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public health, health law, international policy


Global strategy to control highly pathogenic avian influenza (HPAI) has changed dramatically since 2003 when it was first reported that a confirmed bird flu jumped the species barrier to infect a human in Hong Kong. Evidence of this shift in priorities in the global fight against HPAI can be found most clearly in program funding trends. In late 2008 and into 2009, financial commitments from international donors for all HPAI programs dropped significantly. Meanwhile, within HPAI programs, funding shifted substantially away from animal biosecurity projects and into human response and preparedness work. This Article examines three reasons for this shift in priorities: the global experience with the H1N1 pandemic, the rise of the “One World, One Health” movement, and hard-learned lessons about both the locus of HPAI risk within the various sectors of poultry production in developing nations and the difficulty of changing behaviors in the name of making poultry production more secure. The Article concludes that the twin strategies of (1) building an international public health infrastructure that can better respond to emerging infections at the human-animal interface and (2) boosting preparedness for a potential human pandemic, while well-intentioned, are siphoning resources away from HPAI prevention at least in the short-run. Likewise, the strategy within HPAI prevention of concentrating efforts to improve biosecurity in commercial poultry production sectors leaves the vulnerable population in the backyard sector at greater risk for poultry infections that threaten their livelihoods and human infections that threaten their lives unless and until the benefits of commercial biosecurity trickle down to the backyard sector. In the end, we cannot afford public health strategies that short-shrift HPAI programs generally or HPAI prevention efforts in particular – including prevention efforts in the backyard farming sector – while focusing on other priorities.