Center for Disease Control (CDC)
Department of Health, Taiwan
November 2005
Introduction
The emerging threat of a pandemic of unprecedented proportion due to the spread of the H5N1 avian influenza has caught the attention of world leaders. The world learned a hard lesson from the crisis of the SARS outbreak in 2003, caused by a lack of cooperation in combating the deadly contagious disease that claimed 800 innocent lives and traumatized the entire world. In January 2004, the world faced disconcerting developments in Southeast Asia, where human lives were at stake as a result of the avian flu. The cost of human lives added a new dimension to a problem thought to be limited only to poultry. With the threat of the next influenza pandemic looming just over the horizon, it is essential to place human lives at the center of discourse, and to ensure that human life prevails over political rhetoric.
The imminent threat to global health posed by a possible outbreak of the avian influenza must be understood in terms of the potential human costs of such a pandemic, and its subsequent effects on the world's economy. Three pandemics occurred in the previous century: the 1918 "Spanish Flu" claimed the lives of 40-50 million people worldwide in less than a year; the "Asian influenza" in 1957 caused an estimated 2 million deaths; and the "Hong Kong influenza" in 1968 took 1 million lives. Several experts have pointed out chilling parallels found in the genetic makeup of the H1N1 strain that was responsible for the 1918 flu pandemic and the virulent strain of avian flu H5N1.
The proliferation of H5N1 is of grave concern for human health for three fundamental reasons. The first reason is the documented ability of the avian pathogen to directly transmit from birds to humans. Second, when contracted by human beings, H5N1 has a 50 percent fatality rate. Third, it is not unlikely that the virus will acquire a human gene - meaning that the virus will become transmittable from one human to another, thereby multiplying the threat to human lives exponentially. These three reasons combined lead to the key reason for the world's concern: the potential of H5N1 to ignite a severe pandemic. In no other area is the link between a non-traditional threat and security as salient as between the spreading of a deadly virus and its threat to world health.
According to Dr. David Nabarro, the United Nations System Coordinator for Avian and Human Influenza, deaths from the next pandemic could reach "from 5 to 150 million." Even the WHO's rather conservative estimate stands at a daunting total of 2.0 million to 7.4 million deaths. The social and economic ramifications could be equally if not more catastrophic. Hence, the avian influenza is a trans-national threat that poses serious challenges to the security of the global village. Given the speed and volume of international air travel today - reflecting the growing inter-connectedness of the world - the virus could effectively spread to all continents in less than 3 months. Dr. Lee Jong-wook, Director-General of the World Health Organization warned that "[w]e are facing a challenge which is potentially much bigger than SARS."
On the vital importance of closer cooperation in global disease prevention, Dr. Lee Jong-wook stated, "[w]e cannot afford any gap in our global surveillance and response network." He added, "[t]he issue of universal access is central to our effort to combat disease." Dr. Lee emphasized the importance of the principles of universality, inclusiveness and non-discrimination. Now – more than ever - there is urgency for immediate action. As the world finds itself on the brink of an alarming pandemic, we must make certain that such cogent words do not fall prey to political manipulation and become yet another unfulfilled promise to the people of the world. One death caused by the world's negligence to effectively respond to the ensuing crisis is one death too many.