The
“Avian and Human Influenza Control, Preparedness and Response Project” (Sept.
2008 – Nov. 2011) strengthened the capacity of Mongolia’s emergency
departments, public health system and veterinary services to detect and respond
to potential outbreaks of infectious diseases such as an avian and human
pandemic influenza.

Challenge

Mongolia is a land-locked country bordered by China and Russia. Both
countries have reported outbreaks of highly pathogenic avian influenza that
could be transmitted to humans. Mongolia became vulnerable to this serious
disease.

Mongolia also plays a unique role in global response to avian influenza.
Every year, millions of birds migrate through Mongolia between their Arctic
breeding ground and the wintering ground in the south. Monitoring those birds
is an essential task for Mongolia.

In response to the threat posed by the disease, the Government of Mongolia
prepared a three-year National Strategy and Action Plan for Avian and Human
Pandemic Influenza and requested the World Bank to carry out an independent
evaluation of the strategy, which the Bank conducted in 2007. The assessment
noted the country’s progress in disease preparedness but also pointed out the
existing gaps, such as lack of technical and financial resources and low
personnel capacity in Mongolia to fight diseases.

Approach

The project focused on strengthening the capacity of key agencies involved
in the Avian and Human Influenza preparedness and response: the National
Emergency Management Agency (NEMA), the Department of Veterinary Services (DVS)
of the Ministry of Food, the Agriculture and Light Industry of the Ministry of
Health (MOH), and their counterparts at the aimag (province) level. It aimed to
raise awareness among senior policy makers and officials, review and improve
the existing policy and regulatory framework related to the disease, improve
the existing command and control structures with international best practices,
and develop standard operational procedures.

The project also helped establish computer-based early warning and
surveillance systems across the country, equipped response teams in different
sectors with better technical skills, and upgraded infection control and
intensive care facilities in provincial hospitals that could be most exposed to
such diseases.

Results

The project conducted risk assessments on Highly Pathogenic Avian Influenza,
vulnerability to and preparedness for human influenza pandemic, and hospital
infection control. A manual on zoonotic disease risk assessment has also been
developed.

The project initiated Avian Influenza surveillance among poultry in the
country, expanded coverage of early warning and response system for human
diseases and sustained surveillance among wild birds.

A number of national policies and strategies were developed or revised. The
project also helped develop working tools and technical guidelines, including:
Incidence Response Information System (IRIS);
Standard Operating Protocols for rapid response, command and control, surge
capacity;
guideline for exercise and drills, guideline for hospital infection control;
risk communication plan for influenza.
22 joint response teams (including health, agriculture, emergency management,
professional inspection) have been set up across the country.

Capacity for intensive care for severe respiratory infectious diseases has been
built at 6 aimags (provinces) and the National Center for Communicable
Diseases.
3 provincial veterinary laboratories have been accredited for avian influenza
outbreak detection.

The project started building monitoring and evaluation (M&E) capacity in
the country by developing manuals for it and establishing technical working
groups.
Significant progress has been made in the scale and speed with which test
results are processed. This has enabled authorities to treat animals and human
patients faster and more effectively

Bank Contribution and Partners

The project was financed by a grant of US$ 4,656,463 from the Avian and
Human Influenza Facility (AHIF), a trust fund administered by the World Bank
and currently supported by 10 donor agencies led by the European Commission.

A number of international organizations such as the World Health
Organization (WHO), the United Nation’s Food and Agriculture Organization
(FAO), Wildlife Conservation Society, the United Nations Children’s Fund
(UNICEF) and the United Nations Development Programme (UNDP) provided technical
assistance to the project, or supervised the project implementation.

Moving Forward

Mongolia is an ideal place for ongoing Avian Influenza surveillance among
wild birds. At least three migratory routes cross at the country. Many lakes
are the summer habitats for migratory birds. This makes findings from the Avian
Influenza surveillance among wild birds in Mongolia, which are imperative for
the understanding of evolution of avian influenza virus, valuable to the global
community.

The project outcomes are highly sustainable since the One Health Approach is
now set firmly in place in the country. Capacity to respond to other emerging
infectious disease has been also improved and further improvement can be
expected.

Beneficiaries

Ms. Myagmar is a doctor at the Darkhan Uul Central Health Center. “Before,
we used to screen and treat our patients using only stethoscope. Today the
in-patient department in my hospital has 8 different types of modern medical
diagnostic equipments,” she said

Source : World bank