Even if there is no human pandemic, bird flu threatens to have a devastating effect on the livelihoods of millions of people in Asia and Africa who depend heavily on poultry both for income and food.
Deaths and mass culls have already badly hit rural communities in southeast Asia. In many countries the government says it cannot afford to fully compensate people for destroyed birds.
Aid agencies say inadequate compensation will not only tip millions into extreme poverty but will help spread avian flu by discouraging people from reporting the disease.
"People fear reporting sick birds because their flocks will be destroyed and they may not be compensated for their losses. So instead, they hide the sick birds or sell them and that, in turn, contributes to the transmission of avian flu to new areas." said Sanjay Sinho, CARE International's health programme director.
"Much of the $1.9 billion pledged at the World Bank conference for avian flu must go toward livelihood issues like compensation for destroyed birds, so people will report outbreaks more quickly, and to strengthening health systems."
Whether farmers are compensated at all and by how much varies greatly.
Vietnam, one of the worst hit countries, initially recommended compensating people 50 percent of the value of their birds, but some regions said they could only afford 30 percent, according to the U.N.'s Food and Agricultural Organisation (FAO).
Thailand recommended 70 percent in the early stages but has pushed this up to 100 percent in some cases. By contrast Cambodia said at the end of 2005 it was not planning any compensation at all.
Aid agency ActionAid says the international community must urgently fund generous compensation schemes, public education campaigns and affordable medicines for the poor.
"If we don't act quickly, we will see a human epidemic," ActionAid's Puthanveettil Unnikrishnan said. "And the likelihood is that this will happen first in a poor community in a developing country. Yet the poorest are currently at the bottom of the list as far as global preparations are concerned. Not only is this unjust, it is also foolish."
Escaping poverty
The FAO said a study of one Vietnamese village estimated bird flu had cost households $69-$108 - a large sum when compared to a villager's daily income of $2 or less.
But it is small commercial farmers rather than backyard poultry keepers who are most vulnerable, the FAO says.
Ironically, U.N. agencies and many donor governments have in recent years been promoting small scale poultry farming as a way out of poverty. Chicken is a cheap form of protein and can bring a 700 percent annual return of capital invested.
Encouraged by various development schemes, many people in Asia and West Africa have taken out loans to start small poultry businesses, buying a few hundred birds and building shelters for them.
In countries like Vietnam some of these farmers had not even broken even before having their whole stock destroyed. Compensation, which is only partial, is taking months to come through. Vietnam has urged banks to extend loans to prevent people sinking even further into debt.
The speed of compensation is crucial. India, which saw prices fall 40 percent overnight after the arrival of bird flu in western Maharashtra state in February 2006, has been praised for its prompt payments.
Poultry is one of the fastest-growing sectors in India where there is widespread protein deficiency, particularly in rural areas. The country is the fifth-largest producer of eggs in the world and has nearly 500 million poultry.
There are fears bird flu could affect nutrition levels in poorer countries by reducing people's incomes at the same time as pushing up the price of alternative protein sources. In Indonesia, where bird flu is now endemic, protein choices are already limited - the predominantly Muslim population does not have the option of pork and there is very little beef.
Indian villagers bring their stock of birds to health workers for culling at Digulimalpara village January 20, 2008. Bird flu spread to two new districts in West Bengal, officials confirmed on ...
