I. AHI Globally and in Vietnam

1. Gov't-UN Joint Programme I. AHI Globally and in Vietnam • Worldwide, there have been 277 laboratory-confirmed cases and 167 deaths (WHO as of 1 March 2007) • Vietnam still the highest number of human cases (93) and second highest number of deaths (42) – but no human cases since Nov 2005 • Most concerning situation is Indonesia: 81 cases and 63 deaths, including 6 cases and 5 deaths already in 2007 • Recent human cases in Laos, Nigeria • Recent poultry outbreaks in a number of countries worldwide – including Vietnam • Has been noted recently that most cases are in people < 40 years old

2. Gov't-UN Joint Programme Recent outbreaks in Vietnam • December 2006: First poultry outbreak since December 2005 reported on 20 December (commenced 06 December) • Following this, outbreaks were reported in 8 Provinces in the Mekong Delta: Ca Mau, Bac Lieu, Kien Giang, Hau Giang, Soc Trang, Vinh Long, Tra Vinh and Can Tho • February 13: Vietnam declares the outbreak contained, after the required period of 21 days with no new cases – but warns that more outbreaks are possible in coming period • February 17: test results confirmed an outbreak in poultry in Hai Duong (Doan Tung Commune, Thanh Mien District)

3. Gov't-UN Joint Programme About the recent outbreaks • Many of the outbreaks have occurred in flocks raised since the last major round of vaccination • Many outbreaks have involved ducklings • By mid January 2007, almost all laboratory confirmed outbreaks except one had occurred in unvaccinated flocks, and the one exception was in a flock with a mixture of vaccinated and unvaccinated birds • Surveillance targeted on ‘high risk’ flocks across the country has shown significant levels of H5N1 positive ducks in several Northern / Central Provinces, including Quang Nam, Hai Phong, and Thai Binh • This week, Vietnam has also ended the ban on hatchings of ducks • The next major vaccination round is due to start in March

4. Gov't-UN Joint Programme II. VIETNAM’S NATIONAL PLAN and INTERNATIONAL SUPPORT Vietnam Integrated National Operational Programme for Avian and Human Influenza (OPI) 2006-2010 – a.k.a. “The Green Book” • Enhanced Coordination Activities: $31m • National Preparedness • Policy and Strategy Dev’t • Coordination including PAHI • Public Awareness • HPAI Control in the Agricultural Sector: $116M • Influenza Prevention and Pandemic • Preparedness in the Health Sector: $102m • TOTAL ESTIMATED COST $250m

5. Donor funding for Avian and Human Influenza (AHI) in Viet Nam Total ODA for AHI 2004-2008 $105m (actual and indications as of Nov 06) ODA channeled through UN System $28m Of this: • Through the Govt-UN JP $19.6m (70%) Direct funding to the JP $15.2m Parallel funding to the JP $4.4m • Other funding channeled through the UN $8.3m (30%) Gov't-UN Joint Programme

6. Gov't-UN Joint Programme Overview of OPI Financing • Estimated OPI budget $250m • Indication of expected Govt funding 50% • (central and provincial budgets) • Donor support $70m • (commitments/indications to date) • ODA financing gap (approx) $55m

7. Gov't-UN Joint Programme III. Partnership for Avian and Human Influenza (PAHI) Partnership Framework signed at the Government-Donor-NGO meeting on AHI on 1st November 2006 by: • MARD Minister on behalf of the National Steering Committee for Avian Influenza • 6 bilateral donors (Australia, Canada, Denmark, Finland, New Zealand, USA) and the EC • UN Resident Coordinator and Heads of UN Agencies • World Bank • ADB • INGOs and Research Organisations: PLAN, CARE, CRS, CIRAD

8. Gov't-UN Joint Programme Objectives of PAHI …to improve ODA efficiency as well as mutual accountability, the government and donors are establishing a voluntary PAHI in order to facilitate implementation of the Green Book as the medium-term country programme developed… …with the overall objective to reduce the health risk to humans from avian influenza by: • controlling the disease at source in domestic poultry, • detecting and responding promptly to human cases • preparing for the medical consequences of a human pandemic

9. Gov't-UN Joint Programme Functions of PAHI a forum for information sharing and exchanges with partners • annual high-level plenary meeting of PAHI members with the NSCAI • regular PAHI meetings (quarterly? seasonal focus?) • thematic working groups in support of OPI implementation • other meetings, conferences, workshops • information sharing within the PAHI membership & other stakeholders • newsletter • website • email list • sharing reports, publications, meeting minutes and other documents

10. Gov't-UN Joint Programme Functions of PAHI discuss recommendations to the NSCAI and donors on ODA priorities and allocations • overall financing plan and resource mobilization overview for the Green Book maintained: • comprehensive matrix of donor projects/programmes and financial support • financing plan with GoV investments and international assistance according to the Green Book costing lines • identification of financing gaps against the Green Book costing and emerging needs • annual high-level plenary meeting of PAHI members with the NSCAI to review financing and gaps

11. Gov't-UN Joint Programme Functions of PAHI facilitate monitoring and evaluation (M&E) of the overall national programme, particularly the ODA-funded parts • consensus on an overall M&E framework for the Green Book – based on review and further development of Annex I of the Green Book • discussions through PAHI and Thematic Working Groups on plans, progress, lessons learned and emerging issues for AHI in Viet Nam • consolidation and dissemination of regular (semi-annual) monitoring and evaluation reports on Green Book implementation - incorporating inputs from: • PAHI members • thematic working groups

12. Gov't-UN Joint Programme Functions of PAHI support Viet Nam to share information and experiences with other countries within the region and more widely • Forum and capacity support for sharing and consolidating lessons learned, monitoring and evaluation, research reports through PAHI members, TWG, etc • Enhanced capacity for information-sharing

13. Gov't-UN Joint Programme PAHI Structure: Information Sharing and Accountabilities Prime Minister National Committee for Influenza H5N1 in Humans (MoH) Focus on emerging diseases (initially SARS) National Committee for Avian Influenza (MARD Minister, MARD & MoH V-Ministers) Tasked with AHI donor coordination Donors and INGOs Research institutes National/International Business Sector National/International Mgmt Group (MG) Supervision by MARD & MoH Operational mgmt by MARD ICD PAHI Secretariat (in MARD) Prepares and implements the annual PAHI workplan Partnership for Avian and Human Pandemic Influenza (PAHI) GoV-UN JP (UNDP) Financial support and capacity building PAHI Forum information sharing, policy dialogue, harmonized M&E, review of funding for AHI Endorses and monitors annual PAHI workplan TWG technical info sharing TWG technical info sharing TWG technical info sharing Cooperation, Info sharing Reporting Funding Facilitation and Support

14. Gov't-UN Joint Programme Facilitation of PAHI • a small secretariat located in MARD • Operational management and accountability with MARD ICD • Day-to-day supervision by an assigned focal point from MARD ICD, with support from an assigned focal point in MoH ICD • Overall supervision by a small management group (MG) – proposed membership to include: • MARD and MoH International Cooperation Departments (ICD) • key technical departments of MARD and MoH • Department of Animal Health (DAH) • Vietnam Administration of Preventive Medicine (VAPM)

15. Gov't-UN Joint Programme IV. Joint Gov’t-UN Programme to fight HPAI • “Strengthening the Management of Public Health Emergencies in Viet Nam – with a focus on the Prevention and Control of Diseases of Epidemic Potential including Highly Pathogenic Avian Influenza (HPAI)” • Phase I: Emergency Support (October 2005 – July 2006) • Phase II: Capacity Building Support to OPI implementation (2007-2010) • VN Partners: National Steering Committee for Avian Influenza (NSCAI) • Ministry of Agriculture and Rural Development (MARD) • Ministry of Health (MoH) • Ministry of Education and Training (MoET) • Ministry of Culture and Information (MoCI) • UN Partners: FAO, WHO, UNICEF, UNDP

16. Gov't-UN Joint Programme Why a Joint Programme on AI? “What value does the UN system and a joint approach add to the response to avian and human pandemic influenza (AHI)?” • Brings together the different strengths, expertise and experience of UN agencies to support to the national response: • animal health and livestock • human health • public awareness and behavior change communications • overall coordination support • Brings together MARD and MoH into one programme – the first ODA-supported programme on AHI in Viet Nam to do this • Offers an effective multilateral channel for ODA support -- promoting donor harmonization and coordination, reducing transaction costs for Govt  a contribution to UN Reform and the Hanoi Core Statement

17. Gov't-UN Joint Programme • Phase II: Support to OPI Implementation 2006-2010 • Development of Phase II by Govt and UN agencies, based on the OPI MARD & FAO Animal health, livestock production Joint GoV-UN Programme Phase II MoH & WHO Health care, early warning and response UNICEF, MARD, MoH, MoET, MoCI Public awareness & behavior change MARD, MoH & UNDP Coordination, Partnership

18. Gov't-UN Joint Programme JP II Support toOPI Component 1: Enhanced Coordination Activities • TA for review of National Pandemic Plan, Animal Health and Human Health action plans/strategies • Develop and disseminate guidelines on infectious disease control (human), veterinary regulations and quarantine regulations • Support to coordination on animal health (DAH and RVCs) & Human Health (VAPM/MoH and provinces) • Support to Government-Donor coordination: PAHI Secretariat, thematic working groups, OPI monitoring and evaluation

19. Gov't-UN Joint Programme JP II Support toOPI Component 1: Enhanced Coordination Activities • Public awareness and information • Comprehensive Communication Strategy Development and Implementation • Capacity Building of Local Partners • Studies and Research Framework Development and Implementation • Monitoring and Evaluation, Documentation & Networking • Technical Assistance • * Support to Coordination of the AHI BCC Working Group

20. Gov't-UN Joint Programme JP II Support toOPI Component 2: HPAI Control/Eradication Agric. Sector • Strengthening veterinary services: develop and implement Field Epidemiology Training Programme (FETP); upgrade lab info network • Disease investigation and outbreak control: outbreak investigation teams (1,200 pilot communes), training, logistics and operating costs; training in culling; technical guidelines for bio-safe disposal of birds • Poultry Vaccination: support to mobilization costs, cold chain, etc. • Quarantine, movement and border control: training, logistical support, training on disposal of seized products • Risk analysis for AI: TA and training • Market and slaughterhouse surveillance • Poultry restructuring: TA and review of plans, provincial pilots

21. Gov't-UN Joint Programme JP II Support toOPI Component 3: HPAI Prevention & Pandemic Preparation in the Health Sector • Surveillance and early warning: continue support / TA to establish EWARS assess national surveillance system, coordination with animal health sector, IT system for surveillance information, capacity building, laboratory equipment, operational costs • Rapid response teams: training, logistics • Guidelines, training and logistics for border quarantine health personnel, cross-border meetings • Curative care system: capacity assessment • Infection control in hospitals: instruction manual and training • Field epidemiology training course (FETP)