National Comprehensive Avian and Human Influenza Plan

Objectives

Provide Cambodia with an integrated national framework to control highly pathogenic avian influenza, prevent animal-to-human transmission, prepare for a possible human influenza pandemic, and reduce effects on lives, livelihoods, food security and essential services.[1][2][3]The framework combines animal health, human health, information, education and communication, and inter-ministerial cooperation, with priorities adjusted as pandemic phases change.[2][4]

• Control and eventually eradicate highly pathogenic avian influenza through phased, long-term disease control, rapid detection and response, strengthened veterinary capacity, biosecurity and poultry-sector rehabilitation.[5][6][7]
• Prevent human infection and minimise pandemic consequences through surveillance, case investigation, infection control, laboratory support, health-professional education, public awareness and pandemic planning.[8][9][10]
• Strengthen national veterinary services, including the Department of Animal Health and Production, provincial and district services, village animal health workers and the National Animal Health and Production Investigation Centre.[11][12][13]
• Improve poultry biosecurity across backyard, duck, commercial-farm, movement, market and slaughterhouse systems, while supporting safer production, trade and rural livelihoods.[14][15][16][17]
• Promote practical protective behaviours, including hygiene, safe poultry handling, separation of poultry from living areas and wild birds, safe disposal of carcasses, prompt reporting and early treatment-seeking.[18][19][20]
• Establish legal and institutional capacity for a Pandemic Preparedness, Response and Recovery Plan, integrated into national emergency management and community-based disaster risk reduction.[21][22][23]
• Maintain essential services and support recovery through business-continuity planning, community preparedness and coordinated national emergency operations.[24][25][26]

Implementation

Deliver the strategy through a whole-of-government and multi-sectoral model led by technical animal- and human-health agencies, with the National Committee for Disaster Management coordinating pandemic preparedness, emergency response and recovery.[27][25][28]Implementation combines national policy, decentralised veterinary and health delivery, communication campaigns, surveillance systems, emergency operations and partner-supported capacity building.[7][9][29]

• Coordinate animal-health action through the Ministry of Agriculture, Forestry and Fisheries, the Department of Animal Health and Production, the National Animal Health and Production Investigation Centre, provincial offices, district veterinarians and village animal health workers.[5][30][31]
• Coordinate human-health surveillance and response through the Ministry of Health, health centres, operational districts, Provincial Health Departments, rapid response teams, village health volunteers, private providers and influenza-like illness sentinel surveillance.[9][32]
• Use the National Committee for Disaster Management, chaired by the Prime Minister, to convene ministries, provincial, district and commune disaster-management structures, civil society, private-sector actors, military bodies, United Nations agencies and development partners.[27][29][22]
• Establish an Emergency Coordinator, Pandemic Planning Taskforce, Emergency Operations Centre and sub-national emergency operation centres to manage planning, information flows, simulations, logistics, relief, movement control, medical care and recovery.[25][33][23]
• Strengthen surveillance through community reports, hotlines, village animal health workers, market and sentinel-duck sampling, outbreak investigation, laboratory diagnosis, animal-health information systems and timely feedback to decision-makers.[34][35][36][37]
• Implement outbreak control through confirmation, valuation, culling, safe disposal, disinfection, quarantine, poultry movement restrictions, checkpoints and provincial multi-sectoral committee support.[35][16][38]
• Upgrade laboratory capacity through virology facilities, biosafety systems, quality assurance, virus isolation, serology and Real-Time Polymerase Chain Reaction testing, supported by specialist training and international reference laboratories.[12][37][39]
• Deliver coordinated communication through radio, television, print, internet, hotlines, schools, outreach and interpersonal discussion, engaging local authorities, teachers, monks, health workers, animal health workers, community leaders and media.[19][40][41]
• Coordinate communication through the National Coordinating Committee on Information, Education and Communication for Avian and Human Influenza, jointly moderated by the agriculture and health ministries in World Health Organization phases 3 to 5 and by the National Committee for Disaster Management in phase 6, with the United Nations Children’s Fund as secretariat.[42][41][43]
• Engage the Food and Agriculture Organization, World Health Organization, United Nations Children’s Fund, United Nations Development Programme, Cambodian Red Cross, non-governmental organisations, donors, research institutions and international partners in technical support, funding, communication, surveillance and capacity development.[6][34][4][44]
• Monitor preparedness through emergency-management information systems, data collection and reporting arrangements, vulnerability analysis, field assessments, simulations, regular reviews and external evaluations.[25][22][45][46]
• Mobilise resources through strategy and action-plan budgets, donor coordination and transparent financial-accountability mechanisms; detailed estimates for 2006-2008 identify total requirements of US$26,521,768, existing funding of US$19,730,893 and a balance required of US$6,790,875.[47][48][49]

Monitoring & Evaluation

The plan establishes a multi-sectoral monitoring architecture linking animal health, human health, communication and disaster management, but it does not provide one consolidated indicator framework, common reporting timetable or plan-wide performance-review process.[12][9][23]Surveillance, investigation, information systems, training follow-up, simulations and periodic reviews are the principal accountability mechanisms.[30][32][45]

• Strengthen animal-health surveillance through Village Animal Health Workers, district veterinarians, provincial animal-health offices, the National Animal Health and Production Investigation Centre and laboratory services.[13][34][36][37]
• Collect and analyse field reports, poultry-movement information, morbidity and mortality data, market and sentinel-duck samples, and outbreak-investigation findings to guide rapid control measures.[50][16][36][51]
• Operate laboratory diagnostic, quality-assurance and biosafety functions, including serology, virus isolation and Real-Time Polymerase Chain Reaction testing, with international reference-laboratory support where needed.[12]
• Maintain human-health surveillance through routine syndromic reporting, community event-based reporting, hotline notification, media-rumour surveillance, Rapid Response Teams and influenza-like-illness sentinel sites.[9][32]
• Establish an Emergency Management Information System under the National Committee for Disaster Management to support preparedness assessment, data collection, reporting, vulnerability analysis and active monitoring and evaluation across national and sub-national levels.[29][22][23]
• Require provincial, district and commune structures to submit preparedness, needs, initial-response and final-operation reports, while analysing gaps and overlaps to improve coverage and efficiency.[29][33]
• Use simulations, external evaluations, stakeholder consultation, field assessments and regular reviews to test and refine pandemic preparedness and emergency-response arrangements.[23][45][46]
• Monitor communication and behaviour-change activities through Knowledge, Attitudes and Practices research, distribution review, campaign assessment and indicators on safe poultry handling, hygiene, disposal practices and prompt reporting.[52][53][42][20]
• Track specific pandemic communication outcomes, including home isolation, mask use, public knowledge of reporting channels, treatment-seeking and influenza reporting.[54][55][56][57]
• Apply financial accountability through operational accounting, reporting, external audits and transparent fund-flow arrangements within the Royal Government of Cambodia financing framework.[47][58]

Costing & Financing

Financing is framed around mobilising and coordinating donor, government and partner resources for animal health, human health, communication, disaster management and pandemic preparedness.[59][4][10]Many components identify staff, training, laboratory, logistics, communication, compensation, vaccination and information-system needs, but do not provide activity-level budgets or quantified funding gaps.[12][35][29][60]

• Allocate stated current requirements of US$5.597 million across animal health, human health, information, education and communication, and pandemic preparedness, although the stated allocation for pandemic preparedness is zero.[44][48]
• Recognise that the detailed 2006-2008 resource table gives total requirements of US$26,521,768, existing funding of US$19,730,893 and a balance required of US$6,790,875.[49]
• Mobilise international support from the Food and Agriculture Organization, World Health Organization, United Nations agencies, donors and the World Bank through the United Nations Development Programme, alongside government resources.[6][26][44]
• Use action-plan costing for simulations, information systems, training, consultations, community-based disaster risk management, public awareness and programme support, though the currency for several table entries is not specified.[45][61]
• Provide for compensation of farmers whose poultry are culled or sampled, subject to policy development and available donor support; consider a vaccination fund only if risk-based vaccination becomes appropriate.[35][36]
• Fund priority capacity inputs including laboratory facilities and reagents, protective equipment, surveillance supplies, transport, communications, emergency logistics, training, public awareness and village-level veterinary services.[12][29][62][37]
• Assess cost-effectiveness, cost-benefit and economic impacts to inform eradication and alternative disease-control strategies.[30]
• Recognise poultry-sector disruption, smallholder livelihood losses and broader pandemic-related production losses as material economic risks, while noting that most losses and assumptions are not monetised in the available extracts.[63][64][65]