Answers by Keith Hansen, World Bank Sector Manager for Health in the Latin America and Caribbean Region, and Julian F. Schweitzer, World Bank Director, Human Development Network
The World Bank and Mexico Finance Minister Agustin Carstens announced April 26 the World Bank would support Mexico’s efforts to fight the spread of influenza A (H1N1) with more than $205 million in fast-disbursing funds (3-5 weeks).
$25 million for drugs and supplies (funds redirected from an ongoing Mexico health project)
$180 million for epidemiologic, regulatory, institutional and operational activities
On April 25, the World Health Organization declared Swine Flu virus a Public Health Emergency of International Concern. WHO did not recommend travel or trade restrictions. WHO and the Global Alert Response Network are sending experts to Mexico to work with health authorities. On April 30th, WHO said it would now refer to the virus as influenza A (H1N1). WHO and partners are investigating reports of suspected cases in other countries as they occur.
How is Mexico coping with the outbreak?
Keith Hansen: Mexico’s health authorities are collaborating with the World Health Organization (WHO), Pan American Health Organization (PAHO), Canada and the United States to learn more about the virus as quickly as they can. The government is communicating openly and regularly with the public on what is known and what is not yet known. At the same time, the country has also taken a number of “social distancing” measures. Some are by government decree, such as closing schools and cancelling attendance at football games. Others are spontaneous private behavior, as people avoid large gatherings. These measures look quite dramatic and have made Mexico City a very quiet place these days, but they are all prudent precautions until we know more about the virus.
What kind of help does the country need right now?
KH: On the medical side, Mexico is using technical assistance from WHO and other specialized agencies, which will help the government and the world to understand exactly what we are confronting. On the financial side, government needs the assurance that it can fund its epidemic preparedness plans in full, especially in these first days when fast action is essential. That is why the Bank mobilized $200 million over the weekend to meet the country’s most urgent needs. Beyond that, the Bank and other organizations are helping arrange discussions with countries that have fought SARS and avian flu to learn the lessons of successful responses, as well sharing lessons from our own extensive experience in supporting these efforts.
Keith Hansen, World Bank Sector Manager for Health in the Latin America and Caribbean Region
How will the rest of the $205 million from the World Bank help Mexico respond to this outbreak and enhance pandemic preparedness?
KH: We are working with the Mexican health authorities right now to determine how precisely they would like to use the money. In the short term, the country is incurring large costs in drugs, tests, supplies, and strategic communications, to name just a few activities. As the situation evolves, it may well face additional expenses for expanded clinical care, surveillance, and other crucial program needs. Since we don’t know yet how this will play out, our goal is to keep the funding as broad and as flexible as possible to help the country cover its costs and adapt to circumstances as often as needed.
How is the World Bank coordinating with other organizations to respond to this emergency?
KH: In the wake of SARS and avian flu, a network of global institutions was developed to enable a coordinated response to future health emergencies. The WHO leads this response, and each of the other agencies (including the World Bank) plays a designated role. These coordination mechanisms were engaged immediately after the news broke from Mexico, and the agencies are working in continual contact throughout the crisis.
What kind of impact will the situation have on trade and the economy?
KH: The World Bank’s paramount concern is with the health and lives of the Mexican people, and the people of any other country that may be affected. The economy is not the measure of all things. Good health is a development outcome in and of itself. Therefore, even if the economic impacts turn out to be small, any effect on health or well-being deserves our most serious attention.
That said, we are also obviously apprehensive about potential economic effects, which could further burden countries already hit hard by the economic crisis. We are especially worried about the potential impact on the poor, who may already face reduced access to health services because of the crisis. In the past, epidemics have brought about reductions in trade, travel, and tourism, and a temporary retreat from market activity. The size of any impact is far too early to forecast. It will depend very much on the scale, the nature, and the duration of the epidemic, and we simply don’t know enough yet to say what those will be. We are, however, sharing with Mexico some lessons of past experience about what form the economic impacts could take, and monitoring the impact closely as the situation evolves, especially on the poor. The good news is that short epidemic episodes seem to have had very limited economic effects. That is all the more reason to confront this new illness as aggressively and rapidly as we can.
Julian F. Schweitzer, World Bank Director, Human Development Network
How prepared is the rest of the world for a pandemic?
Julian Schweitzer: It depends on the country. Generally rich countries will be better prepared in terms of surveillance, diagnosis, availability of treatment, social distancing than poorer countries.
What is the World Bank doing to help countries strengthen their health systems and develop pandemic preparedness plans?
JS: We are working with partners to strengthen health systems which can respond to pandemics in many low income countries and middle income countries. We have also supported improved animal and human disease surveillance systems through avian and human influenza projects in more than 50 countries and have disbursed more than $130 million for this purpose.
This article has been revised to reflect the following correction:
Correction: April 30, 2009 The name of the flu virus was changed to influenza A (H1N1) to reflect WHO guidelines. On April 30, WHO said it would refer to the virus as influenza A (H1N1).