The Bird Flu Virus
Addressing Global Health Threats in the 21st Century

Over the past few months, the American public has received almost daily news updates on the development and evolution of bird flu. Absent the growing media attention surrounding this disease, however, is the bigger story on how our world plans for and manages global health challenges. Indeed, experts at the Center for Disease Control (CDC) and the World Health Organization (WHO) have long been saying – with scant press coverage – that Avian Flu, or any other infectious disease threatening our world, can only be addressed with the cooperation of all levels of governments, countries and international organizations.

The big picture of this potential pandemic is not the disease itself, but rather how our world works together, within the framework of international institutions, so as to meet the challenges of global health threats. In order to understand this, we must start by using the information surrounding the current strain of bird flu, H5N1, as a case study.

What is The Story

In 1918, doctors and scientists lacked the ability to identify and battle a flu pandemic that swept the globe in a matter of weeks and claimed the lives of millions. Today, the world has faster and more efficient means of international travel, and, consequently, pandemics are likely to spread more quickly. Not surprisingly much of the information surrounding bird flu has centered on the idea that in today’s interconnected world, a strain such as H5N1 could connected become a massive pandemic rivaling that of 1918.

History, it seems, also supports this notion. In the past, pandemics emerged in a fairly regular fashion. It has been 37 years since the last outbreak and many experts now warn the world is overdue. Recently, scientists reconstructed the genetic code of the deadly 1918 flu hoping to reveal pertinent information into the current outbreak of H5N1.

What they have found alarming about today’s strain is how quickly it turns deadly in birds. In Southeast Asia, the disease has already infected the bird population. Experts consider it an extremely lethal strain in domestic flocks.

These officials are uncertain whether this particular strain of avian influenza will become easily transmittable among humans. More certain is the idea that someday, in our lifetimes, there will be a serious pandemic that affects us and that this could be it.

What is Being Done

Current energies are focused on control of the disease in domestic birds and making it more difficult for the virus to infect people. To this point, preventative measures have kept the epidemic largely confined to birds with only occasional human infections. The World Organization for Animal Health is working to increase global capacity to recognize sick birds and encouraging people to speak up when they see signs of the disease in their flocks. Global humanitarian, development and relief organizations are investing in education programs that teach hygienic practices for working with poultry and domestic birds. The World Bank and others are identifying efficient means of culling sick flocks, vaccinating poultry and creating methods for sanitary disposal.

The World Health Organization and the UN Senior Coordinator for Avian and Human Influenza are organizing on the ground capacity to prevent and locate “human suspect clusters” – groups of infected people in the same location who are often the first signals of an infectious outbreak. Resources to confirm these outbreaks and provide rapid containment and treatment are needed. Once the first clusters occur, experts estimate we will have about three weeks to contain the disease before it becomes a pandemic.

Concerted efforts are being made to provide the infrastructure to keep services running. If an outbreak were to happen, both healthcare systems and everyday needs such as banking, transportation and sanitation must continue functioning while workers are out sick. All levels of governments, international organizations and NGOs are working to accomplish this goal. Months ago, the WHO put out a global call for countries to develop high levels of preparedness. Recently, the U.S. government urged local and state officials to make sure that services do not cease as a result of the pandemic.

The U.S. can take a leadership role but must work hand in hand with all countries, international organizations and NGOs in order to create an effective and sustained approach to combating global infectious diseases. Thus far, the Bush Administration has supported and funded research into vaccines for diseases like influenza. Over time, governments, individuals and organizations need to coordinate effectively to ensure that these vaccinations reach those most in need – frontline health workers, poultry workers and those within the infection clusters – no matter what country they are in.

The Bush Administration is also developing long-term partnerships with other countries which will help to ensure that there will be lasting solutions in place should a pandemic occur. Yet, while the president has shown urgency and commitment in the national effort to address bird flu, his recent request of $7.1 billion in emergency spending largely misses the point. Only $251 million of the requested money has been earmarked to “detect and contain outbreaks before they spread around the world.”

The Bigger Picture

There is a broader picture to consider, regardless of whether this pandemic happens or not, it is important that the world community become prepared for a global health crisis. For in today’s interconnected world, diseases spread with a speed and over distances that make a future pandemic – even if it is not the current one – seem likely.

Currently, positive steps are being taken. But what is needed is a more pragmatic, long-term approach, one that includes the global community as well as international institutions. In order for preventative strategies to be meaningful, the world must coordinate efforts in the short and long-term and provide equipment and training in places most in need.

Experts have already stated support for effective surveillance in every corner of the world in order to head off a global health challenge of such magnitude. Having the surveillance capacity to correctly identify possible emergence of human-to-human transmission will help slow and stem the spread of the disease. Already, international institutions are coordinating these preventative measures. However, many countries currently lack the know-how or capacity to assist in this much-needed role. It is vital that capable nations form committed partnerships with those countries that lack the resources to set up surveillance capacities.

In addition, cities, countries and towns alike must make business and economic preparations for a possible pandemic. Proper preparedness means having the capability to continue providing essential services should an epidemic surface. Not only hospitals, but banks, supermarkets and trash collectors need to be ready to function even in light of a depleted workforce.

Another important aspect of a global response to emerging health threats is a coordinated system of gathering and dispersing information about the disease. Individuals at every level must understand bird flu and know what to do and who to contact should they be confronted with cases. Other considerations center around access to infrastructure already in place. For example, lab ability to test and identify human cases currently exists, but there is often no way to transport extracted samples to the labs. Governments and their citizens must make coordinated, long-term commitments to ensure that the capacity to recognize and respond to bird flu exists when the time comes.

Our world is fragile when it comes to disease. Borders cannot and will not protect us from pandemics. This is a threat that we need to meet and address at a global level, with long-term, sustained leadership including support for development and peacebuilding operations. While initiatives are being put forward to battle bird flu, more comprehensive approaches need to be implemented in order to address not only this threat but also threats that may happen in the future.

Updated December 15, 2005