Interview with François Le Gall on Animal Diseases: Emerging Global Threat

So there are two questions in one here. On the first one, what are the chances avian flu will be a problem in North America. This is closely linked to the migration flyways. It is highly possible that the virus may be introduced in the north part of the American continent through that pathway, and that can occur within six to twelve months. So it is a possibility.

On the second question, how can people protect themselves, this refers to really simple hygienic practices. It is important, first, to avoid contact with sick animals, sick birds and dead birds. It is important also to educate children, saying please don't pick up dead birds and don't manipulate sick animals. If you do, it is important to wash your hands frequently with soapy water. That is very effective because the virus is very vulnerable to soap. To avoid to put your hand on the face when you are in areas where there are outbreaks. So these are very simple things that you can apply.

The second element here is on food safety, but I will come back to that because there are a few questions on that.

It is a very important question because in the case of Vietnam and Indonesia, the disease is an endemic disease now, meaning that the virus is everywhere and for a long time. So, no, it is not necessary to kill so many chickens. Actually you start with the killing measure as the best measure to try to stop the spread of the virus. But in some cases, when it is not efficient or not possible because you don't have the means to do so, it is important to add to this measure additional tools, like, for example, vaccinations of poultry; and so what we recommend is not to kill so many birds because, if you do so, that means that you are not able to contain the disease, but to start with killing and compensation first, try to contain the virus and prevent its spread, apply control of movements of birds and any contaminated products , apply bio-security measures, all these kinds of things in place and try to stop the spread. If you are not successful, you will have to consider to vaccinate birds as complemantary measure.

So in the case of the avian flu disease, ocular and respiratory routes are involved. For other diseases, there are many possible contacts, direct or indirects contacts from animal to people or through the animal products depending on the disease involved. On the protective equipment, yes, gloves and protective clothing and masks, because of the respiratory routes, are efficient means of protecting people. This is usually used by front-line workers whot are in close contact with dead and sick animals, because they need to walk on the outbreak area. It is not recommended for everyone, just for these people who are really exposed and who have close contact; in that case they would use masks, single-use masks that are effective for six to eight hours only and clothes and protective gear. Otherwise, I come back to my previous answer here, the most efficient way of protecting from contamination is to avoid contact and to wash hands.

Yes, you can. But in general, temperature will kill various viruses. For example, meats, if you cook at a temperature of 70 degrees Celcius for a few seconds that will be enough to kill the virus; and for eggs, 60 degrees Celcius for a few seonds will kill the virus. Usually viruses do not survive over 60 degrees Celcius. So everything that is cooked well will kill the virus. On the contrary, parasites and bacteria can develop resistant forms. We call it spores in the case of bacteria, or they can produce some thermostable toxins; so this can be a problem for food safety. On this one, you should be aware that official veterinary services are taking care of that and making sure that every animal product that are put on the market are inspected and are safe for consumption.

It is important to recall that this is primarily an animal disease; this is affecting the poultry sector, and that it is very difficult for humans to get infected. It is important, also, to mention here that one of the best ways to avoid the contact and the infection from humans to animals is to tackle the disease at its animal source, within the poultry sector, and in that case to lower the load of the virus in the environment, and therefore, the level of exposure to humans will be minimized. That is the message, if you want to protect the citizens, the best thing to do first is to tackle the disease at its animal source, and this is the job of the official veterinary services.

Now, the second measure that needs to be taken is on communication. Communication is key, and to make sure that the citizens and the rural people, in particular, are well aware of the risks, and well aware of what things to do, in particular, how to protect themselves with very simple hygienic practices.

Well, they are both what we call zoonotic diseases, meaning of animal origin or common to animal and humans. They are both viral diseases; it is a different virus but these are two viral diseases of the same geographic origin, from South Asia. They transmit by respiratory route, both of them, and to a lesser extend by ocular routes. They are both very pathogenic to humans. The main difference is that SARS is highly contagious from human to human, and this is not the current case with the highly pathogenic avian flu virus which is not able to easily pass from animal to humans.

That is, again, an important question. Let me start here by saying Africa is a special case because livestock is so important for the livelihood of people there, in particular for poor people and for the economy. It is also a continent which is affected by many important diseases, human and animal diseases, including major zoonotic diseases, and this is also a continent in which a majority of countries has very weak capacity both from veterinary and human health services. So it is important to support Africa in that sense.

But Africa has also many advantages. First of all, Africa is equipped with institutions such as the African Union and its livestock bureau (IBAR) in Nairobi, which is involved in battling the disease. We have the equivalent for human health diseases, with the the WHO AFRO bureau in Brazzaville. In addition, in Africa, we have a platform which is called ALive (for African Livestock), which regroups the key actors, political partners, donors partners and technical partners, and this platform has been mobilized to support African countries and regional institutions to tackle this virus. In Africa, we are doing the same thing that has been done in previous countries that have been infected, in Asia and in Europe. We are supporting governments in establishing integrated country plan that addresses both the animal side and human and communication side of the responses.

Recently in Vienna, a few weeks ago, the international community agreed that more support will be needed for Africa and so the donor community is getting mobilized to support Africa.

This is a difficult question, and I am not sure I have the full answer on this one, but I can provide a few limited responses. Again, it comes back to the technical response to the disease. You don't de-capitalize the whole poultry flock of the country. You cull at risk birds in very specific case, in a limited amount, just to try to stop the virus at the very beginning of the outbreak; so in doing that, this is really important, to put in place an efficient compensation mechanism to make sure that farmers are going to declare the disease at the very beginning of the process.

This is the best way: compensation and culling is the best way to avoid the spreading of the disease. But in many cases it is not sufficient enough and you have to combine this tool with the other tools available including the possibility of going with vaccination, being targeted, or mass vaccination, depending on the risk you assess. So this responds a little to your question, meaning that you are not going to de-capitalize poor people in poor countries, but in that case you will shift to more complete measures that will include, in addition to culling, vaccination and other control measures.

Okay, there are several questions in this one. First, on the incubation. For the animals, this is between three to five days; and for humans, this is from one to two weeks before the first symptoms appear.

Now, for the question on the migration, again, this is a complex topic because you have many different species that have different susceptibility to the virus. You can have birds that can be a carrier of the virus with absolutely no symptoms and can fly from a very long-distance and reach several continents and reach Ivory Coast and be in contact with domestic birds there and then been responsible for the introduction of the disease in the country.

You can have birds that are a little bit more susceptible, that can show a few symptoms, and that could die during the migration, but they will have time to transmit the virus to other wild birds that will continue the migration, carry the virus and be in contact with domestic birds, and so you have all these kind of events combined; so this is possible. It is difficult for me to answer by yes or no, because, again, it depends on each bird and the susceptibility of each species. If the birds were all susceptible and will die as quickly as we see in domestic poultry, then the risk migration will be minimized, but this is unfortunately not the case.

On your question on human-to-human transmission, again, it has not been demonstrated, and so far there is no human-to-human transmission. It is important to note that humans can be infected in situations where there has been close contact with sick animals; and when this occurs, then because of the high pathogenicity for humans, we have high mortality rates, in that case up to 50 percent.

The last question is referring to the compensation of farmers. Again, this is really important, to make sure that the farmers are well informed that they will be fairly compensated with the right rate, so they will have incentive to declare early the disease, and we will have a better chance to tackle the disease at the very beginning of the process. This is crucial. But compensation is difficult because you have to set a rate which needs to be not too high or not too low, because otherwise you have all kinds of distortions that you can imagine. You have to put in place a mechanism to make sure that the right people are going to be compensated and so on. So this is a difficult scheme to put in place, but this is something that needs to be done in every countries.

Well, I don't know. I mean, there are three possibilities. The first one is that nothing has happened and the wild birds were not infected or were not in contact with domestic birds. The second possibility is that it has happened, but it was not detected by the official veterinary services. Or the third one, which can also happen, I do not think this is the case in Morocco, but in some other countries it does happen, is that the country chooses not to declare it or to delay de declaration for obvious reasons, and so again I don't know the particular case of Morocco, but you have the three theoretical possibilities.

On this one, first let me recall that contamination from wild birds is only one way of contamination, but this is not the only one and probably not the main one. Uncontrolled or illegal movements of birds, live birds or contaminated products, poultry products, are also responsible for the transmission and the spread of the disease, and this is something really important to acknowledge. So in the case of poors poultry farmers, I think what is important again for them is to be well informed and trained on the disease, on the risks, on what are the first measures to take into account and try to minimize or avoid the introduction of the disease; and if the disease enters, make sure that they will be fully compensated and help them with control measures.

This is the question on capacity, country capacity of poor countries on the disease and veterinary services. Avian flu has shown us that this is now crucial for the international community to support poor countries in making sure that they will have the proper means and the veterinary services in place with all the means to make sure that this country will be able to prevent the introduction, or in the case of introduction of the disease, prevent the spread of the disease and not only making reference to avain flu, but to mention that these are roughly the same measures that will prevent all the emerging and remerging diseases and there are many, many diseases that occur in the animal kingdom. So, again, this comes from capacity building, and when we talk about veterinary services today, this is including not only the public sector, which is responsible for that, but also the private sector, the private vets, and the producers organizations, the farmers themselves, who are the first sentinels, who are the ones who are going to see the disease at the very beginning, and who are going to call the private vets or the public vets to initiate the response. So this is a true partnership between the public, the private and the associative sectors that we are talking about here when we talk about veterinary services, and this is overdue now for the international community, including the World Bank, to strengthen veterinary services for early detection and rapid response of emerging and re-emerging diseases of animal origin like avian flu.

There are several symptoms, but because of the highly pathogenicitys of the virus most of the times this is the high mortality in the flock that you observe. In addition to that, you have all of the symptoms that are associated with respiratory disease. On the preventing measures and control, again, you start with making sure that this is not going to enter your farmthe village or the country. These arepreventative measures of surveillance and early detection. When it enters, this is really important to alert the official veterinary services and make sure that you will contain the spread of the virus, and what you start to do when there is just one or a few outbreaks, is that you kill all the birds that have been infected or at risk; then you process with the disposal of carcasses and al animal products; and then you go on cleaning and desinfectionand then wait three weeks before you begin restocking your farm. These are measures that are very well developed by the World organization for Animal Health (the OIE) and that every country should follow.

On the treatment, there is no treatment of birds. If it enters a farm, especially if it is a very dense, concentrated farm, you have a very high mortality and you will lose all of your birds.

Nobody today and no expert can predict if and when a pandemic will occur. Again, this is a low probability, high impact event, and this is why even if the probability is low, it is very important because of the tremendous impact that the pandemic will generate throughout the world that we make sure that every country is getting prepared for this possible event.

Again, the probability of a pandemic is connected to the load of the avian virus in the environment, and, therefore, one of the best ways to avoid a pandemic is to tackle the disease at the animal sources and to make sure that we control the disease in the poultry sector through veterinary measures.

Well, it has not been calculated or estimated, to my knowledge, but what we know is that Ivory Coast is a country for which the poultry industry is really important. The country has invested a lot in this sector. So at both village-based production level or industrial level, this is important for the country. What we have is the experience of Vietnam, where it was calculated: just the fact that they were losing 44 million birds equivalent to 17 percent of the bird population therethat had died or that had been killed for sanitary measures, represents an estimated direct loss of 120 million U.S. dollars, equivalent to 0.3 percent of the GDP of the country.

So the socioeconomic consequence can be very, very huge. We are now seeing that in addition to the direct costs that I was just mentioning for Vietnam, this disease and other diseases of animal origin can cause major impact because you add to the direct costs, the indirect costs: the ripple effects, the spill-over effect to other sectors, the long-term effects and so on. So if you combine everything it can equal a huge, huge socio-economic cost.

There are two elements to consider here. First, the need to put in place compensation to make sure that the farmers are going to declare at the early stage the disease because he or she knows that he or she will be fairly compensated, and so that if one comes and destroys their birds because of sanitary measures, it will be okay with them. So the compensation is really part of the control measures

Now, in addition to that, there are countries that have put in place other compensation mechanisms for farmers in case of losses from animal diseases. Most of the time this is private compensation schemes that are put in place. What we are trying to do at the international level with the World Bank, and with the World Organization of Animal Health and others is to think of a possible global fund that will be able to address these compensation measures, the compensation measures that are needed in poor countries to quickly react to the disease and what could be the global mechanisms to address all of these losses that are not covered by the compensation fund that I was just referring to. This is something new, really important, that is more of a medium-term objective for us and that we will tackle not only avian flu but all the emerging and re-emerging diseases of animal origin. The rationale behind that is that this is a global public good and therefore it is the interest and the duty of the entire international community, to mobilize around this issue.

Bird flu is avian flu causes by influenza viruses that circulates among birds. This is something that is not new. What is new is the high pathogenicity and the quick spread of this one within domestic poultry. When did it start, this is hard to say. These viruse are circulating among wildbirds that have contacts with domestic birds. And this is when you get a highly pathogenic strain for domestic birds circulating in wild birds that come into contact with susceptible domestic birds that outbreaks in domestic poultry are obseved.

The H5N1 subtype strain originated from Hong Kong in 1997, from an outbreak for which we had a few human cases. So we believe that it comes from Hong Kong in 1997 and it was quickly spreading and has reached three continents now. This king of spread of a highly pathogenicvirus among domestic birds, does not happen every day, as you can imagine. So this is typically a zoonotic disease with a global reach that we are seeing with avian flu.

Well, what we are concerned with is the transmission to humans from animals. So there are two aspects: the fact that this animal disease can destroy the animal production industries and the obvious implication in t erms of poverty and economic growth and trade; and there is also the human public health aspect of it.

The World Bank now is clearly tackling the issue, recognizing that the prevention and control of the disease is a global public good. We have long-term kind of research program on what needs to be put in place to have a global framework for global funds to support our client countries, and we have the immediate emergency response that we have put in place with the global facility for avian and human influenza at the Bank to support our client countries with emergency operations right now to address the crisis.

On the research side, we are also active in terms of the socioeconomic implication of the disease. On this one we are not alone. And on everything which addresses the more scientific aspect of this disease, you have international institutions, technical organizations, like the World Organization for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO). You have the CDC in Atlanta. You have the Instituts Pasteur network. You have all these institutions that are actively involved in research because this is an area where we are learning every day and it is important for us and for our clients to be advised by these scientific and technical institutions on the latest developments to make sure that we adjust our responses accordingly.

Let me answer the vaccine question and I will leave the human health aspects of the question since am not an expert on human health

But on the vaccine, if you are referring to the poultry vaccine, it is important to say that we have several different vaccines in poultry that are available that are very efficient and we have sufficient production capacity worldwide, and that although this is triggering a lot of difficulties in terms of logistics, it is feasible and this is again efficient. When you decide to combine this vaccines with the other available tools, you will have to decidewhether you go on massvaccination or targeted or emergency vaccination, depending of the situation. Here the message is, it is kind of complex. So it is important to refer to the standards and guidelines that are being produced by the World Organization of Animal Health (OIE), and which are available on its web site

On human health, this is difficult, because they will only be able to start the human vaccine only if and when they get the pandemic strain, which fortunately for us doesn't exist now. So this is a more difficult issue because, first, there is a time issue involved with that. You can only start when you have the strain; and secondly, there is the issue of capacity for mass production right now. So this is something again that the international community and the technical agencies, in particular, WHO, are working on right now.