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PROJECT INFORMATION DOCUMENT (PID)
CONCEPT STAGE
Report No.: AB2163
Project Name
Region
Sector
Project ID
Borrower(s)
Implementing Agency
Environment Category
Date PID Prepared
Estimated Date of
Appraisal Authorization
Estimated Date of Board
Approval
Avian Influenza Preparedness Project
EUROPE AND CENTRAL ASIA
General agriculture, fishing and forestry sector (50%); Health (50%)
P099832
GOVERNMENT OF ARMENIA
[ ] A [X] B [ ] C [ ] FI [ ] TBD (to be determined)
February 10, 2006
April 4, 2006
1. Key development issues and rationale for Bank involvement
The continuing outbreaks of highly pathogenic avian influenza (HPAI), which began in late 2003
in several Southeast Asian countries and more recently in Europe, have been disastrous to the
poultry industry in the two regions and have raised serious global public health concerns. As of
October 2005, nearly 140 million domestic poultry had either died or been destroyed and over 120
people had contracted the infection (of which 63 have died). 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.
At the same time, it is important to emphasize that 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
16th century, occurring at intervals of 10-50 years. In the 20th 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 interventions as proposed in this Project, and in
collaboration with other national and international partners, it should be possible to minimize a
pandemic’s consequences in Armenia through advance preparation to meet the challenge.
Cases of avian flu have already occurred in several countries, including most recently in Romania
(a number of those within 10 km of the Ukrainian border), Greece, Turkey (which has prompted
the ban by the EU on the import of poultry from these countries), and Croatia (H5N1 strain
confirmed). There are also possible cases in Macedonia. The Russian outbreak of HPAI H5N1
has to date affected six administrative regions, beginning in the Ural Mountains and moved west to
within 200 km of Moscow. With AI reported in one country in the Balkan Peninsula (Croatia),
other countries in the Balkan peninsula and the Caucasus are at risk due to their proximity to two
main flyways, the East Africa-West Asia Flyway, which crosses Turkey, and the Central Asia
Flyway. Both flyways cross areas in North-eastern Europe, where avian influenza in wild and
domestic fowl has been diagnosed.
In January 2006, a widespread outbreak occurred, starting initially in northeastern Turkey along
the border areas with Georgia, Armenia, and Iran. This area is directly on the flight path of
migrating birds (the so-called Central Asia Flyway) and sits between three large lakes: Sevan in
the east (Armenia), Van in the west (Turkey), and Urmia in the south (Iran). The initial outbreak
in the provinces of Ardahan, Kars, Erzurum, Ağrı, Iğdır, and Van was met quickly with culling of
over 50,000 birds (in the first week of January). As of January 13th, its presence was confirmed in
11 of Turkey’s 81 provinces, with 16 other provinces reporting suspected cases. Though the
epidemiology of this spread is not yet clear, it is widely believed that H5N1 has been circulating
undetected in Turkey for longer than previously recognized. To combat the intensification of this
spread, the Government of Turkey has moved quickly ahead with the culling of over 350,000 birds
in the imposed protection zones around villages with confirmed cases
Over the past half decade, the Armenian economy has grown by double-digit rates annually, on
average at 10%. The agricultural sector’s contribution to GDP fluctuated over the past decade
from 12.9% in 1990 to a peak of 46.3% in 1993 and subsequent fall to 23% in 2004. Despite its
decreasing contribution to GDP, agriculture has maintained its central importance for the
employment (46% in 2003) and rural incomes (52% in 2003). As such, agriculture serves two
important functions in the economy – being an important contributor to the country’s economy and
serving as the key safety net for large parts of the rural population.
The poultry industry is one of the main sectors of Armenia’s agriculture comprising around 7.5%
of the gross agricultural output (GAO) and around 1.5% of the country’s GDP. The poultry
industry is mainly specialized in the production of eggs (5% of the GAO) and fresh/frozen chicken
meat (2.5% of GAO). The total value of the annual output of the poultry industry is estimated at
around US$ 60-90m, of which around 83% is the value of egg output. Armenia today is a net
exporter of eggs at around US$ 1.3m per year. The Armenian poultry industry is characterized by
a small number of vertically integrated poultry farms that produce around 51% of the country’s
egg output and around 82% of chicken meat. The remaining output is produced by small
household farms that own several chickens and other birds. Turkey and duck production is mainly
concentrated in small household farms. There are around 219,700 household farms that own birds.
Commercial poultry plants are closed-cycle operations, where the birds have minimum contact
with the outside world. These plants have modern equipment and technologies. The feed (grains)
is mainly imported from Russia, Iran, and Turkey. There are 5 large commercial farms which are
concentrated in regions close to Yerevan. Small household farms are believed to be the most
vulnerable in the event of Avian Influenza outbreak. These farms hold on average 8 chickens or
other birds, which are normally grazed outside during the day and return to small chicken houses at
nights. These chicken houses are closely attached to human houses. These birds are in constant
contact with wild birds and other animals.
In order to adequately respond to an Avian Influenza (AI) outbreak and in order to execute AI
surveillance, Armenia has to improve its administrative and laboratory capacities in the long term.
Presently Armenia is not prepared for an AI outbreak: neither diagnostic capacities nor adequate
legal procedures are in place and exercised. Staff have no protective gear or sampling equipment
and insufficient means of transport. Armenia appears to be, presently, unable to meet an outbreak
event adequately.
First Step: Emergency interventions are necessary on the diagnostic and administrative side.
Priority emergency measures include: purchase of rapid test kits, of protective gear, and of
sprayers and disinfectant; training on use of the test kits; preparation of adequate rooms for sample
preparation and dispatch; purchase of sampling equipment and training on sampling and sending of
samples to OIE reference laboratories; preparation of simple forms such as sample history forms,
epidemiological inquiry forms; creation and distribution of essential procedures in case of
suspected and confirmed outbreaks of the disease (i.e., protection of personnel, measures on site,
killing and disposal of animals); and, advice in collection and evaluation of surveillance and
outbreak data at the headquarters of the veterinary services.
Second Step: An ordered and adequate build up of diagnostic and administrative capacities is
recommended as a second step. It is likely that the first outbreak will arise in Armenia before the
necessary diagnostic and administrative changes are in place, and that the competent authorities
will be driven by the event rather than be in full control of the event.
The justification for the Bank 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 global experience in multi-sectoral,
emergency response and risk-mitigation projects gives it considerable qualifications in bringing
together the relevant agencies and the donor community, understanding and addressing the social
and economic impact, and in ensuring high level political coordination.
Given the Bank’s work with FAO, WHO, OIE, EU and other partners in Armenia and at the
international level to address both preparedness and outbreaks and to assist with institutional
assessments, the Bank can assist the country in leveraging additional resources from other
international and bilateral agencies. In addition, the Bank’s technical assistance 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 FAO, WHO,
OIE and EU activities. Furthermore 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 Armenia posed to humans by
highly pathogenic avian influenza (HPAI) and other zoonoses in domestic poultry, and to prepare
for the control and response to an influenza pandemic and other infectious disease emergencies in
humans. To achieve these goals, 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 Armenia, 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 include activities under three components: (i) animal health, (ii) human health,
(iii) public awareness and coordination support.
Component 1. Animal Health ($6.33 million). The Project will support activities to cover the
needs in the short and medium term. These activities range from prevention, to control and
eradication of HPAI and are being designed based on a rapid assessment of the particular
conditions, constraints and possibilities in Armenia. The dimensioning in final form of particular
activities would be based on a complete assessment of veterinary services during the first months
of project implementation. These activities fall into the main sub-components listed below.
I. National policy framework and development of a national strategy;
II. Strengthening disease surveillance and diagnostic capacity; and,
III. Outbreak containment.
Human Health Component (US$ 1.86 million). Building an effective national public health
response will require an enabling environment and the necessary resources to bring proven
interventions quickly up to nationwide scale. Thus, the Project will help to operationalize some
elements that are contemplated as part of the global strategic plan, expanding and intensifying the
responses rapidly. As it is unlikely that the global spread of a pandemic influenza virus could be
prevented once it emerges, the emphasis is on reducing its impact. Several tools will help achieve
this aim: (i) year-round surveillance; (ii) effective and accurate methods of diagnosis; (iii) social
distance interventions; (iv) vaccines (once they become available); (v) anti-viral drugs; and (vi)
strengthened medical services. The interventions supported under the Project will be based on
Armenia’s epidemiological and programmatic needs, and well-assessed options for meeting them.
The interventions will be grouped in three sub-components:
I. Enhancing public health program planning and coordination;
II. Strengthening of national public health surveillance systems; and,
III. Strengthening the health system response capacity.
Component 3. Public Awareness and Coordination Support (US$ 0.79 million). The
component will provide information and communication activities to increase the attention and
commitment of government, private sector, and civil society organizations, and to raise
awareness, knowledge and understanding among the general population about the risk and
potential impact of the pandemic Activities include:
I. development of basic communication materials (such as question and answer sheets and
fact sheets) on influenza, influenza vaccine, antiviral agents, and other relevant topics,
and, information and guidelines for the health care providers;
II. developing and testing messages and materials to be used in the event of a pandemic or
emerging infectious disease outbreak, and further enhancing the infrastructure to
disseminate information from national to state and local levels and between the public
and private sectors; and,
III. development of training courses in communications methodology for extension and
veterinary staff as well as health workers at the central and provincial levels; and,
IV. project coordination, implementation support, and monitoring and evaluation.
4. Safeguard policies that might apply
Safeguard Policies Triggered by the Project
Environmental Assessment (OP/BP/GP 4.01)
Natural Habitats (OP/BP 4.04)
Pest Management (OP 4.09)
Cultural Property (OPN 11.03, being revised as OP 4.11)
Involuntary Resettlement (OP/BP 4.12)
Indigenous Peoples (OD 4.20, being revised as OP 4.10)
Forests (OP/BP 4.36)
Safety of Dams (OP/BP 4.37)
Projects in Disputed Areas (OP/BP/GP 7.60)*
Projects on International Waterways (OP/BP/GP 7.50)
Yes
[x]
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No
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[x]
[x]
[x]
[x]
[x]
[x]
[x]
[x]
[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:
BORROWER/RECIPIENT
($m.)
BENEFICIARIES
INTERNATIONAL DEVELOPMENT ASSOCIATION
PHRD CO-FINANCING (to be confirmed)
US Agency for International Development
Foreign Multilateral Institutions (Unidentified)
Total
*
0.00
0.33
5.67
0.94
0.50
1.53
8.77
By supporting the proposed project, the Bank does not intend to prejudice the final determination of the parties' claims on the
disputed areas
6. Contact point
Contact: Mark Lundell
Lead Agriculture Economist
Tel: (202) 458-4655
Email: [email protected]