The Vietnam Integrated National Operational Program On Avian Influenza, Pandemic Preparedness And Emerging Infectious Diseases (AIPED)

Objectives

The Integrated National Operational Programme for 2011–2015 seeks to reduce risks to humans and animals from avian influenza A(H5N1) and other emerging infectious diseases through a sustained One Health approach linking human, animal, wildlife and ecosystem health. Its central aims are to control infection at source, prevent disease emergence and re-emergence, detect and respond rapidly to high-impact threats, and prepare for the health, social and economic consequences of a severe human pandemic.[1][2]

• Strengthen coordinated prevention, surveillance, early warning, outbreak investigation, laboratory diagnosis, rapid response, risk communication, clinical care and recovery arrangements across animal and human health sectors.[3][4]
• Progressively control and eliminate highly pathogenic avian influenza in poultry while addressing other emerging, re-emerging and transboundary diseases, including risks associated with livestock, wildlife, markets, slaughterhouses, trade and changing agro-ecosystems.[5][6]
• Build veterinary, livestock-production, public-health, laboratory, epidemiological and curative-care capacity to manage avian influenza, pandemic influenza and other serious infectious disease threats.[7][8]
• Align national action with the International Health Regulations (2005), the Asia Pacific Strategy for Emerging Diseases 2010, and the Food and Agriculture Organization and World Organisation for Animal Health global strategy on avian influenza.[9][1]

The programme shifts from a predominantly emergency-focused response towards longer-term prevention and preparedness while retaining readiness for outbreaks. It is organised around enhanced coordination, agricultural control and eradication of avian influenza and emerging diseases, and health-sector pandemic preparedness and infectious-disease prevention.[10][4]

Its measurable overall ambitions include halving, by 2015, the three-year rolling average of locally acquired human H5N1 cases and of H5N1-positive poultry or environmental samples from sentinel markets and slaughterhouses. It also sets maximum periods from field reporting to diagnosis and appropriate action of 72 hours for suspected highly pathogenic avian influenza, 14 days for known emerging diseases in livestock and wildlife, and 30 days for new diseases.[11][2]

Implementation

Delivery is government-led and multisectoral, coordinated principally by the Ministry of Agriculture and Rural Development and the Ministry of Health through linked national, provincial and lower-level steering committees. The National Steering Committee for Avian Influenza leads cross-ministry coordination and implementation oversight, while the National Steering Committee for Human Influenza Pandemic Prevention and Control leads national pandemic planning, budgeting, implementation and monitoring.[12][13]

• Coordinate animal health, livestock production, human health, wildlife, environmental management, local authorities, civil society, private providers and development partners through a One Health model.[1][14]
• Finalise and implement a joint ministerial circular to provide a sustainable legal and institutional basis for information-sharing, joint surveillance and joint response between the agriculture and health sectors.[13]
• Use the Partnership on Avian and Human Influenza and its Secretariat, located within the Ministry of Agriculture and Rural Development under joint ministerial supervision, to convene government, United Nations agencies, donors, research bodies, non-governmental organisations and private-sector organisations.[15]
• Mobilise domestic resources and official development assistance, coordinate donor contributions, share technical and policy information, and connect the programme with related national sectors and projects.[16][17]

Operational delivery combines strengthened veterinary command and field services, risk-based vaccination, culling and compensation, movement controls, biosecurity standards, disease-free compartments, traceability, market and slaughterhouse improvements, wildlife-risk management, active and passive surveillance, laboratory networks, and joint animal-human investigations.[5][18][19]In the health sector, it includes electronic reporting for notifiable diseases, community and private-provider surveillance, rapid response teams, applied epidemiology training, border health measures, laboratory quality assurance, hospital preparedness, infection prevention and control, surge capacity and simulation exercises.[20][21][22]

Implementation is supported by behaviour-change and emergency communications, coordinated through the AHI Behaviour Change Working Group under the Partnership. Activities include reviewing evidence and target groups, developing communication materials, engaging mass organisations and commercial stakeholders, promoting safe poultry handling and disease reporting, and integrating messages into health, food safety, hygiene and agricultural programmes.[23][24][25]

Monitoring and evaluation are embedded in delivery. Implementing agencies monitor their own work; the Ministry of Agriculture and Rural Development leads monitoring for the agriculture component and the Ministry of Health for the health component. Overall monitoring and evaluation rests with the National Steering Committee for Avian Influenza, complemented by the pandemic steering committee, with the Partnership Secretariat consolidating national and international inputs.[25][26]Annual, mid-term and final reviews, sectoral milestones, financial-progress reporting and funded joint national-international evaluations are intended to identify gaps, support corrective action and maintain accountability.[25][2]

The estimated five-year implementation cost is 8,069 billion Vietnamese dong, equivalent to 384 million United States dollars. Proposed financing comprises 3,789 billion Vietnamese dong from the State Budget and 4,279 billion Vietnamese dong from official development assistance; private-sector investment is excluded from this programme cost estimate.[27][4][28]

Monitoring & Evaluation

The programme uses a multi-level monitoring and evaluation system to track implementation, outputs and impact across animal health, human health and cross-sectoral preparedness. Implementing agencies monitor their own activities; the Ministry of Agriculture and Rural Development leads Component II monitoring and evaluation, the Ministry of Health leads Component III, and the National Steering Committee for Avian Influenza has overall responsibility, complemented by the National Steering Committee for Human Influenza Pandemic Prevention and Control for pandemic preparedness.[25][29][26]

• Track overall impact by halving the three-year rolling average of locally acquired human H5N1 cases and H5N1-positive poultry or environmental swabs in sentinel markets and slaughterhouses by 2015.[11][2]
• Measure responsiveness by limiting reporting-to-diagnosis-and-action times to 72 hours for suspected highly pathogenic avian influenza, 14 days for known emerging livestock or wildlife diseases, and 30 days for new diseases.[11][2]
• Monitor sectoral indicators on outbreaks, vaccination, laboratory testing and certification, surveillance coverage, reporting timeliness and completeness, outbreak response, joint investigations, culling, illegal poultry seizures and poultry-production planning.[30]
• Expand animal-health surveillance through provincial plans, active and passive surveillance, market and slaughterhouse sampling, outbreak diagnosis, epidemiological investigation, disease-free compartment verification and modelling.[7][31][32]
• Strengthen human-health surveillance through electronic reporting for 26 nationally notifiable diseases, community event-based and rumour surveillance, private-provider reporting, sentinel influenza surveillance, antimicrobial-resistance monitoring and cross-border information exchange.[20][21][33][34]
• Require provinces to develop surveillance plans and investigate, trace and report suspected H5N1 outbreaks, with targets for at least 90% of provinces to submit appropriate plans and at least 90% of suspected outbreaks to be fully investigated.[18][31][32]
• Conduct annual, mid-term and final reviews, supported by the Partnership on Avian and Human Influenza Secretariat, which consolidates national and international monitoring and financial-progress inputs.[25][10][26][2]
• Undertake funded mid-term and final evaluations through joint national and international expert teams.[25][10]
• Report notifiable human and animal health events internationally under the International Health Regulations and World Organisation for Animal Health requirements.[10][35]

The plan also uses simulation exercises, laboratory performance reviews, quality assurance, veterinary-service assessments, after-action reviews and external reviews against the International Health Regulations and Asia Pacific Strategy for Emerging Diseases to identify gaps and adjust implementation.[36][1][37][38][39]Formal reporting schedules and detailed accountability procedures are not consistently specified beyond annual reviews, steering-committee oversight, international reporting and Partnership monitoring.[15][28][35]

Costing & Financing

The estimated cost of implementing the 2011-2015 programme is 8,069 billion Vietnamese dong, equivalent to approximately 384 million United States dollars.[27][28]The proposed financing mix comprises 3,789 billion Vietnamese dong from the State Budget and 4,279 billion Vietnamese dong from official development assistance.[27][28]

• Allocate 44.58 billion Vietnamese dong to enhanced coordination, 4,168 billion Vietnamese dong to agriculture-sector disease control, and 3,857 billion Vietnamese dong to health-sector pandemic preparedness and emerging-disease prevention.[28]
• Mobilise national resources and official development assistance, including grants and loans, while excluding separate private-sector investment from the programme cost estimate.[17][28]
• Use government funding for core administration, baseline veterinary and laboratory operations, selected surveillance, rapid response, vaccination, planning and communications activities.[40][18][32][41]
• Seek donor support for institutional strengthening, laboratory accreditation and equipment, training, active surveillance, research, border capacity, biosecurity, market and slaughterhouse improvements, and programme evaluations.[40][42][31][43]
• Mobilise resources through the Partnership on Avian and Human Influenza, including operational support for its Secretariat and replacement funding after the Government-United Nations Joint Programme on Avian Influenza ended in December 2011.[15][17]

More than 200 million United States dollars was committed during 2006-2010, including at least 70 million United States dollars from government and 132 million United States dollars from official development assistance.[11]Private-sector investment is expected to finance many livestock-sector modifications, while government intervention remains necessary to manage animal-health, public-health and environmental risks.[19][43]The programme identifies potential resource constraints and continued dependence on international assistance, but does not quantify an unfinanced gap beyond proposed State Budget and official development assistance contributions.[28][39]