A severe pandemic would harm health, economies, and communities in all countries, but especially in poor and fragile states. Pandemic prevention requires robust public health systems (veterinary and human) that collaborate to stop contagion promptly.
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Thanks to contributions from the European Commission and nine other donors, the Avian and Human Influenza Facility (AHIF) financed a transformational project that is key to development and health secu... Show More +rity. The World Health Organization (WHO) and the World Organization for Animal Health (OIE) worked closely together, with support from AHIF, to develop and refine their tools for assessing human and veterinary public health systems and to develop an accompanying joint WHO-OIE guide. This project, the last financed by AHIF, was successfully completed on schedule this year. The international community now has critically-needed assessment tools that work across the human and animal health sectors. Only robust public health systems in all developing countries can reduce the global risks of antimicrobial resistance (AMR), pandemic influenza, Middle East respiratory syndrome (MERS), and other conditions. The achievements of this project are very relevant and timely because these risks are high and rising, and the impacts could be catastrophic. AHIF thus not only effectively responded to H5N1 avian flu and H1N1 pandemic flu, but it deserves credit for financing the basis to strengthen public health systems in the medium term, which will reduce risks in the future. In our interconnected world, where a dangerous novel pathogen can travel from a remote village in a poor country to cities on all continents in 36 hours, robust public health systems in all countries are a priority for the global community.The project took advantage of the good experience with OIE’s Performance of Veterinary Services (PVS) assessment program and the lessons that WHO has learned in overseeing implementation of the International Health Regulations (IHR). Close collaboration between the two sectors is necessary because many infectious diseases of humans originate in animals, and their spread does not stop at borders. Indeed, 75% of infectious diseases in humans are now of animal origin (zoonotic). Every year, poor people in developing countries suffer the impact of 2.3 billion zoonotic infections. Moreover, weak public health systems in some countries increase the risks of globalized contagion and antimicrobial resistance; when a country does not check the spread of pathogens in time, all countries are at risk. The tools produced by this project will help countries determine where the gaps are in the performance of their systems relative to international standards, and assess the costs of investments and other measures that are required for compliance. All countries should be able to detect diseases early, assess and report them correctly, and respond to them effectively. Thanks to this project, every developing country will be able to set out its investment program to close the worst - most dangerous – gaps. The World Bank and other partners can support this investment program, confident that the assessments are comprehensive, thorough, and technically robust.On behalf of the World Bank, Juergen Voegele (Director, Agriculture) and Timothy Grant Evans (Director, Health) welcomed the completion of the joint OIE-WHO project. They emphasized use of One Health approaches, promptly sharing information and jointly analyzing risks and response effectiveness. The tools for assessments of the veterinary and human public health systems and the bridges between them are clearly needed to guide improvement in capacities of public health systems to prevent and control diseases, including those that can become pandemics. The tools will enable smooth implementation of One Health approaches, consistent standards across countries, and badly-needed investments in essential public health capacity. WHO and OIE presented the tools at a joint meeting in Geneva on April 17, 2014. In this short video, Juergen Voegele and Tim Evans highlight the importance of this project and its results for public health in the 21st century: http://streaming2.worldbank.org:8080/vvflash/hdn1 Show Less -
As part of its contribution to the global community's response to avian and pandemic influenza threats, from 2006 to 2009, the World Bank offered a series of inter-regional distance learning seminars ... Show More +using its Global Development Learning Network. These seminars promoted discussion of topics relevant to pandemic preparedness and One Health. Institutions, governments, technical agencies, donors, nongovernmental organizations, and other stakeholders exchanged knowledge, reviewed progress in specific countries, and shared experiences and good practices and lessons that have been learned. Select videos are posted below.The Importance of Integrated Country Programs in the Fight Against Avian and Human Influenza – July 2006Communications Planning – September 2006Compensation Policies: Issues and Good Practice – February 2007 Show Less -
Created in 2006, the Avian and Human Influenza Facility (AHIF) helps developing countries minimize the risk and socioeconomic impact of avian influenza and other zoonoses and of possible human pandemi... Show More +c influenza. The AHIF is led by the European Commission and supported by the governments of Australia, China, Estonia, Iceland, India, Korea, Russian Federation, Slovenia and the United Kingdom. The trust fund is administered by the World Bank.As of March 2013, the AHIF and the World Bank together had provided $1.3 billion for 72 operations in 60 countries; eight operations are ongoing but will close within two years.Trust Fund Quarterly ReportsPeriod, January 1 - March 31, 2013Period, October 1 - December 31, 2012Period, July 1 - September 30, 2012Period, April 1 - June 30, 2012Period, January 1 - March 31, 2012Period, October 1 - December 31, 2011Period, July 1 - September 30, 2011Period, April 1 - June 30, 2011Period, January 1 - March 31, 2011Period, October 1 - December 31, 2010Period, April 1 - June 30, 2010Period, January 1 - March 31, 2010 Show Less -
CONTEXTA pandemic is a global disease outbreak that represents a top global catastrophic risk. Influenza (flu), for example, transmits readily and can spread fast. Every year, up to 500,00... Show More +0 people die from flu. In years when pandemic flu occurs, the toll can rise well into the millions. The 1918 pandemic flu, the most severe of the four flu pandemics in the last 100 years, infected up to 40% of some national populations and killed 50-100 million people. Pathogens with pandemic potential continue to emerge, and most of them are of animal origin (zoonotic). During the past 10 years alone the world has witnessed, among others, H5N1 avian flu, H7N9 avian flu, and two kinds of coronavirus: severe acute respiratory syndrome- SARS and Middle East Respiratory Syndrome -MERS.The World Bank has estimated that a severe flu pandemic could result in $3 trillion in global economic losses, equivalent to 4.8% of gross domestic product (GDP). Most of the losses would not be caused by disease directly, but rather by consumer reactions, labor shortages and cascading failures in economic and financial sectors. The U.S. government has warned of the potential for a severe flu pandemic to impact global security and stability.Every year, 2.3 billion human infections occur in developing countries by zoonotic diseases, and 2.2 million die as a result. The burden on the poor is formidable, as they tend to live in close proximity to animals in communities with inadequate veterinary and human public health services. Such diseases diminish livelihoods, nutrition, food security, trade, and assets of poor households. Reducing this burden is a global development imperative. Increasing global pandemic prevention and preparedness is essential to achieve the global goals to end extreme poverty by 2030 and boost shared prosperity.Managing pandemic risk is important for developing countries. A severe pandemic would harm health, economies, and communities everywhere, but especially in poor and fragile states. Pandemic prevention requires robust public health systems (veterinary and human) to detect contagion early, ensure correct diagnoses, and respond rapidly to defend against contagion.The World Bank has estimated the cost of this essential, permanent, global infrastructure at $3.4 billion per year in all developing countries. The expected benefit is at least $37 billion per year, making such infrastructure a profitable use of public funds. The economic rates of return range from 50% to 123% per annum, depending on disease risk.Yet although the threat posed by avian flu and other zoonotic diseases remains, country and donor investments in pandemic prevention and preparedness have decreased markedly in recent years. Show Less -
ChallengeFollowing the outbreak of the new A/H1N1 Human Influenza strain in Mexico, the virus quickly spread into the Central America region. Nicaragua was among the more severely affected countries i... Show More +n the region, with more than 2,152 confirmed cases of the A/H1N1 Human Influenza, and eleven official deaths, when WHO declared a worldwide pandemic in 2009. Important constraints faced by Nicaragua at the time included uneven quality of services, limited laboratory, diagnostic and surveillance capacity, poorly trained staff and inadequate supply of drugs.SolutionProject design focused on reducing the risk of illness and case fatality, particularly among high-risk groups. Thereby a substantial part of the grant was invested in relevant drugs and a smaller part in the capacitation of human resources and facilities. What made this approach so interesting was the versatility of focusing on a number of essential drugs and not only on Influenza vaccines. In the end the pandemic was far less pronounced in Nicaragua than anticipated, but the grant still benefitted a very large segment of the population. An innovative feature was the procurement of drugs through the Pan American Health Organization’s (PAHO) revolving fund mechanism, which required a waiver for certain Bank operation policies, otherwise PAHO’s UN status would have prohibited the agency to enter a standard World Bank supply contract.ResultsThe Project’s main result was to strengthen the countries health system capacity and pandemic preparedness and response (between 2009-2012) by supporting the following improvements:Nicaragua’s epidemiologic emergency preparedness and surveillance capacity improved substantially, as reflected in the availability of appropriately equipped facilities, availability of relevant medicines in 100 percent of targeted facilities and trained personnel. The capacity of the Nicaraguan Health System to effectively treat secondary infections in the case of human influenza improved, as reflected by 31 hospitals with staff certified in Human Influenza AH1N1 control, and the number of health workers with training in diagnosis, treatment and care of influenza patients. The population is increasingly aware of preventive measures against. The measure increased by 33 percentage points during one year of project implementation, surpassing the target of 80 percent by 13 percentage points. This finding is partly attributable to the rollout of the Bank supported communication and prevention strategy.The extent of the effectiveness of these inputs to increase prevention, surveillance and emergency response is not yet measurable, although there are indications of improvement.The direct beneficiaries were people at high risk for secondary infection, like pregnant women, children and elderly people, but through prevention and treatment the Project benefitted the general population. Show Less -