Global Action Plan on Pandemic Moves Forward

Delegates from more than 100 nations agree on urgency

Health officials from more than 100 nations agreed November 9 on the key elements of a global action plan to control avian influenza in animals, and in doing so, to limit the threat of a flu pandemic in humans.

A three-day meeting in Geneva ended with recognition of the urgency of providing assistance to the nations where a highly dangerous form of bird flu has been most widespread – primarily countries in Southeast Asia. The session called by the major international health organizations also expressed resolve to identify and respond to an outbreak of disease among humans as soon as it occurs.

This decision comes as the number of human infections rises for the viral strain H5N1. The World Health Organization (WHO) November 9 reported another human death from a form of avian influenza that has caused the deaths of more than 150 million birds through either disease or culling.

A total of 125 human cases have been recorded, 64 of them fatal. All the human cases of the disease have been reported in four nations so far, Vietnam, Thailand, Indonesia and Cambodia. Vietnam, with 92 cases, has the largest number of human cases.

These human cases have given rise to the fear that H5N1 will mutate to become contagious among humans who will have no immunity to this viral strain. Those are the conditions that could lead to pandemic influenza with the potential for millions of deaths, and illness so widespread that economic and social disruption result.

The key steps endorsed by the national representatives meeting in Geneva include:

• Control of the disease in birds with better veterinary services and emergency preparedness plans devised through greater assistance to affected nations;

• Disease surveillance to detect the emergence of disease, supplemented by improved laboratory capacity;

• Rapid containment achieved through better investigation of both animal and human outbreaks; and

• Development of pandemic preparedness plans and improvement in the capacity of health systems.

The International Partnership on Avian and Pandemic Influenza, initiated by the United States in September, is working toward the same goals. Department of Health and Human Services Assistant Secretary for Public Health Emergency Preparedness Stewart Simonson outlined the U.S. concerns about disease surveillance in a presentation at the Geneva meeting. (See related article.)

For more information on U.S. and international efforts to combat avian influenza, see Bird Flu/Avian Influenza.

The text of the joint press release of the WHO, the Food and Agriculture Organization of the United Nations, World Organisation for Animal Health and the World Bank follows:

(begin text)

Joint News Release WHO/FAO/OIE/WORLD BANK
9 November 2005



Global influenza meeting sets key action steps, agrees on urgent need for financing

Geneva -- A global meeting has identified key components of a global action plan to control avian influenza in animals and simultaneously limit the threat of a human influenza pandemic.

More than 600 delegates from over 100 countries agreed that there is an urgent need for financial and other resources for countries which have already been affected by avian influenza, as well as for those which are most at risk, and to identify and respond to a human pandemic the moment it emerges.

In his conclusions to this historic meeting, Dr LEE Jong-wook, Director-General of the World Health Organization (WHO), said: "The world recognizes that this is a major public health challenge. WHO is ready to focus its resources to reduce the risk of a human pandemic. We have plans on paper, but we must now test them. Once a pandemic virus appears, it will be too late."

Experts and officials set out key steps that must be taken in response to the threat of the H5N1 influenza virus which is currently circulating in animals in Asia and has been identified in parts of Europe:

Control at Source in Birds

Improving veterinary services, emergency preparedness plans and control campaigns including culling, vaccination and compensation.

Assisting countries to control avian influenza in animal populations.

Surveillance

Strengthening early detection and rapid response systems for animal and human influenza.

Building and strengthening laboratory capacity.

Rapid Containment

Support and training for the investigation of animal and human cases and clusters, and planning and testing rapid containment activities.

Pandemic Preparedness

Building and testing national pandemic preparedness plans, conducting a global pandemic response exercise, strengthening the capacity of health systems, training clinicians and health managers.

Integrated Country Plans

Developing integrated national plans across all sectors to provide the basis for coordinated technical and financial support.

Communications

To support all of the above, factual and transparent communications, in particular risk communication, is vital.

Dr David Nabarro, Senior UN System Coordinator for Avian and Human Influenza, said: "We must use all our assets and skills to the best effect, avoid duplication, share expertise, learn from our experiences and tune-up our ways of working. We must focus on support for existing country mechanisms and provide integrated global joint plans, programmes and monitoring."

The meeting discussed key financing needs for countries in the short-, medium- and long-term. According to an analysis presented by the World Bank, the needs of affected countries will potentially reach US$ 1 billion over the next three years. This does not include financing for human or animal vaccine development, for antiviral medicines or for compensating farmers for loss of income due to animals which have been culled.

Dr Louise Fresco, Assistant Director-General of the Food and Agriculture Organisation (FAO), said "Many countries where the disease is endemic have already taken action but they are overwhelmed by the situation and require urgent assistance. Fighting the disease in animals is key to our success in limiting the threat of a human pandemic. We know that the virus is being spread by wild birds but we need more research to fully understand their role."

The meeting supported an urgent resource request for US$ 35 million to fund high-priority actions by WHO, FAO, and the World Organisation for Animal Health (OIE) over the next six months. Additionally, surveillance, control and preparedness work in countries requires urgent funding.

Dr Bernard Vallat, the Director-General of the OIE, said, "The priority now must be to address the urgent needs over the next six months. OIE and FAO have identified the key priorities as evaluating and strengthening veterinary services, laboratory and surveillance capacity in affected countries and those most at risk. We must also provide support to the avian influenza network for diagnostic expertise and exchange of isolates with the WHO. I urge you all to remember that we are talking about an international public good."

It is vital to limit the risk of human exposure to the H5N1 virus and the consequent risk of an emergence of a new pandemic virus. WHO's urgent needs are focused on support for countries to improve vital surveillance systems, strengthen early warning systems and build communications capacity. "Time is of the essence," said Dr Margaret Chan, Representative of the WHO Director-General for Pandemic Influenza. "We must act now if we are to have the maximum possible opportunity to contain a pandemic."

"The minute there are more regions or countries with animal outbreaks or human-to-human transmission, the funding needs will increase hugely," said James Adams, Vice-President of the World Bank for Operations and Head of the Bank's Avian Flu Taskforce. "Based on our work here in Geneva over the past three days, we now have a strong business plan to take to the donors financial conference in Beijing in mid-January."

(end text)

(Distributed by the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)