Pandemic perpardeness and multi-sectoral zoonosis risk management: a case study of avian and human influenza prevention and control policy development across

Abstract

Emerging zoonoses have unique consequences for the animal health, public health and trade sectors. This study examined the links between policy. zoonoses, and risk in Zambia and assessed the feasibility of a World Organisation for Animal Health (OlE) risk analysis in informing risk management in this context. The research was a qualitative case study drawing on: in-depth interviews with key informants; informal interviews; documentary review and observation. Snowball sampling was used to select informants directly involved in avian (H5Nl) and human influenza policy development and/or livestock trade policy implementation at national level. A chronology of avian and human influenza policy development in Zambia over the period 2005-2009 was constructed. Policy process and interpretivist policy analysis theories guided analysis. In this resource-constrained setting, external international agendas were found to have considerable influence on policy. National stakeholders initially framed H5Nl as an imminent threat and largely animal health problem. This prioritized the involvement of health and agricultural actors in the policy process and excluded those from trade and other key sectors. H5Nl was a plausible threat to agriculture, and a potential threat to human health, but perceptions of risk presented real economic repercussions for the poultry industry. Despite challenges in coordinating the policy response, the policy process had tangible benefits for Zambia in terms of pandemic preparedness and for raising the profile of the previously underrecognised poultry industry. This study suggests the weighing of both local policy and ecological configurations in assessment of risk and the design of zoonotic disease mitigation policies. While feasible, the merits of an OlE risk analysis in informing policy development in this context would be enhanced by a careful consideration and inclusion of policy processes. An objective and discursive approach to analysis of risk, appropriately communicated to stakeholders, would improve collaboration in disease management across sectors.