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Fight Avian Flu Among Birds First, UN Expert Urges

Posted on: Thursday, 13 October 2005, 06:00 CDT

By Elisabeth Rosenthal

Far more money is needed to stem the spread of avian flu among birds, the best way to prevent the disease from jumping to people, the newly appointed United Nations official in charge of bird flu preparedness said Tuesday.

"Prevention is going to be cheaper and more effective than waiting for the pandemic to occur," said Dr. David Nabarro, UN coordinator for avian and human influenza. "In order to prevent a pandemic of human infection, we need to intensify the global response to the epidemic of avian influenza" in birds, he said.

In recent months, governments across the world have spent hundreds of millions of dollars stockpiling anti-flu medication and experimental flu vaccine.

The United States alone has ordered $100 million worth of vaccine. Italy has ordered 35 million, or $42 million, worth of medicines. The Netherlands is spending tens of millions of euros to cover a third of its population with anti-flu drugs.

In contrast, the United Nations has a budget of about $7 million to control animal outbreaks of bird flu, he said, but it needs close to $175 million for an effective program.

"In my new role, I am very disturbed that there is still such a gap," he said, noting that it was "essential" that efforts to control the disease in animals be well financed by the international community.

There was an air of urgency to the official comments Tuesday, since the first suspected cases of the deadly Asian strain of avian influenza, A(H5N1), appeared in Europe over the weekend. There were massive bird deaths on a poultry farm in Turkey last week from an avian influenza, and scientists were determining whether the dreaded strain was responsible. A number of milder strains of the virus also exist.

Underscoring his recommendation that the wisest course was to prevent the possible spread to humans by controlling bird outbreaks, Nabarro said that if and when a human pandemic occurred, current vaccine manufacturing processes would be far too slow to provide the shots needed. According to current estimates, it would take six months to provide an adequate supply once a human outbreak started, he said. "In the case of a pandemic we would need to have vaccine much more quickly than that," he said, noting that the United Nations and governments were meeting with vaccine manufacturers in search of a solution.

Until this year, the A(H5N1) virus was limited to Southeast Asia, where it has killed hundreds of millions of birds since its emergence in 1997. But this summer, the virus has made its way steadily westward through China, Mongolia and Russia in flocks of migrating birds, and its arrival in Europe had been predicted by many scientists.

Health officials have flagged this particularly nasty virus as a likely source of a worldwide flu epidemic that could kill millions of people. Such epidemics have occurred periodically throughout history, though the virus responsible is different each time.

Although the Asian virus does not appear to spread among humans, about 120 people have contracted it after close contract with birds in markets and on farms in Southeast Asia. It has proved extremely deadly, killing about half of those infected.

But health officials worry that A(H5N1) could acquire the ability to pass from human to human through several natural processes that would alter slightly its genetic makeup, potentially setting off a wave of human infection. The best strategy to prevent that, officials said, was to "stamp out" avian influenza at its source in the animal world. "There is a window of opportunity right now to reduce the risk," said Louise Fresco, assistant director general of the UN Food and Agriculture Organization, which is based in Rome. "What we know is that we need to act right now on the animal side. If we control H5N1 well we have a very good chance of preventing a human pandemic. It is in out hands."

Scientists believe that the principal route by which the virus spreads among birds is through close contacts in crowded animal markets and farms, Fresco said. To keep the disease in check, veterinarians have recommended improved hygiene in such settings, as well as early detection systems that would allow farmers to identify animals suffering from the Asian flu with lab tests.

Such capabilities are limited to date, especially in poor countries. Though birds started dying in Turkey last week, typing of the virus is not expected to be completed until Wednesday.

"What is required is enhanced preparedness, particularly in countries that haven't seen it before," Nabarro said.

He acknowledged that most developed nations had spent far more money stockpiling drugs for a future human epidemic than for preventing that eventuality by controlling the disease in animals. Such stockpiling is of uncertain value because it is difficult to say whether any vaccine under development would be effective against a mutated virus that affected humans.

Nabarro added, however, that such expenditures should not be regarded as wasteful. "Governments have really difficult choices when deciding how to prepare," he said.

Source: International Herald Tribune

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