Last April’s East Asia update noted the threat to regional and global public health from outbreaks of avian influenza A (H5N1) in East Asia. Since then outbreaks among wild birds and poultry have spread to Russia, Kazakhstan, Turkey, Romania and Croatia, while, in East Asia, new outbreaks this year have occurred in Cambodia, China, Indonesia, Lao People's Democratic Republic (PDR), Thailand, and Vietnam.
... See More + While the bulk of human cases so far are thought to be the result of transmission of the virus from animals to humans, there is great concern that genetic changes will allow the H5N1 virus to achieve the capacity for efficient and sustained transmission among humans, leading to a human influenza pandemic, with high levels of illness, death and other human, economic, and social costs in East Asia and around the world. As a result the question of how to prevent or prepare for such a pandemic is quickly vaulting to a top priority for governments around the world. Since a human influenza pandemic will rapidly spread all over the world, stopping or controlling avian flu is therefore a true global public good, which all countries have an interest in acquiring. Thus, while country level leadership and engagement is essential for success, it must be backed by global resources.
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The development objectives of the Regional Disease Surveillance Systems Enhancement (REDISSE) Project are: (i) to strengthen national and regional cross-sectoral capacity for collaborative disease surveillance and epidemic preparedness in West Africa; and (ii) in the event of an eligible crisis or emergency, to provide immediate and effective response to said eligible crisis or emergency.
... See More + The project has five components as follows: 1) The first component, Surveillance and Information Systems, will support the enhancement of national surveillance and reporting systems and their interoperability at the different tiers of the health systems. It has three sub components as follows: (i) Support coordinated community-level surveillance systems and processes across the animal and human health sectors; (ii) Develop capacity for interoperable surveillance and reporting systems; and (iii) Establish an early warning system for infectious disease trends prediction. 2) The second component, Strengthening of Laboratory Capacity, aims to establish networks of efficient, high quality, accessible public health, veterinary and private laboratories for the diagnosis of infectious human and animal diseases, and to establish a regional networking platform to improve collaboration for laboratory investigation. It has three sub components as follows: (i) Review, upgrade and support network laboratory facilities; (ii) Improve data management and specimen management; and (iii) Enhance regional reference laboratory networking functions. The third component, Preparedness and Emergency Response, will support national and regional efforts to enhance infectious disease outbreak preparedness and response capacity. It has three sub components as follows: (i) Enhance cross-sectoral coordination and collaboration for preparedness and response; (ii) Strengthen Capacity for emergency response; and (iii) Contingent Emergency Response. 4) The fourth component, Human Resource Management for Effective Disease Surveillance and Epidemic Preparedness, aims at bringing the right people with the right skills to the right place at the right time. It has two sub components as follows: (i) Health workforce mapping, planning and recruitment; and (ii) Enhance health workforce training, motivation and retention. 5) The fifth component, Institutional Capacity Building, Project Management, Coordination, and Advocacy, focuses on all aspects related to project management, coordination by West Africa Health Organization (WAHO) as well as support to enhancing the capacity of the Recovery Health Access Center (RHAC) to coordinate the implementation of animal health interventions. It has two sub components as follows: (i) Project coordination, fiduciary management, monitoring and evaluation, data generation, and knowledge management; and (ii) Institutional support, capacity building, advocacy, and communication.
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The Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response for Vietnam received a highly satisfactory outcome with moderate risk to development outcome.
... See More + Both the Bank and the Borrower received a satisfactory performance rating. Components were not revised during the project life, and there were no other significant changes in design, scope and scale, and implementation arrangements. The following lessons can help inform future programs that build veterinary and human public health systems for prevention and control of diseases: (1) An emergency is an opportunity to reduce risks over the medium term. This will help prevent future costly emergencies. (2) One Health approaches are effective in disease control and prevention. (3) One Health approaches are feasible when there is good leadership. (4) Behavior change takes time and resources. (5) Upstream attention to environmental impacts helps prevent problems. (6) Transition from emergency response to systemic improvements is important. (7) Successful market upgrades. (8) M&E indicators. Final outcome indicators (such as disease prevalence and the case fatality ratio) are by themselves not sufficient to evaluate progress and thus may be misleading. They need to be complemented by measures of system performance for functions that are required for disease control and prevention. (9) Technical definitions are critical for M&E. (10) Use of consultants. External expertise was essential for the highly technical task of improving laboratories and their management. (11) Decentralized implementation. This was both necessary (because disease control and prevention activities occur in numerous districts and villages) and challenging (because local capacity was uneven and alignment with national policies and programs was required). (12) Engaging stakeholders beyond Ministry of Health (MOH) and Ministry of Agriculture and Rural Development (MARD). (13) Training health workers on communications, especially risk communications. This helped extend messages to communities and improved infection control in health care facilities. (14) Rule to balance expenditures on training and equipment in health care centers. (15) Quality of supervision and implementation support. Substantial implementation support was instrumental to the success of this technically complex, emergency, and multisectoral operation.
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Implementation Completion and Results Report ICR3330 DEC 23, 2014
This report reviews some of the accomplishments of the Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI).
... See More + This multisectoral program comprised 72 projects in 60 developing countries in all regions and received $1.3 billion in financing from the World Bank. This support for GPAI projects was one of the World Banks contributions to a coordinated global response to the threats of avian and pandemic influenzas, which benefited from financing of $4 billion from 35 donors in 2006-2013. Thanks to this support, developing countries strengthened their capacity for early and effective disease control, bringing substantial public health and economic benefits to the countries and to the world. According to Harvard University Professor and former US Treasury Secretary Lawrence Summers, "[veterinary and human public health systems are] probably the single most important area for productive investment on behalf of mankind." Indeed, circulation of the highly pathogenic avian flu virus was reduced, helping to lessen the likelihood of onset of a pandemic. Moreover, the projects improved public health systems for reducing locally-relevant health threats. The report presents a brief background on the global program and cross-country accomplishments and then highlights accomplishments for each project, by region.
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Ratings for the Avian and Human Influenza Preparedness and Response Project for Uganda were as follows: outcomes were moderately satisfactory, the risk to global environment outcome was moderate, the Bank performance was moderately satisfactory, and the Borrower performance was also moderately satisfactory.
... See More + Some lessons learned included: for civil works contracts under execution, it is important for the Borrower's contract managers to supervise the contractor regularly (such as weekly) to establish the capacity/readiness of the contractor. The frequency of visits can be increased or reduced depending upon the contractor's strengths or other measures taken for noted poor performance. Adequately engaging key parliamentarians about the project's broad scope and the varied and persistent nature of the threats addressed under the project could have potentially facilitated an expedited and favorable consideration of the project in Parliament. It is particularly important that relevant parliamentary sectoral committees be closely associated with the project preparation process. With the growing and persistent threat from zoonotic diseases, a culture and effective modi operandi of collaboration between the ministries in charge of health and livestock are critical in ensuring adequate monitoring of, and rapid response to major zoonotic disease outbreaks.
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Implementation Completion and Results Report ICR3144 JUN 30, 2014
Ratings for the Prevention and Management of Influenza Type Illness and Strengthening of Argentina's Epidemiological System Project for Argentina were as follows: outcome was satisfactory, risk to development outcome or global environment outcome was moderate, Bank performance was satisfactory, Borrower (of guaranteed loan) and implementing party performance was satisfactory, and Government performance was satisfactory.
... See More + Some lessons learned included: Argentina's adoption of a high-risk targeted vaccination strategy against A-H1N1 influenza was effective in containing the epidemic. A comprehensive (human and animal) pandemic preparedness plan will benefit from moving from a response approach using emergency instruments to one that favors preventive risk reduction and risk management through regular country program and operations. High-risk groups can only be reached through an intense communication effort. Despite a short preparation period, it is important to avoid having tunnel vision and think broadly when designing emergency loans. The execution of projects within existing technical and administrative structures has significant positive externalities. A result-based financing (RBF) model is a valuable strategy to influence subnational government policies in federal systems. The World Bank should re-evaluate the objective of the emergency recovery loan instrument and its consistency with other fiduciary policies.
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Implementation Completion and Results Report 89199 JUN 25, 2014
The purpose of drafting this plan is to, through implementing the policy of prioritizing prevention and comprehensive control, to set up ten to twenty exemplary demonstration bases, introduce the conception of integrated pest management (IPM), offer IPM technique technologies trainings for farmers, grass-roots agricultural technique technologies cohorts and staff from the project office, and widely exercise large scale prevention and control against plants pests plant pests and animals diseases animal diseases.
... See More + The pests prevention and control should cut the outbreak by more than 90 percent, the utilized dosage of pesticides by over 30 percent, and the usage of chemical drugs in the core green exemplary demonstration areas by above 50 percent. We hope the average mortality of sheep and beef cattle can be lowered by 2 percent and 4 percent respectively compared with the level prior to this project. The foot-and-mouth disease and parasites among other animals epidemics of sheep and beef cattle must also be effectively contained, with certain localities reaching purification standards. Such major zoonoses as Brucella should be substantially curbed, while the prevention capacity against imported epidemics must be significantly enhanced.
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The development objective of the Guizhou Rural Development and Poverty Alleviation Project for China is to develop and implement models for agricultural sector restructuring and modernization, improved organizational arrangements, and strengthened public service delivery in Guizhou's poverty stricken areas which increase rural income in an equitable and socially acceptable way.
... See More + Some of the negative impacts and mitigation measures include: To properly settle down the problems caused by the project on the society, economy and environment and make sure the environment within the project area can meet the functional requirements of the environment; to control soil erosion due to the destruction of vegetation and soil excessive use of resources, and agricultural chemical pollution, maintain the integrity of the ecosystem, ecological balance and diversity as well as protect the rare and endangered species and ancient woods with great value; to control the emissions of noise, waste water and solid waste during the construction and operation period, and protect the air, sound and water in the surrounding environment; to meet the planting and aquaculture planning of agriculture, forestry, animal husbandry and protect the farmland, woodland and grassland in the protected areas; to respect local customs in ethnic minority areas, and protect minority activities, nature reserves, drinking water source, scenic areas, heritage areas, world heritage sites and forest parks from destroy.
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The development objective of the Guizhou Rural Development and Poverty Alleviation Project for China is to develop and implement models for agricultural sector restructuring and modernization, improved organizational arrangements, and strengthened public service delivery in Guizhou's poverty stricken areas which increase rural income in an equitable and socially acceptable way.
... See More + Some of the negative impacts and mitigation measures include: To properly settle down the problems caused by the project on the society, economy and environment and make sure the environment within the project area can meet the functional requirements of the environment; to control soil erosion due to the destruction of vegetation and soil excessive use of resources, and agricultural chemical pollution, maintain the integrity of the ecosystem, ecological balance and diversity as well as protect the rare and endangered species and ancient woods with great value; to control the emissions of noise, waste water and solid waste during the construction and operation period, and protect the air, sound and water in the surrounding environment; to meet the planting and aquaculture planning of agriculture, forestry, animal husbandry and protect the farmland, woodland and grassland in the protected areas; to respect local customs in ethnic minority areas, and protect minority activities, nature reserves, drinking water source, scenic areas, heritage areas, world heritage sites and forest parks from destroy.
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The development objective of the Guizhou Rural Development and Poverty Alleviation Project for China is to develop and implement models for agricultural sector restructuring and modernization, improved organizational arrangements, and strengthened public service delivery in Guizhou's poverty stricken areas which increase rural income in an equitable and socially acceptable way.
... See More + Some of the negative impacts and mitigation measures include: To properly settle down the problems caused by the project on the society, economy and environment and make sure the environment within the project area can meet the functional requirements of the environment; to control soil erosion due to the destruction of vegetation and soil excessive use of resources, and agricultural chemical pollution, maintain the integrity of the ecosystem, ecological balance and diversity as well as protect the rare and endangered species and ancient woods with great value; to control the emissions of noise, waste water and solid waste during the construction and operation period, and protect the air, sound and water in the surrounding environment; to meet the planting and aquaculture planning of agriculture, forestry, animal husbandry and protect the farmland, woodland and grassland in the protected areas; to respect local customs in ethnic minority areas, and protect minority activities, nature reserves, drinking water source, scenic areas, heritage areas, world heritage sites and forest parks from destroy.
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Disease risks to humans, animals, and plants are determined by interconnected environmental variables that affect incidence, transmission, and outbreak.
... See More + Climate change affects many of the environmental variables that lead to disease. Regardless of the species involved, the impacts can ultimately affect the health, livelihood, and economic security of humans. The objective of this World Bank economic and sector work is to build on scientific and operational knowledge of early action tools to help practitioners reduce the risks of key climate-sensitive infectious diseases by strengthening risk management systems for disease outbreaks. The report includes an assessment of known interventions such as the establishment of surveillance systems, the development of region and nation-specific disease outlooks, the creation of climate-sensitive disease risk maps, and the construction and implementation of early warning advisory systems. This research highlights the need for better understanding of the evolving interactions between the environment and emerging and reemerging disease pathogens. It also points to the inseparable interactions between animal health and human health, which climate change appears to be reinforcing and even diversifying. The assessment looks at investments that can lead to the development of these tools, working toward reducing global climate-sensitive disease risk. Because of the breadth of species affected by climate-sensitive disease, it has been helpful to select a model through which the specific impact of climate change and disease can be traced. In this instance, livestock has been chosen, given its significant global presence, economic importance, and susceptibility to disease outbreak. The livestock sector plays a vital role in the economies of many developing countries. Globally it accounts for 40 percent of agricultural gross domestic product (GDP).
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Working Paper (Numbered Series) 84956 APR 01, 2014
The development objective of the Zoonoses Control Project for Nepal is to enhance the country capacity for the prevention and control of infectious diseases that transmit between animals and humans (zoonoses) under a one health approach.
... See More + This restructuring paper, therefore, creation of a new category 'Compensation' for reallocation of USD 886,000 from category 'Training' to the newly established category.
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The development objective of the Zoonoses Control Project for Nepal is to enhance the country capacity for the prevention and control of infectious diseases that transmit between animals and humans (zoonoses) under a one health approach.
... See More + This restructuring paper, therefore, creation of a new category 'Compensation' for reallocation of USD 886,000 from category 'Training' to the newly established category.
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