Sunday, February 27, 2005

No sense of a real emergency

The regional conference in southeast asia aimed at stemming the bird flu that has become endemic in the region is now over. With a few exceptions, the warnings were coming thick and fast, even as another human case was diagnosed in Vietnam.
“We at WHO believe that the world is now in the gravest possible danger of a pandemic,” the director of World Health Organization’s Western Pacific office, Shigeru Omi, told the conference.

“The health impact in terms of death and sickness will be enormous and certainly much greater than SARS,” he said, referring to an outbreak of severe acute respiratory syndrome that killed nearly 800 people two years ago. (AFP via Manila Times)
At the same time all concerned acknowledged that no one can predict if and when the feared pandemic will occur. As one expert said, it is like tossing a coin. But of the two ways we can get it wrong--not being prepared for an actual event versus preparing for an event that doesn't happen--it is clear which mistake is the one we prefer.

The outbreak of Highly Pathogenic Avian Influenza (HPAI) in poultry is unprecedented in its size and geographic scale. The virus has also mutated, increasing its host range to encompass mammals, including humans. Experts at the conference now say there is little hope of eradicating it from southeast asia any time soon, but strenuous efforts can still be made to control it by strengthening veterinary services, surveillance, research into how the virus is spread from bird to bird, what are its most important reservoirs in nature and what are its biological mechanisms of infection. The cost of this was put at between $100 million and $300 million. In an earlier post, we compared this sum to two days of the war in Iraq. The FAO's Vietnam representative Anton Rychenar, being more diplomatic regarding the UN's chief donors, still had an apt comparison:
“By the time the sun sets [on the three-day conference], the rich countries will have spent $3 billion to subsidize their farmers,” he said, referring to subsidies that amount to $1 billion a day. [my emphasis]

Asked how much he was hoping for, he said, “One percent of that is $30 million.”

And despite what some called the “alarmist” message of the Ho Chi Minh City meeting, “Many donor countries say they didn’t get a sense of real emergency,” Rychener said.
Maybe CDC Director Julie Gerberding should do more to promote that sense of urgency among her bosses. Or did I say that already? (here, here, here, here, . . . )