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US steps up efforts to fight bird flu in SE Asia

The US government has recently stepped up efforts to combat a potential influenza pandemic whose origins are almost certainly going to be somewhere in Southeast Asia. 

I have always said that in the fight to contain pandemic influenza, as in law enforcement, Follow the Money.  And Follow the Tamiflu.  Nowhere was that more evident than in the efforts of the US, Indonesian authorities and the WHO to contain what appeared to be an outbreak of human H5N1 in Cikelet, West Java, in August, 2006.  More than 2,000 villagers from all adjacent hamlets were placed on Tamiflu as a precaution.  The story can be recalled by clicking on the reference at Crof's H5N1 blog entry from that time, "Drenching Cickelet in Tamiflu", here.

The US had shipped a substantial quantity of Tamiflu into the theater of operations some weeks before, which made quick distribution of Tamiflu possible. 

As we all know, Tangerang, Indonesia is just about the hottest spot in the world for catching bird flu, if you are a human being.  And there is precious little people know there about bird flu, despite the well-intended efforts of the Indonesian government to make them more aware.  I refer again to a blogger and respondent to one of my recent Computerworld.com blogs, a man known only as H&T:

I live in bird flu central (Indonesia). My wife is Indonesian and hails from a rural background in east Java. Traveling in that part of the world I am struck by two things related to bird flu:

1) Everyone keeps chickens and ducks in their yard;
2) Almost no one has any inkling about bird flu or what precautions to take (almost everyone is a subsistence farmer with little access to or interest about information on global events and concerns). (bold mine)

Bird flu is almost certainly coming soon to a theatre near you. It will almost certainly "made in Indonesia" stamped on the side.

Apparently that message is not lost on the US, which is acting to try and stamp out H5N1 in Tangerang before it is too late.  The United States has announced it is spending some $15 billion Rupiah, or roughly $1.7 million dollars US, to increase awareness of H5N1 in Tangerang Province alone.  The following news article is from Indonesia's Antara news service:

US envoy to give Rp15 bln to Tangerang to fight bird flu

Tangerang (ANTARA News) - US Ambassador to Indonesia Cameron R Hume is expected to hand Rp15 billion in humanitarian aid to the Tangerang administration to fight bird flu in the region, a local health official said on Tuesday.

"The grant will be presented by Ambassador Cameron Hume during his visit to Tangerang on Wednesday," a spokesman of the local health office, Aceh Kurniawan, said.

He said the funds would be used to control bird flu in the city and district of Tangerang by implementing a familiarization program.

The bird flu familiarization program would involve the local people and students in an effort to make them aware of the deadly disease.

Meanwhile, the chief of the Tangerang Health Office, Hani Heryanto, said the district administration already had a bird flu control program which could be implemented as soon as the US financial aid had been received.

Meanwhile, the chief of the National Committee on Bird Flu Control, Bayu Krisnamurthi said in Jakarta recently that Indonesia had suffered financial losses of Rp4.1 trillion due to bird flu (avian influenza/AI) outbreaks during 2004-2007.

Bay said in a statement that the losses were estimated based on the impact of bird flu outbreaks during 2004-2007 using the Computable General Equilibrium (CGE) model.

The impact calculated in the estimation was financial losses due to chicken culls, reduced demand for poultry products, lower chicken and egg consumption, costs incurred by farmers as well as the government for bird flu control, and the decline in the number of tourist visits.

According to Bayu, programs to control bird flu in Indonesia had shown progress, both in communication and surveillance, managing the spread of the virus in poultry and humans, as well as efforts to anticipate a possible pandemic.

The authorities would improve the control program from time to time, he said.

AI infection of poultry which was first reported in 2003 has spread fast and now poultry in 31 out of the country`s 33 provinces have been affected.

The disease has become endemic in Java, Sumatra, Bali and South Sulawesi. (*)

http://www.antara.co.id/en/arc/2008/4/1/us-envoy-to-give-rp15-bln-to-tangerang-to-fight-bird-flu/

Indonesia has lost a half-billion US dollars in the past four years, all because of bird flu.  And this half-billion dollars is almost wholly contained within rural, family farms.  Not to mention the loss of a major protein source.  When we talk about the threat of bird flu, we sometimes lose sight of the enormous financial toll this virus takes on the living.  This virus has become endemic to the nation's largest and most fertile areas.  Culling exacts a massive financial toll on the standard of living for those impacted by the disease's presence.  It is an extremely destabilizing and draining event for the nation, which has other things to worry about:  Volcanoes, earthquakes and tsunamis, Dengue fever, chikungunya virus, malaria, al Qaeda, and a paranoid health minister. 

The US is not limiting its most recent anti-bird flu efforts to Indonesia.  It is also building a significant depot of supplies in Thailand, to be used throughout the Southeast Asia region.  From news service AFP:

US officials launch bird flu stockpile in Thailand

Tue Mar 25, 12:16 PM ET

US officials on Tuesday officially opened a stockpile of equipment in Thailand designed to help Asian nations react rapidly to battle outbreaks of potentially deadly bird flu.

The US ambassador to Thailand Eric John presided over the Bangkok launch ceremony for the Regional Distribution Centre (RDC), which is located in Thailand's eastern province of Chachoengsao.

"The RDC will help ensure that countries in Asia will be able to take fast action to counter avian influenza without endangering the lives of rapid-response teams," John said.

"This centre will help ensure that avian influenza outbreaks can be contained safely and efficiently," he added.

The warehouse, funded by the US government's aid arm USAID, will initially stockpile 45,000 protective suits, 400 decontamination kits, 10 laboratory specimen kits and other equipment worth a total of 548,300 dollars.

John MacArthur, infectious diseases advisor with USAID, warned that bird flu remained a serious threat in the region around the Mekong river, and said the kits could be shipped to outbreaks within 24 hours.

Authorities in Laos earlier this month reported a fresh bird flu outbreak near its northwest border with Myanmar and China, while Vietnam has so far reported five bird flu deaths this year.

The World Health Organisation has confirmed that 236 people have died worldwide from bird flu since 2003.

The H5N1 avian influenza virus mainly kills animals but scientists fear it could mutate to easily jump from human to human, sparking a global pandemic.

http://news.yahoo.com/s/afp/20080325/hl_afp/healthfluthailandus_080325161612