India's public health risk from the emerging zoonotic bird flu (H5N1) transmission from backyard flock: a call for people-centric actions for improved sustainable development goals.

The escalating global circulation of highly pathogenic avian influenza (HPAI) A(H5N1) viruses, particularly genotype D1.1 within clade 2.3.4.4b, and their increasing transmission to diverse mammal populations and sporadic human cases represent a significant and evolving international public health threat. Recent developments across various continents illustrate this risk, including the emergence and spread of genotypes like D1.1 in North America linked to outbreaks in dairy cattle and poultry, with associated human infections in the United States and Canada. This dynamic global situation poses a significant transboundary transmission risk to India, particularly given the country's position along migratory Central Asian bird routes. Moreover, India's large and unorganized backyard poultry sector, coupled with limited biosecurity measures, the unavailability of vaccines, and weaknesses in public health infrastructure, amplifies the risk of zoonotic transmission, primarily risking the health and livelihoods of over 300 million people engaged in this farming. Therefore, India needs an integrated approach that is localized and "bottom-up", paying special attention to the needs of economically backward sections. This strategy should prioritize risk-based culling, engaging local farmers, promoting cost-effective farm biosecurity measures, incentivizing reporting of suspected cases, and integrating technologies like mobile apps and AI-driven monitoring for better surveillance. This combination of local engagement, technology, and public health preparedness is crucial for mitigating the risk of future outbreaks and protecting both animal and human health while advancing the Sustainable Development Goals.