The Political Economy of HPAI in Thailand Rachel M. Safman, Ph.D.

Key Characteristics Thailand in recovery from Asian Economy crisis at time HPAI hit Thai political system in transition – era of populist & pro-business politics under leadership of Thaksin Shinawatra Thai poultry industry is large, profitable and sophisticated (4 th largest poultry exporter @ time HPAI hit)

Thailand in recovery from Asian Economy crisis at time HPAI hit

Thai political system in transition – era of populist & pro-business politics under leadership of Thaksin Shinawatra

Thai poultry industry is large, profitable and sophisticated (4 th largest poultry exporter @ time HPAI hit)

Overview of the Crisis ~33 million birds destroyed (2,000 flocks infected) $130 M (USD) in losses in first wave of infections alone Human infections: 25 cases, 17 deaths 4 waves of disease (in poultry) with shift from epidemic to endemic pattern of infection

~33 million birds destroyed (2,000 flocks infected)

$130 M (USD) in losses in first wave of infections alone

Human infections: 25 cases, 17 deaths

4 waves of disease (in poultry) with shift from epidemic to endemic pattern of infection

Chronology of HPAI in Thailand I II III IV

Timeline of Major Events 1 st appearance of disease – Nov ’03 Government initially denied HPAI’s presences – treat as point-outbreak Admitted to outbreak in Jan 2004 2 human cases (deaths) 1 st wave: 32/76 provinces affected, 30 M birds culled Jan 2004 Jun 2004 Jan 2005 Jun 2005 Jan 2006

1 st appearance of disease – Nov ’03

Government initially denied HPAI’s presences – treat as point-outbreak

Admitted to outbreak in Jan 2004

2 human cases (deaths)

1 st wave: 32/76 provinces affected, 30 M birds culled

Timeline of Major Events Response to 1 st wave adhered closely to international guidelines 5 km cull radius, movement controls Compensation of farmers @ 75% of market value resulted in high levels of compliance – but logistical complications in implementing culls Export ban (90 days) Jan 2004 Jun 2004 Jan 2005 Jun 2005 Jan 2006

Response to 1 st wave adhered closely to international guidelines

5 km cull radius, movement controls

Compensation of farmers @ 75% of market value resulted in high levels of compliance – but logistical complications in implementing culls

Export ban (90 days)

Timeline of Major Events Virus waned May ’04, re-appeared in July ’04 Attempt to deny re-emergence 2 nd wave more widespread and intense than 1 st (264 districts, ~1500 flocks) More targeted culling reduced economic losses (3 M birds culled) Jan 2004 Jun 2004 Jan 2005 Jun 2005 Jan 2006

Virus waned May ’04, re-appeared in July ’04

Attempt to deny re-emergence

2 nd wave more widespread and intense than 1 st (264 districts, ~1500 flocks)

More targeted culling reduced economic losses (3 M birds culled)

Timeline of Major Events X-ray surveillance introduced Oct 04 Nationwide active case-finding based on house-to-house survey Integrated effort of public health and animal health control authorities Dramatic increase in case detection initially, but ultimately effective in bringing epidemic under control Jan 2004 Jun 2004 Jan 2005 Jun 2005 Jan 2006

X-ray surveillance introduced Oct 04

Nationwide active case-finding based on house-to-house survey

Integrated effort of public health and animal health control authorities

Dramatic increase in case detection initially, but ultimately effective in bringing epidemic under control

Surveillance Rapid Response System

Timeline of Major Events 3 rd “wave” appeared June ’05, following long disease-free hiatus 2 days before TH was to be declared “bird flu free” Limited duration and extent but major psychological blow Infection pattern closer to seasonal recurrence of endemic infection Jan 2004 Jun 2004 Jan 2005 Jun 2005 Jan 2006

3 rd “wave” appeared June ’05, following long disease-free hiatus

2 days before TH was to be declared “bird flu free”

Limited duration and extent but major psychological blow

Infection pattern closer to seasonal recurrence of endemic infection

Timeline of Major Events Data collected via ongoing X-ray surveillance allowed for more targeted intervention Focus on role of ducks as hosts/ vectors of transmission Small poultry producers also targeted National Strategic Plan adopted Jan 2004 Jun 2004 Jan 2005 Jun 2005 Jan 2006

Data collected via ongoing X-ray surveillance allowed for more targeted intervention

Focus on role of ducks as hosts/ vectors of transmission

Small poultry producers also targeted

National Strategic Plan adopted

National Strategic Plan Enhanced bio-security at production points Ongoing disease monitoring w/periodic active surveillance (X-ray campaigns) Public education to promote safe handling and quick response to human disease Capacity building within public health system Integrated response management

Enhanced bio-security at production points

Ongoing disease monitoring w/periodic active surveillance (X-ray campaigns)

Public education to promote safe handling and quick response to human disease

Capacity building within public health system

Integrated response management

Timeline of Major Events Since 2006 TH has experienced semi-annual outbreaks of low intensity, typically v.localized No human cases since early 2006 Response has now shifted (quietly) to more endemic-style of control, though with readiness for large-scale outbreak Jan 2004 Jun 2004 Jan 2005 Jun 2005 Jan 2006

Since 2006 TH has experienced semi-annual outbreaks of low intensity, typically v.localized

No human cases since early 2006

Response has now shifted (quietly) to more endemic-style of control, though with readiness for large-scale outbreak

Major Policy Positions Preventative culling of all susceptible animals within 1-10 km radius of cases Movement controls w.i./10 km – permit needed to move animals from/through Census & registration of livestock Upgrading of livestock facilities No preventative vaccination of animals Readying of public health facilities & staff

Preventative culling of all susceptible animals within 1-10 km radius of cases

Movement controls w.i./10 km – permit needed to move animals from/through

Census & registration of livestock

Upgrading of livestock facilities

No preventative vaccination of animals

Readying of public health facilities & staff

Key Stakeholder Groups Industrial producers Cock-fighting enthusiasts Duck farmers Public Health community

Industrial producers

Cock-fighting enthusiasts

Duck farmers

Public Health community

Industrial Producers Well organized, politically sophisticated Major drivers of government policy Primarily concerned with maintaining (restoring) access to foreign markets Militantly opposed to the use of vaccination (in any subsector) Very closely linked to policy-makers through personal and business connections

Well organized, politically sophisticated

Major drivers of government policy

Primarily concerned with maintaining (restoring) access to foreign markets

Militantly opposed to the use of vaccination (in any subsector)

Very closely linked to policy-makers through personal and business connections

Poultry Population of Thailand Composition by # of birds Composition by # of flocks

Growth of the Thai Poultry Sector

Cock-Fighters Actual number of fighting cocks low (6-10 million birds) but supported politically by larger community of enthusiasts Became proxies for small-holders and rural residents more generally, therefore important constituency for Thaksin Represented through lobbying groups with excellent media access History of defying government policy

Actual number of fighting cocks low (6-10 million birds) but supported politically by larger community of enthusiasts

Became proxies for small-holders and rural residents more generally, therefore important constituency for Thaksin

Represented through lobbying groups with excellent media access

History of defying government policy

Cock-fighters (cont.) Strong proponents of vaccination Cock-fighters badly impacted by movement controls – also poorly served by other gov. policies Used strategies of popular resistance to pressure administration to loosen vaccine and movement controls Widespread subversion of policy – illegal vaccine use & illicit movement of birds

Strong proponents of vaccination

Cock-fighters badly impacted by movement controls – also poorly served by other gov. policies

Used strategies of popular resistance to pressure administration to loosen vaccine and movement controls

Widespread subversion of policy – illegal vaccine use & illicit movement of birds

Fighting Cock Passports

Duck Farmers Industry rose in prominence/importance in wake of economic crisis Formerly sideline enterprise but now main source of income for duck herders Production largely decentralized but funded by locally influential backers Current production techniques: low-cost, high yield (from farmers’ perspective)

Industry rose in prominence/importance in wake of economic crisis

Formerly sideline enterprise but now main source of income for duck herders

Production largely decentralized but funded by locally influential backers

Current production techniques: low-cost, high yield (from farmers’ perspective)

Duck Farmers (cont.) Duck farmers targeted for control after research identified ducks as important reservoir for disease & transmission vector Attempts to shift production to closed-farm systems and prevent trans-provincial movement – strongly opposed by farmers Poor enforcement of legislation – few mechanisms for outreach, enforcement

Duck farmers targeted for control after research identified ducks as important reservoir for disease & transmission vector

Attempts to shift production to closed-farm systems and prevent trans-provincial movement – strongly opposed by farmers

Poor enforcement of legislation – few mechanisms for outreach, enforcement

Public Health Community Human health has long been held up as the central goal of HPAI prevention efforts Public health community in TH is organized, technologically sophisticated and well networked internationally Saw HPAI response as a continuation of earlier outbreaks (HIV, SARS, etc.) Used HPAI as opportunity for capacity building & to raise int’l prestige

Human health has long been held up as the central goal of HPAI prevention efforts

Public health community in TH is organized, technologically sophisticated and well networked internationally

Saw HPAI response as a continuation of earlier outbreaks (HIV, SARS, etc.)

Used HPAI as opportunity for capacity building & to raise int’l prestige

Concluding Comments Thai response gave disproportionate advantage to large producers & nearly wiped out small commercial producers Timing of epidemic emphasized commercial interests over social impact Close alliances between government and industry shifted policy-making out of realm of popular participation

Thai response gave disproportionate advantage to large producers & nearly wiped out small commercial producers

Timing of epidemic emphasized commercial interests over social impact

Close alliances between government and industry shifted policy-making out of realm of popular participation

Concluding comments (cont.) “ Effective” information management preserved image of Thailand internationally while diminishing internal effectiveness of control efforts Public health-veterinary health alliances (SRRT) developed as part of HPAI response may offer effective model for future emergent infectious disease response

“ Effective” information management preserved image of Thailand internationally while diminishing internal effectiveness of control efforts

Public health-veterinary health alliances (SRRT) developed as part of HPAI response may offer effective model for future emergent infectious disease response