In a study released May 11 in the journal Science, researchers from Imperial College London, along with WHO staff and Mexican scientists, conclude that H1N1 is transmitted considerably easier than the regular seasonal flu and is about as deadly as the 1957 Asian flu, which killed about 2 million people worldwide. A World Bank study last year found that a pandemic of similar severity today might kill 14.2 million people around the world, and cut 2% from the global economy.’ 

 

7 May 2009 Update

As of 7 May 2009, there were 2,371 confirmed cases of swine flu in 24 countries and 46 deaths from this infection, all but 2 of the deaths occurring in Mexico. Scientists described 11 cases of Americans who were infected before the current outbreak with swine flus that partly matched the new epidemic strain that emerged in Mexico in March 2009. The first case was in December 2005. In articles published online in The New England Journal of Medicine, virologists from the US Centers for Disease Control and Prevention (CDC) described those cases, most of them in young people in the Midwest who touched or were near pigs. All had a ‘triple reassortant’ virus that combined human, swine and avian flu genes. The H1N1 flu now spreading out from Mexico also has those genes, as well as genes from Eurasian swine. The CDC reports that the pandemic does not appear to be petering out, that we appear to be still on the upswing of the epidemic curve, and that only about 10% of those infected had a travel history to Mexico.

 The role of livestock scientists in the developing world
Livestock scientists have a vital role to play in helping to predict, prevent and control zoonotic diseases, which are all those transmitted between animals and people. Remarkably, zoonoses make up more than 60% of all human infectious diseases and more than 70% of all emerging infectious diseases. These diseases occur most frequently in Asia and Africa, where limited resources hinder both surveillance and response. The growing threat of emerging diseases such as Nipah and SARS, and re-emerging diseases such as Rift Valley Fever and avian influenza, has served as a wakeup call to animal health and public health services that their collaboration is necessary if these threats are to be minimized. There is increasing recognition that, for a number of zoonotic diseases, the most effective way to protect the health of the public is to control disease in the animal host.

The work of livestock scientists working in and for developing countries has special relevance in tackling these animal-human diseases, because within developing countries today, fast changes in food systems wrought by skyrocketing demand for, and production of, livestock foods is creating new niches and transmission pathways for pathogens, with unprecedented numbers of diseases emerging and re-emerging in recent decades. New tools and approaches for managing diseases in developing countries are urgently needed.

 

The animal-human disease interface
Most pathogens (61%) that affect people also affect animals; such shared infecting organisms and infections are known as ‘zoonotic’. A full 71% of all the world’s emerging infectious diseases are zoonotic, or transmissible between people and animals. In addition to swine flu, bird flu and SARS, these diseases include such devastating plagues as BSE (mad cow disease), HIV/AIDS, ebola and Rift Valley fever. The bugs that cause these diseases are notorious for their ability to evolve. Flu viruses, for example, can change both from severe to mild and from mild to severe.

Researchers at ILRI have been working at the livestock-human disease interface, supporting better integration of veterinary and public health surveillance programs, for three decades. ILRI’s particular interests are aspects of zoonotic diseases that impact the world’s poorest communities, where animal husbandry is a way of life and a central means of livelihood for more than half a billion people. ILRI and its partners, for example, make evidence-based assessments of the different impacts on the poor of employing different disease-control methods, thereby helping policymakers determine optimal pro-poor strategies for different regions and agricultural production systems of the developing world.

ILRI works with many research institutions within developing countries to better control zoonotic diseases at local, national and regional levels. It works with WHO and its international network of institutions to bolster disease surveillance. It works with the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) on participatory epidemiology, a grassroots approach to disease surveillance and control that is being successfully applied in the battle against bird flu in Indonesia. And it works with regional agencies such as the Africa Union / Inter-African Bureau for Animal Resources to improve laboratory testing and diagnosis of bird flu and other infectious livestock diseases.

ILRI and its partners are also investigating risk-based approaches that focus on key hazards and maximize benefits with available resources. With case studies in Africa and Asia, and concepts derived from ‘one medicine’ and ‘one health’, ILRI scientists argue that a ‘risk-analysis framework’ both can and should be extended to integrate risks to animal, human and environmental health.

The role of policy
ILRI also works with the International Food Policy Research Institute (IFPRI) and other institutions on providing evidenced-based policy support so that we don’t fall into the trap of doing more harm than good in our efforts to control infections, particularly in poor countries which can least afford such mistakes.

Some of the most profound consequences of disease threats are economic rather than medical, with inappropriate policies devastating local and national economies. Egypt’s on-going culling of its entire population of some 300,000 pigs, for example, is reported to be reigniting religious and economic tensions, and may end up doing more harm than good. The pigs are kept not by Egypt’s majority Muslim population, which views the animals as unclean, but by Egypt’s Coptic Christians, many of whom maintain pigs on the rubbish heaps of shantytowns, where entire families pick out organic waste to feed their pigs. On the other hand, Egyptian authorities may be trying to prevent a repeat of events two years ago, when they were criticized for not responding swiftly enough to an outbreak of bird flu, which killed 26 people in the country, three in just the last month.

‘Misconceptions and inappropriate responses can spread quickly during the early stages of a new disease outbreak,’ says John McDermott, a veterinary epidemiologist and ILRI’s director of research. ‘This “swine flu” is spread by people, not by pigs,’ he said. ‘So most authorities are appropriately focusing their current attention on stopping the spread of swine flu among people.’ (Bird flu, in contrast, is spread by birds, so authorities focus on controlling that disease within poultry rather than human populations.)  This new swine flu virus, and our reactions to it, like the more lethal bird flu and SARS before it, should provide us with many lessons for the future.

Research gaps
We still know little about the nature of this new influenza virus strain, other than its genetic makeup is a ‘mashup’ of human, bird and pig elements (making the name ‘swine flu’ something of a misnomer we shall probably have to live with; ‘Spanish flu’ didn’t originate in Spain, but the name stuck anyhow). We don’t know yet when it first made the jump from pig to person, why it has been so deadly in Mexico but not elsewhere, or how virulent it will eventually prove to be. The pathogenicity of a virus can become milder or more severe over time. Until now, the influenza A(H1N1) virus thankfully has proven relatively mild, with most of those infected responding well to usual flu treatments and recovering.

Our ignorance of this new strain of swine flu virus is partly due to our neglect of animal health matters. In rich as well as poor countries, veterinary health care and research remains chronically under-funded. And there is increasing need for disease control policymakers, agents and researchers to collaborate at the interface of the human-and-animal-health sectors, exchanging up-to-date information on disease outbreaks and transmission.

Controlling emerging infectious diseases
 ‘To get serious about preventing new zoonotic infections from spreading,’ says Carlos Seré, director general of the Africa-based International Livestock Research Institute (ILRI), ‘we need to get serious about veterinary resources. We need new ways to look for new pathogens infecting animals, new ways to assess those which may be most dangerous, and new ways to determine how they may be transmitted to people. We have just had a demonstration as to the danger of waiting for a new flu to emerge and begin spreading among people before trying to contain it.’

The influenza A(H1N1) virus is spreading rapidly because in our ever-shrinking, ever-globalizing world, pathogens are crossing species and borders with increasing ease. In such a world, says Seré, ‘we ignore veterinary health problems in developing countries at our peril.’ With high-quality collaboration among countries (rich and poor alike), scientific disciplines (e.g. socio-economics as well as genetics), and sectors (e.g. medical, veterinary, agricultural, environmental, wildlife), Seré argues, we can manage today’s emerging disease threats.
 
Because animals are the origin of most emerging diseases, they could play the same role that canaries did in the mines, in that case, alerting the coal workers to the presence of noxious gases or too little oxygen.

‘We should be spotting many infectious disease threats not in people, as we did in the case of this new flu virus,’ says Seré, ‘but rather in animal populations.’ That should give authorities more time to design and implement interventions to protect people from becoming infected. ‘But as we’ve seen in recent outbreaks of bird flu and Rift Valley fever, all too often it is people rather than animals that serve as our sentinels, sickening and dying after the disease has begun circulating in local livestock populations.’ That’s largely because in poor countries, livestock diseases tend to go unreported (it’s hard to tell one livestock disease from another in countries with spotty veterinary coverage) and/or underappreciated (people facing serious human health problems have little time to spare worrying about animal diseases), and/or ignored (it may be considered political suicide to report a disease outbreak that might have large economic consequences).

‘To find better ways of controlling human diseases,’ Seré concludes, ‘we’re going to have to find better ways of understanding and controlling diseases in both domesticated and wild animal populations. And we’re all going to have to work together, breaking down traditional barriers between organizations and scientific disciplines in the process. We need new thinking to tackle these new threats. And bringing diverse expertise together is the best way of staying on top of fast-evolving situations that threaten our global public health—as well as the well being of the world’s poorer livestock keeping communities.’

 

For more information contact

John Mc Dermott
Deputy Director General-ILRI
Nairobi, Kenya
Email: j.mcdermott@cgiar.org
Telephone: +254 20 422 3207

Climate and health experts warn that scientists must work together, or risk ‘disastrous consequences’ to human and animal health in Africa

Consensus: Spread of Malaria, Rift Valley fever, and Avian flu far more likely if researchers continue to ‘operate in silos’ and if solutions ignore local conditions.

human and animal health in Africa

Faced with the prospect of more variable and changing climates increasing Africa’s already intolerable disease burden, scientists must begin to reach out to colleagues in other fields and to the people they want to help if they hope to avert an expected “continental disaster,” according to leading climate, health, and information technology experts, who met in Nairobi last week.

Climate change will further increase the already high variability of Africa’s climate, fostering the emergence, resurgence and spread of infectious diseases. “A warmer world will generally be a sicker world,” said Prof. Onesmo ole-MoiYoi, a Tanzania medical, veterinary and vector expert. “We scientists need to adopt a new way of working, one that makes African communities bearing the burden of disease part of the solution rather than part of the problem.” The separate fields of human health, animal health, climate, vectors and environment must come together to avert a “continental disaster,” according to leading experts who attended the meeting.

Patti Kristjanson of ILRI, which hosted the meeting, agreed. “We need to do things differently than we have in the past. The impact of disease will increase if we continue to operate in silos. Our only chance at reducing the impact of deadly diseases in Africa is to increase collaboration across the disciplines of environment and health, and in a way that involves local communities. Failure to do so could lead to disastrous consequences.”

The experts concluded a three-day meeting sponsored by Google.org and organized by researchers from the IGAD Climate Predictions and Applications Centre (ICPAC), the Kenya Medical Research Institute (KEMRI), the International Centre of Insect Physiology and Ecology (icipe), the International Livestock Research Institute (ILRI) and Google.org.

The meeting was one of the first on the continent to link climate and health researchers to reduce Africa’s infectious disease burden. The experts cited malaria, Rift Valley fever and bird flu as diseases poised to spread to new areas, along with an increasing threat of diseases such as Chikungunya and the emergence of as yet unknown disease pathogens, unless researchers, disease control workers and local communities share information and communicate faster and more strategically across their professions.

Prof. ole-MoiYoi of icipe and Kenyatta University stressed the importance of tapping the expertise of local communities. “By using bed-nets and anti-malarial drugs, and by removing the human-made breeding sites of mosquitoes, communities in the Kenyan Highlands have managed to stop recurrent malaria epidemics.”

“To combat disease, we need a holistic approach that involves local communities,” ole-MoiYoi said. “We can control malaria across Africa if we can divorce ourselves from the linear thinking that looks for ‘a’ solution and adopt an integrated approach.”

The World Health Organisation (WHO)estimates that changes to the earth’s climate are already causing five million more severe illness and more than 150,000 more deaths each year. By 2030, the number of climate-related diseases is likely to more than double.

Dr. Rosemary Sang, a researcher from KEMRI, described a case study of an outbreak of Rift Valley fever that claimed the lives of 155 Kenyans in late 2006 and early 2007. The virus is transmitted from livestock to people either through handling of infected animal material or by the mosquito vectors. Sang said the outbreak, which peaked 24 December, highlights most of the critical challenges researchers and health officials face in connecting data and advanced warnings to realities on the ground.

Kenya’s Garissa District, in the remote north-eastern corner of the country, experienced heavy rains and flooding starting in mid-October 2006, resulting in standing pools of water that became breeding sites for the mosquitoes that transmit Rift Valley fever. The first veterinary interventions did not take place until mid-January 2007, almost three months after the onset of the heavy rains, 2.5 months after mosquito swarms were reported, 2 months after the first livestock and 1.5 months after the first human cases were recorded, respectively.

“We need to move up our response times to these outbreaks,” said Sang. “All of the warning signs of an outbreak were there but we weren’t able to connect the dots.”

She cites poor tele-communication and roads in the region as major challenges. “Many of these areas lie outside mobile phone networks and far from health or veterinary clinics. As animals and then people began to get sick and die, the word didn’t get out fast enough.”

In the end, however, human and animal health officials, working together, were able to save the lives of more people in the 2006/07 outbreak than in the same region in 1998, when more than 600 people died from Rift Valley fever and millions of dollars were lost in livestock trade and tourism.

“The key is predicting outbreaks before they happen and preparing high-risk areas to act quickly to reduce the impact on communities,” said Sang.
Frank Rijsberman of Google.org called on technical experts to strengthen their capacity to predict and prevent infectious diseases. That will take more and better climate, vector, human and animal data, as well as more data sharing.

“The links between the climate and health research communities across Africa need to be strengthened,” Rijsberman said. “By sharing information we can stop some disease outbreaks and dramatically shorten our response time to others – which can not only save lives but also protect communities against subsequent severe economic losses.”

Mapping the way forward
The researchers pointed to climate models and new mapping software such as Google Earth and Health Map as useful tools for integrating vast amounts of environmental, health, and poverty data. “We’re working to identify the populations of people that are most vulnerable to disease and other external shocks,” said Phil Thornton of ILRI. “That includes communities that are at high risk for malaria because, for example, they are located both far from health clinics and near to water sources. We make these ‘vulnerability maps’ publicly available so that these high-risk communities can get the support they need to respond quickly and effectively to disease outbreaks.”

Google.org environmental scientist Amy Luers said better disease responses will also require tackling diseases at their root causes. “We scientists have to do a better job of informing the public of the underlying drivers of the spread of infectious diseases. The impacts of increasing populations and environmental degradation will require institutional and governance changes put in place for a ‘one health’ approach to human, animal and environmental well being.”

“We need to prepare now to avoid future catastrophe,” says Prof. ole-MoiYoi. “We are discovering that climate variability is playing a bigger and bigger role in the spread and severity of diseases across the globe. Our survival, and that of our environment, may depend on our joining hands to understand that environment. And our roles in it.”

Germany helps Africa fight bird flu by investing in its people

Substantial GTZ support provided to ILRI and AU-IBAR has provided 80 laboratory staff in 37 African countries with specialized knowledge in rapid detection of highly pathogenic avian influenza
 
This program of the German Technical Cooperation (GTZ) for early detection of bird flu in Africa did more than train people in advanced techniques for diagnosing a new disease. It invested in people, connecting them in a ‘who’s who’ of skilled African laboratory staff as well as a handful of international bird flu experts focusing on Africa. It united these laboratory experts in a common cause.

As Carola von Morstein, coordinator of the GTZ Task Force on Avian Influenza, puts it, ‘This—remarkably the first regional training in Africa to diagnose avian influenza—is helping to improve transparency, communication and information exchange in bird flu campaigns. We will publish in print and on the web a training manual so we can widely share the lessons learned in this training. One of those lessons is the great advantage to be gained in coordinating work to prevent and control bird flu across the continent.’

Staff at the International Livestock Research Institute (ILRI) and the Africa Union’s Interafrican Bureau for Animal Resources (AU-IBAR), who organized the series of intensive training courses conducted over the last year across the continent, are interested in continuing their work with GTZ to sustain this cooperation among agricultural, veterinary and medical experts. Such inter-sector cooperation in disease control is regrettably unusual in all countries but particularly so in those lacking resources to bring together experts from different ministries and disciplines.

ILRI’s research director John McDermott is excited about this cooperative aspect of the project. ‘The network of African veterinary and human diagnosticians created by this training over the past year has great potential. It has fostered “diagnostic champions” in Africa who are being consulted by their colleagues. The benefits of this will go beyond avian influenza to other important infectious diseases of both people and animals.’

ILRI’s director general Carlos Seré also sees opportunity to build on the momentum that has been created. ‘We’re interested to explore with others how this regional emergency training might be transformed into long-term indigenous capacity-building for better control of infectious diseases in Africa.’

Other partners involved in organizing the training courses or providing training materials were the Food and Agriculture Organization of the United Nations (FAO), the World Animal Health Organization (OIE), the World Health Organisation (WHO) and the U.S.-based Centres for Disease Control (CDC). ILRI and AU-IBAR worked closely together to conduct a basic 10-day training course that they held in three countries: Cameroon, Kenya and Senegal. They drew trainers from OIE/FAO/WHO avian influenza reference laboratories, ILRI, AU-IBAR, CDC-Kenya, the Institut Pasteur, the Centre Pasteur and African universities and research organizations.

These courses revealed that most African countries have the capacity to collect samples of bird flu virus, including the highly pathogenic H5N1 avian influenza virus, and ship these to designated laboratories for analyses. Some of these labs can also perform basic serological tests for bird flu virus. But few of them are equipped with the advanced diagnostic tests in molecular diagnosis and virology or with the BL3 facility (a laboratory built to a secure biosafety level 3) needed to handle the deadly live H5N1 virus. ILRI and AU-IBAR staff organizing the training courses targeted the few labs that did have these facilities to serve as regional reference laboratories and provided 20 of their staff with two advanced training courses (one in English, the other in French) conducted at South Africa’s ARC-Onderstepoort Veterinary Institute (OVI), in Pretoria, which is equipped with all the facilities needed for diagnosis of avian influenza. (OVI had previously trained staff in southern African countries.)

Funding for this project was provided by Germany’s Federal Ministry for Economic Cooperation and Development (BMZ) and implemented by GTZ within its ‘Poverty Reduction in Rural Areas’ project. The latter works to boost—in a sustained manner—the capacity of developing countries to prepare for and respond to outbreaks of bird flu. With uncommon foresight, this German project further helps countries implement preventive measures that help their farming communities maintain their livestock, the mainstay of livelihoods of the rural poor. Among the farm animals at risk from zoonotic diseases and conventional programs implemented to control them are many local poultry breeds kept by the poorest of the poor.

Carola von Morstein, leader of the GTZ Task Force conducting this pro-poor work fighting avian and human influenza, visited Nairobi this week to consult with ILRI and AU-IBAR directors and scientists who organized the training and tailored the English and French courses to suit African circumstances.

In early July, the first follow-up training took place in three veterinary laboratories in Ghana. Staffs of the laboratories in Accra, Pong Tamale and Kumasi were trained by the German Friedrich-Löffler-Institute (FLI). This Federal Research Institute for Animal Health has a Task Force for Epidemiology. GTZ and FLI are together providing training to affected countries such as Ghana. GTZ also procured for these laboratories equipment, such as Quick Tests Influenza Kits, V-bottomed Microtest-Plates and Pipettes, to ensure that the country is equipped for diagnosis of bird flu.

For more information about this GTZ project, email the GTZ task team:
carola.morstein-von@gtz.de> or
kerstin.schoell@gtz.de

or the Rene Bessin at AU-IBAR:
rene.bessin@au-ibar.org

or Duncan Mwangi or Roger Pellé at ILRI:
d.mwangi@cgiar.org and r.pelle@cgiar.org

Controlling bird flu in Indonesia through local knowledge

‘Participatory epidemiology’ – an approach to controlling livestock diseases pioneered by ILRI’s Jeff Mariner and colleague Christine Jost – is being used to improve control of bird flu in Indonesia.

Indonesia has the worst bird flu problem in the world. Experts fear that the country provides the perfect setting for the highly pathogenic form of avian influenza, H5N1, to evolve into a form easily passed among humans, touching off a global pandemic. Through an approach known as ‘participatory epidemiology’, teams of veterinarians are tapping into local knowledge of where and when bird flu outbreaks are occurring and then enlisting villagers’ cooperation in control efforts.

The H5N1 virus is endemic among poultry throughout much of Indonesia. ‘You simply couldn’t get more virus in the environment,’ says Jeffrey Mariner, a veterinarian at the International Livestock Research Institute (ILRI), in Nairobi, who is helping train surveillance teams under the auspices of the Food and Agriculture Organization (FAO) of the United Nations.

To establish a systematic control program, officials will have to track where and when outbreaks of bird flu are occurring, especially among the estimated 300 million chickens kept in backyards by 60% of all Indonesian households. That’s the challenge for a new approach called ‘participatory epidemiology’ pioneered by Jeff Mariner and his colleague Christine Jost, an assistant professor at Tufts University, in Massachusetts. By talking to villagers and about disease incidences and symptoms, researchers can gather valuable epidemiological data on how disease is spreading and kept in circulation, which in turn informs control strategies. Mariner and Jost pioneered participatory epidemiology to help control rinderpest in Africa. This approach enabled authorities in Sudan to target vaccination programs that eradicated rinderpest from the country. Although participatory approach has never been tried for avian influenza and has never been tried on such a large scale for any disease, international and Indonesian animal health officials believe that this approach will be a key component for bringing the H5N1 crisis under control, both in Indonesia and elsewhere in the developing world.

Early in 2006, with USD1.5 million in funding from the United States Agency for International Development (USAID), a pilot program was established in 12 districts in Java comprising two teams of publicly funded vets specializing in either participatory disease surveillance or participatory disease response. The teams ‘turned up much more avian influenza than anyone expected,’ Mariner says. ‘Poultry populations were fully saturated with the disease.’

Those alarming results persuaded Indonesian authorities and international experts to push for a rapid expansion of participatory epidemiology. Even though coverage of the country is still fairly limited, the data being accumulated are providing clues to what keeps the virus in circulation.

Participatory response is an important part of the program. Mariner says that until recently the standard response was for government vets to indiscriminately cull all poultry around the villages where infected birds were found and then vaccinate widely. This mass culling, known as ‘stamping out’, causes resentment among smallholders, who may correctly believe that their birds have not been exposed to the virus. Delays in compensation exacerbate the ill feelings. The participatory approach aims to involve villagers in decisions—ideally, to cull all poultry directly exposed to infected birds, with immediate compensation, and then vaccinate other birds in the vicinity. Mariner says that even smallholders can be convinced of the need to cull birds that have been directly exposed to H5N1-infected chickens.

At the same time that Indonesia is verifying the effectiveness of participatory epidemiology, the country, with FAO support and financing from the United States, Australia and Japan, is planning to extend the program to all of Java and Bali and parts of Sumatra by next May.

This article was taken from a longer article published in Science on 5 January 2007 titled: Indonesia Taps Village Wisdom to Fight Bird Flu.

Download article (subscription required): http://www.sciencemag.org/cgi/content/full/315/5808/30

Vaccine agency to reduce loss of human and animal life in developing countries is launched

The Global Alliance for Livestock Veterinary Medicine (GALVmed) recently unveiled animal health projects it will tackle over the next ten years.

GALVmed announced progress on vaccine and treatments for Newcastle disease in poultry and East Coast fever and Rift Valley fever in cattle at its international launch at the Kenya Agricultural Research Institute (KARI), in Nairobi, on Friday 9 March 2007. This marked the beginning of a 10-year program aimed at creating sustainable solutions to the loss of human and animal life caused by livestock diseases, which threaten 600 million of the poorest people in developing countries in Africa, Asia and Latin America.

GALVmed, a non-profit organization funded by the UK Department for International Development (DFID), is partnering with private and public-sector organizations around the world. It has identified 13 livestock diseases as key targets for development of livestock vaccines and animal health diagnostics and medicines. Founder members of the agency include the International Livestock Research Institute (ILRI), FARM-Africa, Pfizer, Intervet and Merial. GALVmed exists to broker partnerships among pharmaceutical companies and other public and private-sector organizations to develop accessible and affordable animal vaccines for the whole world’s poorest farmers.

Zoonotic diseases, which are transmitted between animals and humans, mainly afflict the poorest households, as evidenced by the recent outbreak of Rift Valley fever in livestock in Kenya, which killed 150 people. Brian Perry, a senior scientist at ILRI, warns that ‘Today, combating livestock diseases is everybody’s business – tropical animal diseases are no longer “just a local problem”. For example, there is a threat that diseases like Rift Valley fever will follow bluetongue into Europe.’

GALVmed’s chief executive Steve Sloan explains that ‘Every year, poor farmers worldwide lose an average of a quarter and in some cases half, of their herds and flocks to preventable disease. This devastates developing economies. Many of these are zoonotic and so also cause human deaths.

Livestock play a critical role in helping people escape poverty. Livestock disease is one of the greatest barriers to development for poor livestock keepers. Flocks and herds die every year from diseases for which vaccine simply do not exist or are beyond the reach of the poor. John McDermott, ILRI’s deputy director general for research says, ‘ILRI scientists and partners have done ground breaking science to develop an experimental vaccines to protect cattle against East Coast fever. The next steps are to conduct trials to facilitate the delivery of this vaccine to the farmers. To do that, we need specialist partners who will test, manufacture and market the vaccine and make it accessible and affordable to the thousands of livestock keepers afflicted by this cattle killing disease.

Click here for the GALVmed News release.

To find out more about GALVmed visit the website
www.galvmed.org

Battling bird flu: Taking developing countries and their contexts into account is an imperative for success

Fighting deadly bird flu in the developing world is more complex and difficult than in the industrialized west. To be effective, global control strategies must take developing-country contexts and perspectives into account.

A recent consultation on highly pathogenic avian influenza (HPAI) highlighted the complexities of fighting bird flu in the South. The consultation, held in Nairobi 14–16 June 2006, was organized by the International Livestock Research Institute (ILRI) and the International Food Policy Research Institute (IFPRI). Participants worked towards identifying how the research community can best assist developing countries and frontline personnel in the fight against bird flu both now and in the medium to longer terms.

 

The consultation report, How Research Can Support Efforts to Control Avian Influenza in Developing Countries: First Steps Toward a Research Action Plan, is now available. The report contains a comprehensive list of service and research needs identified by participants. The next step will involve validating and prioritizing these lists in a broader email-based consultation.

Battling Bird Flu: Developing Country Context & Perspectives
Developing countries have large numbers of widely dispersed small-scale and backyard poultry keepers. This makes detecting and controlling the disease difficult. In addition, these countries generally have insufficient numbers of professional in disease control and communication work and insufficient institutional support for controlling disease. All of this makes it difficult to communicate the risks of the disease and to get people to comply with control efforts. ‘Stamping-out’ (mass culling of poultry infected or suspected to be infected) is routinely adopted in industrialized countries, but this approach is likely to be impractical in developing countries. If our strategies to fight bird flu don’t take developing-country contexts into account, we will fail to control bird flu globally.

As important, John McDermott, ILRI’s Deputy Director General for Research, warns, ‘In the battle against bird flu, the world’s poorest people could become the main victims of the disease. They have little voice in how we control the disease and the burden of controlling it falls disproportionately on the rural poor, who both consume their own poultry and rely on it for their livelihoods.’

McDermott and his colleagues at ILRI and partner institutions in Africa and Asia are saying, in effect, that ‘one size does not fit all’. What works in the North will not necessarily work in the South. To fight bird flu successfully, we must attend to social as well as to economic and technical issues, we must learn from frontline experience, and we must understand the developing-country context for disease control. If we do these things, we will help develop control strategies that countries can tailor to their conditions and circumstances.

The Consultation: Experiences from the Front Line
The Nairobi Consultation opened with interviews of scientists with direct field experience in Asia and Africa. These experts with first-hand knowledge of fighting the disease identified illegal cross-border trade and live bird markets as key vehicles for the spread of bird flu within and between countries. Constraining early notification of disease outbreaks and subsequent control of the disease, they reported, were insufficient or total lack of compensation for lost birds, lack of trust in governments, and the common  farmer experience of losing lots of birds to Newcastle Disease and other, endemic, diseases.

Key Issues Highlighted
Compensation

  • Well-publicized and carefully thought out compensation plans are critical to achieving early notification of outbreaks and effective control of bird flu. Lessons from the front-line tell us that compensation plans should consider more than just direct compensation for birds lost to the disease or culling operations. While some countries have provided poultry owners with compensation, others have not done so or do not intend to offer any form of compensation. A key message from the experts at this consultation was that compensation matters, and it matters a great deal to millions of poor small-scale farmers.
  • In India, for example, although farmers received compensation within a few hours of their birds being culled, they were compensated for no associated investments. Many farmers had cash tied up in grain bought to feed their chickens and had no other use for the grain once their chickens were gone. India’s experience suggests that a broader view of compensation is required. The bird flu scare in India caused people to panic, poultry prices plummeted, and those directly and indirectly involved with poultry and grain lost their livelihoods as their industry crashed.
  • Implementing different compensation levels for different sizes and/or ages of birds lost could create new problems. Farmers might be tempted, for example, to hide their young birds until they grew to a size that would attract the highest price, thus putting people and animals at greater risk of the disease.


Major threats

  • Migrating birds: Many participants believed that migrating wild birds were not the greatest threat to the spread of bird flu in developing countries. Although southern Africa had not at the time of the consultation had any confirmed cases of the highly pathogenic H5N1 virus, different forms of bird flu have been present there for some years, typically infecting ostriches. Experts there are concerned about possible introduction of new strains from ostriches and introduction by illegal cross-border movement of people, birds, and avian products, as well as the wild birds who migrate from nothern Europe to this region.

 

  • Trade: Illegal cross-border transfers of both live poultry and carcasses was identified as one of the biggest threats to the spread of bird flu and a key route for transmission within and between countries. Live birds and poultry carcasses are already being smuggled across borders and this is likely to increase if widespread culling is implemented and little or no compensation is offered. The borders of many developing countries are large and porous with only certain parts patrolled, making illegal cross-border transportation of birds relatively easy.
  • Markets: Live bird markets represent another key route for transmission of bird flu. In some countries, farmers are being advised not to take home any live birds that they are unable to sell at market to avoid infecting flocks at home, but what they should do with their live unsold birds is not specified. And where live bird markets are being made illegal, some are simply going underground.


Diagnosis and control

  • Poor farmers are familiar with dead and dying chickens – this is a fairly regular occurrence for them. Newcastle disease is endemic in many developing countries and can kill many birds fast. Confusion in the diagnosis of poultry diseases – notably in distinguishing the Newcastle disease from HPAI and other diseases  – is a further obstacle to early notification and identification of bird flu. Needed are clear communication and information about the physical signs and symptoms of poultry diseases, what to do if the farmer sees these, and the risks the farmer faces if he or she does nothing about the disease.
  • People’s lack of trust in their governments and/or promises of compensation were identified as key constraints to implementing emergency response and control procedures such as mass culling. The utility of employing mass culling as a means to control the spread of bird flu in developing countries was also questioned by these experts.
  • Most smallholders keep only a few birds in their backyards. Mass culling of all poultry infected and suspected to be infected would be impractical. If no incentives are provided to the smallholders for complying with culling operations, and if most of the smallholders do not recognize the risks of not culling, it is likely that many of them would simply hide their chickens or try to sell them quickly. The incentives provided to poultry keepers have to be sufficient to encourage people to be extra vigilant and to report any suspected cases of bird flu immediately.


Poultry to human transmission

  • Many poor people live close to their livestock, with household members and their chickens often sharing the same small dwelling at night. This increases the potential for transmission of bird flu from poultry to humans. How do you educate people about the dangers of poultry-to-human transmission when practices such as sleeping in the same room with your chickens are widespread? What alternatives do people living in great material poverty have that will ensure their poultry are safe from predators or theft?


The value of chickens to the poor

  • For many small farmers, chickens are ‘coins’ in the bank used for small emergencies: the birds can be sold quickly to raise money for such essentials as food, school fees and medicines.
  • Chicken and eggs are relatively cheap sources of animal protein for the poor. If eggs and chicken become unavailable to the poor, the nutrition and health of many children, women of childbearing age, and other vulnerable groups will be put at risk.
  • Poor people value chickens for more than their market value. For many, chickens represent the first step on the ‘livestock ladder’ out of poverty. Compensation schemes based on market rates are thus unlikely to satisfy farmers or provide them with sufficient incentive to report suspected cases of bird flu.


Alternative investment strategies

  • If chickens are culled and people advised not to restock, what livestock can replace the chickens? Larger livestock are out of the reach of many poor people. And even financial compensation at market values for a small number of chickens would be insufficient to enable the poor to reinvest in other types of livestock. Thus, the living assets of the poor would be liquidized with few alternative (livestock) reinvestment options on offer; other livelihood options would have to be explored.


Information, education and communication

  • Information, Education and Communication has been the mantra working well in Vietnam, one of the first countries to suffer from bird flu. Vietnam has been continually developing, refining and improving its communications to make them relevant to the local communities.
  • Many communications concerning bird flu have been written in English and/or other European languages and do not translate well into local languages. To be effective, communications must consider social and cultural contexts and be open to continual revisions.
  • The bird flu outbreak in Laos highlighted the lack of basic science education and lack of veterinary infrastructure. No veterinarians had been trained there since 1975, leaving only nine veterinarians to serve the whole country. Laos is now working hard, however, to build capacity. The bird flu outbreaks in Laos were largely in commercial poultry farms in urban areas and there were only a few commercial poultry farmers with large numbers of birds. This is in stark contrast to other developing countries in Asia and Africa, where the poultry structure is made up of very large numbers of widely distributed small commercial operations.
  • Community and religious leaders were identified as key players to raise awareness of the dangers of bird flu. Having a series of clear, simple messages conveyed in local languages to communities by trusted sources was viewed as vital to preparedness, emergency response and control. Community action worked well in communities that were relatively stable, and where people were regularly informed and involved and had a vested interest in working together to protect the community as a whole.


According to Dr Carlos Seré, ILRI’s Director General: ‘The global fight against bird flu has to equitable as well as effective – protecting the livelihoods of the world’s poor as well as lives worldwide.

‘To be more effective, efficient and sustainable, bird flu control technologies and strategies must be adapted to the particular realities and constraints of developing countries, including the need to balance public health and poverty reduction objectives. Otherwise, bird flu control will not work in developing countries, and poor control there will continue to threaten the North.’

Short Movie
Robyn Alders of the Kyeema Foundation on The difficulties of diagnosing bird flu in developing countries.

Resource guide now available for research on agriculture-health linkages

A new initiative aims to improve health, reduce malnutrition and food insecurity and promote pro-poor agricultural development through closer collaboration between the agriculture and health sectors.

Research at the crossroads of agriculture and health conducted by the 15 centers of the Consultative Group on International Research (CGIAR) has been building and increasing in recent years. The CGIAR centers have a long tradition of working on nutrition, and now conduct a wide range of health-related work in the context of agriculture, such as malaria, HIV/AIDS, food safety and the health effects of pesticide use.

Since 2004, steps have been taken to co-ordinate the health-related work conducted by the 15 centers. This included the founding of a committee of the directors general of the centers, a stock-take of the centers existing health-related work, a workshop on agriculture-health research in the CGIAR and the publication of a series of briefs on ‘Understanding the Linkages between Agriculture and Health’.

In 2006, the Alliance Executive of the CGIAR endorsed the concept of a research platform on Agriculture and Health as a way to move forward.

The ‘Resource Guide on CGIAR Research on Agriculture-Health Linkages’, hosted on the website of the International Food and Policy Research Institute, is a portal to the work conducted in this area by different CGIAR centers, showing who is doing what on health.

The International Livestock Research Institute (ILRI) now has a webpage on IFPRI's website highlighting the following areas of ILRI's research in relation to human health:

Livestock keeping and human health
As part of its People, Livestock and the Environment Theme, ILRI conducts research to protect and enhance the physical human capital of the poor by developing strategies to reduce health risks and improve nutritional benefits associated with livestock keeping. Other projects focused on the use of water and feed for livestock also consider human health impacts.

Impact of livestock production on human health and nutrition
ILRI is working to improve understanding of the links between livestock keeping and the health and nutrition of poor people, particularly those engaging in smallholder livestock production and marketing. Activities under way include field studies, literature reviews and explorations of the ways in which livestock keeping might benefit the care of people with HIV/AIDS.

Zoonotic diseases

Poor people in developing countries have a high risk of exposure to zoonoses—diseases transmitted from animals to people. ILRI is helping to bridge the artificial divide between animal and human health. With over 75% of human infections having a zoonotic origin, the need to examine the epidemiological relationships between pathogens and their animal and human hosts is paramount. ILRI is putting specifically focusing on a major neglected zoonoses, Cysticercosis, a highly complex disease affecting both people and pigs. ILRI is participating in a Cysticercosis Working Group of Eastern and Southern Africa (CWGESA), which promotes effective communication, collaboration and coordination of integrated research and control activities aimed at combating cysticercosis. CWGESA and ILRI have recently developed a Cysticercosis Prevention Poster which is currently available in English, Xhosa and Afrikaans. This poster is being used for a rapid information campaign in Eastern Cape Province, South Africa where a neurocysticercosis outbreak among children has been reported.

Livestock, water quality, and human health

ILRI has recently initiated limited research on water-mediated impacts on human health and on INRM approaches to reducing health risks. Most of this research falls within ILRI’s collaboration with the CGIAR Challenge Program on Water and Food and the CGIAR Comprehensive Assessment of Water Management and Agriculture. Key issues include the transmission of water-borne pathogens such as coliform bacteria, cryptosporidium, and Fasciola that result from animal manure contaminating domestic water supplies and where simple remedial interventions are feasible

Wastewater is increasingly used for irrigation of fodder crops that fuel the growing urban and peri-urban dairy production in mega cities such as Hyderabad (India) and Faisalabad (Pakistan). ILRI in collaboration with IWMI and Indian and Pakistani public health institutions and municipal water authorities is investigating the relationship between water – soil – produce quality (fodder and milk) to assess the chain of possible contaminations (heavy metals, nitrate, parasites) and ultimately the hazards to producers (farmers, dairy producers) and consumers of livestock products in these urban areas.

Livestock feed quality and human health
Aflatoxin in milk – a possible hazard to human health: ILRI in collaboration with ICRISAT is investigating aflatoxin contamination of fodder (mainly crop residues) as a source of aflatoxin content in milk. In selected sites in Andhra Pradesh, India, close to 50% of the milk samples contained non-permissible levels of aflatoxin. At the same time, only one of the collected fodder samples (groundnut cake) contained non-permissible levels of alflatoxin. Aflatoxin in milk can clearly present a health hazard to the consumer.

Food safety associated with livestock and livestock products

This research program has focused on identifying the public health risks associated with the marketing of unpasteurized milk, with an emphasis on developing policies and technologies for improved quality and safety without jeopardizing market access for the poor. An outcome of this work has been changes in government policies towards more acceptance of raw milk marketing in several East African countries, based on the identified low risks and high dependence of resource poor people on these markets. This work is being expanded, in cooperation with IFPRI, to examine the marketing of other livestock and livestock products, particularly in South Asia. Studies provide policy-relevant analyses of the risks and economic benefits to poor farmers, market agents, and resource-poor consumers.

Demand for better quality and safe food is increasing among urban consumers, especially among affluent ones. This poses threats to the market opportunities of smallholder producers who often are unable to access technology, inputs and services to produce high quality products demanded by the market chains serving high-end consumers. ILRI research is trying to understand the nature of quality and safety attributes demanded by consumers, their willingness to pay for such attributes and how smallholders may respond to these through participation in market chains.

Vaccines, diagnostics and disease resistance
ILRI research on livestock vaccines has direct and indirect links to medical vaccine and diagnostic research. One aspect of this work involves host functional genomics as it relates to livestock diseases that can be transmitted to humans.

A project investigating resistance to trypanosomosis in cattle is shedding light on some of the basic questions of disease resistance, which may have implications for human medical treatment. ILRI researchers first identified several regions of the cattle genome in which genes contributing to resistance or susceptibility must lie. They then identified genes within a part of the bovine genome that affects anemia, a characteristic of the disease. Remarkably, significant differences between cattle breeds that are susceptible and resistant to the disease were found in one of the candidate genes. Such a result makes it possible that the gene in question is responsible for the difference in susceptibility to anemia in the two breeds. This is now being further investigated. More recent results of this trypanosomosis genomics research appear to have implications for medical research on cholesterol. For more information, contact ILRI’s Steve Kemp at s.kemp@cgiar.org

Initiatives and Networks
Urban Harvest Programme
ILRI is a member of Urban Harvest, a CGIAR initiative to use the collective knowledge and technologies of the CGIAR Centers to strengthen urban and peri-urban agriculture (UPA) practiced by the poor.

System-wide Initiative on Malaria in Agriculture (SIMA)
ILRI backstops a CGIAR-wide initiative addressing malaria in agricultural communities. The System-wide Initiative on Malaria in Agriculture (SIMA) focuses the combined skills and abilities of the agricultural and health research communities, government agencies and community-based organizations. Water- and land-use and crop- and livestock-production practices are studied across a range of agro-ecosystems in Africa to identify farming activities that encourage and discourage the breeding of the mosquito vector or alter the transmission of the disease. Research-based guidelines and tools are developed and tested for use by poor communities and the non-governmental organizations and governments that serve them.

Outreach and Events

CGIAR Challenge Program on Water and Food
ILRI, IWMI and the CGIAR Challenge Program on Water and Food is inviting individuals and organizations located in any of the ten riparian countries of the Nile River Basin to submit short well-written case studies describing traditional or contemporary innovations in technologies, in community and household practices, and in policies that result in better management of water and livestock resources. Relevant topics include the prevention of transmission of waterborne and water related zoonotic and animal diseases such as Cryptosporidiosis and Fasciolosis. This contest is offering USD 1000 for first prize, USD 500 for second prize and USD 250 for third prize. For more information, contact ILRI’s Don Peden at d.peden@cgiar.org

CGIAR Science Award for Promising Young Scientist

In 2005, ILRI scientist Simon Graham won the CGIAR Science Award for Promising Young Scientist for research leading to the development of a sensitive and robust system for identifying vaccine candidate molecules from Theileria parva that causes East Coast fever, a fatal disease of cattle in sub-Saharan Africa. Graham’s research may also contribute to ongoing efforts to control tropical theileriosis, a cattle disease which puts 250 million cattle around the world at risk. Furthermore, by using genomics to understand and fight T. parva, scientists may make advances against related parasites that cause malaria, tuberculosis, and other diseases in which killer T cells also play a role in immunity. And because T. parva launches a cancer-like illness inside the white blood cells of cattle, it may provide a model system for understanding the mechanics of cancer biology.

Visit http://www.ifpri.org/themes/aghealth/aghealthrg.asp for the resource guide on IFPRI's website.

Bird flu consultation

ILRI and IFPRI are convening a consultation in Nairobi from 14 to 16 June 2006 to determine how the research community can best assist developing countries in the fight against bird flu.
 
The International Livestock Research Institute (ILRI) and the International Food Policy Research Institute (IFPRI) are convening a consultation to explore how research can support efforts to control the highly contagious avian influenza, with special emphasis on the needs of developing countries and the poor. The consultation is a response to requests from donors on priorities for targeting their research investments for Asia and Africa.

The consultation has four main objectives:

  1. To share the experiences of those in the front-line of avian influenza outbreaks to provide a realistic, objective, and up-to-date backdrop for the consultation.
  2. To identify and prioritize immediate service needs that research can provide in support of preparedness and emergency responses.
  3. To identify and prioritize medium-and long-term research needs.
  4. To develop an action plan and decide how to put it in place, including the possibility of forming an inter-institutional task force.

Much of the present effort in fighting bird flu is focused on immediate actions – emergency preparedness and response. The research community, however, also has a critical role to play in anticipating and addressing medium-and longer-term issues associated with bird flu in developing countries.

One of the greatest concerns is that bird flu could eventually become endemic in developing countries due to large poultry populations, weak infrastructure, scarce veterinary expertise and a general lack of resources. Poor poultry keepers in developing countries are also at a high risk of contracting bird flu, because they live in such close proximity to their livestock. Those who keep poultry and are desperately poor have the most to lose – and many may choose to save or eat sick chickens. This could put all family members and their other livestock at risk of contracting the deadly bird flu. The impacts on poor livestock keepers in Africa are highlighted in a recent article in the New Agriculturist.

New Agriculturist news article


 

Falling fowl of avian flu? New Agriculturist 1 May 2006

Members of the international development community wishing for more information about the ILRI-IFPRI Avian Influenza Consultation should contact Keith Sones ksones@africaonline.co.ke.

Further information about bird flu is available at ILRI’s Livestock in the News: Bird Flu page.

One world, one health

Holistic approaches to controlling the 'perfect storm' of health problems in poor countries, particularly Africa's catastrophic disease burden, must include better control of diseases transmitted between animals and people.

A paper to be published this May 2006 in the Public Library of Science (PLoS) journal PLoS Medicine, a peer-reviewed open-access journal (available online at www.plosmedicine.org) advocates linking integrated work on ‘neglected’ tropical diseases with major global health partnerships recently formed to tackle the three most devastating diseases of the poor: malaria, TB and AIDS. The authors of the paper, which include development economist Jeffrey Sachs, argue that while new partnerships and initiatives have significantly raised funding and awareness of the need to scale up the fight against the ‘big three’ diseases, conspicuously absent is work on a group of ‘neglected tropical diseases’ that may threaten the poor as much as malaria, TB and AIDS and for which there are already cheap and effective control strategies. The authors propose that our success in controlling the big three may depend on a concurrent attack on this group of neglected diseases, which include three vector-borne protozoan infections (leishmaniasis, human African trypanosomosis and Chagas disease), three bacterial infections and seven kinds of helminth (worm) infections.

The potential benefits of taking a more holistic approach to disease control are being popularized in complementary initiatives advocating ‘one health’ strategies that simultaneously address human and animal health. (See, for example, a new book exploring grass roots ideas from East and Southern Africa on how to integrate wildlife, livestock and human health for both conservation and development: ‘One World, One Health’ is available online from LEAD, the Livestock, Environment and Development Initiative.

ILRI supports these holistic health approaches and further argues that another class of neglected diseases of the poor—‘zoonotic’ diseases, or those transmitted between people and animals—should be included. Zoonotic diseases account for a remarkable 75% of all human diseases and include such emerging diseases as avian influenza. Esther Schelling, a veterinary epidemiologist on joint appointment with the International Livestock Research Institute (ILRI) and the Swiss Tropical Institute, points out that zoonotic diseases are virtually excluded from most health initiatives ‘because they’re simply not accounted for’. ILRI is helping to ensure that they are accounted for and that methods to control them are friendly to the poor.

Two papers on this topic by Schelling and colleagues are available online:
British Medical Journal article
Lancet article

Carlos Seré, director general of ILRI, says that with the sequence in recent years of BSE (‘mad cow disease’), foot-and-mouth disease, and now bird flu, there is definitely increasing interest in zoonotic diseases.

‘Donors like the Welcome Trust’, he says, ‘are increasing their investment in tropical animal disease research. Our own strategy is to develop appropriate methods for researchers and policy-makers to evaluate the risk of these zoonotic diseases and together identify the most promising strategies and policies that can help to reduce such risk, particularly for the poor. We have activities specifically looking at zoonoses such as brucellosis and bovine TB, and we are building up our expertise in food safety issues. Strengthening our expertise on food safety and the risks posed by zoonoses is central to two of ILRI’s strategic research themes, the first on sustaining lands and livelihoods which involves protecting human health, and the second on improving livestock-related market opportunities in domestic and international markets, which are increasingly threatened by such food safety concerns.’

In relation to bird flu, Dr Seré explains, ‘ILRI will not be the virologists or poultry specialists. But we have comparative strength in systems analysis, which combines social science with epidemiology and animal genetics and other lab bench research to address complex health problems. We do this in conjunction with partners who bring more specific expertise, such as in poultry or vaccines. What we specifically bring to the picture is a “poverty lens” to understand the implications of health problems, issues and control strategies on the poorest populations in the world.’

‘Clearly, research is not a “rapid deployment tool”’, he says. ‘There are other organizations—such as the World Health Organisation (www.who.org), the Food and Agriculture Organization of the United Nations (www.fao.org), and the World Animal Health Organisation (www.oie.org) —that have a regulatory mandate and policy responsibility and are linked directly to governments. ILRI’s comparative advantage is in the longer term: in understanding the issues and in providing sound technical research to back these agencies which are doing the short-term response work. As we see more and more that boundaries don’t work, that disease is a global problem, we encourage industrialized countries to share their resources with developing countries, not just out of enlightened self-interest, but also, for example, to ensure food safety for their domestic consumers. And finally, we are particularly interested in helping developing countries to build their own research capacity to understand, model and control complex disease problems.

Bird flu threatens countries already in crisis

The deadly H5N1 virus claims its first victim in Iraq while Africa girds itself for a battle against a new pandemic.

BirdFluThreatLive guinea fowl and eggs for sale in a market outside Kano, NigeriaAt the end of January has come news the world was dreading—a preliminary positive report from a US Navy medical laboratory in Cairo of the first death of a person from avian fly in Iraq, a country fighting an insurgency and perhaps in the early stages of civil war. The victim, a girl from Iraq’s Kurdistan region, died two weeks ago in a household that had sick birds; an uncle of hers died later with similar symptoms. With four confirmed deaths of people from avian flu in neighbouring Turkey, where the victims also became infected from sick birds, the fear is that this lethal virus could mutate into a form that can pass from human to human, rather than bird to human as it is normally transmitted now, provoking a flu epidemic that could kill millions of people in a short space of time.

While the fear of avian influenza is keeping some African farmers watchful for sick birds in their flocks, most smallholders are too poor and are facing too many other risks to pay much attention to this flu threat as of yet. African governments, however, are readying themselves. This January, 140 experts from 43 African countries met in Congo’s Brazzaville to draft a blueprint for tackling an outbreak in the world’s poorest continent, already battling AIDS and tuberculosis.

There are fears that avian influenza could spread to the continent via populations of migrating wild birds now residing in eastern Africa to escape the European winter, with the peak of migration being January to March. An outbreak of the lethal H5N1 virus anywhere in Africa’s Horn could spell disaster. More than three-quarters of the people in this region farm for a living and almost all households outside cities keep some chickens. Existing high rates of mortality among domestic birds here will make it hard to detect the virus. Unaware of the risks, villagers would tend to eat birds showing symptoms of the disease. And few African governments would have the resources to pay for culling bird populations and compensating farmers for their losses.

Avian influenza has not been detected in Kenya or any other African country yet. Kenya is close to completing a National Preparedness Plan after a series of weekly meetings by experts, including ILRI immunologist David Mwangi, which started late last year. Kenya has formed a National Avian Influenza Secretariat hosted by the Ministry of Health (MOH) and manned by that Ministry and the Directorate of Veterinary Services (DVS). Dr Mwangi participated in an Avian Influenza National Taskforce meeting in early January, where Kenya’s six-level response system was outlined. Kenya is now in Alert Phase I, which involves surveillance, laboratory support, infection control measures, case management, preparedness and communication and education. A Cabinet paper has been submitted to request funds from the Kenyan Government for this Task Force and donor funds are being sought.

Activities are being conducted now using the limited budgets of the MOH, DVS, Kenyan Museums (whose ornithologists are helping to check wild bird populations for diseased or dead birds), and an office of the US Centers for Disease Control (CDC), whose laboratories at the Kenya Medical Research Institute (KEMRI) include a Biosafety Level-3 Laboratory, the only kind in the country capable of carrying out diagnosis of avian influenza in conjunction with a CDC laboratory in Egypt. Kenya’s frontline national laboratories, KEMRI and DVS, have joined hands in this fight with the Kenya Agricultural Research Institute (KARI) and ILRI to form sub-committees responsible for various work. ILRI is represented on the coordination and resource mobilization team; the surveillance and monitoring team, which are exploiting ILRI’s expertise in epidemiology and geographic information systems; and laboratory support, particularly diagnosis and DNA sequencing and database work.

To read more about ILRI and Kenya plans and activities on this task force, read ‘Bird flu threat still hovers over Kenya’ in the Sunday Nation, 15 January 2005.

The good news is that so far the bird flu virus has remained hard for people to catch. Most human cases acquired their infection during the home slaughtering and subsequent handling (defeathering and eviscerating) of diseased or dead birds before cooking them. The bad news is that in Africa as in Asia, birds are often marketed live, with home slaughtering common, increasing the risk of human infections in areas with outbreaks in poultry. Those buying poultry meat, however, are in no danger because chickens and other poultry are safe to eat if cooked properly.

ILRI agrees with other international organizations that key elements in helping developing countries cope with avian flu outbreaks among animals is strengthening surveillance systems and veterinary laboratories and services, improving people’s access to veterinary services, and providing proper compensation to poultry farmers and marketers for culled birds. World Bank Vice President Jim Adams says that, ‘Experience shows if you get the animal side right, one substantially reduces the risk of a human pandemic.’

With the continuing spread of avian flu beyond its stronghold in Asia, it is clear that combating the disease requires a long-term, internationally coordinated and well-funded effort. That’s why it is good news that donor and international health organizations meeting in Beijing January 17 and 18 pledged US$1.9 billion over the next 3 years to fight bird flu. About $1 billion will be disbursed as grants, the rest as loans. The donors of this massive new program—which include the European Union, United States and World Bank—have set up an Avian Influenza Multidonor Financing Framework to coordinate it.

Read a CGIAR news release and briefing on how the threat of avian flu impacts the developing world.