U.S. Government Support to Combat Avian and Pandemic Influenza -- Europe and Eurasia

There is an updated version of this fact sheet dated November 28, 2007 located at http://www.state.gov/r/pa/scp/95844.htm

Europe's first outbreak of the highly pathogenic avian influenza (HPAI) H5N1 virus in birds occurred in Russia in July 2005. Since that time, outbreaks of HPAI H5N1 have affected wild birds as well as backyard domestic and commercially raised poultry in more than 20 countries in the region. Human infections with HPAI H5N1 have so far been confirmed in only two countries: Azerbaijan and Turkey, both in 2006. There were eight confirmed human cases and five deaths in Azerbaijan, and 12 confirmed cases and four deaths in Turkey. Millions of domestic birds were culled in the region during 2005-2006 alone, at significant cost to the economies of the countries concerned. In 2006, the United States:

• Committed $19.2 million in bilateral assistance to 14 countries in the region; and
• Dedicated nearly $2.9 million to regional assistance programs.

The United States combats HPAI H5N1 in European and Eurasian nations by working with governments and regional entities, and with international organizations such as the World Health Organization (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 the region and donors around the world.

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 strengthening preparedness and response planning, building Europe and Eurasia's capacity in human and animal health, strengthening laboratory diagnostics, increasing the level of public awareness and information, and enhancing disease surveillance and detection. 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 Europe and Eurasia for preparedness and communication include:

• Placing mid- to long-term avian influenza advisors in five countries in the region and providing technical assistance to all high priority countries in the region (USAID);
• Supporting national pandemic preparedness plan and strategy development through activities in 14 countries including technical assistance, training, regional and U.S.-based conferences, and simulations (USAID, USDA);
• Conducting a training course for 450 government, private and university veterinarians on diagnostics, control, eradication and containment of highly pathogenic avian influenza in Bulgaria (USDA, USAID);
• Conducting (through regional support to WHO and FAO) tabletop simulations for pandemic preparedness in Armenia and several other European Eurasian countries to be determined (USAID);
• Sending a public health expert to Ukraine to provide influenza information to medical students and faculty, emergency response officials, epidemiologists and the media (DoS);
• Producing Russian, Albanian, Georgian and Azeri versions of the Public Broadcasting Service documentary "Killer flu" for broadcast and education (DOS);
• Promoting the model of private-public partnerships in regulating and containing animal disease through pilot initiatives in Armenia, Georgia and Romania. These activities include training and seek to engage the commercial poultry industry to comply with biosecurity regulations as well as to provide leadership in the poultry industry and the general public on safe behavior, reducing the risk of infection, and promoting the continued consumption of poultry and poultry products (USAID);
• Providing funding to support WHO activities in Albania, Armenia, Bulgaria, Romania and Russia to support human health surveillance, the development of infection control protocols, in-country coordination and preparedness activities (USAID);
• Contributing (through support to the World Bank) to a pilot project to ensure the safe re-introduction of poultry into an area that has experienced an outbreak and extensive culling (USAID);
• Broadcasting news on avian and pandemic influenza on the voice of America (VOA) and Radio Free Europe/Radio Liberty in Albanian, Armenian, Bulgarian, Russian and Ukrainian (BBG);
• Maintaining area-specific web pages on VOA websites with up-to-date information on avian and pandemic influenza news and prevention efforts (BBG);
• Providing information on avian influenza to regional journalists and training journalists to report more accurately on the disease in Armenia, Azerbaijan, Bosnia and Ukraine (USAID);
• Developing and testing avian influenza communications plans, materials and messages distributed through puppet shows, posters, public service announcements, national logos, brochures, posters and radio spots in 11 countries to build awareness of avian influenza prevention (USAID);
• Providing on-site technical assistance to Armenia, Georgia, Romania, Turkey and Ukraine to prepare applications for funds to develop national pandemic preparedness plans that reflect appropriate science and guidance for preparing and responding to a potential pandemic (HHS/CDC); and
• Reviewing and providing comments to Georgia's pandemic preparedness plan (HHS/CDC).

• Expanding disease surveillance and response capacity in the region through risk mapping, wild bird surveillance, establishing hotlines, engaging community-based surveillance systems, training on virus detection and sample collection, and setting up referral systems in veterinary services (USAID, USDA, DoD);
• Providing training for officials, veterinarians, epidemiologists and laboratory diagnosticians in nine countries in surveillance methodology, virus detection, diagnostics and sample shipping procedures (USAID);
• Upgrading national, regional and academic laboratories in Azerbaijan, Romania, Russia, Turkey and Ukraine; providing diagnostic equipment and supplies including rapid diagnostic test kits to 11 countries (HHS/CDC, USDA, DOD);
• Providing U.S.-based diagnostic training programs to 14 scientists from six countries (USDA);
• Placing a senior medical advisor in Almay, Kazakhstan, for two years to support the CDC central Asia regional office and providing country and regional influenza and avian/pandemic influenza capacity building (HHS/CDC);
• Conducting a needs assessment in Azerbaijan to identify capacity/capability gaps to better target HHS/CDC technical and bilateral assistance (HHS/CDC);
• Funding a workshop representing 13 countries and 230 attendees to provide technical assistance in influenza and avian/pandemic influenza surveillance, epidemiology, rapid diagnostics, clinical management of cases, containment and vaccine development strategies (HHS/CDC);
• Providing grantsmanship training for CDC cooperative agreement grantees in the European region: Armenia, Georgia, Kazakhstan, Romania, Turkey and Ukraine (HHS/CDC);
• Providing grant funds to the WHO European regional office to assist in regional technical assistance and trainings, including rapid response training, laboratory diagnostics, pandemic planning, health risk communications, surveillance and epidemiology (HHS);
• Providing CDC-produced guidelines for building surveillance systems to all CDC European and Eurasian grantees (HHS/CDC); and
• Funding activities in Azerbaijan, Belarus, Bulgaria, Georgia, Kazakhstan, Kyrgyzstan, Romania, Ukraine and Uzbekistan, including capacity building and training supported by the U.S. Naval Medical Research Unit No. 3 (NAMRU-3) in Cairo (DOD, HHS/CDC).

Response and Containment

To help Europe and Eurasia cope with avian and possible pandemic influenza outbreaks, the United States is:

• Providing essential commodities including PPE, decontamination kits and laboratory kits to 10 countries in the region (USAID);
• Expanding rapid response, including infection control capacity, in Armenia, Romania, Turkey and Ukraine through establishing protocols and procedures for health care providers; hospital infection control (Romania) (USAID);
• Conducting integrated rapid response team training for epidemiologists, veterinarians, laboratory personnel and infection control specialists in all high priority countries, with plans to extend training to regional and district levels in the next fiscal year (USAID);
• Providing technical assistance to seven countries for avian influenza containment and response efforts, including training in safe culling, establishing a quarantine, and sample collection and transport (USAID);
• Providing U.S.-based epidemiology training programs to 13 scientists from Belgium, Bosnia-Herzegovina, the Czech Republic, Kosovo, Portugal, Serbia and Spain (USDA);
• Conducting live bird market training programs for Romania (USDA);
• Deploying staff to Romania and Turkey in response to requests from ministries of Health, WHO and the Global Outbreak and Alert Response Network (GOARN) (HHS/CDC);
• Launching a fact-finding U.S. Government mission to Armenia, Azerbaijan, Georgia, Turkey and Ukraine in the wake of avian influenza outbreaks in Turkey (DoS, HHS/CDC, others); and
• Participating with GOARN teams in conducting avian influenza preparedness assessments in Armenia, Azerbaijan, Georgia and Ukraine (HHS/CDC).

The U.S. Government's official website on avian and pandemic influenza is www.pandemicflu.gov.

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This region encompasses: Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Holy See, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Macedonia, Malta, Moldova, Monaco, Montenegro, Netherlands, Norway, Poland, Portugal, Romania, Russia, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, Ukraine and the United Kingdom.