US Special Rep. on Avian and Pandemic Influenza
Remarks at The National Chicken Council Annual Conference
Ambassador John E. Lange, Special Representative on Avian and Pandemic Influenza
October 5, 2006
As prepared for delivery
First, let me begin by expressing my appreciation to Chairman Jackson, President Watts and the other organizers of this conference for inviting me to speak. As the Senior Coordinator of the office in the U.S. Department of State established to coordinate the U.S. Government international efforts to combat avian and pandemic influenza, I am especially pleased to have this opportunity to address key executives of the poultry and allied industries. We obviously share a common goal: to confront and contain the threat of avian influenza and its possible mutation into a human pandemic, to stop it at its source, preventing its entry into the United States.
In this regard, I should state up front that my remarks here -- and I know that time is limited -- will be confined to addressing the nature of the avian threat abroad and the measures the U.S. Government and the international community are taking to limit that threat. In contrast, the vastly important responsibility of how we might deal with the possibility of a human pandemic outbreak in this country primarily falls under the purview of other government agencies, particularly the Departments of Health and Human Services, Homeland Security, Agriculture, and Defense.
To accomplish this in a coordinated way, President Bush directed the Homeland Security Council to issue the National Strategy for Pandemic Influenza.
The 227-page Implementation Plan for the U.S. National Strategy ensures that U.S. Government efforts and resources will be brought to bear, domestically and internationally, in a coordinated manner. The Plan encompasses both animal health (highly pathogenic avian influenza H5N1) and human health (the possibility of a human pandemic). It includes an outline of the roles of U.S. Government agencies in addressing the threat to avian populations abroad -- that is, in trying to stop what heretofore has been an ominous march of the highly-pathogenic H5N1 virus from east to west across the globe. And this is my main topic today: how the U.S. Government, in concert with the international community and on many fronts, is rising to the challenge of avian influenza. But first, let me take a few minutes to describe what we're up against, and why our limited successes are so important.
I said that avian flu is on the march. And indeed it is, as you will see from this slide. Think about these statistics. When the highly pathogenic H5N1 strain of avian influenza showed up in Hong Kong in 1997, it killed a lot of chickens and six people. Fearful of a possible pandemic, health authorities took the extreme step of ordering the slaughter of every chicken in Hong Kong. The H5N1 virus virtually disappeared for a few years, only to reappear -- again in many, many birds and very few people -- in Southeast Asia in 2003. Since then it has spread throughout Asia, then to Europe and Africa. It is almost inevitably on its way to the Americas. As of June 2004, the highly-pathogenic H5N1 virus had appeared in six East Asian countries. By January of this year, 14 countries had reported outbreaks. And now, only nine months later, a total of 55 countries have been affected. The geography of this aggressive spread is sobering: the first African cases appeared in Nigeria in February. That same month, Italy, Greece, Germany, Austria, France, Iran, Niger, and Egypt reported cases. March added Poland, Afghanistan, Burma, Denmark, Pakistan, and Jordan. Britain, Ivory Coast, Burkina Faso, Cameroon, and Sudan followed in AprilÂ—and the list goes on.
Equally disturbing, we began to see areas in which the disease appeared to have become endemic. For example, while Vietnam and Thailand reported enormous successes in controlling the virus, Indonesia and Nigeria emerged as areas in which containment efforts could not be implemented as efficiently as had been the case by the authorities in Hong Kong, Hanoi and Bangkok. For a variety of reasons -- administrative decentralization, cultural differences, a paucity of resources -- Indonesia and sub-Saharan Africa saw a rapid spread of the virus, to the point that last month Indonesia overtook Vietnam as the country with the highest number of human fatalities (52, versus Vietnam's 42, and Vietnam has not had a case, fatal or not, since 2005). Indeed, it is safe to say that Indonesia has become ground-zero in the fight to contain avian flu and to prevent the virus from mutating into one that can spread efficiently and on a sustained basis human-to-human.
So the virus is advancing, country-to-country. The question is, of course, what can one do about it? Here the picture is more encouraging, and I will address it in a moment. But first, let me outline a few figures on losses already incurred as a result of the avian disease, and the possible economic consequences of a human pandemic.
The United Nations' Food and Agriculture Organization reports that over 200 million poultry have died or been culled worldwide since the end of 2003 -- a tremendous economic loss in itself, which is multiplied by losses from lower egg production and reduced activity in distribution channels. The largest declines have occurred in Vietnam and Thailand, where they were equal to 15-20 percent of the stock of poultry. In the spring of this year, consumption of poultry meat dropped by more than half in some states in the European Union. And the European public harbored misunderstandings about the nature of the problem. According to a European Commission survey of 25,000 people in 25 countries done in March and April, 28% of respondents did not know that avian flu cannot be transmitted through properly cooked eggs and poultry meat.
What would be the cost of a human pandemic? According to one worst-case scenario by Australia's Lowry Institute, a human influenza pandemic could lead to $4.4 trillion of lost economic output and could kill 142 million people worldwide. On a less draconian note, the World Bank has estimated that a severe avian flu pandemic among humans could cost the global economy about 3.1% of gross domestic product -- around $1.25 trillion on a world gross domestic product of $40 trillion.
I said earlier I would outline what we and the international community are doing to combat the spread of avian influenza and avert a human pandemic. The fact is, as you know, that a pandemic is unlikely to start in a large integrated broiler production enterprise in the United States, but it will quickly reach the American population if it starts through a mutation in poultry in a backyard farm in Asia or Africa, transmitted thereafter not by birds but by people. President Bush in 2005 instructed the U.S. Government to draw up a National Strategy, followed by the National Implementation Plan, based on three pillars: preparedness and communication; surveillance and detection; and response and containment. Secretary of State Condoleezza Rice assumed the lead for coordinating international engagement in the Plan. The State Department's Avian Influenza Action Group, which I direct and which works directly for Under Secretary of State for Democracy and Global Affairs Paula Dobriansky, assumed responsibility for coordinating the interagency, day-to-day aspects of this engagement. In this regard, the U.S. has pledged $392 million for avian and pandemic influenza worldwide -- the largest single contribution among the greater than $1.9 billion that has been pledged by the international community.
In September 2005, at the UN General Assembly, President Bush announced the establishment of the International Partnership on Avian and Pandemic Influenza (IPAPI). In doing so, the President focused the attention of the world community on the need for timely and sustained high-level political leadership and concrete, cooperative action. Specifically, the International Partnership aims to combat the threat of avian flu and improve global readiness for human pandemic influenza by elevating the issue on national agendas; coordinating efforts among donor and affected nations; mobilizing and leveraging resources; increasing transparency and the quality of surveillance; and building local capacity to identify, contain, and respond. The Partnership is a voluntary coalition built on a set of ten core principles that call for enhanced preparedness, surveillance, transparency in the form of rapid reporting and the sharing of data and samples, and cooperation among Partners and with several key international organizations, including the World Health Organization (WHO), the Food and Agriculture Organization (FAO), and the World Organization for Animal Health (know by its initials in French, OIE). The International Partnership has met twice -- in Washington, D.C., in October 2005 and in Vienna, Austria, in June 2006 -- and will convene again in New Delhi, India, in 2007. In addition, the African Union working with the European Commission will sponsor an international meeting supported by the Partnership in Bamako, Mali, this December.
Last September, UN Secretary General Kofi Annan appointed Dr. David Nabarro as the UN System Influenza Coordinator. Dr. Nabarro merits particular praise for his work in orchestrating the work of the UN system to cope with avian influenza and prepare for a potential pandemic.
Just as the International Partnership elevated the international engagement against avian and pandemic influenza to the political level, we and others in the international community have been active in addressing the threat on the technical level (and I cite only a partial list):
Â Â *Â The U.S. Government is supporting avian influenza preparedness efforts in at least 53 countries in collaboration with the WHO, FAO, and OIE. Â Â *Â U.S. Government agencies, including the Departments of Agriculture (USDA), Health and Human Services (HHS), Interior, and Defense, as well as the U.S. Agency for International Development (USAID), have deployed scientists, veterinarians, public-health experts, physicians, and emergency-response teams to affected and high-risk countries to assist in the development and implementation of emergency preparedness plans and procedures for the response to avian and pandemic influenza. Â Â *Â Over 175 nations now have national plans for combating avian and pandemic influenza -- up from about 40 in November of last year. Â Â *Â FAO and the OIE have established a Crisis Management Center in Rome to facilitate and coordinate an international rapid-response to avian flu animal outbreaks. This was largely in response to the vision and efforts of Dr. Ron De Haven of USDA. Â Â *Â In this hemisphere, U.S. Government agencies work with the Inter-American Institute for Cooperation on Agriculture (IICA) and the Pan American Health Organization to address animal health and food safety issues. IICA, which receives 60% of its funding from the U.S. Government, works on the larger issue of building veterinary infrastructure, and it also has produced and distributed a series of radio messages for farmers, educating them about the avian influenza virus and how they can work to help control and contain it. Â Â *Â International stockpiles of antiviral medications and other vital commodities have been established. The first stockpile of antivirals has been positioned in Asia. Since January, the U.S. has deployed approximately 93,000 personal protective equipment kits in 66 countries and is building a stockpile of 1.5 million such kits, plus 100 lab kits and 15,000 decontamination kits. Â Â *Â U.S. training for medical personnel is occurring in many parts of the globe, such as Thailand, Egypt, Kenya, Guatemala, Bangladesh, and Cambodia. In addition, training for veterinary personnel has been carried out in 60 countries, including China, Mexico, Turkey, Thailand, Indonesia, and Vietnam. Laboratory capacity and surveillance systems are being improved in more than 25 countries such as Pakistan and Kenya. Â Â *Â The governments of the United States, Singapore, and Indonesia are cooperating on a project with the eventual goal of eradicating avian influenza in the Indonesian province of Tangerang.
This is an impressive, albeit partial, list. I do not wish to suggest, however, that our efforts have been entirely successful: we are doing our best, but with mixed results. Our state of preparedness in this country may be state-of-the art, but contrasting it with the lack of preparedness in many of the world's developing nations can be dispiriting. Governments that possess the administrative, economic, and scientific ability to organize and enforce the kinds of preventive and containment measures required are in the minority, as the virus' endemic presence in Indonesia and parts of Africa demonstrates. We have our National Implementation Plan, and our U.S. Department of Agriculture in particular is prepared to react quickly and decisively should the H5N1 virus reach these shores -- but there are limits to our ability to substitute for the national will or ability in all areas of the world.
That said, we and our international partners will continue to emphasize the active engagement of governments, international organizations, the private sector, non-governmental organizations and others to deal with continuing challenges and emerging needs. We are looking to you, the private sector, to see where you have partnerships internationally and to ask where you might have the comparative advantage in gaining the commitment of important private sector players in affected countries to militate for an effective response to the animal disease in those countries.
I mentioned the upcoming global conferences in Bamako and New Delhi, but there are a host of smaller, regional meetings and exercises being conducted each month that are designed to buttress this international cooperation and sharing of technical expertise Â– some with the goal of helping countries to stamp out avian influenza outbreaks, others aiming to avert or mitigate the 21st Century's first global human health catastrophe. Avian influenza is not like the other notorious afflictions that have been totally or partially eradicated from the face of the earth (such as polio or smallpox), insofar as the international community cannot be mobilized to administer a human vaccine against it. Nevertheless, we have made great strides in mobilizing the international community in a new direction -- that of vigilant prevention and containment in the animal host before it reaches humans in any great numbers. Accordingly, I can assure you that your government will not desist from this path.
Thank you again for the invitation to address you today.
Released on October 5, 2006