Early detection and rapid response to suspect outbreaks of disease is one of the major challenges faced in disease control programmes. FAO has provided technical assistance for capacity building for the field veterinary services. The main objective has been to strengthen the detection and the rapid response capacity of the local veterinary authorities through training in health monitoring, outbreak detection, diagnosis and control of HPAI and also other emergency animal diseases.

Control of HPAI in Viet Nam is no longer in an emergency response phase as the disease is recognised as endemic in many areas. FAO is increasingly advocating a risk-based approach to the design and development of control strategies and is working with government agencies to build risk analysis capacity. It is also increasingly apparent that a more farmer-centered approach is required with a clearly defined and important role to be played by the private sector. FAO has increasingly engaged stakeholder consultation and multi-disciplinary approaches to ensure ownership, and active engagement in disease control programmes. It is clear that to motivate stakeholders in the value chain and forge meaningful partnerships, a strong understanding of the livelihoods and incentive structures of the stakeholders is required and that benefits must go beyond the impact of controlling HPAI alone.

Preventative approaches have focused on vaccination but increasingly are broadening to good poultry production and marketing systems, enhanced bio-security, movement control and support to development of the structure of the poultry sector and its governance to ensure safe food production and equitable economic development in the long term.

Standard Operating Procedures

It is important that outbreak responses are carried out safely and effectively to minimize the risk to human health or of further spread to animals. With the support of the Government of Viet Nam, FAO has developed a series of Standard Operating Procedures (SOPs) for outbreak investigations and response. Outbreak responses are carried out by the provincial Sub Department of Animal Health offices and supported by the Department of Animal Health.

Following the development of standard outbreak investigation procedures, FAO has carried out training for veterinary staff from regional, provincial, district and commune offices to ensure that outbreak investigations are conducted consistently and well. The developed SOPs have been adopted by the Department of Animal Health at the national level.

The SOPs set out an outbreak management system which provides a structure for emergency disease control and practical task guidance to ensure consistent application of control measures. The approach can easily be used with other important animal diseases such as duck plague, rabies, porcine respiratory and reproductive syndrome (PRRS) and foot and mouth disease.  In addition to the SOPs, Job Cards have been created. The Job Cards describe the duties of key disease control roles as well as set out the reporting relationships. Veterinary staff in pilot provinces have been trained and are now using the SOPs and Job Cards.

Vaccination

Viet Nam has been practicing vaccination of poultry twice a year (October and April) since autumn of year 2005 to control epidemic HPAI H5N1 with some considerable empirical evidence of success. In order to assist the Government of Viet Nam to maintain vaccine quality to ensure effective response to vaccination, FAO procured and installed 39 prefabricated walk-in cold-rooms in 39 provinces together with other key equipment to maintain the cold chain integrity. In addition 714 fridges were delivered one each in 714 communes in five provinces. Other interventions include the delivery of trainings in Good Vaccine Manufacturing Practice, the audit of national vaccine production facilities, the development of a national vaccine inventory database, efficacy trials and technical support to develop domestic vaccine production.

Although, vaccination remains very important in Viet Nam, it has been recognised that the current mass vaccination control strategy is not sustainable in the long term and that a suitable exit strategy will have to be determined. Mass vaccination entails a large amount of financial resources from the government and ties up significant human resources in the agriculture sector. Therefore, alternative control strategies will have to be devised as Viet Nam moves from initial emergency measures to a period of consolidation and ultimately on to the stated aim of control/eradication beyond 2010 (Green Book). 

The purpose of the Gathering Evidence for a Transitional Strategy (GETS) for HPAI H5N1 Vaccination Programme, funded by USAID, is to assist the Government of Viet Nam in transitioning from the current national, mass vaccination of poultry to more cost-effective and targeted measures for sustained control of HPAI. FAO will provide the evidence gathered during the GETS project to the Government of Viet Nam in time for the National Government Strategy Review for HPAI.

The GETS strategy is to trial alternative HPAI vaccination strategies in five high and low risk pilot provinces to manage risk with a package of ancillary disease control measures and to gather comprehensive field data using a multi-disciplinary approach. This approach consists of a vaccine strategic intervention that incorporates public awareness, training and surveillance field activities, a cost-effectiveness component, a sociological behavioural component and a policy analysis component.

Post-vaccination Monitoring

FAO has supported the National Surveillance Programme for post-vaccination and virus circulation monitoring since 2007 for control of Influenza A/H5N1. The monitoring has confirmed that about 60 perfect of vaccinated poultry and about 75 percent of poultry flocks that have had appropriate vaccination generate a good protection against influenza virus. However, virus circulation surveillance demonstrates that the avian influenza virus is circulating widely throughout the national flock. FAO is providing epidemiological advisory to the Department of Animal Health to ensure that this important activity is carried out using a methodology which will meet the highest international standards.

Quarantine and Movement Control

HPAI is a disease which is spread largely by the movement of poultry and poultry by-products. A number of studies have been carried out by FAO to better define poultry trade using value chain methodologies. Studies have included mapping cross border trade between China and Viet Nam, Viet Nam and Laos; a further study is characterising the lower Mekong poultry trading patterns. These studies help to identify the critical control points where intervention can have greatest impact and support the development of zoning approaches to disease control.

FAO has strengthened provincial veterinary department’s ability to control poultry movements and implement quarantine in high risk border provinces by providing training and equipment and other logistic support. Illegally imported live poultry, poultry meat and eggs have been confiscated and safely destroyed. FAO is working to promote further risk reductions through better understanding and management of cross-border trade.

Poultry Sector Strengthening

The distribution and infrastructure of poultry production and marketing systems are important limiting factors in the control of HPAI. FAO has conducted studies to understand the structure of the poultry industry to provide evidence to assist government restructuring policy. These assessments have highlighted important trends in poultry production and consumption. FAO is promoting the development of a commercial sector with high standards but seeking to protect the small holder sector which makes a vital contribution to rural livelihoods.

Improving Farm Biosecurity

The commercial poultry sector has expanded in Viet Nam with little promotion of animal husbandry and farm biosecurity.  Upgrading farm practices is an imperative for disease control and the long term protection of the industry and public health. Approaches to upgrading must fit the financial ability of producers to pay but recognise the to farm profitability of improved animal health.

In collaboration with the Department of Livestock Production, FAO established a biosecurity working group with representatives from a wide range of government agencies and donors. The working group provides a forum for information sharing and has developed a database of technical and training materials.

FAO is currently developing minimum biosecurity standards, with SOPs, for the larger commercial sector.  The small holder sector presents a considerably greater challenge and FAO is working with small scale poultry producer groups through a participatory process to develop appropriate good practices and training materials. 

Market Hygiene and Marketing

Viet Nam has started to modify its poultry marketing systems by providing better infrastructure with regulations to move away from live marketing to processed products. FAO has provided support to government and coordination of partners to pilot initiatives for economically viable safe poultry marketing. 

A series of studies on infections rates at markets and in poultry traded across borders has identified likely reservoirs of infection that will need to be addressed to control HPAI.

Farm registration schemes have been piloted and this supports good farm practices with health certification.

Socio-Economics

Avian influenza is spread by the trade in poultry. Understanding the behaviour of people engaged in poultry production, trade and processing is necessary to understand the motivation for change and successful disease control. FAO has promoted a multi-disciplinary approach using anthropologists, economists, sociologists and animal health and production experts.