SAIDR Project Activities Quarter II Year Two

1
SAIDR Project ActivitiesQuarter II Year Two

• Quarter Review Meeting, FAO
• May 13, 2009 Cairo

2
Outlines

• Project objectives
• Activities undertaken during the reporting
  period.
• 3rd quarter planned activities.
• Major challenges and solutions.
• Recommendations

3
Project objectives

• Overall objective
• to minimize the risk to human health and to
  reduce the impact on peoples livelihoods from
  HPAI through its effective prevention and control
• Specific objectives
• Improve preparedness and planning to contain H5N1
  HPAI bird-to-bird and bird-to-human transmission
• Prevent future H5N1 HPAI outbreaks in poultry
• Improve detection of H5N1 HPAI in poultry and
  wild birds
• Improve containment measures in poultry
  populations
• Limit exposure of bird-outbreak investigators,
  poultry cullers, and poultry vaccinators to H5N1
  virus.

4
Activities in Quarter two (JAN-MAR 09)
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IR 1.1 Improve preparedness and planning to
contain bird-to-bird and bird-to-human
transmission of H5N1

• Team of consultants defined and start with first
  meeting for assessment of the animal component of
  national integrated HPAI plan.
• General Policy of HPAI control was discussed and
  ongoing data gathering on real control situation.
  
• Output (changes to be drafted in the plan)
• Update general Policy of control of HPAI in
  poultry
• Animal health Command structure to be defined.
• Define clear reporting system within the plan.
• Define clear communication strategy.

6
IR 1.1 Improve preparedness and planning to
contain bird-to-bird and bird-to-human
transmission of H5N1 (Cont.)

• Three Monthly Publications of HPAI-EGYPT News
  Review were produced and disseminated to key
  partners in Egypt and abroad and Posted on SAIDR
  and UNDP websites.
• Those publications are increasingly getting wider
  acceptance and demand

7
IR1.2 Prevent future outbreaks in poultry

• RFP- KAP survey (Knowledge, Attitude and Practice
  Survey) sent to five companies focus will be on
  bird to bird transmission.
• Response from 2 companies and process is ongoing
  for selection.
• Qualitative and Quantitative studies will be
  conducted successively.

8
IR1.2 Prevent future outbreaks in poultry
(Cont)

• KAP survey Qualitative study in 3 governorates
  representing high, medium and low risks

9
IR1.2 Prevent future outbreaks in poultry
(Cont)

• KAP survey Quantitative study in 7 governorates
• three in lower Egypt (Dakahlia, Gharbia and
  Sharkia)
• four in Upper Egypt (6th October, Fayoum, Beni
  suef and Menia)

10
IR1.2 Prevent future outbreaks in poultry
(Cont)

• Assessment of vaccination coverage and flock
  immunity completed
• Data on characteristics of poultry production
  collected from 52 villages in 5 Governorates
  (June-Dec 2008) using Participatory Epidemiology
  tools
• Data analyzed in a model for flock immunity due
  to vaccination
• The analysis output concluded that
• Vaccination coverage in large villages rarely
  exceeded 10, and in the medium and small size
  villages around 20.
• Total flock immunity over a year are poor (1-15).

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IR1.2 Prevent future outbreaks in poultry

• Cont
• Assessment of the current vaccination strategy in
  Egypt carried out
• 1st phase - March 2009
• 2nd phase April, 2009
• Technical workshop involving relevant
  stakeholders and key partners conducted.
• Clear and concise recommendations produced.
• Vaccination strategy and operational plan
  developed ready for submission to GOVS for
  approval

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IR1.2 Prevent future outbreaks in poultry
(cont.)

• 5 Training were held for extension personnel on
  strategic communication (101 Veterinarians)

13
IR1.2 Prevent future outbreaks in poultry
(cont.)

• Pilot outreach program using the Agriculture
  Extension Workers for house to house
  communication (Menofia and Sharkia)
• Selection of agriculture staff to be trained (All
  districts in Menofia and 3 districts in Sharkia).

14
IR1.2 Prevent future outbreaks in poultry
(cont.)

• Pilot outreach program using the administration
  staff in veterinary clinics as rural leaders
• TOT training for administrative staff in Dakahlia
  Governorate
• Developing a flip-chart as a tool to be used in
  this activity.

15
 IR1.3 Improve detection of H5N1 in poultry
and wild birds

• Hotline Center
• Official approval on the Hotline proposal by the
  Chairman of GOVS and an approval received for the
  telephone lines from MALR
• GOVS contacted EGYTEL company for the telephone
  lines.
• Working on to finalize the requirements for the
  center

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 IR1.3 Improve detection of H5N1 in poultry
and wild birds (cont.)

• Implementation of Surveillance Plan
• inception workshop to start implementation of the
  activity of LBM surveillance (205 Markets over 23
  governorates) attendees were 27 participants
  representing head of poultry departments in
  governorates.
• Implementation started and 432 LBM visits were
  conducted 940 samples were collected 60 markets
  came positive up to March 2009.

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 IR1.3 Improve detection of H5N1 in poultry
and wild birds (cont.)

• A TOT training course for 13 participants to
  start the strengthening passive surveillance
  activity of HPAI at the veterinary clinics level.
• Training of 363 veterinarians from veterinary
  clinics through 18 training courses on
• HPAI and HPAI case definition
• Surveillance
• outbreak investigation.

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 IR1.3 Improve detection of H5N1 in poultry
and wild birds (cont.)

• Participatory Disease surveillance (PDS)
• field work for PDS teams in Gharbia, Sharkia and
  Behera governorates.
• 18 HPAI outbreaks in poultry were detected by PDS
  teams and confirmed by RT PCR test at NLQP.
• 25 field missions performed by FAO-GOVS staff to
  follow-up the PDS teams.

19
 IR1.3 Improve detection of H5N1 in poultry
and wild birds (cont.)

• Participatory Disease surveillance (PDS) cont
• Two refresher courses for the PDS teams conducted
  (37 veterinarians) aim was to
• Enhance their performance and overcome the field
  challenges,
• Exchange experience and discuss outputs/ways to
  improve field work

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 IR1.3 Improve detection of H5N1 in poultry
and wild birds (cont.)

• Information system TADinfo (epidemiological
  database)
• Refresh training for previously trained data
  managers in districts of Gharbia.
• Training of district data managers in Behera and
  Sharkia, 3 training courses were carried out with
  43 participants on Epidemiology, TAD info, data
  collection, disease investigations.
• Installation of computers in all the district
  veterinary services of Behera (16).

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IR1.3 Improve detection of H5N1 in poultry and
wild birds (cont.)

• LOA with CIRAD was signed to conduct two training
  events
• Risk analysis and risk-based surveillance carried
  out in March 2009 involving staff Epi-Unit at
  central and governorate level
• GIS and Spatial Analysis (Planned for May 2009)

22
IR1.3 Improve detection of H5N1 in poultry and
wild birds (cont.)

• Procurements
• 1st edition of GIS map received from the
  contractor (QS company). Verification and
  clearance of the product in process.
• Specifications and quantities identified and
  approved for the following (procurement under
  process)
• PCR and other diagnostic kits.
• HI Test for sero-surveillance program for testing
  6000 blood Samples.
• 5 Vehicles (4 pick ups and 1 station wagon).
• 40 computers, printers and 5 laptops for data
  management.

23
IR1.4 Improve containment measures in poultry
populations

• 10 seminars,772 audiences, at village level
• The priority areas were recently infected areas
  by either human or poultry cases.
• Seminars were carried by personnel trained in
  SAIDR strategic communication courses.

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IR1.4 Improve containment measures in poultry
populations (cont.)

• Start a mechanism for the RRCT (Rapid Response
  Communication Team) aimed to make a coordination
  between the Vet. authorities and SIS
  representatives in governorates in cooperation
  with CHL.

25
IR1.4 Improve containment measures in poultry
populations (cont.)

• A Coordination meeting - Jan. 5, 2009 involving
  stakeholders and key partners to harmonize
  activities for effective HPAI outbreak response
  and implementation of disease control measures.

• 26 participants representing FAO, GOVS, NLQP,
  USAID, USDA, MOH, CHL and UNDP attended the
  meeting.
• Agreement reached to hold regular consultative
  meetings between key players at all levels to
  find solutions to prevailing challenges and
  improving HPAI response.

26
IR1.4 Improve containment measures in poultry
populations (cont.)

• Four coordination workshops conducted
• Upper Egypt Governorates (17 Directors VS)
  Jan/09
• Lower Egypt Governorates (13 Directors of VS)
  Feb/09
• Alexandria Governorate (40 Participants) Jan/09
• Assiut Governorate, (29 Participants) Feb./09
• Aim
• To improve coordination between GOVS and
  governorate level veterinary services for better
  detection and response of HPAI.

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IR 1.5 limit exposure of bird-outbreak
investigators, poultry cullers, and poultry
vaccinators to H5N1 virus

• 1 TOT for personnel on proper use of PPE and self
  protection, disposal of used PPE, cleaning and
  disinfection (25 participants).
• 16 Step-down Training courses for personnel in
  proper use of PPEs and self protection, and
  disposal of used PPEs, cleaning and
  disinfection(378 vet).

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Plan for Quarter Three Apr-Jun 09
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Improve preparedness, coordination and cooperation

• Final Updated National HPAI control plan drafted
  and presented for authority
• Spokesperson workshop for decision makers
• Preparation for mass media campaigns with CHL.
• Regular publication and dissemination of
  HPAI-EGYPT News Review

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Surveillance

• Continue with the implementation of active
  surveillance in live bird markets in Egypt.
• Implement passive surveillance strengthening
  related activities for HPAI in all governorates.
• Start to implement SAIDR surveillance plan for
  detection of HPAI in the farms (sector2 and 3).
• Start with vaccine monitoring in backyard
• Epidemiological database (TAD info) and data
  managers training expansion to 4 governorates up
  to district level.

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Surveillance (cont.)

• Complete procurements of remaining items needed
  by GOVS and NLQP and process new ones in line
  with project document, knowing that a decision is
  to be taken for replacing the culling bags and
  cold chain items during strategy review
  assessment.
• Monitoring of PDS field activities.
• Develop SOPs for the implementation of the
  proposed vaccination strategy and operational
  plan.

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Surveillance (cont.)

• Finalize LoA and follow up implementation with
• International Livestock Research Institute (ILRI)
• PDS activities in at least 6 new governorates.
• Royal Veterinary College (RVC)
• On job training for Central Epidemiology Unit
  staff.
• Cairo University
• Training on applied statistics for Central
  Epidemiology Unit staff.

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Surveillance (cont.)

• Training
• Training on GIS and spatial analysis for EPI UNIT
  and Governorate Vet. Services (May, 2009).
• TOT training to PE/PDS practitioners (6-days)
• Two introductory PE/PDS courses for core staff
  from 6 governorates
• Advanced training on epidemiology (FAO
  consultant).

34
Communication

• Finalizing Hotline furnishing and equipments.
• Training of hotline operators.
• Implementation of field communication activities
  for administrative staff of vet clinics as rural
  leaders
• Start with training of Agriculture extension
  staff for house to house communication (2 TOT and
  16 step down training courses)
• Biosecurity training for sector 3 farms (1 TOT
  and 15 courses)
• Training for field vets on how to use
  communication materials and biosecurity measures
  (1 TOT and 15 step down courses)
• 30 courses on use of PPEs and decontamination.

35
Communication (cont.)

• 3 courses on strategic communication
• Training for religious leaders (50 workshops)
• Working on development of a flip-chart targeting
  the kids ( to be produced on the 4th quarter)
• Develop the flip-chart targeting the household
  breeders and develop posters (out from the
  flip-chart)
• KAP survey Select research center to implement
  the activity and finalize the contract, then
  start of survey work.
• Use previously trained veterinary extension staff
  to implement 150 seminars in different
  governorates.
• Printing and distribution of the field manual and
  dependant Job aids for veterinarians.

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Challenges and solutions

• No HPAI case reporting from Sectors 1, 2, 3
• FAO-DAI (STOP AI) with support from USAID new
  project Private-public partnership to address
  the complex issue of alliance between the two
  major players.
• Some Governorates discourage outbreak reporting
• FAO-GOVS undertook 4 successful coordination
  meetings.
• Weak Animal health communication at all levels
  (producers, vaccinators, cullers, etc)
• Regular meetings with all partners and
  stakeholders, they started appreciating the gaps
  in animal health communication and preparing to
  play their share.

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Challenges and solutions (cont.)

• No clear command structure for HPAI control and
  response at all levels.
• Include a clear command structure within draft
  Updated control Plan of HPAI and approve it from
  Minister of Agriculture then National Supreme
  Committee
• Non effective cooperation between the partners
  responsible for outbreak response at the
  governorate level.
• Coordination meeting with other partners related
  to HPAI response at the governorate level.
• Increase Veterinarian awareness regarding
  surveillance, reporting and response.

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Challenges and solutions (cont.)

• Limited cooperation from Directors of VS at
  governorate level in implementation of project
  activities.
• Organize an orientation workshop for head of
  veterinary services in the governorates to smooth
  the progress of project implementation and
  inspire brain storming for future interventions
  of the project.
• Lack of awareness of the governors and political
  authorities which hinder the implementation of
  some activities.
• A successful meeting was held by CVO with
  Governor of Behera in presence of Director of
  Behera Veterinary services, SAIDR Project Manager
  and FAO surveillance consultant to empower the
  implementation of surveillance activity in the
  governorate.

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Recommendations

• Continue Coordination meeting with other partners
  related to HPAI response at the governorate
  level.
• Focus on strengthening Response at local level.
• Increase Veterinarian awareness regarding
  surveillance, reporting and response.
• Speed up the operational plan for compensation.
• Regular meetings with the authority and governors
  leaded by the CVO to increase the level of
  understanding.

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Thank You