In reaction to the 2009 flu pandemic, governments around the world have responded with sometimes extreme reactions against pigs, which has included the official extermination of all domestic pigs in Egypt and the culling of three wild boars at the Baghdad Zoo in Iraq. Many of these slaughters occurred in Muslim countries, and religious restrictions on the consumption of pork have been cited as influencing the decision to take such action. Many other countries have banned international trade in pigs and pork products.
The World Health Organization (WHO) has stated that there is no reason to believe that pigs are transmitting the flu to humans.[1]
On May 2, the first incidence of transmission of the flu from humans to pigs, was discovered on a farm in Alberta, where infected pigs were discovered.[2] It is suspected that an infected farmhand who recently returned from Mexico infected the animals.[3]
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According to researchers cited by The New York Times, "based on its genetic structure, the new virus is without question a type of swine influenza, derived originally from a strain that lived in pigs".[4] This origin gave rise to the nomenclature "swine flu", largely used by mass media in the first days of the epidemic. Despite this origin, the current strain is a human-to-human transmitted virus, requiring no contact with swine.[5]
International health officials from the CDC, WHO, FAO, OIE and other food organizations have reaffirmed that pork is safe to eat and hogs are not to blame for the epidemic. However, as of early June, China, Russia and more than a dozen other countries were still banning pork imports from the U.S. The World Trade Organisation (WTO) planned to highlight the pork bans in a forthcoming report on protectionism and reiterate that pork is not a source of infection and is safe to eat provided it is prepared properly.[6] Some U.S. officials speculated that the bans may be more about "market share than health concerns," and were costing the hog industry millions of dollars every week.[7] Dave Warner, a spokesman for the Washington-based National Pork Producers Council, pointed out that long-standing disagreements with China and Russia may be a factor.[7][8][9][10]
As a result, by mid-August, pork had become the second-worst commodity investment of 2009, and may fall 33 percent by yearend. U.S. exports plunged 20 percent in the first half of 2009 and are heading for the first annual decline since 1990. Tyson Foods Inc. idled slaughterhouses, and U.S. hog farmers haven’t been profitable in a year. Imports from the U.S. fell 38 percent in Russia this year and 73 percent in China, including Hong Kong, USDA data show.[11]
At the beginning of June 2009, the U.S. Agriculture Department said it would launch a pilot surveillance project to look for new strains of flu virus in pigs. Some experts claim that global health officials have underestimated the risk that pig herds might be a source of new influenza strains, choosing instead to focus on the threat of bird flu. Until recently, health experts have done very little surveillance of influenza among pigs—even though the virus is very common in the animals and just as transmissible as it is among people. Flu viruses have also been shown to pass from pigs to people and from people to pigs.[12]
As reported by Telegraph.co.uk, Afghanistan's only pig has been taken off display in the Kabul Zoo and "quarantined" as a response to visitor's fears about contracting swine flu.[13]
A case of human-to-swine transmission was discovered in Buenos Aires province, on June 25. The hog farm where it occurred has been interdicted.[14]
On May 2, Canadian Food Inspection Agency executive vice-president Brian Evans announced that an infected Alberta farm worker recently returned from Mexico had apparently passed the virus to a swine herd in his care. Although the herd had been quarantined, Evans stressed that the infection represented no threat to food safety and judged the possibility of infected pigs passing the virus back to humans "remote". Evans said the infection of the herd was the first known case of the H1N1 virus being transmitted from humans to pigs.[15]
In Canada in early June, an Alberta pig farmer whose herd was infected with the new swine flu virus culled his entire herd. In May he had already culled 500 animals from his herd. The farm owner said the animals cannot be marketed because they are under quarantine and he is facing a problem with overcrowding.[16]
Transmission from the same herd of pigs back to humans was revealed on 20 July, though it occurred on 7 May when the humans, animal health inspectors, were taking samples from the infected herd with improper self-protective measures.[17]
The People's Republic of China has banned pork imports. [18]
On 29 April 2009, the Egyptian Government announced the decision to slaughter all pigs in the country, roughly 300,000, despite a lack of evidence that the pigs had, or were even suspected of having, the virus.[19][20] This decision reportedly raised religious tensions since pig owners are mostly in the Coptic Christian minority (15% to 20% of the population) in the predominantly Islamic nation. Egyptian human rights lawyer Nadia Tawfiq claimed that the pig extermination was a form of attack on Christians.[21] Many international newspapers attributed the action to the global swine-flu outbreak,[22] even though no cases of swine flu had been reported in the country.[20]
According to the Egyptian Ministry of Health (MOH) the extermination was not based on either the swine flu outbreak, nor it is against a specific group of citizens. On the Elkahira Elyoum TV show, Dr. Hatem El-Gabaly announced the pig extermination was based on the fear that the bird flu could mutate in the unkempt pig herds. The decision was reached because so many of the areas used by pig growers are specifically trash dumps and do not follow any veterinary supervision, unlike most other countries that raise pigs in a tested and controlled environment. The extra attention and urgency by the emergence of the bird flu, then the swine flu, provided an opportunity to act on a plan that had been there for several years, . Josep Domènech, the chief veterinary officer at the U.N. Food and Agriculture Organization (FAO) called the decision "a real mistake", saying that FAO had been trying to reach Egyptian officials but there has been no response.[23]
Egypt commenced the slaughter on 2 May 2009.[1] This led to clashes between pig owners and the police in Cairo. On the next day in Cairo, an estimated 300 Coptic Christian residents of the Manshiyat Nasr district set up blockades on the street in attempt to keep government officers from confiscating their pigs,[21] which led to clashes with the police.[20] Al-Ahram, a widely circulated Egyptian newspaper, reported that owners of destroyed pigs will receive 1000 Egyptian pounds (approximately US$177.70) per animal in compensation,[23] but Reuters reported that the issue was still "under discussion", citing an Egyptian cabinet spokesman.[23]
On June 5, the UK-based Compassion in World Farming organization warned Egypt that its brutal measures and its mass slaughter of pigs could negatively affect Egypt's tourism industry. Philip Lymbery the chief executive of the group was quoted saying that "Britons and people from around the world have joined the international storm of protest against this atrocity in Egypt, with many saying they'll no longer consider Egypt as a possible holiday destination,"[24]
Analysis of the Egyptian health policy for the H1N1 flu pandemic control
By Sameh Seef
2009
Introduction
This article analyses the Egyptian health policy for controlling the pandemic H1N1 flu, exploring its context, content, process, and actors. In purpose of evaluating it based on data collected from literature review and policy documents. According to Leichter Context refers to systemic factors – political, economic and social, both national and international – which may have an effect on health policy. (1) Novel H1N1 “swine flu” or H1N1 is a new influenza virus that was first detected in people in April 2009. Globally the WHO uses a series of six phases of pandemic alert as a system for informing the world of the seriousness of the threat and of the need to launch progressively more intense preparedness activities. The world is presently in phase 6: a new influenza virus subtype is causing disease in humans, and spreading efficiently and sustainability among humans. (2) On July 16, 2009, the WHO the World Health Organization stopped producing global tables showing the numbers of confirmed cases for all countries. So the 2009 influenza pandemic has spread internationally with unprecedented speed. In past pandemics, influenza viruses have needed more than six months to spread as widely as the new H1N1 virus has spread in less than six weeks.(2) In Egypt several hundred thousand pigs were killed in May, in spite of advice from global health authorities that this was unnecessary. Where are pigs are raised and consumed mainly by the Christian minority, which some estimates put at 10 % of the population. Health Ministry estimated there are between 300,000-350,000 pigs in Egypt. (3) Generally in societies where formal hierarchies important, it may be difficult to question or challenge high officials or elder statesmen. The position of ethnic minorities or linguistic differences may lead to certain groups being poorly informed about their rights, or services that do not meet their particular needs. (4), (1) Specifically in Egypt under the present conditions and the activation of emergency law, power is mainly presented by the government and top officials and expressed as thought control. In other words, power is a function of the ability to influence others by shaping their preferences. Reality which might be done through the control of information, the mass media and or through controlling the processes of socialization. Which are hidden under the name of Arab Republic of Egypt and its democratic system and not shown to outsiders. It is an example of elite which can manipulate the values of the masses to reflect their own. Interest groups exist but they are not all equally powerful and do not have equal access to the policy making process. The values of the elite are conservative and consequently any policy change is likely to be incremental. (5)
Political systems: participation, benefits and openness
Egypt is constitutionally a democratic republic based on a multiparty system. The 1971 Constitution provides for the separation of powers between the Executive, Legislature and Judiciary. No constitutional changes have taken place in Egypt since 1980. In the 1980 referendum, the current president, Hosni Mubarak, assumed office with a two-thirds majority vote of the People’s Assembly (PA). (The president is currently in his fifth presidential term.) He holds wide-ranging authorities and is the supreme commander of the armed forces, chair of the higher council for police agencies, and the higher council for judicial entities. The president nominates ministers, appoints 10 of the 454 members of the PA and 88 of the 264 members of the Shura Council, appoints and dismisses governors, university chairs, and other high ranking officials. The president is also the chair of the ruling National Democratic Party (NDP), which has been in power since it was established by former President Anwar Sadat in 1978 and effectively controls local government, the media, and the public sector. (6) Egypt’s 16 legally registered opposition parties’ ability to compete has been frustrated by the NDP’s dominance in the PA with a large majority of almost 90% (Figure 1). However, NDP has experienced a disappointing result in the parliamentary elections of 2000, which has prompted the substantial changes introduced to reform the party led by the President’s son Gamal Mubarak. (6) In terms of openness of the political system the issue currently predominating public discussions is that of “banned” political groupings, i.e. Islamic groups, in particular the Muslim Brotherhood. Standing as independents during the 2000 parliamentary elections, and despite government efforts to discourage participation, the Brotherhood emerged with 17 seats—the largest opposition grouping. Extremist Islamists were responsible for the 1992-99 insurgency aimed at overthrowing the regime and instituting an Islamist state. Drawing followers from the younger and middle classes, the power base of the militants lies in the slums of Cairo and Upper Egypt where poverty and unemployment are widespread. But, weakened by internal divisions and a sustained campaign against militants by the state security forces, as well as a public backlash following the Luxor attack in 1997—where 58 tourists and 4 Egyptians were killed—the militants announced an unconditional ceasefire in March 1999, which is still in force. (6) The results of a household survey showed that the public has little trust in the representational mechanisms of the political system. The mainstream political culture in Egypt still considers public affairs to be governmental a. airs, under the sole authority of central administrators who decide without being accountable to public “demands”. Moreover, representative institutions are unable to mobilize public awareness and gain public trust. Hence, 97% of the household survey respondents do not attend political party meetings or rallies, whilst 94% of them do not discuss community problems with their local representatives, and 99% have never wrote to a newspaper to press for their interest. (6) Women’s representation in the political system is marginal. The current People’s Assembly includes only 11 women (2.43%). Youth participation is also a matter of interest at the national and local level. In late 2000, the President declared a new policy to encourage youth participation in public life. (6) Almost all political parties tend to be elitist, male-dominated and ageing entities, which are dominated by “historic” leaders (e.g. the Unionist, the Labour, and the Umma parties) causing internal splits between “younger” and older generations (e.g. the Nasserist and the Wafd parties). None of the parties explicitly exclude social groupings, for the law regulating political activity preconditions that all parties should be open to all Egyptians. However, most of the established parties are characterized by social classes, (e.g. the NDP being “the government” party, the Wafd representing the upper strata of professionals and liberal entrepreneurs, the Unionist party the radical leftists, and the adjourned Socialist Labour Party representing the Social Islamists).(6)
Problem identification and issue recognition
H1N1 has swept around the world in weeks, infecting millions and killing more than 4735 by official counts. It could worsen as temperatures cool in the Northern Hemisphere, making conditions better for viruses. H1N1 (also referred as "swine flu") is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. (2) As of 11 October 2009, worldwide there have been more than 399232 laboratory confirmed cases of pandemic influenza H1N1 2009 and over 4735 deaths reported to World health organization. (2), (3) The WHO Regional Office for the Eastern Mediterranean (EMRO) reported 13855 cases and 90 deaths. As of 10 October 2009, 23:00 hours, Cairo time, 13,855 laboratory-confirmed cases of Pandemic (H1N1) 2009 were reported to WHO by 21 out of 22 Member States of WHO Eastern Mediterranean Region. Djibouti became the latest country in the Region to report cases of pandemic (H1N1) 2009. There are 90 related deaths from Pandemic (H1N1) 2009 reported, so far, from 12 member states in the Region. These deaths were reported from Saudi Arabia (28), Oman (21), Yemen (11), Kuwait (9), Islamic Republic of Iran (7), Bahrain (4), Egypt (2), Lebanon (2), Syrian Arab Republic (2), Iraq (2), Palestine (1) and Qatar (1). (7) With the increasing incidence rate and wide spreading of the H1N1 flu all over the world with its fatality the Egyptian government considered the issue as high political issue to be place in the political agenda for the taking the necessary measure . The pandemic flu was perceived as crises which open the window for policy, where problem stream, policy stream and political stream all are met together. According to Kingdon’s model, the three streams work along different, largely independent channels until at particular times, which become policy windows, they flow together, or intersect. This is when new issues get onto the agenda and policy is highly likely to change. (8)
According to the position map most power was to the side of the government and policy maker and majority of the Egyptian society presented by Muslims, and low power was presented by the poor farmers and pork industry represented by almost half million Egyptian most of them are from Coptic minority from the Egyptian population, where the church, WHO and NGOs reflected medium power but with no effect as well. As mentioned before how complex is the health system in Egypt and its branching providers , the ministry of health and population developed the national plan for pandemic control with the other concerned ministries and this plan to be conducted at all the country levels . At the 4th of March 2009 it was discussed at the Egyptian parliament generating a law of prohibiting raising of pigs and dealing with its products in all parts of the Egyptian region, and at the same session the parliament agreed on that law to be directed to the concerned authorities to be discussed. At the 27th of April the minister of health and population presented the plan for facing this pandemic flu and mentioned the main aims of this plan and its objectives to be presented and shared by all the concerned ministries including the ministries of education, transportation, environment, agriculture .to control the spreading of the disease and preventing its mortalities. During the 27th session parliament members mentioned that Egypt is an Islamic country and it is logically to not practice such actions ‘‘requesting killing all the pigs in the country, with compensating the farmers for that .others recommended strongly use of the emergency law that is activated in Egypt since the terrorists attacks, and it should be used even it will not be easy for the people to accept it. That all reflecting the pressure of the interest group for certain policy to be formulated and shows how interest groups differ in the way they are treated by governments. Some are given high legitimacy, ‘insider’ status and are regularly consulted. Sectional groups often fall into this category because they are typically powerful and can employ sanctions if they do not approve of a government’s policy. In contrast, cause groups may be highly regarded and consulted but have less recourse to sanctions. They may be perceived as ‘outsider’ groups or even deliberately pursue an ‘outsider’ strategy organizing demonstrations and ensuring a high level of media coverage in a bid to embarrass or put pressure on government.
Policy implementation
At the 28th of the same months after days of the previous discussion , the Egyptian parliament decided to pass the law concerning killing all the pigs , to be done as soon as possible and to be carried out it places where it is exist not in special places or farms as was suggested before . The parliament sent the decision to the government specialists to be acted and giving feedbacks about that. At the 30th of April 2009 Egypt began slaughtering the roughly 300,000 pigs in the country as a precaution against swine flu even though were no cases had been reported there. At the 17th of May 2009 it was discussed by the parliament urgent request of some member about compensating the farmers in satisfactory ways , after they been badly treated from the officials and the way they slaughtered their pigs , that affect the way how Egypt presented for the international society, after slaughtering all the pigs in Egypt that were the main income resource for more than half million of the poor Egyptians, the decision that were acted without discussing its consequences reflecting the community worries about this population of waste collector in the Egyptian society.
The policy implementation had been carried out through top-down approach where the entire policy process passed as a linear sequence of activities in which there was a clear division between policy formulation and policy execution. Goals had been clearly defined and widely understood, the necessary political, administrative, technical and financial resources were available, a chain of command had been established from the centre to the periphery, and a communication and control system had been in place to keep the whole system on course. But pig farmers _ overwhelmingly Christian - were angered. Government efforts to start the slaughter Wednesday were met with farmers who hurled stones at Health Ministry trucks. Also to be mentioned that WHO’s role as policy adviser and broker is emphasized rather than simply contributing to the implementation of routine public health activities in the country. Policy evaluation
For evaluating the Egyptian health policy for swine flu pandemic control, we need to look at some important aspects and look carefully in the process of making and implementing the policy which mainly discussed and carried out in few days even were no cases reported in Egypt, affecting many poor Coptic Egyptian families mainly living at the little income coming from raising the pigs. Egypt's government was hoping to look strong and proactive in the swine flu scare with its decision to slaughter all the country's pigs, after taking heavy criticism at home for poor planning and corruption in past crises .But instead, some Egyptians called the move a knee-jerk overreaction that even the World Health Organization said was unnecessary. Egypt, which has no swine flu cases, is the only country in the world to order a mass pig slaughter in response to the disease. The move mirrored Egypt's battle with bird flu, in which the government killed 25 million birds within weeks in 2006. But international health officials said the swine flu virus that has caused worldwide fear is not transmitted by pigs, and that pig slaughters do nothing to stop its spread. The WHO stopped using the term "swine flu" to avoid confusion. In Egypt, even the editor of a pro-government newspaper criticized the order to slaughter the estimated 300,000 pigs, which was pushed by parliament and issued by the government. Conclusion The extinction of the Egyptian pigs is an example of how a health issue can be used to persecute a minority within a country. Although the current influenza has nothing whatsoever to do with pigs, the previous name of the epidemic was used as an argument to violate the rights of the Christian minority in Egypt.
References
1-Leichter H (1979), a Comparative Approach to Policy Analysis: Health Care Policy in Four Nations. Cambridge: Cambridge University Press. 2-WHO, Global Alert and Response (GAR), http://www.who.int/csr/en/ 3-WHO, Global Alert and Response (GAR), Egypt, http://www.who.int/csr/don/archive/country/egy/en/ update sept 2009. 4- Walt G and Gilson L (1994). Reforming the health sector in developing countries, The central role of policy analysis. Health Policy and Planning 9: 353–70. 5- Lukes S (1974). Power: A Radical Approach. London: Macmillan. 6- United Nations, economic commission for Africa, governance profile, Egypt, 2004, www.uneca.org/dpmd/publications/countryprofiles/Egypt-Final.pdf 7-WHO, Global Alert and Response (GAR), Pandemic (H1N1) 2009 - update 70, http://www.who.int/csr/don/2009_10_16/en/index.html 8- Kingdon J (1984). Agendas Alternatives and Public Policies, Boston: Little Brown & Co.
After a coordination meeting about the flu on April 27, 2009, the Indonesian government halted the importation of pigs and initiated the examination of 9 million pigs in Indonesia.[25]
Adel Salman Musa, the director of the Baghdad Zoo claims to have "received an order issued by the multi-ministry committee aimed at preventing swine flu" to kill Baghdad's supply of three wild boars.[1] He said the cull was initiated "to break a barrier of fear" which had been developed amongst zoo visitors.[26] There had been a decline in the number of visitors in the days prior to the culling.[27]
The health ministry said that killing the pigs would serve no purpose in preventing an outbreak in the country that has no reported cases of swine flu.[1] Ehassan Jafar, a spokesperson for the country's health ministry, said that "it does not matter" since the virus is able to transmit itself between humans now.[1] In its dispute with the agriculture ministry, the health ministry said "if you really want to kill them then just kill them".[1]
The boars were tested prior to their culling, and results proved negative.[26] The zoo's director said they were killed humanely.[26] This involved the use of an anesthetic.[27] The three carcasses were later buried.[27]
The deaths were relayed around the world via Agence France-Presse, CNN, Israel's Ynetnews and China's Xinhua News Agency.[1][26][27][28]
Kurdistan's Regional Government has outlawed boar hunting.[26] The area has a large population of wild boars.[26]
Inhabitants are told to avoid the consumption of pork.[26] Travelers are being monitored for their activity in relation to this.[26]
The Ministry of Agriculture, Forestry and Fisheries of Japan instructed animal quarantine offices across the country to examine any live pigs being brought into the country to make sure they are not infected with the H1N1 strain of influenza.[29] Japanese Agriculture Minister Shigeru Ishiba appeared on television to reassure consumers that it is safe to eat pork.[30] The Japanese farm ministry said that it would not ask for restrictions on pork imports because the virus was unlikely to turn up in pork, and would be killed by cooking.[31]
On April 27, 2009, the government of the Republic of Macedonia prohibited all exports and imports of live pigs.[32]
According to Daily NK, the sale of pork has been prohibited in a portion of the jangmadang because AH1N1 is still sometimes called "swine flu"
No official decree has been issued by the state or any political entity, but some officials of the People’s Safety Agency have been unilaterally preventing the sale of pork. In the Hyesan, Wiyeon and Masan Markets, it is still difficult to find pork.[33]
500 pigs were mass slaughtered on October 16, after swine flu was detected on a farm in Nord-Trøndelag county the week before the slaughtering. Another 900 pigs from a second farm will also be slaughtered. [34][35]
The Philippines issued a ban on pig imports from countries affected by the disease. The ban was lifted on May 4 except imports from Canada because of authorities were still checking the possible transmission of the A(H1N1) from a human to a pig. The pig import ban from Canada was lifted on May 11.[36] [37]
The Russian Federation has banned pork import. [38]
Imports of pork and live pigs from all affected countries have been banned. The ban also applies to all shipments after April 21.[39]
As of June 2009 it was reported that Flu will halt import of pigs [40] by Arab countries.