- The Washington Times - Tuesday, November 15, 2005

If avian flu, caused by the virulent influenza strain known as H5N1, sparks a pandemic among humans, no country will be safe. Indeed, if the virus mutates to pass easily between humans and is allowed to spread rapidly, the ensuing pandemic could cripple economies, bring international trade and travel to a standstill, and devastate entire societies. To respond to this threat, the Bush administration has launched an unprecedented international effort.

Why is avian flu so worrying? First, it is uncommonly deadly in animals. In birds, the virus is highly contagious and has led to the deaths of more than 150 million of them in Cambodia, China, Indonesia, Japan, Kazakhstan, Laos, Malaysia, Mongolia, Russia, Thailand, Vietnam and, most recently, Romania, Turkey and Greece. Infected migratory birds threaten flocks and, therefore, people in Europe, the Middle East and Africa. Second, since H5N1 has infected humans only since 1997, people have not developed immunity. In known cases of human infection, more than half die. Victims, mostly in Southeast Asia, now number more than 60. Third, there is potential evidence of limited human-to-human transmission. If the virus mutates to facilitate easier human-to-human transmission, the end result could be a pandemic.

The 1918 Spanish Flu pandemic killed more than 40 million people, and scientists consider another flu pandemic of that scale a worrying possibility. What we do not know is whether a pandemic will come next week, next year or next decade.

Since no country can successfully combat avian flu alone, all countries must join in the fight. The costs of inaction vastly exceed the cost of enhanced preparedness, surveillance, response and containment. The 2003 SARS outbreak cost more than 700 lives and some $80 billion worldwide.

To avoid the much higher toll of a flu pandemic, all countries must elevate the need to address avian flu on their national policy agendas and commit appropriate resources. They must educate their publics, especially in rural communities, and improve surveillance and reporting procedures. Flu viruses first spread slowly and locally, then exponentially and widely, so a flu pandemic can be stopped only if outbreaks are detected early, reported to the World Health Organization and international community, and treated quickly through containment and the administration of antiviral drugs.

An enhanced capacity for rapid response and coordination should be put in place now. With the lives of millions at stake, doing anything else is both dangerous and immoral.

Recognizing the need for an effective global response, the president announced the International Partnership on Avian and Pandemic Influenza at the September meeting of the U.N. General Assembly. The president is personally engaged and has raised this issue directly with, among others, the presidents of China, Indonesia and Russia, as well as the prime minister of Thailand.

This week, during the Asia Pacific Economic Cooperation Leaders’ Meeting in Pusan, Korea, he will also highlight the urgent need to take action. He has met with representatives of the major pharmaceutical companies, whom he encouraged to develop and produce vaccines and anti-flu medicines faster. Our country is working closely with the private sector and more than 90 partner countries and organizations, such as the United Nations, World Health Organization, Food and Agriculture Organization, World Animal Health Organization (OIE), the World Bank, Asia Pacific Economic Cooperation forum and Association of Southeast Asian Nations.

Within the United States, agencies across the federal government are working jointly to implement a $7.1 billion national strategy for combating pandemic influenza. Recently, Secretary of Health and Human Services Secretary Mike Leavitt and I met with key partners in Southeast Asia to engage senior government leaders in the anti-flu effort. The United States has sent two additional multi-agency missions led by USAID to work with health and agriculture experts abroad and offer assistance.

The State Department hosted a major international meeting to develop and implement a comprehensive global strategy to combat avian flu. We have already committed $38 million to prevent the spread of avian influenza in Southeast Asia and the President has just requested an additional $251 million to detect and contain outbreaks around the world. These monies fund such vital measures as preparedness plans, expanded surveillance and testing activities, training of first responders and purchase of protective gear.

Avian flu has not yet mutated in a way that threatens to become a pandemic. If we are lucky and proactive, it never will. But even if H5N1 does not spark a pandemic, another strain could. To prepare, we must work globally and we must work together. When nature strikes, we must be ready.

Paula Dobriansky is undersecretary of state for democracy and global affairs.

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