1. Avian Influenza Preparedness: Observations from World Bank Project Development in South Asia S. Ostroff Aug 2006

2. Context WB involvement stems from Jan 06 Beijing AI donors conference $500m loan fund Manage ~$250m multi-donor trust fund Program known as Global Program on Avian Influenza (GPAI)

3. Bank Process Very structured Assessment, pre-appraisal, appraisal, approval Multi-person teams of technical experts Current involvement –Bangladesh, Nepal, Afghanistan, Pakistan, Sri Lanka, Bhutan –Two with AI, four without

4. GPAI Framework Government endorsed national AI plan Single, unified proposal from government High level involvement/coordination Focus –Animal health –Human health –Public information/education

5. Observations I National plans highly variable –Content –Quality –Process & result largely driven by international agencies (WHO, FAO) Sub-optimal interaction between animal & human health at all levels Minimal coordination with other parts of government, private sector, NGOs, etc

6. Observations II Surveillance infrastructures weak –Anecdotal rather than systematic Communications challenges Response teams variable Lab capacity poses challenges

7. www.whopak.org

9. Observations III Personal protective equipment for culling activities Designation of culling workers Training of culling workers Ability to monitor culling workers Antiviral & seasonal vaccine Communications strategy

10. Observations IV COMPENSATION Quarantine zones Disposal Decontamination

12. Kapisa “Provincial Hospital”

13. Questions?