Bird Flu &Epidemic &One Health &Zoonoses Bill Brieger | 22 Mar 2025
Bird Flu in Cambodia is a Global Concern
As part of the work for the Johns Hopkins University course on Social and Behavioral Foundations of Primary Health Care, Daniel Gomez Ramos posted in the class blog about the challenges of Bird Flu as shared below.
The Avian Influenza (H5N1) is increasingly becoming a significant concern in the kingdom of Cambodia with developing news revealing that a recent novel variant has the potential to increase the risk of a new pandemic in which human transmission could occur if no measures are taken to identify individual via screening/testing.
Given the limited quantity and quality of testing instrumentation, viable standard protocols, low personnel for both operating equipment and investigating areas of high incidence in humans and wildlife, and training programs, it is imperative that a standardized approach is created and implemented. A mandate for integrating real time-Polymerase Chain Reaction (RT-PCR) for individuals (i.e. workers who are in contact with livestock such as cattle and poultry) aged 12-65 years of age would be appropriate while focusing on the southern and central regions of Cambodia.
The following organizations and associations would have to be engaged for the policy to have any possibility of being successfully supported:
The World Health Organization (WHO): The Western Pacific regional office would be contacted to have their expertise involved into the policy making by way of utilizing their capability of conducting investigations to prevent community transmission by testing in targeted areas with high incidence rates for H5N1. Additionally, they would draw in their Cambodian partners who work within the ministry of environment, ministry of agriculture, forestry, and fisheries.
Food and Agriculture Organization (FAO): They would be involved by gathering support from the United Nations (UN) to increase resources for testing kits, and recruiting more personnel members to operate the various testing sites that are strategically located. The data collected will further advance their research efforts as well.
Pasteur Network (PN): As an experienced partner in the policy proposal, they will assist in fundraising for all objective points, and they would permit the usage of their name and network to display in blog posts as a support of a cohesive front for H5N1 testing as an approach to reduce exposure and risk.
One World One Health (OWOH): Given their extensive expertise in wildlife intervention throughout the eastern and southern regions of Cambodia, they would be an excellent partner to address wildlife testing for Avian flu as a form of tracking in areas with nearby communities.
World Bank Group (WBG): The branch of Human Development Network would be included in the process. They would provide guidance and direction of in-depth educational programs for both local workers and newly hired individuals. They have a track record of directing Avian Influenza testing sites in multiple types of setting across the globe.
Cambodian Farmer Federation Association of Agricultural Producers (CFAP): It would be paramount to engage in dialogue with this association as they have publicly shown to be uncommitted to any policy of mandatory testing, specifically for small-scale farmers who would experience the brunt of any potential interventions to prevent spread (e.g. culling of poultry). We would monitor their view and when a sufficient amount of support from the aforesaid organizations have been acquired, we can attempt to collaborate with them by presenting a report which is convincing for mandating H5N1 testing.
The goal would also ensure the well-being of the farmers and communities, while simultaneously providing alternative solutions that would not negatively impact the livelihood of the farmers. For Cambodia to successfully address the Avian Influenza situation and reduce the risk of a pandemic for the long-term trajectory, the following must be actualized:
- The Kingdom of Cambodia willingness to allocate a certain amount of funding to initiate and maintain a robust and dynamic testing program.
- The WHO and WBG to invest into programmatic development and maintenance via both in-person and remotely.
- The FAO and PN for the inclusion of their broad and supportive network that will address the logistics of the entire process.
- CFAP must be persuaded of the vitality of the testing program and ensured that protection will be provided for the farmers.
Borders &Conflict &COVID-19 &Ebola &Epidemic &One Health &Yellow Fever Bill Brieger | 10 May 2023
Outbreaks Emergency Preparedness And Response In Uganda
Solomon Afolabi, a graduating MPH student from the JHU Bloomberg School of Public Health examined the challenge of epidemics and outbreaks in Africa with special reference to Uganda as an example. The abstract of his report is found below.
According to the WHO, preparedness for emergency health conditions like infectious disease outbreaks should be an ongoing action supported by adequate funding, resources, partnerships, and political will that is executed at all levels to keep it sustained. Emergency preparedness is a framework that identifies practical in-country health emergency preparedness principles and elements by acknowledging lessons learned from previous response activities for priority planning, implementation, and reinforcing operational capacities.
Uganda is an ecological hotspot for various infectious diseases making the country liable to outbreaks. In the last two decades, multiple significant outbreaks have occurred, prominent of which are from yellow fever, Ebola virus disease, and COVID-19 global pandemic. Efforts to build a strategic framework for emergency outbreak preparedness and to strengthen the national operational capacity led to the establishment of the Ugandan National Institute of Public Health (UNIPH) in 2013.
This paper presents a blend of literature that takes account of the successes, challenges faced, and gaps identified in the preparedness and response capacities to the infectious disease outbreaks experienced in the last two decades. It also reviewed how the national efforts had fared in operational readiness for an emergency response to epidemics, building a resilient health system, practicing the One-Health human-animal-environment interface, and in government, community, and individual capacities to contribute effectively to strengthen the national emergency preparedness and response to these frequent disease outbreaks. The findings revealed that Uganda’s outbreak preparedness had made much progress over two decades, from the overwhelming Sudan strain Ebola virus outbreak in 2000-2001 to a similar episode from the same species in 2022 to 2023.
The response measures that feature the activation of a national response plan by the MoH were well coordinated locally to swiftly lead to the activation of NTF, NRRT, DTF, DRRT, and VHTs for immediate mobilization and deployment of operational resources to affected districts. The response was strengthened by well-organized local coordination by the MoH and development partners (WHO, CDC, UN agencies, etc.). The immediate setting up of treatment and isolation centers, provision of Ebola kits, training of more health workers, and coverage of 10 high-risk districts ensured a significant impact.
The provision of more than 5000 doses of vaccines with the support of WHO and partners was a global capacity milestone impact, and the country was declared Ebola-free in a record 69 days. Uganda’s current national emergency preparedness and response plan has received commendations locally and from global international partners, having progressively built capacity from lessons learned in just over a decade of responding to frequent infectious disease outbreaks and using the recommendations proffered accordingly.
This sustained momentum of preparedness supported the swift transition to contain COVID-19 and laid a good foundation for their strengthened readiness for an emergency response to outbreaks.