Bioscope ‘05

by Dr. Barbara Price

Avian Flu, Poised on the Edge of Pandemic

           As the number and frequency of statements from various experts increases, warning of the certain change of avian flu to human-human transmission and an imminent pandemic, taking a look at global readiness to deal with this is a necessity, but only one of many steps. After the SARS outbreak in Asia two years ago, no one can shirk from understanding the economic and health disaster a pandemic flu will create. While the actual number of deaths and cases from SARS were not high, 774 deaths out of 8099 probable cases in 27 countries, compared to say the deaths from 65,000 deaths from influenza and pneumonia in the US in 2003, the appearance and rapid spread of a new form of flu-like disease created concern around the world. Justifiably, scientists and health-care professionals are worried about the way in which the world has approached the problem of treating, identifying and curbing the transmission of the virus and how we would all fare in an influenza pandemic. The economic loss in Asia for just the part of the year SARS gained worldwide news coverage, was between $11 and 18 billion. Pandemic influenza occur every 20 years or so, but not all raise the concerns the avian flu in China and SE Asia has.

           Some reasons for concerns include the US’s inability to produce and distribute enough vaccine for a regular seasonal change in influenza, a perceived “crisis in health care” for regularly occurring diseases, political confusion with respect to our rights as citizens, and an understanding that interaction with everyone on the planet affects our abilities to survive and prosper. The concerns in the US are the same concerns in every country, with some variations in priorities. The GAO’s recent report of May 26, 2005, Influenza Pandemic, Challenges Remain in Preparedness, highlights only some the US’s concerns and reminds us that even a year after their first report, the CDC only has a DRAFT plan. Most of the report focuses on the responsibilities of various government organizations, including the CDC, WHO, FDA, USDA, various parallel state agencies, DoD, and even the FBI, for influenza surveillance. How these groups will interact for surveillance is unclear. The biggest gaps are in how these groups will interact for treatment programs (procuring and distributing, including setting priorities, vaccines and anti-viral drugs) and restricting disease spread, population control. Without a plan, our best medical responses and treatments are in jeopardy.

           In WWI, during the 1918 pandemic, the US and other governments set priorities on building and maintaining armed forces, at the expense of existing medical knowledge and best practice, and at the expense of individual and civilian rights. Propaganda, limited freedom of speech, and disregard for medical practice overrode the advice of our best medical professionals. In a time of a “global war on terrorism” we will certainly repeat these policies and practices unless we specifically address them now.