Reducing the risk of HPAI H5N1 transmission to humans in live bird markets using a One Health approach

Reducing the risk of HPAI H5N1 transmission to humans in live bird markets using a One Health approach by strengthening capacity and raising awareness of traders, market managers, and consumers

Pudjiatmoko1, G.B. Utomo2, R. Yahya2, F.C. Zenal2, M. Azhar1, E. Wuryaningsih1 , I. Deviyanti3, D. Pandansari3, S.E. Irianto3, D. Marlina4, T. Saptaningsih4, M.S. Astari2, Mardiatmi1, W.H. Purba4, L. Schoonman2, E. Brum2, J. McGrane2.

1. Directorate General of Livestock and Animal Health Services, Ministry of Agriculture, Indonesia; 

2. Food and Agriculture Organization ECTAD, Indonesia;

3. World Health Organization, Indonesia; 

4. Directorate General of Disease Control and Environmental Health Services, Ministry of Health, Indonesia.

 

INTRODUCTION

The pilot healthy market program conducted by the Ministry of Health (MoH) is based on MoH Decree No. 519/2008 on the implementation guidelines for healthy markets. One element of the One-Health approach to control highly pathogenic avian influenza (HPAI) H5N1 in live bird markets, conducted jointly by the Ministry of Agriculture (MoA), MoH, and local government under the Ministry of Internal Affairs (MoIA), was improving hygiene and sanitation in ten live bird markets in ten districts in Indonesia; namely East Jakarta, Kota Pekalongan, Sragen, Gunung Kidul, Kota Malang, Gianyar, Kota Mataram, Kota Bontang, Kota Metro and Kota Payakumbuh.  The main purpose of the joint intervention program was to improve the understanding, awareness and skills of traders and market managers to implement appropriate cleaning and disinfection activities, enhance food safety inspection and improve hygiene and good sanitary behaviour to reduce the risk of HPAI H5N1 virus transmission to humans associated with live poultry trading.

METHOD

The methods used and focus for joint One Health interventions were:

MoH and WHO focused to improve public health aspects, through the following roles:

strengthen communication and coordination among stakeholders through a municipal health forum and market taskforce

build capacity of market communities on food safety inspection and  Participatory Hygiene and Sanitation Transformation (PHAST) training in markets

develop and disseminate healthy markets Information, Education and Communication (IEC) materials to market communities

repair hand washing facilities and install radio broadcasting systems in markets

 

MoA and FAO focused to improve animal health aspects, through the following roles: 

build the capacity of market communities on cleaning and disinfection practices 

educate the market communities on the danger of HPAI H5N1 infection  from  live poultry trading

 

Local government and MoIA, responsible for pilot locations, focused on implementing the pilot project and ensuring the sustainability of the program 

 

RESULTS

 

The results achieved during the joint interventions were as follows:

The Healthy Market Program was accepted by market communities at 10 pilot markets following intensive communication and coordination by the municipality health forum and the market task force; capacity was built for 329 participants through PHAST, Food Safety inspection, and Cleaning and Disinfection training as well as dissemination of key healthy market messages and the danger of HPAI H5N1 infection.

Improved hygiene and health behavior of market communities were also promoted by market radio broadcasting, which disseminated key messages to market communities; market hand washing facilities were improved.

Local government support was provided for the pilot healthy market program through the improvement of market facilities and infrastructure, especially repairing vending stalls and waste treatment plants, using central and local government resources.  

 

DISCUSSION AND CONCLUSION

H5N1 HPAI control programs in markets must involve all relevant stakeholders (MoH focus on public health, MoA focus on animal health, and MoIA focus on environmental health) and requires a strong legal framework to sustain the program at the local level

The main challenges to joint market interventions are the difficulty of cross-ministerial coordination, lack of budgetary support and market community awareness, as well as the complexity of market management systems

 A key lesson learned from joint interventions was the importance of partnerships among market communities through the establishment of a forum and joint task force with the livestock and veterinary service, the health service, and the market management service to foster a sense of belonging to a healthy market.

REFERENCES

Indonesian Government Regulation No. 47/2014 on Animal Disease Control and Prevention, Jakarta, Indonesia.

Ministry of Agriculture Decree No. 28/ Permentan /2008 on Guidelines for compartmentalization and poultry business zoning, Jakarta, Indonesia.

Ministry of Health Decree No. 519 / Kemenkes / SK / 2008 on Guidelines for the implementation of healthy markets, Jakarta, Indonesia.

UN-FAO, 2015, Biosecurity Guide for Live Poultry Markets, 17th Ed, ISSN 1810-0708,  Rome, Italy.

UN-WHO, 2012, Final Report of Implementing the National Strategic Plan for Avian Influenza (INSPAI), CRIS No. ASIE/2007/145-079, Jakarta, Indonesia.

 

ACKNOWLEDGEMENTS

This poster was supported by the United States Agency for International Development (USAID) with the technical cooperation of the Food and Agriculture Organization of the United Nations (FAO), Emergency Centre for Transboundary Animal Diseases (ECTAD).

This work was performed by staff from the Indonesian Directorate of Animal Health, Directorate General Livestock and Animal Health Services, Ministry of Agriculture; the Directorate of Environmental Health, Directorate General of Disease Control and Environmental Health Services, Ministry of Health, Indonesia; and Local Health Services, Local Livestock Services, market managers and traders in ten pilot markets.