Reem Leila attends two different preparatory seminars ahead of the Sixth International Conference on Avian Influenza and finds international strategies finally being tailored to local needs Preparatory seminars to the Sixth International Avian Flu Conference, which will convene in Sharm El-Sheikh in October, were held on 30 July. Representatives of the United Nations Children's Fund (UNICEF) met with officials from the Ministry of Heath and Population to present the mid-term Avian Influenza Intervention Community Education Programme as well as stress the importance of applying bio-security measures within the poultry industry, while the second meeting brought together the Ministry of Agriculture and Land Reclamation, the UN Food and Agriculture Organisation (FAO) and the General Organisation of Veterinary Services. Both events were also attended by poultry industry representatives and veterinary professionals. An educational video starring veteran actress Karima Mokhtar, the centerpiece of the Avian Influenza Intervention Community Education Programme, was shown during the initial meetings ahead of widespread distribution via TV, screenings at health centres and during family awareness campaigns. The video disseminates the key message of the programme, informing families on how to avoid infection. The Japanese-funded community- based programme was initiated in August 2007 and will target 17 Egyptian governorates. It encourages correct poultry breeding practices, including washing hands with soap after handling birds, separating poultry from living areas and keeping children away from birds. Since it began to be implemented there have been positive changes among targeted population of over seven million households: washing hands jumped from 36 per cent at the baseline to 56 per cent, separating poultry from living areas increased from 64 to 74 per cent and keeping children away from poultry from 45 to 55 per cent. To date 50 cases have tested positive to the virus, resulting in 22 deaths. Sixty per cent of patients were children, none of whom died, and 72 per cent of the total female. The vast majority of human infections, 91 per cent, were a result of backyard breeding. "We have been collaborating with the Ministry of Health to address an issue of national concern," says Erma Manoncourt, UNICEF Egypt Representative. "Once people get proper education and accurate information at risk groups can be transformed into positive forces contributing to the containment of the disease." Abdel-Rahman Shahin, official spokesman of the Ministry of Health and Population, reports that more than 10,000 community health workers have been trained and deployed to lead a house-to-house education campaign. In all 17 targeted governorates they have been supported by street banners and road shows that travel to villages. A school-based education programme will now be unrolled aimed at equipping children with information to protect themselves and minimise the risk of infection. The programme targets an estimated 3.7 million school children between six and 12 in 13 governorates. "More than 8,000 teachers will be trained to utilise an interactive educational package which will be implemented in collaboration with the Egyptian Red Crescent and the Ministry of Education to deliver key messages related to hand washing with soap and staying away from poultry," says Shahin. To face the threat of highly pathogenic bird flu outbreaks in Egypt national and international organisations are working together to ensure biosecurity within poultry producing units. FAO international and national consultants have produced a report on potential biosecurity measures for smallholders and backyards producers: the aim, says FAO Avian Flu consultant Nick Taylor, is to minimise the risk of the virus spreading within farms or from one farm to another. Transmission of the virus can be prevented by identifying critical control points within possible scenarios to minimise risks: poultry breeders, says Taylor, must focus on combating the virus in private areas, including the inside of homes, often in villages where there is no awareness of biosecurity or practical steps that could halt the spread of the virus. Biosecurity is given due attention and sufficient funds are available to implement biosecurity measures in the commercial sector, says Mona Mehrez, head of the Central Laboratory for Poultry Monitoring at the Ministry of Agriculture and Land Reclamation. "The problem is in rural areas where poultry is raised inside houses and where, unfortunately, people are not educated enough or do not have sufficient funds." Participants highlighted proximity between producers and the continuous presence of visitors in homes in which birds are reared as major contributors to the spread of the disease. "We try to provide producers with funds and create awareness, but we need the full participation of the public sector to ensure better access to these people," Mehrez says. Changing people's perceptions of biosecurity has to be initiated at the grassroots level, she argues, since passing laws that are then disregarded is clearly not enough. FAO's Jonathan Rushton pointed out that the diversity of products and production methods within the poultry industry in Egypt increased the risk of a viral outbreak. He suggested subsidising farmers to upgrade their livestock, a strategy that worked in Europe during the 1950s and 60s. In order to really reduce the risks of poultry disease transmission, the government must interfere by issuing acts and directives in the form of laws and enforce their implementation, says Rushton. "Minimum distance between farms and small poultry breeders of at least four kilometres is a must, also construction specifications including concrete flooring, proper insulation, appropriate ventilation, cooling and lighting are essential biosecurity measures in places where poultry is bred."
