[afro-nets] WHO DG Warns African Countries To Prepare For Avian Flu

[Leela McCullough <leela@healthnet.org>]

WHO Director-General Warns African Countries To Prepare For
Avian And Pandemic Influenza
-----------------------------------------------------------
http://www.who.int
10 Mar 2006

Here is the speech by WHO Director-General, Dr LEE Jong-wook:

Honourable Minister Charity Ngilu,
Your excellencies,
Colleagues,
Members of the media,
Good morning.

We have just visited the Kibera district, and the Mbagathi Dis-
trict Hospital, where I talked to staff in the TB/HIV clinic. In
both these places some progress in health has been made by dedi-
cated people. But the challenges people here are facing are also
very obvious. One is the consequence of infectious disease. As
an example, in this country, one child in every 10 does not
reach their fifth birthday. Pneumonia, diarrhoeal diseases
HIV/AIDS and malaria are the main infectious conditions that
kill them, together accounting for two thirds of child deaths.
In older age groups, progress continues in HIV, but there is
more work to do to ensure universal access to prevention, treat-
ment and care. The combination of HIV and tuberculosis remains
deadly. Last September tuberculosis was declared a public health
emergency in the African region, and much work is needed to de-
tect and treat people who have TB.

The second challenge is to change the social conditions that
foster and sustain these diseases.

In a slum like Kibera, people's health can depend on their ac-
cess to education, to safe water and sanitation, to safe housing
and clean neighbourhoods, to jobs, and gender equality. WHO is
helping countries to improve health by focusing on these social
determinants. We have to break the grim cycle of treating peo-
ple's illnesses, then sending them back to the living and social
conditions that made them sick in the first place.

The key driver of this effort is the Commission on Social Deter-
minants of Health, which WHO launched one year ago.

Kenya is contributing to this through its prominent role in the
Commission. The honourable Minister of Health Charity Ngilu is a
distinguished member of the Commission. Kenya will host the Com-
mission's next meeting in Nairobi this June. Dr Anna Tibaijuka,
the Executive Director of the United Nations HABITAT Programme
based in Nairobi, is also a distinguished member of the Commis-
sion on Social Determinants of Health.

Action on the social determinants of health complements WHO's
work to expand treatment coverage for HIV/AIDS, TB, malaria and
other illnesses. Research suggests, for example, that people
with TB from poorer backgrounds are far less likely to success-
fully complete their treatment than patients from more privi-
leged backgrounds.

We also know that some factors largely out of people's control,
such as drought, will also affect the most vulnerable. In north-
ern Kenya and in neighbouring countries, millions of people are
facing one of the worst droughts in recent history. The drought
is gravely impacting their access to food. It cripples their
livelihoods as their livestock die or become almost worthless.
It also impacts their access to clean water. In addition, stag-
nant pools can become ideal breeding grounds for mosquitoes,
raising the risks of malaria and other vector-borne diseases. We
must bring more attention and action to the drought-affected ar-
eas.

Disease prevention, control and treatment takes a lot of time
and money. But it is worth the cost. As an example, I was in
Mauritius earlier this week -a country which used to suffer a
high toll of infectious disease. Through a longstanding policy
of prioritizing health in the federal budget, infectious disease
is now responsible for just 2 % of deaths there. Here in Kenya,
I congratulate the Ministers of Health and Finance for the 30 %
increase in the health budget, with further increase projected.
They recognize that spending on health will result in a healthy
and productive population, which is key to a prosperous nation.
But now, every country, no matter its health standing, must pre-
pare against the possibility of the advent of a potential new
deadly threat - human pandemic influenza.

As you know, the avian influenza virus, H5N1, has spread in
birds to two new continents in the last month: to Europe, and to
Africa. Nigeria and Niger are now fighting outbreaks in poultry.
Egypt has reported the disease in birds, and other countries are
testing animals to determine if they too have avian flu. The
spread of H5N1 to Africa is cause for great concern. H5N1 can
wipe out entire flocks in 48 hours. It is deadly to birds.

At the moment H5N1 is rarely deadly to humans. Globally, 175
people have fallen ill, and 96 have died due to H5N1. In almost
all those cases infection was caused by very close contact with
sick or dead birds, such as children playing with them, or
adults butchering them or taking off the feathers. People in
every corner of every affected country must have information
about the risks and the ways they can protect themselves and
their children when handling sick or dead poultry. And, on this
continent where poultry is a major source of protein, people
must know that if poultry is thoroughly cooked, it is safe to
eat. Where there are outbreaks of H5N1 in birds, the government,
partners and the media play a crucial role in giving factual,
relevant health messages to the population.

So, if so few people have died from this disease in birds, why
are we worried? Because, the second, far greater concern is that
this virus, H5N1, could change into a type that spreads easily
from person to person. This would be a virus against which none
of us is immune, and it could cause an influenza pandemic.

It is critical to limit the spread of H5N1 in animals, and the
opportunities for this virus to be in contact with humans. Coun-
tries on this continent must be equipped to take many important
actions.

One: they must be able to find, confirm and quickly report H5N1
in birds - whether wild or domestic. They must then take immedi-
ate action to stop the bird outbreaks. In Africa in particular,
immediate "on-the-spot" cash compensation to backyard poultry
owners is necessary, or they will have no incentive to cull.

Two: countries must be equipped to find, confirm and treat peo-
ple who may be ill with this bird virus.

Three: countries must be able to collect, examine and share vi-
rus samples from these people, in order to determine whether the
virus is changing in any way. Every country must have an avian
influenza and human pandemic influenza preparedness plan. In
practice these require surveillance and laboratory capacity for
animals and for people; early warning systems and virus track-
ing; strong coordination between the animal and human health
sectors; and very importantly, immediate and transparent report-
ing of animal outbreaks and of human cases.

I have discussed these issues with many heads of state. Now, be-
fore H5N1 spreads further here on the continent, I am talking to
heads of state in this region; today with the President of
Kenya, and earlier this week with the Presidents of Mauritius
and Madagascar.

Kenya has already been very active. It was the only African
country to participate in the WHO's November 2005 meeting in Ge-
neva on avian and human influenza. Kenya was also the only Afri-
can country at the Beijing meeting in January. It has developed
a detailed national emergency plan and budget. There is an in-
tersectoral avian influenza task force here, and I met with them
yesterday afternoon. Kenya has also already spent money to im-
plement its plans. The Minister of Health has made clear that
the government will need assistance to fully fund the avian in-
fluenza and pandemic influenza plan. However, overall the Afri-
can continent remains vulnerable. We do not know, for example,
what kind of an impact a pandemic influenza virus would have on
people who are already immunosuppressed as a result of HIV. The
impact of an influenza pandemic on African countries' already
overburdened health care systems could be extremely grave.

Generally, veterinary services are weaker here than in other
parts of the world. Human health services also need to be
strengthened. Almost two billion dollars were pledged at the
Beijing meeting in January, and this funding is needed here,
now, to strengthen health and veterinary services.

At the same time, African governments need to finalize avian in-
fluenza and pandemic influenza plans. They need to allocate
their own resources to turn these plans into action. This in-
cludes simulation exercises, so that plans can be tested and im-
proved. As part of this, it will be vitally important to have
disease containment plans in place. These outline the actions
that help to stop infection spreading.

I want to stress that there is no evidence of sustained human to
human transmission of H5N1, or any other potential influenza
pandemic virus at this time. We must use this time nature is
giving us to prepare.

Thank you.



--
Leela McCullough, Ed.D.
Director of Information Services

SATELLIFE
30 California Street, Watertown, MA 02472, USA
Tel: +1-617-926-9400
Fax: +1-617-926-1212
mailto:leela@healthnet.org
http://www.healthnet.org