In 2010, the number of countries where H5N1 HPAI was reported increased to 18 (from 12 in 2009), and the overall number of reported outbreaks worldwide also increased. The disease was reintroduced to five countries, including Bulgaria and Romania, which were the first disease events in Europe since 2008. Human fatalities continued to occur. Thus, H5N1 HPAI continues to be a major concern, including the risk of human infection. This report highlights achievements and directions in combating HPAI, animal diseases which have an impact on livelihoods and food security, and in the case of zoonotic diseases, those which threaten human health.