Bureau of Public Affairs
October 25, 2008
U.S. Government Support to Combat Avian and Pandemic Influenza -- Europe and Eurasia PDF version
Europe’s first outbreak of the highly pathogenic avian influenza (HPAI) H5N1 virus in birds occurred in Russia in July 2005. Since then, outbreaks of HPAI H5N1 have affected domestic or wild birds in more than 20 countries in the region, with recent outbreaks in Germany, the U.K., Poland, Russia, Ukraine and Turkey.
Human infections with HPAI H5N1 have so far been confirmed in Azerbaijan and Turkey, both in 2006. There were eight confirmed human cases and five deaths in Azerbaijan, and twelve confirmed cases and four deaths in Turkey. Millions of domestic birds have been culled in the region, at significant economic cost.
As of December 2007, the United States had committed $28.9 million in bilateral assistance to sixteen countries in the region and dedicated more than $8.8 million to regional assistance programs. The United States combats HPAI H5N1 in European and Eurasian nations by working with governments and regional entities, and with international organizations, such as the World Health Organization (WHO), the Food and Agriculture Organization (FAO), UNICEF, the World Bank and the World Organization for Animal Health (OIE). Through the International Partnership on Avian and Pandemic Influenza, the United States works to elevate the issue on national agendas – and to coordinate efforts between affected nations in the region and donors around the world.
The activities of the U.S. Agency for International Development (USAID), the U.S. Department of Agriculture (USDA), the U.S. Department of Health and Human Services (HHS) – including the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Food and Drug Administration (FDA) -- the Department of Defense (DoD), including the Global Emerging Infection Surveillance and Response System (DoD-GEIS), represented by the Naval Medical Research Unit-3 (NAMR U-3) -- the U.S. Department of State (DOS), and the Broadcasting Board of Governors (BBG) focus on strengthening preparedness and response planning, building regional capacity in human and animal health, strengthening laboratory diagnostics, increasing public awareness and information, and enhancing disease surveillance and detection. The U.S. Department of Defense (DoD) also provides medical technical assistance and has purchased personal protective equipment (PPE) for combatant command use in military-to-military and international humanitarian assistance globally. USAID has deployed nonpharmaceutical commodities, including PPE, lab investigation kits and decontamination kits throughout the region.
PREPAREDNESS AND COMMUNICATION
U.S. assistance efforts to Europe and Eurasia for preparedness and communication include:
- Placing mid- to long-term avian influenza advisors in five regional countries and providing technical assistance to all high-priority regional countries (USAID);
- Assigning an influenza expert to the European Centre for Disease Prevention and Control (ECDC) in Stockholm (HHS/CDC);
- Supporting national pandemic preparedness plans and strategy development in fourteen countries through technical assistance, training, regional and U.S.-based conferences, and simulations (USAID, USDA);
- Training over 600 government, private, and university veterinarians on diagnostics, control, eradication and containment of highly pathogenic avian influenza throughout the region (USDA, USAID);
- Conducting (through WHO and FAO) tabletop simulations to test national pandemic preparedness plans throughout the region (USAID) and a tabletop/field exercise in Bulgaria using real-life, complex response scenarios (USAID, USDA);
- Sending a public health expert to Ukraine to provide influenza information to medical students and faculty, emergency response officials, epidemiologists and the media (DOS);
- Sending a USDA expert to Azerbaijan and Turkey to address animal health audiences (DOS/USDA);
- Producing Russian, Albanian, Georgian and Azeri versions of the PBS documentary “Killer Flu” for foreign broadcast (DOS);
- Bringing seven Azerbaijani influenza professionals to the U.S. to meet with experts in avian and pandemic influenza, education and communications (DOS);
- Promoting private-public partnerships to regulate and contain animal disease in Armenia, Georgia and Romania (USAID);
- Funding WHO activities in Albania, Armenia, Bulgaria, Romania and Russia to support human health surveillance, and to develop infection control protocols, in-country coordination and preparedness activities (USAID);
- Contributing (through support to the World Bank) to a pilot project to ensure the safe re-introduction of poultry into affected sites in Turkey following extensive culling (USAID);
- Broadcasting news on avian and pandemic influenza on the Voice of America (VOA) and Radio Free Europe/Radio Liberty in Albanian, Armenian, Bulgarian, Russian and Ukrainian (BBG);
- Maintaining area-specific web pages on VOA websites with up-to-date information on avian and pandemic influenza news and prevention efforts (BBG);
- Providing information on avian influenza and offering training in health reporting to journalists in Armenia, Azerbaijan, Bosnia and Ukraine (USAID);
- Consulting with WHO, ministries of health, and other stakeholders to develop specifications and regulations for a proposed H5N1 vaccine stockpile (HHS/FDA);
- Working with partners to ensure the availability of laboratory materials to identify influenza viruses with pandemic potential (HS/FDA);
- Building awareness by developing and testing avian influenza communications plans, materials and messages distributed through puppet shows, posters, public service announcements, national logos, brochures, posters and radio spots in eleven countries (USAID);
- Delivering an HPAI epidemiology workshop for 30 veterinary officials and the private sector in Turkey (USDA);
- Providing on-site technical assistance to Armenia, Georgia, Romania, Turkey and Ukraine to apply for funds to develop national pandemic preparedness plans that reflect appropriate science and providing guidance for preparing and responding to a potential pandemic (HHS/CDC); and
- Reviewing and providing comments on Georgia’s pandemic preparedness plan (HHS/CDC).
SURVEILLANCE AND DETECTION
The United States has assisted Europe and Eurasia in building capacity for surveillance and detection by:
- Expanding regional disease surveillance and response capacity through risk mapping, wild bird surveillance, hotlines, community-based surveillance systems, training for virus detection and sample collection, and setting up veterinary referral systems (USAID, USDA, DoD-GEI S/NAMR U-3);
- Training officials, veterinarians, epidemiologists and laboratory diagnosticians in nine countries in surveillance methodology, virus detection, diagnostics and sample-shipping procedures (USAID);
- Upgrading laboratories in Azerbaijan, Romania, Russia, Turkey and Ukraine and providing diagnostic equipment and supplies including rapid diagnostic test kits to eleven countries (HHS/CDC, USDA, DoD-GEI S/NAMR U-3, USAID);
- Providing technical support for laboratory-based surveillance on causes of acute fever in Azerbaijan and Georgia (HHS/CDC);
- Providing U.S.-based diagnostic training programs to fourteen scientists from six countries (USDA);
- Funding a workshop for 230 participants from thirteen countries to provide technical assistance in influenza surveillance, epidemiology, rapid diagnostics, clinical case management, containment and vaccine development strategies (HHS/CDC);
- Providing grants to the WHO European regional office to assist in regional technical assistance and training, including rapid- response training, laboratory diagnostics, pandemic planning, health risk communications, surveillance and epidemiology (HHS);
- Conducting HPAI laboratory diagnostic workshops for 40 official and private veterinary personnel in Turkey (USDA);
- Providing CDC-produced guidelines for building surveillance systems to all CDC European and Eurasian grantees (HHS/CDC); and
- Supporting surveillance activities in 14 European countries, including capacity building and training assisted by the U.S. Naval Medical Research Unit No. 3 (NAMR U-3) in Cairo (DoD-GEI S/NAMR U-3, HHS/CDC, USAID).
RESPONSE AND CONTAINMENT
To help Europe and Eurasia cope with avian and possible pandemic influenza outbreaks, the United States is:
- Delivering essential commodities including PPE, decontamination kits and laboratory kits to ten countries and providing training in their use in six countries (USAID);
- Expanding human influenza response capacity, including infection control capacity, in the region by establishing protocols and procedures for health care providers and for hospital infection control (USAID);
- Conducting integrated rapid-response team training for epidemiologists, veterinarians, laboratory personnel and infection control specialists in all high-priority countries, with plans to extend training to regional and district levels (USAID);
- Supporting twelve countries in avian influenza containment and response to animal disease, including training in safe culling, establishing a quarantine, and sample collection and transport (USAID);
- Providing epidemiology training programs to scientists from Azerbaijan, Belgium, Bosnia-Herzegovina, the Czech Republic, Kosovo, Portugal, Serbia, Spain and Turkey (USDA);
- Conducting live bird market training programs for Romania (USDA);
- Providing technical and financial assistance to respond to avian influenza in Azerbaijan, Romania and Turkey (USAID);
- Deploying staff to Romania and Turkey in response to requests from health ministries, WHO and the Global Outbreak and Alert Response Network (GOARN) (HHS/CDC);
- Launching a fact-finding mission to Armenia, Azerbaijan, Georgia, Turkey and Ukraine in the wake of avian influenza outbreaks in Turkey (DOS, HHS/CDC, USDA); and Participating with the Global Outbreak Alert and Response Network (GOARN) teams in conducting avian influenza preparedness assessments in Armenia, Azerbaijan, Georgia and Ukraine (HHS/CDC).
The U.S. Government’s official website on avian and pandemic influenza is www.pandemicflu.gov.
This region encompasses: Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Holy See, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Macedonia, Malta, Moldova, Monaco, Montenegro, Netherlands, Norway, Poland, Portugal, Romania, Russia, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, Ukraine and the United Kingdom.