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Bird Flu Prep Boosts General Disease Capacity

By Cheryl Pellerin

Vietnam Bird Flu Preparations Boost General Disease Capacity

This is the first in a series of articles about the response to avian influenza in Southeast Asia.

Hanoi, Vietnam -- In the four years since highly pathogenic H5N1 avian flu began infecting and killing the chickens, the ducks and eventually the people of Vietnam, the government has made changes on the ground and across the animal and human health infrastructure that will serve the nation far beyond the threat of avian flu.

In this serious venture, it has had help from many donors -- the U.S. Agency for International Development (USAID), the U.S. Department of Health and Human Services (HHS) and its Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture (USDA), the United Nations Food and Agriculture Organization (FAO), the U.N. Joint Program on HIV/AIDS, Japan, the World Bank and many others.

In November, USAID and HHS increased support to Vietnam for avian flu. A new $8 million USAID grant builds on an $8.6 million USAID assistance program that, in partnership with the Vietnamese government, supports national, provincial and district activities to fight avian flu in poultry and reduce its risk to people.

USAID is expanding support of disease surveillance, response and containment, communication and prevention activities. New grants will support surveillance mechanisms, build veterinary laboratory capacity, support operational research and strengthen health surveillance and infection-control capacities.

Of the funds, $1.5 million is being channeled though the World Health Organization (WHO) to support Vietnam's development of a human vaccine against avian flu.

CDC is giving the Vietnamese government another $1 million for support and technical assistance to the Ministry of Health's National Institute of Hygiene and Epidemiology and the Vietnam Administration on Preventive Medicine.

Since 2005, the U.S. government has contributed more than $22 million to Vietnam for avian flu prevention and containment efforts.


One success arising from this support involves the nation's diagnostic laboratories for avian flu.

"Before the crisis of bird flu in Vietnam," Dr. Hoang Van Nam, deputy director of the Department of Animal Health in the Ministry of Agriculture and Rural Development, told USINFO, "the laboratory system was very weak. Not good. But international donors have supported us and now we have nine laboratories for detecting and diagnosing [avian influenza]."

Vietnamese boys herd their ducks in Ha Tay province near Hanoi in August. (© AP Images)Each lab now has a real-time polymerase chain reaction (PCR) machine, and one lab has two machines. PCR is a method for amplifying a small amount of DNA or RNA into large quantities in a few hours. Real-time PCR lets a scientist view the increase in DNA as it is amplified, and allows rapid screening of samples for diagnosis and disease tracking.

International donors are bringing molecular biology to Vietnam, and the country's National Institute for Veterinary Research now has a DNA sequencing machine. This technology can be used in many advanced applications, including classifying and identifying influenza and other viruses.

Donors, including the USDA and the Japanese government, also are providing critical training for Vietnamese veterinarians and laboratory technicians.

"We're not only interested in stopping avian influenza," John Wade, an agriculture officer with the USDA's Foreign Agricultural Service, told USINFO. "This [support] has built up all aspects of the system, for other diseases like foot and mouth. It's really helped their whole animal health care system, which is what we want to see in the long run."


In addition to international assistance, the government of Vietnam has put great commitment, time and resources into efforts to stop the spread of avian flu. Since 2005, it has powered a long-term nationwide vaccination program for high-risk poultry and duck populations that animal health officials say could last until 2013, subsidizing the cost of vaccines for millions of small-scale farmers.

The Vietnamese government also is driving related efforts, including shutting down live-bird markets in rural areas and implementing measures to improve the country's vast backyard poultry enterprise, improve hygiene in the poultry trade and slaughtering, increase biosecurity and restructure the poultry industry to reduce disease risk.

"The government's political and government approach, which is very complicated, can change behavior rapidly, effectively and comprehensively in this country, said Dr. Michael Iademarco, a captain in the U.S. Public Health Service and HHS health attaché in Hanoi.

An example, he added, occurred December 15, when the nation's new motorbike helmet law went into effect. Overnight, 21 million motorbike drivers went from riding without helmets to more than 90 percent compliance with the law, according to local news reports.

"It's not magic," he said, "it's a reflection of Vietnam's entire political and government system and the way they communicate with their people, and, in that context, people change their behavior."

That is what happened with avian influenza, Iademarco added. "When they needed to take rapid action with chickens in terms of getting them out of cities and markets and massive culling, within days they were able to do this. In countries that don't have that approach, it's going to be more difficult."


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