Avian Flu Pandemic – Not A Question of If, But When, and How Severe?

			> Interview with Dr. Olusoji Adeyi (mp3)

October 19, 2005 — Nobody knows what an avian flu pandemic would do, but a severe pandemic among humans could lead to the collapse of the global economy and society as we know it.

That’s the view of Dr Olusoji Adeyi, Coordinator of Public Health programs at the World Bank, if there’s a rapid spread of a killer pandemic across the globe.

Dr Adeyi is candid in his assessment about the prospect of avian flu – commonly known as bird flu – spreading from birds to humans.

"The probably is very high. So it’s not a question of if, it’s a question of when this is going to happen, how rapidly it will happen and how devastating it might be," Dr Adeyi says.

"Now in that scenario, even if one country were able to hunker down – if one country were able to immunize all its residents effectively – what about the knock on effect of the potential global economic meltdown?

Dr Olusoji Adeyi, Coordinator of Public Health programs at the World Bank.

Dr Adeyi says in the event of a rapidly spreading pandemic of avian influenza, the world would "face a difficult time indeed."

Worse Case Scenario

"Picture a situation where there is utter confusion. People are confused because they don’t have access to all the necessary information.

"Health care workers might be dying in large numbers therefore the health services as we know them might cease to function. Supply and distribution chains might break down. We don’t know in that kind of scenario what the armed forces and police will be capable of doing. "

Global estimates of the death toll from an avian flu pandemic vary. Dr Adeyi says at this stage no-one knows.

"Nobody knows. Extrapolations from previous experiences particularly the 1917 to 1918 pandemic suggest we could be looking at a very wide range – anywhere from five million to over a hundred million people."

As for how long a pandemic would affect the world? Dr Adeyi says that depends on how many people are infected on average by each person.

"An epidemic dies out eventually if each person who is infected in turn infects less than one person on average. So we don’t know exactly how long it might take. It could be anywhere – 12 or 24 months. I cannot tell you an exact number."

Level of Preparedness

Amid the dire possibilities, Dr Adeyi says he believes awareness is now high.

"At the global level, we are seeing the emergence of a global architecture for addressing the issue with leadership from the World Health Organization and the World Organization for Animal Health and others including the World Bank.

"So I think the international organizations are swinging into action. That said, it’s going to be a very hard slog, but it’s doable."

Need for Surveillance

Dr Adeyi says one of the key considerations will be tackling the problem at source – trying to stem the disease before it spreads from birds to humans is a first step and eventually addressing the pockets of human infection as they occur.

For that, he says open lines of communications are needed across countries so that information flow is unimpeded so rapid action can be taken if there are outbreaks in one part of the world.

Dr Adeyi says the need for effective surveillance is crucial – and that there are trained workers with the equipment required to do their work.

"Without an effective surveillance system in public health, it’s like an army fighting without any command and control facilities whatsoever."

A Question of Timing

Dr Adeyi says as effective containment of any outbreak depends largely on timing.

"If it hits today for example, then all bets are off. Even if one identified the particular strain of virus you need a long lead time to produce vaccines and get them out.

"But if it hits in two years, then that’s a different story. It will then be dependent in part on how effectively we utilize the next two years to prepare for that scenario."

High Risk

Dr Michael Osterholm, the Director of the Centre for Infectious Disease Research and Policy at the University of Minnesota in the United States also believes an outbreak of avian flu among humans is inevitable.

He describes the risk of a pandemic as a "one."

"We are potentially sitting on the cliff of a pandemic of avian influenza. I lay awake at night thinking about pandemic influenza. It scares the hell out of me."

And like Dr Adeyi he warns an outbreak could potentially have severe global economic consequences

"If we could – and we can’t – but if we could find a vaccine that could be readily available to US citizens shortly after or near the onset of the new influenza pandemic, and we could protect all of us, the collateral damage to the country would be unimaginable anyway," Dr Osterholm says.

"It’s because we live in a global just in time economy today that depends on both the developed and developing worlds. "

"Do you realize when global transportation shuts down; we could lose most of our food supply both domestically or as it is brought in from foreign countries?"

"I could go through a long list of essential products and services that will collapse with the collapse of the global economy associated with a pandemic, because of what I believe will be an inevitable closing of borders."

"And that’s even if we are fully protected."