|
Following is the text of the keynote
address by Dr. Anbumani Ramadoss, Union Minister for Health & Family
Welfare, today at the New Delhi International Ministerial Conference on Avian
and Pandemic Influenza:
“Welcome to incredible India and welcome to this almost
incredible conference. This conference
is momentous. It has woven so many of us
together into a world that is truly united in the fight against Avian and
Pandemic Influenza. When India hosted the Asia Conference on Avian
Influenza in June last year I had one apprehension. Were we being over zealous by engaging with
Avian and Pandemic Influenza so frequently?
One year down the line, our concern now is whether we all our doing
enough to keep the pandemic at bay.
The global threat of Avian &
Pandemic Influenza continues. Over 61
countries have experienced outbreaks of Avian Influenza since 2003. To date, millions of birds have been culled,
and the economic cost to the affected countries has been colossal. It is likely that the virus infections among
domestic poultry have become endemic in some parts of the world. While the number of people infected appears
small, the case fatality rate is very high with over 61% deaths. We will hear about these facts in greater
detail as we progress with the Conference.
But, the question we need to ask
upfront is whether as a global community we are really doing enough? We could all draw solace from the UN
System & World Bank Progress Report on the Global State of Influenza
Pandemic Readiness and Capacity to Control Highly Pathogenic Avian Influenza released
a few days ago. The report confirms
improvement in country responses to Avian Influenza. The report, however, also underscores the
need for greater effort in coordination of pandemic planning between countries.
This conference is a manifestation
of that much-needed ‘greater effort’. We
are indeed encouraged that more than 600 delegates from 105 countries and 20
international and inter governmental organizations have congregated here. We are immensely pleased to have with us seventy
ministers from the public health and animal health sectors. In a world that is so intrinsically
connected, avian & pandemic influenza can only be controlled if all
countries work towards this agenda. Any
country that lags in its efforts could become the weak link that negates the
consolidated efforts of the rest of the world.
We acknowledge that the capacities to respond to the threat of a
pandemic would vary from country to country, given the wide range of cultural,
economic and political differences. But
we must stand together and move forward as one, in our commitment and resolve
to fight this virus. We can collectively
achieve this by setting agreed-to milestones and work towards realizing them
with sincerity and transparency.
For example, most countries have
prepared their plans for responding to an outbreak of Avian and Pandemic
Influenza. India has clearly defined Action Plans
for both animal and human health. We
could agree that all of us will test these plans through mock drills or other
similar mechanisms periodically.
Similarly, we all agree that we need to build capacity for a sustained
response to the pandemic. We now need to
work towards actualizing this capacity.
In other words, it is now necessary for each country to develop its own
road map towards creating such a capacity with clearly defined milestones to
measure success and an action plan for doing so.
Before the conclusion of this
conference, India would share with all of you, its
vision of such a road map. I am sure that
you would find it to be a simple yet effective tool in creating national and
global capacity to resist and fight the threat of an avian influenza
pandemic. This vision for the road map
is based, amongst other things, on India’s experience in successfully
containing the outbreaks in 2006 and 2007.
I take pride in informing you that
during the avian influenza outbreaks in poultry, India maintained absolute transparency in
sharing information promptly. We did not
quibble over issues of pathogenocity of the virus nor about the fact that in
2007 the disease was confined and localized to a small farm of less than 150
birds in the north eastern part of the country.
The containment measures mounted by the Government of India in the
affected areas were greater than those known to be followed
internationally. For instance, given the
nature of the outbreak and the involvement of backyard poultry, India took a bold decision to cull birds
across a radius of 10 kms. in the 2006 outbreak. We were, therefore, able to revert to the
avian influenza free status within three to five months.
Prompt and reasonable compensation
has been the hallmark of our containment operations. Our National Action Plan
for Preparedness, Control & Containment of Avian Influenza, establishes the
framework for the compensation mechanism.
The Plan recognizes that the programme of culling of affected birds will
succeed only if a system of adequately compensating the poultry farmers is put
in place and activated immediately after the outbreak of Avian Influenza is
confirmed. The plan emphasizes that any expenditure incurred on compensation is
more than justified by way of bringing about effective control of the disease.
In addition compensation is paid for feed and feed materials destroyed in operations.
The Government of India paid more than US $19, 47,619 as compensation for
poultry and feed / feed material in 2006. More than US $2, 23,810 have been
paid for birds culled in the 2007 outbreak.
It is a matter of satisfaction that
during the outbreaks, both the concerned ministries - the ministries of public
health and animal husbandry worked in perfect co-ordination. The joint
monitoring mechanisms worked well and even on technical matters, both
departments shared their concerns on all key issues. I must also acknowledge
that in India, the lead role for handling the
outbreaks was played by the Deptt. of Animal Husbandry while the Public Health
Ministry played more of a supportive yet strategic role in providing
prophylactic cover of anti viral drugs to the cullers and labourers working in
the operations, with constant monitoring of their health status.
In India we recognize the importance of
these two sectors working together and we have continued to work as an extended
team for avian influenza. One of the
most significant achievements has been the modification of our World Bank
funded Integrated Disease Surveillance Programme to include surveillance for
animal diseases as well. There is
another facet of such co-ordination that is between the Union Government and
the provincial States. Animal Husbandry and Health are provincial subjects in
the Indian federal framework. But the Union Government assumed a lead role in
co-coordinating and monitoring operations. A nationally regulated system of surveillance
with weekly disease reporting has been activated. The Union and the State Governments share the
costs of compensation.
Communication
is one of the major pillars for combating any outbreaks. An important decision
taken jointly by the two concerned ministries was to be completely transparent
in our actions and to keep the public informed about the situation by regular
interaction with the news media. Daily joint briefings were held by both
ministry focal points and the media had access to cover the sites and report
directly on what was happening. While
the media interest was the highest during the first outbreak, by the time of
the third outbreak, the media and the public who were by then better informed
about Avian Influenza, reacted with moderation.
Government of India in partnership with UNICEF and
other Consultants has developed an evidence-based national communication
strategy and materials for prevention and outbreak scenario related to Avian
Influenza. It primarily focuses on backyard poultry farmers and their families
at risk and includes use of mass media and inter-personal channels. The
campaign approach is non-judgmental and is designed to alert families to the
risks associated with poultry diseases, including H5N1.
The
communication strategy also advocates building the capacities of the frontline
workers within Health and Animal Husbandry departments to become effective
communicators. We also feel the need for
a global trans-disciplinary, integrated communication network on HPAI and pandemic
influenza. It is encouraging that WHO,
FAO, OIE and UNICEF are already working jointly in this direction.
While India achieved freedom from Avian
Influenza in November 2007, we continue to maintain a constant vigil for any
outbreaks. Our surveillance network is being strengthened further. Laboratories
for animal and human health have been identified and equipped. All guidelines
have been circulated to the States and territories; training of rapid response
teams has been done on priority. A large cadre of medical doctors both in the
public and private sector has been trained for the clinical management of human
cases of avian flu. Veterinarians in the public health sector have also been
trained. Our pharmaceutical companies are producing ‘Oseltamivir Phosphate’ an
antiviral drug for avian flu. During the outbreak in 2006, there was a public
scamper for this drug in India. To prevent its misuse and also to
ensure that it is administered only under medical supervision, we have banned
the retail sale of Oseltamivir Phosphate. In India, this drug would be available only
through the government public health system. Our pharma companies are however
free to accept export orders to meet
the requirements of other countries.
An important concern is
the need to raise the level of bio-security in poultry holdings. However bio-security measures do not come
without a cost. Effective measures need
a commitment and financial investment from governments, the private sector and
the commercial farms. Bio-security is equally important for the large
commercial breeders as well as for the small, back-yard poultry holders. To
ensure affordability and compliance of implementing such strategies, we may
need to develop simple and affordable bio-security measures and to provide
institutional support at the community level to mobilize prevention and control
actions.
We
are acutely aware that resources are scarce and there are competing claims for
these from other health issues. By pooling our resources, we could perhaps ward
of the threat of a pandemic and at the same time tackle many other infectious
diseases that are linked to poor hygiene. The World Bank has projected that for
a reasonable level of preparedness for avian and human influenza, developing
countries would need to spend at least US$2.2 billion over a two to three-year
period, while international organizations would require at least $325 million
annually to support these activities.
The current gap for mobilizing resources for country programmes is $960
million, or more than 40% of the identified needs. From the Beijing and Bamako pledges, $649 million is still
available to help fill this gap, but these resources are in the form of loans,
while grants would be a more appropriate form of financing for this global
public good. While this gap must be
minimized, I would urge that we need to look at low cost options also. As
explained earlier, empowerment of the community is emerging as the most
powerful tool in preparing for the pandemic and all countries and organizations
need to focus on this aspect.
I have tried to draw attention to
issues we will be deliberating upon in this conference in the hope that at the
end we will all carry back with us our own vision of what we will be doing over
the next one year. When we meet next, hopefully in 2008, we should be able to
look back with satisfaction that we have moved closer towards One World- not
only united but better prepared for the fight against the avian flu virus”.
SRK/SK/Keynote address -189
|
Speech of Dr. A Ramadoss at avian Flu International Conference
