Bureau of Public Affairs
November 28, 2007
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 (HPA) H5N1 virus in birds occurred in Russia in July 2005. Since then, outbreaks of HPAI H5N1 have affected wild birds, backyard domestic and commercially raised poultry in more than 20 countries in the region. Human infections with HPAI H5N1 have so far been confirmed in two countries: 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 June 2007, the United States:
- Committed $19.3 million in bilateral assistance to fourteen countries in the region; and
- Dedicated more than $3.1 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 (USA D), 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) and the National Institutes of Health (NI H) -- 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 non-pharmaceutical commodities, including PPE , laboratory 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);
- 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 450 government, private and university veterinarians on diagnostics, control, eradication and containment of highly pathogenic avian influenza in Bulgaria (USDA, USAID);
- Conducting (through WHO and FAO) tabletop simulations to test national pandemic preparedness plans throughout the region (USAID);
- 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" (DOS);
- Promoting private-public partnerships to regulate and contain animal disease through pilot initiatives 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 sites in Turkey where there has been an outbreak and 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 to regional journalists and training journalists to report more accurately on the disease in Armenia, Azerbaijan, Bosnia and Ukraine (USAID);
- 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 to build awareness of avian influenza prevention (USAID);
- 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 to Georgia's pandemic preparedness plan (HHS/CDC).
SURVEILLANCE AND DETECTION
To assist Europe and Eurasia in building capacity for surveillance and detection, the United States has provided the following:
- Expanding regional disease surveillance and response capacity through risk mapping, wild bird surveillance, establishing hotlines, engaging community-based surveillance systems, training for virus detection and sample collection, and setting up referral systems in veterinary services (USAID, USDA, DOD);
- Training officials, veterinarians, epidemiologists and laboratory diagnosticians in nine countries in surveillance methodology, virus detection, diagnostics and sample-shipping procedures (USAID);
- Upgrading national, regional and academic laboratories in Azerbaijan, Romania, Russia, Turkey and Ukraine;
- Providing diagnostic equipment and supplies including rapid diagnostic test kits to eleven countries. (A real-time PCR donated to Romania increased the capacity of a Tulcea laboratory to detect the H5N1 virus by 50 percent.) (HHS/CDC, USDA, DOD, USAID);
- Providing U.S.-based diagnostic training programs to fourteen scientists from six countries (USDA);
- Placing a senior medical advisor in Kazakhstan for two years to support the CDC Central Asia regional office and provide country and regional influenza and avian/pandemic influenza capacity building (HHS/CDC);
- Conducting a needs assessment in Azerbaijan to identify capacity/capability gaps to target HHS/CDC technical and bilateral assistance better (HHS/CDC);
- Funding a workshop for 230 participants from thirteen countries to provide technical assistance in influenza and avian/pandemic influenza surveillance, epidemiology, rapid diagnostics, clinical management of cases, containment and vaccine development strategies (HHS/CDC);
- Providing grantsmanship training for CDC cooperative agreement grantees in Armenia, Georgia, Kazakhstan, Romania, Turkey and Ukraine (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);
- Providing CDC-produced guidelines for building surveillance systems to all CDC European and Eurasian grantees (HHS/CDC); and Providing support for surveillance activities in Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Bulgaria, Georgia, Macedonia, Moldova, Romania, Russia, Turkey and Ukraine, including capacity building and training supported by the U.S. Naval Medical Research Unit No. 3 (NAMR U-3) in Cairo (DOD, HHS/CDC, USAID).
RESPONSE AND CONTAINMENT
To help Europe and Eurasia cope with avian and possible pandemic influenza outbreaks, the United States is:
- Providing essential commodities including PPE , decontamination kits and laboratory kits to ten countries and training in the use of these commodities in six countries (USAID);
- Expanding human influenza response capacity, including infection control capacity, in Armenia, Azerbaijan, Bulgaria, Georgia, Romania, Russia, Turkey and Ukraine through establishing protocols and procedures for health care providers and for hospital infection control (Romania) (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);
- Providing support, including technical assistance, to twelve countries for avian influenza containment and response to animal disease, including training in safe culling, establishing a quarantine, and sample collection and transport (USAI D);
- Providing epidemiology training programs to scientists from Azerbaijan, Belgium, Bosnia and 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 GOARN teams to conduct 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.