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Why Asian countries are finding it so hard to tackle avian flu

Alarm bells are ringing across Europe as the H5N1 strain of bird flu wings its way across the continent, but in grassroots Southeast Asia, where the virus has been around for more than two years, the lack of panic is increasingly seen as a major problem.

"Local authorities tell us about it almost every day, but we still have no problem at all," said Pham Van Hung, a chicken and duck trader at a market in Hanoi. "Wouldn't we be the first to die if it was that lethal?"

No one at the sprawling Long Bien wholesale market had been infected with bird flu, so all was well, he reasoned. Other traders chipped in that there had been a big die-off of birds 15 years ago.

People ate the dead birds then, and there were no problems, another added.

Since the virus first emerged in Vietnam in late 2003, 62 people have died there and in Thailand, Indonesia and Cambodia. Today, Vietnam is now seeing what has been dubbed the "third wave of infection."

The virus infects the vast majority of patients through contact with sick birds or their waste. However, scientists have warned that the longer H5N1 is in the human and bird populations, the greater the risk that it could mutate into a form that is easily spread from person to person, triggering a worldwide pandemic.

Awareness

"Whether or not our fight is successful depends a lot on how fast and how much we can improve people's awareness and change their attitudes," said Dau Ngoc Hao, director of the veterinary department of Vietnam's Ministry of Agriculture and Rural Development.

Recent weeks have seen high-level health delegations visit Vietnam from the US, Australia and the UK but panicky headlines in Europe are not worrying people enough in Vietnam to change their ways, even though it is the country with the most bird-flu deaths at 41.

In Vietnam and other Southeast Asian countries hit by bird flu, free-range and backyard chickens and ducks as well as fighting cocks are an integral part of rural society, and changing the way of farming and living to try to reduce the risk of the virus' mutation into an easily spreadable form is not going to be easy.

"This is a very sensitive area with high political impact because it involves the livelihood of people, so what's needed is to make sure that people raising chickens avoid risks," said Somchai Peeratakorn, resident avian-influenza expert at the World Health Organization in Thailand, where 13 people have died from bird flu.

Cullings

Mass cullings of bird populations might seem the simple next step from a European perspective, but that's not really a realistic proposition for millions of Southeast Asians, who have had to get used to H5N1 becoming entrenched in bird populations.

"The government doesn't have enough money to compensate farmers if mass culling were used as part of efforts to combat the bird-flu outbreak," said Suharsono, an Indonesian bird-flu expert at the Department of Agriculture who, like many in Indonesia, goes by only one name. "That would need a huge amount of money."

Vietnam tried culling. In the first wave of infections that began in late 2003, about 43 million birds either died or were culled.

During the second wave, another couple of million died or were slaughtered. Now the country is trying to vaccinate its entire poultry population, a process that is proving difficult.

Low wages for the people carrying out the vaccinations, difficulties in establishing which chickens have been vaccinated and late vaccine delivery are indications that the massive vaccination campaign the government planned might still not be enough to keep bird flu in check.

"In the Mekong Delta provinces, farmers hide their poultry to avoid the vaccinations," Hao said. "And then there is the question of how high people's awareness is. In some remote areas, some farmers have never even listened to a radio."

Unlike China, Indonesia and Vietnam, Thailand has decided not to vaccinate poultry out of fear of undermining exports of its massive commercial chicken industry, but it has earmarked US$100 million to contain the virus over the next three years.

Vietnam, meanwhile, has outlined an action plan that will cost about US$430 million.

But money alone is not enough. People's basic ideas about farming and contact with birds also need to be changed among Southeast Asia's myriad of backyard chicken raisers to really limit outbreaks of the virus that some health experts see as inevitably becoming a human pandemic.

"You're introducing new practices, so that means it will take time for farmers to change their habits," Somchai said. "This is long and tedious work."
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