High-level representatives from some 80
nations and eight international organizations convened
at the U.S. State Department October 7 in the first organizational
session of the International Partnership on Avian and Pandemic
“Our goal really is to elevate the
issue on national agendas, to coordinate efforts among donors
and affected countries to leverage resources wherever we
can,” said a senior State Department official in a
press briefing, “and, in particular, to increase the
transparency and the timeliness of disease reporting.”
President Bush announced formation of the
partnership at the U.N. General Assembly session in New
York September 14.
“If left unchallenged, this virus
could become the first pandemic of the 21st century,”
Bush told the United Nations. “We must not allow that
President Bush and Secretary of Health and
Human Services Michael Leavitt met with leaders of the pharmaceutical
manufacturing industry October 7 about their role in the
prevention of an influenza pandemic.
A strain of avian influenza known as H5N1
has appeared in 11 nations since December 2003, causing
the deaths of an estimated 150 million birds.
In 116 cases so far confirmed by the World
Health Organization (WHO), the disease has infected
humans, resulting in 60 deaths in four nations.
In Indonesia, one of the affected nations,
health officials suspect that dozens more sick patients
also may have bird flu, but their cases have not yet received
official laboratory confirmation by WHO.
All but a handful of these sick people developed
the disease after exposure to sick birds.
International health officials are worried
that the H5N1 virus is on the verge of undergoing a transformation,
allowing easy transmission from person to person through
Those are the conditions that could set
a global pandemic in motion because this particular strain
of influenza only rarely has infected humans.
Prior to 1997, when human cases of H5N1
first appeared in Hong Kong, health officials thought that
people were not susceptible to this strain of bird flu.
Because humans lack prior exposure to this
virus, they lack immunity, making vast numbers vulnerable
to illness and death.
“Disease, as we know, does not respect
borders and spreads quickly across them,” said Under
Secretary of State for Global Affairs Paula Dobriansky,
speaking to partnership representatives October 6.
“If avian flu does mutate to allow
easier human to human transmission,” she added, “the
results would be catastrophic locally, regionally and globally.”
WHO’s official prediction is that
a global pandemic of bird flu could cause 2 million to 7.4
Tens of millions more would suffer illness,
numbers so significant that health officials envision the
closure of workplaces and schools, disruptions in travel
and trade, actions which could cause social and economic
“We are all very aware that every
hour, every day, every week, every month matters right now
in terms of getting as prepared as possible,” said
a top U.S. Agency for International Development (USAID)
official in a press briefing.
Bird flu has become the top priority for
USAID Director Andrew Natsios, he added.
A senior State Department official said
the partnership meetings will focus on three primary topics
in this initial session:
•Prevention: Limiting the spread of
the disease and reducing the risk to humans.
•Response and containment: Planning
rapid action at the first sign of sustained human transmission.
•Preparedness and planning: Developing
national plans for action in the event of outbreaks.
Sharing information is a critical element
in any international strategy. Because of the capability
of infectious disease to spread rapidly through travel and
trade, officials say, every nation must be willing to alert
others and seek help if necessary at the first sign of sustained
“What we’re trying to do is
encourage in a nonthreatening way and a very collaborative
way that a community of nations like this partnership has
a collective responsibility,” said a senior official
from the Department of Health and Human Services (HHS).
The HHS official, who participated in the
October 6 background briefing, added that “all members
have a responsibility to each other, working with the international
organizations, for the good of the rest of mankind, to share
information that they have as early as possible, as accurately
When an individual poultry farmer finds
he has chickens dying, however, the good of mankind may
not be the first thing on his mind.
The farmer is thinking about immediate business
questions – will he lose more birds, will the markets
refuse those who survive, will he suffer an economic loss,
can his operation survive that loss, can his family?
In the face of those hard economic realities,
farmers have an incentive to conceal sickness among their
When sickness is concealed, it can spread
further and faster, and that is when health officials fear
they lose all opportunity to contain spread of the virus.
Another goal of the partnership meeting
is to win commitments from top-level officials of the 80
participating nations that they will adhere to the principle
of transparency, disease surveillance and information sharing.
“If national governments in Southeast
Asia and the Far East and Eurasia are able to tell us early,
be honest with us, share epidemiological samples with us
that might give us better scientific indication of what's
happening, there is an opportunity for us to intervene and
we're ready to do so,” said the HHS official.
“But without that kind of early cooperation,”
he added, “we will pull back to the next firebreak
because we have to begin to protect ourselves.”
Health officials point to the severe acute
respiratory syndrome (SARS) outbreak to emphasize the importance
Some nations withheld information about
an unusual, highly infectious disease for months after it
was first detected in late 2002, when an earlier warning
may have prevented its spread to 26 countries on five continents,
with 8,000 infections and almost 800 deaths.
“We’re very hopeful that every
single government in Asia learned a great lesson out of
the SARS epidemic,” the HHS official said.
For more information on U.S. and international
efforts to combat avian influenza, see Bird
Flu and fact
sheets on the issue.
Washington File Staff Writer