4 November 2005
Preparedness Plans, Vaccine Development, Farmer Compensation Called for, as ECOSOC Holds Special Event on "Urgent, Global" Threat from Avian Flu
NEW YORK, 3 November (UN Headquarters) -- No country was exempt from the spread of Avian flu, and preventing the virus from becoming a pandemic would depend on the willingness and ability of countries to share information about outbreaks and develop preparedness plans, high-level representatives of agencies and departments of the United Nations system stressed today during a special event organized by the Economic and Social Council (ECOSOC) held at Headquarters.
Opening the discussion, Munir Akram (Pakistan), President of ECOSOC, said the world was facing another re-emerging disease -- Avian flu -- which was spreading outside its area of emergence and of which very little was known, except that it was a possible global threat. The virus had spread from Asia to the Middle East and Europe along the path of migratory birds, and there were now fears that it would spread to Africa. The problem was urgent, global and cross-cutting, and necessitated a sustained effort by all. It was also exactly the kind of challenge that the new mandates given to the Council by the recent Summit were designed to address, he said.
The Avian flu, he said, was a call for collective action -- a call for more investment in vaccines and for action that would ensure the entire world shared the costs. To that end, international financial institutions should consider setting up a fund to help put in place preparedness plans and compensate farmers for losses incurred culling their poultry.
Mr. Akram added that the special event was part of a series of initiatives focusing on strengthening the work of the Council by addressing key challenges faced by the international community, which could be considered a concrete implementation of the outcome of the Summit held in September.
Also speaking at the event was General Assembly President Jan Eliasson (Sweden), who stressed that the international community's awareness, preparedness and training were insufficient to deal with a major global disease outbreak. The world was closer to another human influenza pandemic than at any time since the late 1960s, and it was unknown when such a pandemic would strike and how severely. Policymakers were now faced with the dilemma over whether to give more priority to preventing the pandemic's spread or national efforts to ensure vaccines were in place. Controlling Avian flu would depend on countries' willingness and ability to share, without delay, information about outbreaks through the World Health Organization (WHO), the Food and Agricultural Organization (FAO) and the World Organization for Animal Health, and the United Nations must lead that global response.
David Heymann, Assistant Director-General of the WHO, said that, while the avian flu had not yet spread easily among people, it could in the future. To address the problem, the international community could reduce the risk of pandemic virus, and that required minimizing human exposure to the bird flu virus and ensuring fair compensation for farmers whose infected poultry had to be destroyed. In addition, the international community must use the existing influenza virus to the maximum, in the form of vaccines for humans at risk for exposure. Further, countries should develop pandemic preparedness plans. The best protection was an effective vaccine, he added, stressing the need to put resources into vaccine development and manufacturing capacity.
Also speaking during the event was David Nabarro, Senior United Nations System Coordinator for Avian and Human Influenza, who said that he was trying in his new role to make sure that the rest of the United Nations system did what it needed to do to support countries and to back up the technical leadership being provided by the FAO and the WHO. The challenges that Governments and the United Nations system had to work together on included, most importantly, the improvement of the infrastructure for animal health so that the scale of the epidemic of Avian flu could be reduced and stamped out, and to make sure that any new outbreaks were tackled. Such action was needed in every country because of the potential role of wild birds to move the virus around the world. Another challenge was preparedness for the next influenza pandemic, and that required getting together many different parts of Government.
Also taking part in the discussion today were Louise Fresco, Assistant Director-General for Agriculture at the FAO; and Margareta Wahlström, Assistant Secretary-General for Humanitarian Affairs and Deputy Emergency Relief Coordinator.
The representatives of the United States, Malaysia, Canada, China, United Kingdom (on behalf of the European Union), Singapore, Japan, Viet Nam, Thailand and Indonesia participated in the interactive debate and highlighted efforts by their countries to deal with the virus.
Opening the special event, MUNIR AKRAM (Pakistan), President of the Economic and Social Council (ECOSOC), said the world was facing another re-emerging disease, the Avian flu, which was spreading outside its area of emergence and of which very little was known, except that it was a possible global threat. Avian, or bird, flu, like SARS, HIV/AIDS and other new and re-emerging diseases, had demonstrated that no country was exempt from the spread of infectious diseases. The virus had spread from Asia to the Middle East and Europe along the path of migratory birds, and there were now fears that it would spread to Africa, where experts believed health and economic consequences could be severe. One key lesson of the past was that if those new and emerging diseases were not quickly and effectively contained, they could significantly aggravate global threats and problems, and not only in terms of health, but also in financial, trade and even security areas.
Applauding the combined efforts of the Food and Agriculture Organization (FAO), the World Health Organization (WHO) and other entities that had led to greater awareness of the Avian flu threat, he expressed hope that quick and coordinated action of those two organizations -- and the United Nations system as a whole -- to control the spread of the flu would limit its geographical reach, impact and human and economic costs. The Avian flu problem called for strengthening of collaboration at all levels and among all relevant partners, he said. It was a call for collective action -- a call for more investment in vaccines and for action that would ensure the entire world shared the costs. To that end, international financial institutions should consider setting up a fund to help put in place preparedness plans and compensate farmers for losses incurred culling their poultry.
The issue on the agenda today was symptomatic of the challenges that the international community and the United Nations family were facing, as it was urgent, global and cross-cutting, and necessitated a concerted sustained effort by all. It was also exactly the kind of challenge that the new mandates given to the Council by the recent Summit were designed to address, he added.
JAN ELIASSON (Sweden), President of the United Nations General Assembly, said the international community's awareness, preparedness and training were insufficient to deal with a major global disease outbreak. The world was closer to another human influenza pandemic than at any time since the late 1960s. It was unknown when such a pandemic would strike and how severely. Policymakers were now faced with the dilemma over whether to give more priority to preventing the pandemic's spread or national efforts to ensure vaccines were in place. The world needed a multilateral system to deal with the dangers of a human pandemic resulting from avian flu.
SARS killed 800 people and cost $30 billion, he continued. The situation could have been far worse if the Global Outbreak Alert and Response Network of the WHO had not kicked in so well. Controlling Avian flu would depend on countries' willingness and ability to share, without delay, information about outbreaks through the WHO, the FAO and the World Organization for Animal Health. The United Nations must lead that global response. Many of the world's poorest countries had overstretched, underfunded and ill-equipped health services, he said, stressing that it was particularly timely that the General Assembly was considering a draft on action to improve the global public health system.
LOUISE FRESCO, Assistant Director-General for Agriculture at the Food and Agriculture Organization (FAO), said her organization believed that eliminating Avian influenza among poultry could delay or prevent the transformation of the H5N1 virus into a form that would create a human pandemic. The good news was that it was possible to reduce the poultry virus exposure to humans. The bad news, in a way, was that it was necessary to act now, as the problem was very complex. Population growth, urbanization and the rise of incomes increased the demand for animal protein at an exponential rate. Annual growth of the poultry sector now exceeded 5 per cent, and the poultry bird population stood at 18 billion today. With an increase of virus circulation in Asian poultry, there had been numerous events of spillover.
The disease had to be contained at source, that is, in domestic poultry from where transmission to humans occurred. Her organization believed that was possible. To combat Avian flu at its source, the FAO promoted an approach that included the implementation of biosecurity measures aimed at preventing the disease; the improvement of disease surveillance and detection; and controlling the disease, once detected, to limit its spread. In the worse case scenario, the FAO estimated that about $425 million was needed to combat the disease in all countries at risk. Of that, half would be for increased preparedness and surveillance. Only $30 million had been received or pledged thus far, while the FAO had already mobilized more than $7 million of its own resources, she said.
DAVID HEYMANN, Assistant Director-General, World Health Organization (WHO), said when a virus crossed from animals to humans, it could then spread easily among humans. When a virus new to human beings emerged, it infected people and caused them to seriously suffer, and then spread easily to other people. A pandemic could start. While the Avian flu had not yet spread easily among people, it could, in the future. Of the 122 known cases of H5N1, or Avian flu, 60 persons had died. No scientist today could quantify the risk of the H5NI virus, since the virus was unstable and was gradually changing. However, during three past epidemics, millions had died. The SARS outbreak had killed 800 people and resulted in $30 billion in economic damages. Some countries were better able than others to prevent the spread of Avian flu to their poultry flocks by vaccinating them against H5NI or by sheltering domestic stock from infectious migratory birds. However, at present, the world was not able to do the same for pandemic influenza. All countries were at risk for pandemic influenza, regardless of whether they had sick birds.
To address this problem, the international community could reduce the risk of a pandemic virus, he said. That required minimizing human exposure to bird flu virus and ensuring fair compensation for farmers whose infected poultry had to be destroyed. In addition, the international community must use the existing influenza virus to the maximum, in the form of vaccines for humans at risk for exposure. Further, countries should develop pandemic preparedness plans. The WHO had sent information to countries worldwide; more than 40 countries had developed such preparedness plans. Risk communication was also very important before and during pandemics, he said, stressing that all countries must be able to detect, investigate and report cases without delay. Countries must be able to quickly dispatch antiviral stockpiles and take other measures to stop or limit the spread of infection.
The best protection was an effective vaccine, he said, stressing the need to put resources into vaccine development and manufacturing capacity. At present, production capacity of influenza vaccines was 300 million doses, but billions would be required if a pandemic occurred. The lead time between the emergence of the virus and the production of a vaccine must be as short as possible to minimize the death toll. Better surveillance of diseases in animals and humans, field investigations, diagnostic support and incentives for people to report cases were necessary, as were better infrastructure and skills to communicate immediate and long-term need. Supplies of antivirals that could contain infection during a pandemic, such as oseltamivir, were inadequate. Drugs with great potential were being stockpiled. International collaboration was essential for success, he said, noting that the 7 to 9 November meeting among the WHO, the FAO, the World organization for Animal Health, and the World Bank in Geneva would aim to make sure the global response system worked.
DAVID NABARRO, Senior United Nations System Coordinator for Avian and Human Influenza, said Governments were facing some extra difficult challenges regarding Avian flu. With his new role, he was trying to make sure that the rest of the United Nations system did what it needed to do to support countries and to back up the technical leadership being provided by the FAO and the WHO. The challenges that Governments and the United Nations system had to work together on included, most importantly, the improvement of the infrastructure for animal health, so that the scale of the epidemic of Avian flu could be reduced and stamped out and to make sure that any new outbreaks were tackled. Such action was needed in every country because of the potential role of wild birds to move the virus around the world. Another challenge was preparedness for the next influenza pandemic, and that required getting together many different parts of Government.
Another necessity was actually getting the contingency planning done, he continued. It was also important to determine how Governments could make sure that the people most in need received the antiviral medicines, and that such medicines were promptly developed as soon as the pandemic virus appeared. Furthermore, when major crises loomed, Governments depended on help from all different stakeholders in society, he said. Non-governmental organizations and private sector groups were ready to work in response, and it was necessary to bring them in and have them work at the country level, as well as regionally and globally. It was also important to have public communication about the risks of and responses to the problem, as well as to have countries easily get access to the resources, know-how and supplies that were needed. He added that a scheduled meeting in Geneva next week on the subject should yield a programme of work, and that it was very important for all to work together.
MARGARETA WAHLSTRÖM, Assistant Secretary-General for Humanitarian Affairs and Deputy Emergency Relief Coordinator, said it was necessary to mobilize support, at the international level, regarding the problem of Avian flu. It was also necessary to contribute and to apply coordination tools, and to have consistent and coherent communication and information management, as well as early warning planning. That was typically done in support of United Nations country teams. There could also be a range of common services put at the disposal of the system, if needed. That included commonly held logistics resources and good contacts with many Governments that had assets that could provide support. It was also necessary to assist in advocacy and information-sharing, to keep track of resources, and to have early warning and preparedness. She added that it was also important to have a coherent body of information and knowledge, and to keep a clear record of what was advised and what was current knowledge.
During the interactive discussion that followed, the representative of the United States said that on 1 November, United States President Bush had released a national strategy for pandemic influenza, which was available at: www.pandemicflu.gov . He urged all countries to implement national plans immediately. The President would ask for $250 million from United States Congress to fund the strategy, he said, noting that the United States had contributed $25 million to the emergency fund to prevent and control the spread of Avian flue in infected countries, as well as $5.5 million in technical assistance to Asia.
During his recent address to the General Assembly, President Bush has asked affected countries to immediately share information and provide samples to the WHO. Such transparency could prevent and control outbreaks. The first meeting of senior officials in Washington, D.C., in November was central to prevent outbreaks, he said, noting the importance of sufficient vaccine stockpiles, production capacity and distribution. To contain the disease, Asian countries were most concerned with how the international community could intervene with a sustained response to contain the disease and prevent further outbreaks. Next week's meeting in Geneva, organized by the WHO, the FAO and the World Organization for Animal Health would be an opportunity to collaborate further on key issues that could greatly benefit from global cooperation.
The representative of Malaysia said his Government had taken prompt action in eradicating the disease and in being transparent with the public and international community in disseminating information. His Government was also working at the domestic, regional and international levels on influenza and pandemic planning and response measures. In response to a call by the WHO, his Government had also set up a national influenza-planning committee under the Ministry of Health to provide the framework and a plan in dealing with pandemic influenza. His Government believed that cooperation between countries and international organizations, such as the WHO, the FAO and the World Organization of Animal Health were essential to eradicate the disease effectively.
The representative of Canada expressed hope that the international community would not repeat past errors. It must step up international cooperation to deal with a global influenza-pandemic outbreak. During an international meeting of health ministers in Ottawa last week, participants zeroed in on four key needs. That included a multisectoral approach beginning with animal and human health; strengthened capacity for surveillance, diagnosis and rapid response to a range of infectious diseases; a global approach to vaccine production; and coordination of risk communications. Further, health leaders had endorsed full transparency between countries and institutions and the need to give full support to the leadership role of multilateral institutions in addressing the problem.
Canada was committed to reducing the threat to emerging infectious diseases, he said. By establishing a public health agency, it was now equipped with substantive antiviral doses. Canada had given some $15 million to international initiatives with respect to the pandemic. He encouraged regional groups to complement, not duplicate, WHO's work.
The representative of China said the Avian influenza and its potential of becoming a full-blown human influenza had posed a common threat to all countries. His delegation deemed it necessary to support the leading role of the United Nations by strengthening coordination and cooperation between the Organization and its specialized agencies, adjusting priorities, improving efficiency and reducing overlapping. It was also necessary to reinforce regional cooperation, and the Asia-Pacific area should formulate necessary regional strategies, since it had a higher rate of Avian influenza. The international community should also offer necessary financial and technical assistance to help developing countries build their prevention and control capacity, as well as improve their emergency response.
The representative of the United Kingdom, speaking on behalf of the European Union, expressed concern over the need to ensure effective preventive measures and preparedness plans. The overall response must concentrate on developing countries' needs. Early assistance was the best hope for success, followed by long-term assistance to achieve sustainable development and poverty alleviation.
He asked the panellists how the United Nations could assist countries in prioritizing their immediate and long-term assistance needs, for production and stockpiling of vaccines. He also inquired about the best multilateral financing arrangements to enhance coherence and effectiveness and reduce the burden on affected countries that were offered assistance from multiple sources. Further, he asked how coordination could be effectively streamlined so that excessive time was not diverted from operational issues.
The representative of Singapore said there was still time to prevent a pandemic, but would need strong international collaboration. He said there should be a call to individual countries and the global community to support affected and at-risk countries to build their capabilities and capacities and implement action plans. It was also necessary to tackle the challenges upstream and at the source, and to build capacity to produce antiviral drugs and vaccines, and to build trust by having real time transparency and respect for public concerns. That all required intensive international cooperation and, in order to avert a pandemic, the global community must act now, he said.
The representative of Japan said it was necessary to make the most of existing frameworks and resources. Information-sharing was vital in the fight against an outbreak and must be done quickly and transparently. The international community must be prepared to handle associated challenges, including building adequate vaccine stockpiles and transparent distribution systems. Japan was cooperating with the international community towards that end.
The representative of Viet Nam said his country was one of the first affected by Avian flu and its response had been proactive. It had quickly contained affected areas, disinfected farms, and enhanced security. Viet Nam had also promoted an information, communication and education campaign based on transparency. It was important to ensure an early warning to avoid an epidemic outbreak, as well as to strengthen national capacity and improve the exchange of information. His Government actively supported international cooperation, and shared in the view of the necessity of enhanced coordination. Specifically, it believed a significant role could be played by United Nations country teams, the private sector and non-governmental organizations.
The representative of Thailand said, in response to the influenza outbreak, the Government had set up a national committee on influenza pandemic control responsible for mapping out a national strategy and development plan and to serve as coordinating body for relevant information. The 2005-2007 national strategy for Avian flu control and pandemic preparedness would tackle the problem in a sustainable manner. Thailand had learned in the past two years the importance of ensuring that plans were being seriously carried out and had set up an Avian flu-control operating centre. A security system was in place so that all poultry products from Thailand could be identified. Local volunteers were deployed in villages.
Since the first case of avian flu was confirmed early last year, Thailand had been working with the international community. In November 2004, Thailand was made the focal point for South-East Asia to deal with the issue and had provided technical and personnel assistance to neighbouring countries. She said Thailand supported the regional establishment of stockpiles for antiretroviral drugs and the assurance that appropriate medication was deployed in 24 hours of infection. She strongly urged other nations to share resources to fight the disease.
The representative of Indonesia said the epidemic of Avian flu required efforts at all levels, including national, regional and international. Her Government shared the common objective of preventing the virus from spreading further. Indonesia had detected the virus in 2003 and four people had died. thus far. Her Government had instituted a national preparedness mechanism, although it reiterated the importance of continued support in the areas of surveillance, preparedness, and for the provision of affordable antivirals in responding to the epidemic. It also supported active participation of the Secretary-General and the United Nations system.
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