The avian flu virus did not spread to any new countries from January to September 2008
A severe global flu epidemic could cost the world economy $3 trillion
Conference in Egypt aimed to keep the world’s focus on the threat of a pandemic
October 27, 2008—The five-year fight against a deadly strain of avian influenza may be at a turning point.
The often-fatal H5N1 virus that mainly affects birds has spread to 61 countries and claimed 245 human lives since it emerged in Hong Kong in 2003. But now the virus has been brought under control in 50 countries. No new countries were infected from January to September this year, according to a new World Bank and United Nations report.
“We are at a watershed moment in the global fight against infectious diseases,” says Piers E. Merrick, who helps coordinate the World Bank’s avian flu response in the East Asia and Pacific region.
Avian flu itself is still a pandemic threat, but it also “harbingers a more persistent global threat because it represents just one in a steady stream of diseases” that could emerge in future and jump from animals or birds to humans, he says.
“Although we have done well with avian and human influenza, addressing many of these infections will require a more sophisticated and comprehensive long-term action plan,” Merrick says.
Stakes Are High
The virus is entrenched and “still circulating” in a number of hotspots, including Indonesia, Pakistan, parts of China, Bangladesh and from time to time in India (West Bengal), Thailand, Lao PDR, and Vietnam. Nigeria and Togo both recently experienced outbreaks.
It’s also constantly mutating and could change to a form that spreads among humans, says Olga Jonas, the World Bank’s Avian and Human Influenza Global Program Coordinator.
“Human to human transmission would be a catastrophic event,” she says. “In six months, the virus would hit people in every part of the world.”
With those stakes in mind, representatives from more than 120 nations went to Egypt to take stock of efforts to contain the virus. Also high on the agenda was the need for comprehensive pandemic plans around the globe.
Egypt is one of several nations that have mounted vigorous responses to the virus. The country has had 50 human cases of avian flu since 2006, about half of them fatal. The government is now waging a public information campaign to encourage safe practices in the handling of poultry.
But many developing countries lack adequate prevention, response and pandemic plans, says the World Bank-UN report.
“We have to look at the fragility and susceptibility of the whole world,” David Nabarro, Senior UN System Influenza Coordinator, said in a recent interview. Countries are not relevant when it comes to a virus of this kind. The whole world is at risk.”
$2.7 Billion Pledged Since First Outbreak
Countries have pledged some $2.7 billion to combat avian flu since the 2003 H5N1 outbreak. About $1.5 billion, mostly in grants, was disbursed during virus outbreaks and used for animal health, pandemic preparedness, and compensation for farmers forced to destroy poultry stocks. Some 600 million chickens have died or been culled in the last five years.
World Bank financing has been used to complement bilateral assistance, which is often in the form of in-kind aid. The Bank has disbursed $100 million of $400 million in commitments for 55 avian flu response and preparedness operations (mainly culling) in more than 50 countries, says Jonas.
Egypt has reported more than 1000 outbreaks of bird flu in poultry, mostly in the Nile Delta region
About a quarter of this financing is from the Bank-administered Avian and Human Influenza Facility, which has received important contributions from the European Commission and eight other donors. The Asian Development Bank has committed another $40 million in loans.
Countries had an opportunity to offer additional financial support at the Egypt conference (the United States pledged $320 million), but “at this point political commitment on response and preparedness is as important as funding,” Jonas says.
Merrick says all countries need to develop pandemic preparedness plans that are part of an “overarching multihazard architecture.”
These plans need to cover more than just the health sector. Banks, government agencies, grocery stores, utilities, and police all need business continuity plans to allow them to keep functioning even if, as expected, a third of the workforce is ill during a pandemic.
Merrick says the “largely effective” global response so far to the avian flu threat should stand as an example of what can be achieved through “sustained investment and focus on public and veterinary health systems.”
Bank-UN Global Progress Report
The Bank-UN Global Progress Report, “Responses to Avian Influenza and State of Pandemic Readiness,” says a global analysis indicates there have been fewer outbreaks of avian flu in poultry, fewer human cases and fewer deaths compared to the same period in 2006-2007.
By September 2008, there were 36 human cases and 28 deaths, mostly in Indonesia, although Egypt, China and Vietnam continue to experience cases and deaths, the report says. Bangladesh is the only new country in 2008 to experience a human case.
No countries were newly infected from January to September 2008, and only 20 countries have experienced outbreaks so far this year (versus 25 in 2007).
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