Pakistani Media on the Decision to End the Nation’s H5N1 Surveillance Program

The Dec. 12 edition of the Pakistan Daily Times warns of avian influenza, or H5N1, “looming” over the country.

In June 2011, the Pakistani government decided to end the National Programme for the Control and Prevention of Avian & Pandemic Influenza due to technical and financial challenges. The last recorded case of H5N1 in Pakistan by the World Organization for Animal Health (OIE) was in 2008. Despite the gap in recorded cases, is the economic gain from ending this program worth the risk incurred from having no surveillance system?

The Daily Times piece explains that as the winter season approaches, birds will be migrating to warmer climates, such as Pakistan, from Europe. With no surveillance, prevention or control program in place, Pakistan may be putting itself at risk. According to the US Interagency Strategic Plan for early detection of H5N1 in migratory birds, “[t]he ability to efficiently control the spread of a highly infectious, exotic disease such as highly pathogenic H5N1 avian influenza is dependent upon the capacity to rapidly detect the pathogen if introduced.”

In August of this year, the Food and Agriculture Organization (FAO) issued a warning, stating that countries should be on “high alert” for avian influenza outbreaks. Juan Lubroth, FAO Chief Veterinary Officer warned: “This is no time for complacency. No one can let their guard down with H5N1.”

Echoing this warning, Asad Farooq, author of the Daily Times piece, suggests that despite the lack of recent cases recorded in Pakistan, the country should remain vigilant as outbreaks have been reported in two neighboring countries: India and Iran.

Just today, China reports an outbreak of H5N1 in Tibet. Nearly three hundred fowl were killed by the virus and 1575 were culled to prevent further spread.

According to the FAO, the virus is firmly “entrenched” in Bangladesh, China, Egypt, India, Indonesia and Vietnam. Due to Pakistan’s proximity to India, one would think that H5N1 would continue to be a high priority.

Other news reports rebut the claims of the Daily Times, stating that there is no threat of avian influenza in Pakistan. Some interviewees even suggested: “non state actors which might be planting such news …are baseless and have no grounds.”

Perhaps the focus of the forming controversy over avian influenza threat in the Pakistani media should focus on the economic issues.

According to an economic analysis of prevention versus outbreak costs conducted by OIE, it was determined that the benefits from prevention efforts outweighed the outbreak costs. In the Asia case study (Vietnam was examined), the authors explained that many Asian countries are at an increased risk of severe H5N1 outbreaks due to factors such as population density and farming practices.

While prevention costs are significant (they range from surveillance costs, warning systems, laboratory costs, vaccination costs, risk communication costs, etc.), they seem minimal when compared to the direct and indirect costs of an outbreak. Among direct costs are production losses (loss of poultry), culling costs (cost to dispose of the birds) and income losses. Other industries, such as the feed industry, are indirectly affected by the mass loss of chickens. The global market is affected as non-poultry prices increase and poultry prices plummet. Agricultural workers and their families suffer not only from illness, but also from financial hardship.

A World Bank report from 2005 states: “the most immediate economic impact of a pandemic might arise – as in the case of SARS – not from actual death or sickness, but from the uncoordinated efforts of individuals to avoid becoming infected, as well as public policy actions likes quarantines and travel restrictions.”

It seems as though the Daily Times is calling out the government: though it may cost a lot to continue a national surveillance program, the risk (both in terms of health and economics) is greater without such a program.

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