Avian Influenza: Critical Program Issues

This Global Technical Brief on Critical Issues associated with Avian Influenza (AI) from the Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, opens with a background update, including bird flu statistics from January 29 2008, as well as current public health standards for pandemic prevention.

Programmatic considerations follow the background section. This section discusses the efficacy of antiviral drugs as a preventative response and concludes that, while trials are ongoing, "[v]accine and antiviral availability, distribution, ethics and access issues must all be considered carefully on a country-basis in planning for AI response and pandemic preparedness." In addition, it discusses the benefits of approaching AI prevention and response in resource-poor settings as an opportunity to work on sanitation- and hygiene-related improvements that also constitute a 'readiness' stance for a possible pandemic, since H5N1 (AI virus) transmission routes are shared with other illness, e.g. typhoid fever, hepatitis A, diarrhoea. Also discussed is the integration of AI risk communication into existing national- and community-based risk communication frameworks.

The document concludes with six lessons learned, including:

• "Strategic communication increasingly plays a role in effective AI prevention and response. Communication can be employed through national level advocacy, educating the media on AI issues, mass media, community mobilization, and interpersonal communication and counselling.... [E]xecuting multilevel communication programs... [can] increase awareness of AI risks, means of transmission, and promote protective practices.
• 'Threat-efficacy' models applied to AI may lead to more effective results by producing a better understanding of local threat perceptions, attitudes toward AI behaviors, and efficacy/ability to act.
• 'Warning fatigue' may pose a risk communication challenge, if too many messages are disseminated with an alarming tone...lead[ing] to reduced vigilance and preparation despite the very real nature of the threat.
• AI protective practices such as 'Wash, Report, Separate, Cook' need to be considered on a country-basis. Some behaviors may not be immediately attainable given local resources and barriers to change, such as lack of soap or insufficient funds to cage. More complex behaviors are best dealt with at the community-level through interpersonal communication. Behaviors that can jointly benefit AI and other related hygiene diseases should be promoted through mass media channels to improve the general health competence of these audiences.
• Information sharing should be immediate, consistent, and transparent. The international AI planning community is growing rapidly and relies critically on lessons learned and best practices. New information is made available on a daily basis. It is important that AI experts continue to publish, present, and teach new findings. Leveraging the Internet for information sharing is advisable.
• Political commitment is essential. Many desired behaviors are contingent on central level support and ongoing political engagement. Given multiple competing priorities in resource-poor settings, political commitment to AI may not exist. Proper compensation policies for farmers, however, must be in place to incentivize reporting. Effective communication channels likewise must exist for proper reporting, culling, and response. AI presents unique opportunities for governments to improve public health infrastructure, services, and overall health by investing in the issue. AI can be easily tackled as a dual or triple benefit program, or positioned as an ‘a la mode’ issue to generate positive publicity for leaders."