Monday, November 28, 2005

Avian flu ... more cases reported

In announcing two new reported cases of H5N1 avian influenza, the Bloomberg wire report concludes: "The virus so far has infected about 132 people in Cambodia, Indonesia, Thailand, Vietnam and China and killed 68 of them, the World Health Organization said on Nov. 25. Bird flu outbreaks in poultry increase the risk of the virus mutating into a strain that's more easily transmissible between humans, leading to a pandemic that may kill millions."

The magazine recently held a joint event with the Eurasia Group on November 15. Dr. Libbie Prescott noted that even if the high mortality rates we've seen so far drop significantly (noting that in some villages or regions a combination of factors, including lowered resistance, malnutrition, and isolation have worked to enhance the lethality of the virus), that the potential for panic and short term economic and social dislocations could be highly disruptive.

Libby was a contributor to the fall issue of the magazine (the Asian Issue Supplement), and I recommend her article in full --but let me close this post with one of her more disturbing observations about some of the choices leaders may face:

In the face of a growing epidemic and a shortage of the supplies needed to protect against transmission, political officials will need to decide how to allocate valuable resources. There is little doubt that, in a crisis situation with closed borders, governments would hold products made within their borders for their own citizens. Presently, there is a concentration of production capacity for critical interventions in developed countries, leaving most of the developing world without the capacity to create products that might be the front line of defense against an epidemic. There are only nine countries--Australia, Canada, France, Germany, Italy, Japan, the Netherlands, the United Kingdom and the United States--that have existing infrastructure to make an influenza vaccine, and the much touted antiviral treatment Tamiflu is manufactured at a single plant in Switzerland. In a situation where the United States has enough antiviral therapy to treat only 1 percent of its citizens, would it be willing to donate doses to treat the citizens of other countries, even, minimally, foreign heads of state? What would be the political ramifications of denying such a request? Sharing coveted resources with countries experiencing the first wave of infections might be politically difficult to sell domestically, forcing leaders to decide between the appearance of protecting their coveted stocks or assisting neighbors in a crisis.

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