September 28, 2005—A global bird flu pandemic could kill between five and 150 million people around the globe. That’s the assessment of David Nabarro, the World Health Organization’s Director General’s representative for health action in crisis. Nabarro was speaking at a meeting at the World Bank in Washington, held during the annual gathering of the Bank and International Monetary Fund. The meeting – called by the Bank – brought together officials from countries hit by bird flu as well as Bank experts and health experts from the UN, and European Commission and comes amid warnings bird flu could be moving towards a form which could be passed between humans. Four people in Indonesia are confirmed to have died from the highly pathogenic H5NI strain of bird flu, which has killed 64 people in four Asian countries since late 2003, and has spread, to Russia and Europe. The meeting was told bird flu was now affecting ten countries around the globe. Joseph Domenech, Chief Animal Health Service with FAO, the Food and Agriculture Organization of the UN, told the meeting due to the migratory patterns of birds, the whole world was now at risk. Nabarro said health authorities were investigating recent deaths in Indonesia, suspected of being caused by the virus. But he said at this stage, current investigations have produced no evidence that the H5NI virus was spreading from person to person. However he warned if there was a flu outbreak which did pass among humans in a country there could be a “pandemic effect across the world within months.” “Once rapid transmission starts it will be hard to stop,” Nabarro said. “There is no time to lose,” Jemal-ud-din Kassum, Vice President for the Bank’s East Asia and Pacific region, told the meeting. “This is a case for all hands on deck…and it needs the top most political support.” Officials at the meeting agreed on the need for a coordinated and integrated approach to combat any outbreak of bird flu – saying there must be country as well as regional plans in place to deal with the issue. Kassum said the level of preparedness within countries in the East Asia region to deal with a pandemic varied considerably. “We have already solicited from teams and countries a sense of where they are in preparation for any outbreak. The early indications are that some countries will need immediate help and long term assistance to attack the problem at source and for surveillance,” he said. To make this happen, he added, donors and governments would have to work together. To this end, Hafiz Pasha, the United Nations Assistant Secretary General for Asia, announced UN Secretary General Kofi Annan had agreed to appoint a special envoy on avian flu and offered the entire UN Resident Coordinator system to help coordinate efforts. The European Commission’s Director for Asia, Fokion Fotiadis, stressed the need for integrated national programs, adding that without country agreement, plans to combat an outbreak would not succeed. He said the political momentum had to be created and “has to be maintained.” Milan Brahmbhatt, the Bank’s lead economist for the East Asia and Pacific region, said a global flu pandemic would come at a high economic cost. He said that some of the immediate economic impact of a pandemic could come from the “uncoordinated efforts of private individuals to avoid infection” – citing the experience of SARS, when people’s attempts to avoid face to face contact with others resulted in large negative shocks to both aggregate demand and supply. Such costs of panic and disruption amounted to about 2% of quarterly GDP in East Asia. Singapore’s former ambassador to the United Nations Tommy Koh told the meeting SARS, while brief, had come at an enormous cost. “It practically shut down tourism, traumatized the nation and caused great economic loss,” he said Ambassador Koh said there were lessons to be learnt from dealing with SARS, including the need of countries’ to be single-minded in dealing with an outbreak, to communicate with the people and gain their support, and the need to have a leadership team in place to direct actions. Kassum too stressed the need for political leadership in dealing with any flu pandemic, saying any response would need the top most political support to deal with the issue in their country. He said while it was vital countries remained in charge, they would need support from the development community. The meeting – during the Bank-IMF annual gathering – is a forerunner to a major conference to be staged in Geneva in November – called by the WHO – to discuss an action plan to fight bird flu.
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