Globalised disease control and response distortion: a case study of avian influenza pandemic preparedness in Zambia

Abstract

The past decade and a half has witnessed an increased and justified interest in global pandemic preparedness, owing to the unprecedented global spread of infectious disease threats, such as Severe Acute Respiratory Syndrome (SARS), H5N1 avian influenza and H1N1 Influenza. The repercussions of human and animal mortalities, and economic losses, have justified the need for globalised disease control responses through global pandemic preparedness. However, the blurring of the distinction between national and global preparedness has implications for the appropriateness of local disease control responses, particularly for poor resource countries reliant on donor aid to support their own preparedness. Examining the case of avian and pandemic preparedness in Zambia, this article explains how international funding led to a distortion of the pandemic response in this developing country. Despite the gains made under the global call for pandemic preparedness, the resulting avian and pandemic influenza response was inappropriate when weighed against Zambia's risk of an H5N1 incursion and the country's wider trade, agricultural and health priorities. We conclude that pandemic preparedness policy processes should take into consideration both the local policy context and realistic risk assessments of the local likelihood and potential impact of disease to ensure both the appropriateness and the sustainability of disease control measures instituted.

Keywords:

• globalisation
• H5N1
• pandemic preparedness
• policy
• Zambia

Acknowledgements

This work was supported by a PhD fellowship funded by the Beit Trust. The author wishes to acknowledge his supervisor Judith Green, and examiners Ian Scoones and Sandra Mounier-Jack for encouraging him to publish this work. The author also wishes to thank the numerous informants in the Ministries of Agriculture, Health and Trade, who provided invaluable data for this policy study.