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.