and limitations of vaccination as a means to control avian influenza (and prevent the infection of other animals, including humans) are further discussed below. Indonesia’s decision to vaccinate poultry against H5N1 was, however, strongly influenced by the fact that illegal vaccine of questionable quality, some of which may have harbored live influenza virus, was already being used throughout the country (ProMED-mail, 2004k; Soebandrio, 2004). To accompany its offer of a free, safer alternative to illegal vaccine, the Indonesian government launched a multimedia public awareness campaign on avian influenza (Soebandrio, 2004).


In Vietnam, the avian influenza outbreak was recognized comparatively quickly, but several factors hindered effective action to control influenza (see Nguyen in Chapter 2; Nguyen, 2004). These included an initial lack of engagement of the highest levels of government in the institution and enforcement of control measures; a delay in imposing a ban on the movement and consumption of poultry; and disagreement within the country’s scientific community as to how to gauge the threat influenza posed to human health. However, once the grave danger of H5N1 was recognized, the Vietnamese government took action to bring the outbreak rapidly under control through culling in infected premises and a ban on the movement and consumption of poultry. Vietnam’s political structure and media were instrumental in educating the public and gaining popular support for infectious control efforts. CDC also played a key role in quelling the epidemic by providing the Vietnamese government with training and materials for the rapid diagnosis of H5N1.

Vietnam was, however, widely criticized for announcing that H5N1 was controlled on March 30, only 15 days after its last human victim died (ProMED-mail, 2004l,m). Successful eradication of avian influenza is generally believed to take at least 2 to 3 years. Nevertheless it is easy to understand why a country where the poultry industry is important not only to economic stability, but as an affordable source of protein for a growing population would be powerfully motivated to pronounce the end of this devastating epidemic (Nguyen, 2004). Nor is it surprising that expert predictions of a resurgence of influenza in Vietnam were realized, with devastating consequences, as described below (ProMED-mail, 2004l).


Two features of Thailand’s response to the avian flu epidemic merit particular attention: the degree to which the country was prepared to address the outbreak, and its willingness to compensate farmers for their losses. When surveillance for highly pathogenic H5N1 first detected the virus in

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