Program Update: Avian Influenza in Ghana

This 3-page report from the United States Agency for International Development (USAID) describes strategic preparation for the May 2007 outbreak of avian influenza (AI) in Ghana. With the appearance of avian flu (bird flu) in Ghana, the country total in Africa reaches 8 countries, which are locations of disease outbreaks: Ghana, Djibouti, Sudan, Niger, Burkina Faso, Core d’Ivoire, and Cameroon. Three geographically significant cities are affected - the port city and crossroads for land routes, Tema; Suyania, located in the agricultural heartland; and Aflao, on the Ghana-Togo border. Laboratory tests link this strain of the H5N1 bird flu virus to those in Cote D’Ivoire, Burkina Faso, and Nigeria. The document reports the US response of aid in dollars, commodities, and technical assistance: "In 2005, USAID supported the establishment of the National AI Working Group in Ghana. The following year, the group developed Ghana’s National AI Preparedness and Response Plan. Therefore, Ghana had preparedness measures in place well before the 2007 outbreaks occurred."


As stated here, USAID invested in educating the public about AI even before it had reached Ghana. Active disease surveillance, veterinary officer training, capacity-building exercises for the Veterinary Services and Ministry of Health, and strengthened laboratory diagnostic capacity are among the preparatory strategies employed.

The report details the collaborative outbreak response of the Ghana Health Service, the Ministry of Interior, other government bodies, and Ghana’s Veterinary Service coordinated by the National AI Working Group. Actions include the destruction of 10,000 birds and containment efforts banning or restricting movement and sales of poultry as farms are being assessed. As of the publication of this report, no human H5N1 AI cases had been identified, but human surveillance was being scaled up and Tamiflu stockpiles are being built.

Following fears about AI in surrounding countries, poultry consumption in Ghana dropped sharply, significantly affecting the poultry industry. Communications materials were developed to help inform the public in Ghana, promote preparedness and healthy behaviours, and dispel rumours. As part of a scaled-up communications campaign by USAID and the United Nations Children's Fund (UNICEF) launched after the outbreak, farmers, traders, health workers, and the public are receiving more focused information, including pictorial posters with health messages such as: "Do not touch birds that you find dead. Report them to your agricultural officer", while at the same time conveying "Save the economy from the bird flu. Eat chicken." and "Always wash your hands after touching birds." In addition, a telephone hotline is now established, and USAID is working with the media on the release of accurate information to reduce the possibility of public panic. USAID is also training veterinary health workers on use of equipment, including instruction on the use of personal protective equipment, decontamination kits, laboratory sample collection kits, and rapid antigen test kits.

The document cites the usefulness of preparation and lists among remaining challenges the economic and cultural centrality of poultry, not only as a food commodity, but also as part of traditions such as the bride price, gifts, and religious rituals. Informal (non agro-industrial) poultry raising accounts for 60 - 80 percent of the poultry population. It is raised in a setting recognised as challenging to the implementation of control measures. Also, enforcement capacity of the bans on movement and sales of poultry is limited by staffing numbers. Surveillance capacity needs to be built, and accurate information needs to reach the public to reduce the sense of panic driven by sensationalised local and international press reports of AI.

Further steps cited in the report are: USAID seeks to unite donor streams, and update the National AI Preparedness Plan as well as coordinate with neighbouring Togo, now suffering outbreaks of AI, and Benin, which is thought to be a possible AI outbreak site.