Food Safety Supply Chain Conference Washington DC

1. Food Safety Supply Chain Conference Washington DC 11th October 2006 David Nabarro

2. Presentation • Links between World Health and Food Safety • Avian Influenza Global Situation • Highly Pathogenic Avian Influenza • Threat of human influenza pandemic • Avian Influenza in Egypt • Challenges faced by Food industries • Ways to get results that benefit all of us • Acknowledgements: Government of Egypt, FAO (Anni McLeod and Jemi Domenech), WHO, UNICEF

3. Three Kinds of Influenza Seasonal Influenza “The Flu” Avian Influenza “Bird Flu” Pandemic Influenza “A Pandemic”

4. and FAO Map courtesy of FAO using data from OIE

5. Map prepared By US Government MYANMAR

6. Global Avian Influenza Situation: What is happening now? • Continued outbreaks in birds and human cases in Indonesia • New outbreaks in the last few months of H5N1 have been confirmed in China, Thailand, Egypt Nigeria and Laos • Human cases reported from Thailand and Egypt • Bird Migration Zones – the cycle continues • Unregulated Trade – an important source of spread • Efforts to encourage safe poultry rearing and healthy human behaviour – in commercial sector and backyard • Pandemic preparedness work throughout the world

7. Sporadic Human Cases of Avian Influenza • Human infection with H5N1 is rare, and usually the result of virus transmission from birds to humans. • Since 2003 H5N1 has infected over 240 people • More than 140 have died, mostly children and young adults. • Human deaths have been confirmed from: Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Thailand, Turkey and Vietnam. • Vietnam (42) and Indonesia (46) account for more than 80 of the total deaths. • No evidence of mutation to sustained human to human transmissibility

8. DETERMINANTS OF PANDEMIC INFLUENZA A new influenza virus emerges to which the general population has little/no immunity The new virus must be able to replicate in humans and cause disease NOT TO DATE The new virus must be efficiently transmitted from one human to another

9. What is the current threat level? UN System Influenza Coordination

10. Economic Impact of Next Pandemic • The next influenza pandemic will start with local outbreaks but will have global impact • Compare with SARS - <1000 dead, $50 billion economic loss. • It could lead to significant loss of life and high absenteeism in all sectors • The IMF suggests a significant temporary impact • markets closed, unreliable utilities and telecoms, cash shortages • Reduced travel and leisure, impact on food industry • There may be threats to Rule of Law, Security, and Continuity of Governance

11. 2 Avian Influenza Case Study – Egypt

12. Egypt 1: Current Situation Dramatic increase in chicken farming Increased availability of low cost chickens 40,000 farms and nearly a billion chickens Two million persons employed First farm with H5N1 Influenza 16 Feb 2006 Information public 17 February 2006 3 governorates affected. H5N1 reported in 21 governorates, 107 districts. 859 farms and 167 backyards affected. 14 confirmed human infected cases, 6 fatalities Chicken production greatly reduced. Many chicken farmers destitute, seeking work

13. Alexandria Kfr elShaikh Gharbia Menofia Damitta Dakahlia Behera Portsaied Ismaillia Matroh Sharkia Qualiobia N Sinai Cairo Giza Suez Faiom S Sinai Banisoif Menia Assuit RedSea Sohag Quena Luxor Aswan NewVally Egypt 2: Location of AI infection * Established in 22 Governorates, 822 Villages,24 Positive site from 7581 Samples taken allover these Governorates

15. Egypt 3: Reporting of Infected Foci Distributed (Feb. – June 2006)

16. Significant initiatives undertaken at Central Government and Governorate level • Programme to improve bio-security and surveillance in poultry farms has started, systematic vaccination is being introduced, restocking linked to bio-security • Improved bio-security is in the interests of the producers • Need for veterinary specialists to exercise strong supervision. • Effort to increase control over movements of live poultry within and between governorates. • Effort to reduce live chicken markets, encourage more hygienic handling of live poultry and discourage the slaughtering of birds at home • Effort to Increase bio-security for backyard chickens (education and legal provisions) • Mass communication campaigns being developed (recognizing importance of poultry and AHI control). Egypt 4: Actions and Challenges

17. Six Success Factors Six factors for national success in control of Avian Influenza: • Consistent high level political engagement and direction, • Procedures, systems and finance for rapidly scaling up implementation of priority actions, • Strong risk analysis, information dissemination and communication systems to encourage compliance with reporting and social mobilization, • Mechanisms to sustain vulnerable livelihoods and relieve distress, • Strategic alliances across all levels of government, that engage private and voluntary sectors, and • Management systems that engage all stakeholders, encourage synergy, analyze progress review results and shift program emphasis when necessary. Plus – coordination and synergy of external support (donors, World Bank, UN system)

18. Key International Bodies • International Partnership on Avian and Pandemic Influenza (launched by US Government Sept 05) • United Nations General Assembly • Food and Agriculture Organization • Crisis Management Centre • Regional Centres (Bangkok. New Delhi, Bamako, Gaborone, Nairobi, Budapest, Buenos Aries) • Monitoring and Risk Assessment • World Organization for Animal Health (oiE) • Standards for animal health • Reporting systems • Response strategies

19. Key International Bodies • World Health Organization • Revised International Health Regulations • (agreed May 2006) • Epidemic and Pandemic Alert and Response Team • Global Outbreak Alert and Response Network • Other United Nations Bodies (UNICEF, UNDP, WFP, OCHA, UNHCR) • Inter-agency Humanitarian Committee (IASC)

20. 3 Avian Influenza: overall market impacts

21. Markets HPAI Human behaviour Human wellbeing Markets, disease, human behaviour tightly interlinked...

22. Demand for poultry has driven a rising market share.... Poultry: 40% of Share 22% of Share

23. 3.1 Market Factors

24. Poultry prices in 2003 were low.... Asia/ Russian Crisis Avian flu

25. Recent AI outbreaks have led to fall in global poultry consumption.... US export prices rose to record levels in Oct 2005, but dropped 13% by the end of the year.

26. AI has shifted export patterns...

27. Some National markets have experienced severe shocks….. • IRAQ, only 50 out of 500 semi-commercial farms continued operating • EGYPT, the poultry industry is reported to have lost 30% of its numbers and 35% of its value • INDIA reported consumption drops of 25%, causing a 12-13% fall in domestic prices • BRAZIL, the price of day old chicks fell by 50% although there has been no outbreak

28. 3.2 The effect of human behaviour

29. Market shocks are caused by consumer perceptions of risk....... • ITALY: one outbreak, consumption fell by 70% • NEPAL: no outbreaks, but falling demand in local poultry markets • MAURITANIA: after an outbreak in Nigeria , poultry prices dropped to 52% of their former level • MIDDLE EAST SHOCKS ARE OUT OF PROPORTION TO RISK

30. Continued risky behaviour from producers, traders.... • Poultry sales continued from affected areas while outbreaks were in progress, in spite of movement bans • Wild birds are still being illegally traded • Some live-bird markets have upgraded their biosecurity, using a mixture of “stick” and “carrot”.

31. 3.3 The effect on human wellbeing

32. Loss of assets and income.... • Total losses are greatest for industrial and large commercial producers, but... • Owners of scavenging flocks are least likely to be compensated for loss. • Small commercial producers lose a major asset and are unable to repay debts.

33. Market barriers raised.... • Biosecurity measures taken in Vietnam have caused market chains to change shape, excluding smallholder producers of chickens and ducks. Contract farmers were protected during the 2003-4 outbreaks, but now find it harder to comply with requirements. • If small farmers can no longer meet biosecurity demands, small traders and input suppliers will be affected • The challenges is for the small farmers and large producers to work as one on the threat

34. 3.4 What might the future hold?

35. POSSIBLE FUTURES Consumer confidence is restored, but disease continues to spread, trade bans continue. Demand rises but sources of supply are limited. Prices rise short term, market balance restored longer term? HPAI continues to spread, consumer confidence in poultry remains low. Demand and supply fall. Long term projections change, shift in favour of other protein? Consumer confidence is restored, disease freedom restored in compartments or zones. Trade is restored while disease is gradually brought under control. Long term total market projections affected very little?

36. Can we lessen the negative impacts? Restore trade more quickly • Creative approaches to disease freedom e.g. compartmentalisation • Effective rapid response mechanisms to deal with outbreaks • Compartments will only work if there is transparency: “timely dissemination of all relevant information about AI outbreaks”

37. 4 An emerging consensus

38. Health Security in the face of Animal Disease • 70 percent of new human infections will come from the animal kingdom. • Defense against these threats must be built in both the animal and human health sectors • Livestock production must demonstrate priority for healthy products

39. Health security as demands for livestock products increase • Urbanization, increases in disposable incomes and dietary changes create an increase in the demand for animal production. • Safe food is a key to health and nutrition; producing safe food will bring increasing benefits to the consumer • Being known as a producer of safe food benefits those working in production (often very poor people)

40. Animal Health Standards a key element of human health security • The demand for livestock products will be sustained if consumers are confident that animal health standards are applied. • This means veterinary services that work, health regulations (like OiE) that are universally applied especially in trade. • Safe on-farm and post-farm production, food preparation and storage contribute directly to better human health and well being.

41. The current problem: • The current epizootic of Highly Pathogenic Avian Influenza has exploded dramatically across the world in a very visible manner. The risk of an influenza pandemic is real. This affects public confidence and minimize the likelihood of poultry flocks being affected by influenza viruses. “Keep the demand dip as short as possible”.

42. The reality for Producers: • Poultry industries are expected to continue to expand rapidly in most countries for the next two decades. Will this expansion be affected by lack of public confidence in the safety of the product? Or can consumers, producers and retailers learn to live with H5N1.

43. The potential reward • The epizootic of H5N1 can be brought under control if poultry production and marketing is made safer. This means introducing sound hygiene, biosecurity, testing, certification and consumer education measures throughout the production and marketing chain.

44. A Common Priority: Mobilizing for Health Security

45. Wash hands thoroughly with soap frequently Cover coughs and sneezes Wear a mask if symptomatic Don’t spit! Promote 4 actions now! ‘Street-wise’ hygiene campaign

46. Conclusion • No simple answers to any of the continuing challenges we all face • The eyes of many are on us • It is imperative that we work together to address these challenges, engaging communities, private entities, different levels of government, political leaders, international community as we do it • We depend on Alliances in which we can discuss these issues and review how we are getting on without fear of attack and recrimination • We need to sustain alliances at local national and global levels. They will enable us to move together as one