AHI FACILITY Avian & Human Influenza CHINA 58048 A Multi-tiered Approach in China Aims to Scale Successful Grassroots Pilots C hina reported over 127 thousand cases of novel request of the Ministry of Finance. Key recommendations influenza A/H1N1 infections, including 796 deaths from the Study included the need to develop stronger by March 2010, across 31 provinces. By the end of overarching coordination and communications 2009, ninety cases of human infections of H5N1 were also mechanisms for AHI and pandemic influenza, better reported, including 27 deaths, with infections coming integration of the national plan across sectors and overwhelmingly due to poultry exposure. strengthening of the animal surveillance system, notably at the grass roots level. The Challenge The Government responded swiftly and effectively to address the crisis. The surveillance system for The frequency of H5N1 and H1N1 influenza like illness was expanded, reporting of H5N1/ A multi-tiered outbreaks, the physical size and H1N1 was expanded (from zero to daily reporting), response was population of China (1.3 billion), the screening and active contact tracing was activated, adopted with pilots at significance of its poultry industry, and hospitals and their back-ups for severe infections were role in the international trade of poultry designated, and treatment of all confirmed H1N1 cases the provincial and and poultry products underscores the was made available at no cost. county level aimed at critical importance of an effective developing a response to Human Influenza Pandemic framework of and Highly Pathogenic Avian Influenza (HPAI). China's role in the global response improvements that to HPAI is also significant. The challenges can be applied to the in building capacity for HPAI prevention overall HPAI response and pandemic preparedness to improve rapid response are significant. in the country. Responding to the Crisis An independent assessment of the country framework for Avian Influenza Control and Human Pandemic Preparedness and Response was undertaken jointly by the World Bank, WHO, FAO and CIDA in 2005 at the Based on the recommendations of the 2006 Study, a multi-tiered response to avian influenza was adopted. Pilot efforts have been focused at the Provincial and County level with the aim of strengthening grass-roots level planning and response, improving the policy environment and developing a framework of improvements that can be applied to the overall HPAI response in the country. Pilots were concentrated in two Provinces, Liaoning (40.7 million people) and Anhui (64.2 million people). The selection of these provinces was based on the contrasting poultry rearing methods used: small scale/back yard poultry in Anhui and intensive compartments (>500 poultry) in Liaoning. Preparedness plans have also been prepared in 2 provinces and 5 counties. These pilots succeeded in developing integrated local levels plans, building the capacities of key agencies and identifying areas for further policy improvements. Strengthening Capacity to Respond Rapidly Capacity building has been the main focus. Over 130 thousand human health staff and 4920 animal health staff have been trained, Communications efforts have focused on development of the exceeding the targets established by the Project. Joint training of risk communication strategy and the Information, Education human and animal health workers was carried out at the grass- and Communication (IEC) toolkit, which has been distributed roots level, the first time this has occurred in to all project counties. Additionally, China. Workers were trained in disease the main Ministries have assigned reporting, outbreak investigation and response spokespersons and produced Key Data among other topics. The joint exercises have Standard Operating Procedures that improved collaboration and communications can guide communications with the Grant Amount: $2,650,000 between the sectors. public in case of a public health emergency. Sector pandemic preparedness plans have Disbursement (to end March 2010) : been produced in health, agriculture, transport, $2.4 million education, public security, finance, civil affairs, Improving the Policy etc. Desktop exercises and drills have been Closing Date: June 2010 conducted to improve the practicality of the Environment plans. The final products, the plans, have not only been endorsed by the local Governments, The China AHI Project Phase I has but are highly valued by the Ministry of Health. helped to develop the national policy on AI free poultry compartmentalization and to revise This process has led to national guidelines on poultry rearing, animal health inspection increased awareness of the and bio-security standards. importance of international expertise and knowledge exchange. A number of study Going Forward tours, international workshops and operational research The follow-on grant will focus on reform of the AI surveillance studies have been supported strategy and the building of epidemiological expertise for by the Facility and partner animal diseases. The Government of China is also planning agencies, including WHO and to adjust the prevention and control strategy from rapid FAO. A case study has also containment to impact mitigation to respond to the been requested by the Ministry evolution of the epidemiological situation of the disease in to distill the good practices the country. emerging from the bottom-up approach for pandemic preparedness. AHI The AHI Facility is a Multi-donor Trust Fund administered by the World Bank and supported by Australia, FACILITY China, the European Commission, Estonia, Iceland, India, Korea, Slovenia, the Russian Federation and the Avian & Human Influenza United Kingdom