U.S. Government Support to Combat Avian and Pandemic Influenza -- Sub-Saharan Africa

There is an updated version of this fact sheet dated November 28, 2007 located at http://www.state.gov/r/pa/scp/95859.htm

Since sub-Saharan Africa's first reported outbreak of highly pathogenic avian influenza (HPAI) H5N1 in Nigeria in February 2006, the disease has spread to birds in Burkina Faso, Cameroon, Côte d'Ivoire, Djibouti, Ghana, Niger and Sudan. As of May 2007, the world Health organization (WHO) had confirmed one human fatality in Nigeria and one non-fatal human case in Djibouti. The deaths or infections of hundreds of thousands of birds are causing social and economic disruption with implications for African food supplies and incomes, and pose serious risks to human health through exposure to infected birds.

The United States combats HPAI H5N1 in sub-Saharan African nations by working with governments and regional entities, and with international organizations such as the WHO, the Food and Agriculture Organization (FAO), UNICEF 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 sub-Saharan Africa and donors.

To assist in responding to HPAI H5N1 outbreaks and in preparing for a possible human pandemic, the United States is supporting efforts in much of sub-Saharan Africa through bilateral and regional programs. In 2006, the United States allocated $29.2 million to bilateral and regional efforts in sub-Saharan Africa as follows:

• $18.8 million had been committed to bilateral assistance to 21 countries in sub-Saharan Africa;
• $2.5 million had been dedicated to regional assistance programs;
• $4.6 million had gone to support the regional disease detection site in Kenya;
• $2.3 million had been provided to sub-Saharan African activities of WHO; and
• $1 million had been provided to FARO for regional emergency response.

The United States is providing various forms of assistance to Angola, Botswana, Burkina Faso, Cameroon, the Democratic Republic of the Congo, the Republic of the Congo, Côte d'Ivoire, Djibouti, Equatorial Guinea, Ethiopia, the Gambia, Ghana, Kenya, Malawi, Mali, Mauritania, Mauritius, Mozambique, Niger, Nigeria, Rwanda, Senegal, South Africa, Sudan, Tanzania and Uganda.

The activities of the U.S. Agency for International Development (USAID), 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 (NIH) -- the U.S. Department of State (DoS) and the Broadcasting Board of Governors (BBG) have focused on building sub-Saharan Africa's capacity in animal and human health sectors through preparedness and response planning, strengthening laboratory diagnostics, increasing the level of public awareness and information, and enhancing disease surveillance and detection and reporting systems. The U.S. Department of Defense (DoD) also provides medical technical assistance and has purchased sets of personal protective equipment (PPE) for combatant command use in military-to-military and international humanitarian assistance globally.

Preparedness and Communication

U.S. assistance efforts to sub-Saharan Africa for preparedness and communication include:

• Providing funds to the Government of Mali to host the December 2006 international conference on avian and pandemic influenza in Bamako (USAID);
• Placing regional avian influenza advisors in sub-Saharan Africa (USAID);
• Providing technical support to Burkina Faso, Cameroon, Mozambique and Nigeria toward development of communications strategies and implementation plans, and providing support for communications plans in West Africa (USAID);
• Assigning experts to give technical assistance to sub-Saharan Africa bilaterally and through the FAO (USDA);
• Supporting regional coordination, technical exchange and strategy development in West Africa through the Economic Community of West African States (ECOWAS) Technical Experts and Ministerial Meeting in Abuja, Nigeria, in June 2006 (USAID);
• Conducting tabletop simulations for pandemic preparedness in Madagascar and Rwanda (USAID), and for highly pathogenic avian influenza response in Senegal with FAO (USDA);
• Promoting the model of private-public partnerships in regulating and containing animal disease through the attendance of African officials at meetings of the U.S. animal Health Association and with participants in the U.S. National Poultry Improvement Plan (USDA);
• Carrying out risk communications and public information activities in 32 countries (USAID, HHS/CDC, DOS);
• Conducting training in risk communications for epidemiologists, communications specialists and laboratory personnel (HHS/CDC);
• Providing a technical expert and funding to WHO in Africa for WHO's February 2007 pandemic communications meeting in Cairo for communicators from around the globe, including sub-Saharan Africa, and other activities (HHS);
• Developing a pilot program to test information and communication technology to determine the most effective means for delivering rapid information to public health and clinical workers and the public in Kenya (HHS/CDC);
• Carrying out health behavior research in Kenya to assist the ministry of Health and UNICEF/Kenya in developing risk communication materials (HHS/CDC);
• Assisting the Nigerian Ministries of Information and Communication, Health and Agriculture in administering surveys and testing messages for use in developing risk communication materials, and testing an educational booklet for Nigerian schoolchildren (HHS/CDC);
• Providing information on avian and pandemic influenza to 132 journalists from 28 sub-Saharan African nations through media workshops in Kenya, Nigeria, Senegal and South Africa (DOS, BBG, HHS/CDC);
• Increasing public knowledge of HPAI H5N1 through increased broadcasting for Africa and Voice of America avian influenza web pages in English, French, Hausa and Kirundi (DOS, BBG, USAID);
• Supporting documentaries broadcast in Nigeria (DOS);
• Participation of health specialists and others from Ethiopia, Kenya, Lesotho, Nigeria, South Africa and Tanzania in an educational project on infectious diseases, including avian and pandemic influenza (DOS);
• Delivering an epidemiology workshop in Dakar for 27 participants from 21 African countries (USDA); and
• Distributing more than 25,000 packets of materials to countries and non-government organizations in sub-Saharan Africa to build awareness of avian influenza and prevention methods (USAID).

Surveillance and Detection

U.S. efforts to assist sub-Saharan Africa in building capacity for surveillance and detection include:

• Expanding surveillance and response capacity in Africa through CDC's Global Disease Detection (GDD) Center in Kenya and the Army Medical Research Unit in Kenya, as well as through Africa-based Institut Pasteur laboratories (DOD, HHS/CDC);
• Launching the Global Avian Influenza Network for Surveillance (GAINS) to improve monitoring of avian influenza viruses in wild birds, track genetic changes in the virus and increase transparency in sharing disease information throughout Africa. This project is being implemented in coordination with USDA and the U.S. Geological Survey (USAID, HHS/CDC);
• Training joint laboratory and epidemiology teams from 14 African countries in laboratory and surveillance methods (HHS/CDC);
• Delivering a workshop on animal disease surveillance technology and management of epidemiological data to Nigeria (USDA);
• Training and supporting training for officials, veterinarians, epidemiologists and laboratory diagnosticians from 32 sub-Saharan African nations (USDA);
• Delivering rapid diagnostic testing kits to nine sub-Saharan African countries (USDA, USAID);
• Supporting the establishment of emergency operations centers in Ethiopia, resulting in an increase from 15 percent to 70 percent in routing surveillance reports (USAID);
• Delivering real-time polymerase chain reaction (RT-PCR) machines for rapidly diagnosing avian influenza in Côte d'Ivoire and Senegal (USDA); and
• Providing support to FAO to conduct avian influenza surveillance training for the South African Development Community (SADC) member countries (USAID).

Response and Containment

To help sub-Saharan African nations respond to and contain avian and possible pandemic influenza outbreaks, the United States is:

• Expanding infection control capacity in both hospital and farm settings in sub-Saharan Africa (HHS/CDC, USAID);
• Providing funding, through FAO and OIE, for the emergency center for trans-Boundary Animal Diseases Crisis Management Center, which has supported multilateral rapid response missions in sub-Saharan Africa (USDA, USAID);
• Conducting integrated rapid response team training for epidemiologists, veterinarians, laboratory personnel, communications specialists and infection control specialists in 16 sub-Saharan African countries (HHS/CDC);
• Sending more than 32,000 sets of PPE as well as decontamination kits for outbreak response and surveillance efforts (USAID, USDA);
• Supporting training of trainers in Burkina Faso, Cameroon, Côte d'Ivoire, Niger and Nigeria in the safe and effective use of PPE, and supplying non-medical commodities for outbreak surveillance, investigation and response (USAID);
• Providing technical assistance to Burkina Faso, Côte d'Ivoire, Nigeria, Sudan and other countries as needed for HPAI H5N1 preparedness and containment efforts (HHS/CDC, USAID); and
• Delivering diagnostic equipment, reagents, rapid test kits, disinfectants, cleaning and disinfection kits and other commodities to laboratories in Côte d'Ivoire, Kenya and Senegal (USDA).

For further information, visit the U.S. Government's official website www.pandemicflu.gov.

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This region encompasses: Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Democratic Republic of the Congo, Republic of the Congo, Côte d'Ivoire, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, Sudan, Swaziland, Tanzania, Togo, Uganda, Zambia and Zimbabwe.