PROJECT INFORMATION DOCUMENT (PID) CONCEPT STAGE Report No.: AB2118 Project Name Avian Influenza & Human Pandemic Preparedness & Response APL 2 Project Region EUROPE AND CENTRAL ASIA Sector Animal production (40%);Health (30%);Agro-industry (30%) Project ID P096262 Borrower(s) GOVERNMENT OF TURKEY Implementing Agency Undersecretariat of Treasury Tel: (90 312) 213 0297 Fax: (90 312) 212 8550 hazine@hazine.gov.tr Ministry of Agriculture and Rural Affairs Ministry of Health Environment Category [ ] A [X] B [ ] C [ ] FI [ ] TBD (to be determined) Date PID Prepared January 23, 2006 Estimated Date of December 16, 2005 Appraisal Authorization Estimated Date of Board March 2, 2006 Approval 1. Key development issues and rationale for Bank involvement The continuing outbreaks of highly pathogenic avian influenza (HPAI), which begun in late 2003 in several Southeast Asian countries and have occurred more recently in Europe, have been disastrous to the poultry industry in the two regions and have raised serious global public health concerns. Nearly 140 million domestic poultry have either died or been destroyed and over 120 people have contracted the infection, of which 63 have died as of October 2005. Recent increases in the number of known cases of avian influenza (AI) transmission have raised concerns over the potential emergence of a pandemic, which could have devastating effects on human health and livelihoods. There are many uncertainties about whether and when a pandemic might occur, as well as about its potential impact. Humans are not very susceptible to the disease, but if infected with the Asian H5N1 strain, they could exhibit a high case fatality rate. The geographical spread of HPAI, the human dimension, and the potential enormous social and economic impact are unprecedented. Economic losses to the Asian poultry sector alone are estimated to date at around $10 billion. Despite control measures the disease continues to spread, causing further economic losses and threatening the livelihood of hundreds of millions of livestock farmers, jeopardizing smallholder entrepreneurship and commercial poultry production, and seriously impeding regional and international trade, and market opportunities. The rural poor, who rely for a larger share of their income on poultry, have been particularly hard hit with income losses.
It is impossible to anticipate when the next influenza pandemic may occur or how severe its consequences may be. On average, three pandemics per century have been documented since the 16 th century, occurring at intervals of 10-50 years. In the 20 th century, pandemics occurred in 1918, 1957 and 1968. The pandemic of 1918 is estimated to have killed almost 50 million people in eighteen months, with peak mortality rates occurring in people aged 20-45 years. The pandemics of 1957 and 1968 were milder, but many countries nevertheless experienced major strains on health care resources. If a major pandemic were to appear again, similar to the one in 1918, even with modern advances in medicine, an unparalleled toll of illness and death could result. Air travel might hasten the spread of a new virus, and decrease the time available for preparing interventions. Countries health care systems could be rapidly overwhelmed, economies strained, and social order disrupted. Through the interventions proposed in this Project, and in collaboration with other national and international partners, it should be possible to minimize a pandemic s consequences in through advance preparation. To date has experienced one outbreak of avian influenza, in the Manyas district of Balikesir province. This outbreak was detected on October 1, 2005 when three turkeys died in a flock of 1,800 turkeys being raised by a medium sized poultry contract farmer in an outdoor grazing environment facility three kilometers south of Manyas Lake. This lake is a natural habitat for migratory birds, which were abundantly present at the time. Most of the rest of the flock died over the next three days, during which time the district veterinary service and a private veterinarian working for the poultry sector developed the diagnosis of avian influenza. Dead and live animals were sent to the Bornova reference laboratory (in Izmir), which detected the presence of the H5 strain (through inoculation and subsequent death in embryonated eggs). The EU reference laboratory in Weybridge (UK) confirmed the presence of the HPAI H5N1 strain on October 13. Sanitary measures had been promptly initiated by the provincial veterinary service on October 7, when a three kilometers protection zone was established with road sings and the presence of the military police. All backyard poultry (over 10,000 head) within the protection zone between October 8-16, and compensation was granted by the private poultry industry itself to the affected farmers. Within the protection zone, there were also nine larger commercial holdings, seven of which were empty. The flock of almost 16,000 in the remaining two enterprises was slaughtered on October 9. In addition to the protection zone, a 10 km radius surveillance zone was established, which contained roughly 45,000 backyard poultry, and 10 active larger poultry farms with a stock of over 130,000 animals. Measure taken in the surveillance zone included a ban on the movement of live poultry, regulation of the transport of table and hatching eggs, prohibition of bazaar market trade of poultry and of hunting of wild birds, and an immediate local awareness campaign to instruct farmers to confine backyard poultry and avoid contact with wild birds. Although the avian influenza outbreak has been quickly contained, and there are no signs of any transmission to humans, the economic impact has been severe. Within two weeks of the outbreak, the consumption of poultry in (roughly 1.2 kilogram per capita per month) had dropped by 50 percent and retail poultry prices had fallen by 30 percent. (The market capitalization of the traded Turkish poultry firms dropped by over 30 percent in the first week). This is partly owing to the fact that Balikesir and the nearby regions of Bursa, Izmir, Manisa, and Sakarya account for over 40 percent of s broiler enterprises and poultry production. Egg production is similarly concentrated in these provinces, and its demand has fallen from 12 eggs per capita per month by a rate similar to that of poultry demand. As a result, the poultry and egg sector is incurring losses of roughly US$ 0.9 million daily. (Prior to the outbreak the GDP of the poultry and egg sector ranged US$ 1.2-1.5 billion annually). The rationale for the Bank s involvement is the Global Public Goods aspect of the HPAI, one of many emerging and re-emerging zoonoses, and its strong link to poverty reduction. HPAI control programs require a multi-disciplinary approach to integrate technical, social, economic, political, policy, and regulatory issues in addressing a complex problem. The Bank is well placed to build upon its knowledge base on multi-disciplinary approaches needed in the proposed Project, which draws on evidence and lessons learned in the various regions
regarding emergency preparedness responses and multi-disciplinary approaches. The Bank s experience in in multi-sectoral, emergency response, and risk-mitigation projects gives it considerable qualifications in bringing together the relevant ministries, government agencies, and the donor community, in understanding and addressing the social and economic impact, and in assuring high level political coordination. Given the Bank s work with FAO, WHO, OIE, EU and other partners in the country and at the international level to address both preparedness and outbreaks and to assist with institutional assessments, the Bank can assist in leveraging additional resources from other international and bilateral agencies. In addition to its financial role, the technical assistance provided by the Bank has been important in similar global or regional emergency situations such as SARS, Tsunami relief, and HIV/AIDS. The Bank s national and regional support will be closely linked with the activities of FAO, WHO, OIE, and the EU, and the proposed Project is fully consistent with, and draws heavily on, the global strategies proposed by FAO and WHO. 2. Proposed objective(s) The overall objective of the Project is to minimize the threat in posed to humans by HPAI infection and other zoonoses in domestic poultry and prepare for, control, and respond to an influenza pandemic and other infectious disease emergencies in humans. To achieve this, three areas will be supported: (i) prevention, (ii) preparedness and planning and (iii) response and containment. Achieving these goals will contribute to diminishing the burden of disease and loss of productivity in, limiting the regional spread of HPAI, and enhancing economic and social prospects at the national, regional, and global levels. 3. Preliminary description The Project will finance activities under three components: (i) animal health, (ii) human health, (iii) public awareness and coordination support. Given the urgency of the situation, following the recent experiences with HIV/AIDS projects in Africa and the Caribbean, priority has been given to detailing the activities to be included in the first year of the project with subsequent activities for later years to be refined in more detail as part of annual project reviews. I. ANIMAL HEALTH COMPONENT The Project will support activities to cover the needs in the short, medium or long-term, and ranging from prevention, to control and total eradication of HPAI, which have been based on an assessment of the particular conditions, constraints and possibilities in (including a rapid assessment of veterinary services and recent assessments of the poultry sector). II. HUMAN HEALTH COMPONENT In the public health field, short-and long-term actions need to be taken and an appropriate balance struck between the two. While immediate steps can be taken to address the crisis, there is also a longer-term agenda given systemic shortcomings with respect to core public health functions. Work on both the short- and long-term fronts, therefore, needs to proceed in parallel, and efforts should be made to ensure that short-term responses are consistent with and contribute to proposed longer-term interventions. Setting priorities in both cases is essential.
III. PUBLIC AWARENESS AND INFORMATION COMPONENT This component is designed to promote public awareness and improved coordination of the execution of the MARA and MOH Contingency Plans and the National AI Strategy. It would have dedicated subcomponents in each of those two areas. 4. Safeguard policies that might apply Safeguard Policies Triggered by the Project Yes No Environmental Assessment (OP/BP/GP 4.01) [X ] [ ] Natural Habitats (OP/BP 4.04) [ ] [ X] Pest Management (OP 4.09) [ ] [ X] Cultural Property (OPN 11.03, being revised as OP 4.11) [ ] [ X] Involuntary Resettlement (OP/BP 4.12) [ ] [X ] Indigenous Peoples (OD 4.20, being revised as OP 4.10) [ ] [X ] Forests (OP/BP 4.36) [ ] [X ] Safety of Dams (OP/BP 4.37) [ ] [X ] Projects in Disputed Areas (OP/BP/GP 7.60) * [ ] [X ] Projects on International Waterways (OP/BP/GP 7.50) [ ] X[ ] Since the Project is assessed as a B-category project, Environmental Management Plans would be prepared during Project implementation and implemented with Project support. 5. Tentative financing Source: ($m.) BORROWER 6.49 INTERNATIONAL BANK FOR RECONSTRUCTION AND 15.4 DEVELOPMENT BILATERAL AGENCIES (UNIDENTIFIED) 3.69 FOREIGN MULTILATERAL INSTITUTIONS (UNIDENTIFIED) 9.84 Total 35.42 6. Contact point Contact: Mark R. Lundell Title: Lead Agriculture Economist. Tel: (202) 458-4655 Fax: Email: Mlundell@worldbank.org * By supporting the proposed project, the Bank does not intend to prejudice the final determination of the parties claims on the disputed areas