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Ambassador John E. Lange - Pandemic Preparedness

Pandemic Preparedness: Information Systems and Health Services Capacity-Building

Ambassador John E. Lange, Special Representative on Avian and Pandemic Influenza, U.S. Department of State
Remarks at the International Conference on Avian Influenza
Bamako, Mali
December 7, 2006

Thank you for this opportunity to address you all here in Bamako. The U.S. Government is pleased to have provided funds to the Government of the Republic of Mali to help pay for this international conference, and we commend President Toure, the African Union, and the European Commission for their work in organizing this important event.

Within the last year, avian influenza in poultry has spread from 14 countries to 55. For the first time, highly pathogenic avian influenza was found on the continent of Africa. More humans have become infected, and over half of those infected have died. The global situation for avian influenza is not improving.

The good news, as you also know, is that the world as a whole is better placed to prevent and combat the disease in animals, and is better prepared for a possible human pandemic, than it was just a year or two ago. Your presence in Bamako this week reflects that reality.

We do not know if the highly pathogenic H5N1 virus will someday mutate or re-assort to the point of sustained and efficient human-to-human transmission. But we do know that influenza viruses have threatened animal and human populations for centuries. The three human influenza pandemics that occurred in the 20th century each resulted in illness in approximately 30 percent of the world population and death in 0.2 percent to 2 percent of those infected. Our Implementation Plan and our cooperative international efforts focus on an outbreak of influenza with pandemic potential, not just on the H5N1 virus.

Strengthening capacity is the most urgent action the United States is undertaking. Our efforts are aimed at urgently building systems that can serve long-term purposes - in individual countries and within international and regional organizations. And our work and resources are building systems to address not only H5N1, but other highly infectious and zoonotic diseases.

Great progress has been made since President George W. Bush announced the International Partnership on Avian and Pandemic Influenza at the UN General Assembly in September of last year. The first meeting of the International Partnership took place in Washington in October 2005 and discussed such Core Principles as the critical importance of transparency in reporting of influenza cases in humans and animals and the immediate sharing of epidemiological data and samples with the World Health Organization, Food and Agriculture Organization, the World Organization for Animal Health, and the international community.

Since then, we have witnessed a series of high-level meetings focusing the international community on the urgency of this issue and have galvanized governments to act. Those conferences include: the International Meeting of Ministers of Health on Global Pandemic Influenza Preparedness in Ottawa (October 2005); the meeting on Avian Influenza and Human Pandemic Influenza in Geneva (November 2005); the International Meeting on Early Response to Potential Influenza Pandemic in Tokyo (January 2006); the International Pledging Conference on Avian and Human Pandemic Influenza in Beijing (January 2006); the Vienna Senior Officials Meeting on Avian and Human Pandemic Influenza (June 2006); and a host of regional meetings in all corners of the globe.

As a result of the global, cooperative nature of our response, the world is now better positioned to confront the reality of the disease - with better communication programs, improved data-sharing, and increased public-health preparedness.

I would like to review the significant strides my own government has made during the six months since the Vienna meeting, and how these relate to the international effort. A key for the United States has been progress on the international action-items in the Implementation Plan of our National Strategy for Pandemic Influenza along its three pillars: Preparedness and Communication, Surveillance and Detection, and Response and Containment. In our National Strategy, the Department of State, under the leadership of Under Secretary for Democracy and Global Affairs Paula Dobriansky, is responsible for the coordination of the U.S. international response. We cooperate closely with the Department of Agriculture, the Department of Health and Human Services, and the U.S. Agency for International Development - all of which are represented on our delegation here today -- and also the Department of Homeland Security on border issues, the Department of Defense on logistical matters, and other departments in the U.S. Government, as well as with a multitude of governments, organizations and institutions outside of our federal government.

All of you are well aware of the importance of targeted educational messages to the general public in threatened and affected countries to promote greater understanding of the threat of avian influenza, and the actions necessary in the event of pandemic influenza. Indeed, this conference has already proven to be a very useful forum for bringing each of us up-to-date on individual countries' initiatives since the International Partnership's Vienna Senior Officials Meeting in June.

Regarding communications, we in the United States have finalized the U.S. Government's public affairs (communications) plan for international engagement on avian and pandemic influenza. The plan places special emphasis on dealing with the host of resource, environmental, cultural, and political challenges any such effort faces, regardless of the country involved. One of our central messages is that health ministries and agriculture ministries must continue to improve cooperation on avian and pandemic influenza for governmental efforts to be effective.

Our Implementation Plan envisages the following policies and actions for U.S. public diplomacy and public-health specialists to explain and advocate:

* Emphasizing the importance of international cooperation and efforts complementary to those of multilateral organizations to contain the spread of the virus;

* Elevating pandemic influenza on national agendas, stressing the role of committed high-level political leadership in containment efforts;

* Advocating transparency in surveillance and reporting of suspected animal and human cases;

* Encouraging the sharing of epidemiological data and samples with WHO, FAO, OIE, and the world community to detect and track outbreaks;

* Assisting others to develop pandemic preparedness plans, build public and animal health capacity, strengthen communications infrastructures, increase logistical capability, and prepare to take effective countermeasures;

* Mobilizing and coordinating global resources; and

* Enhancing public awareness and knowledge of protective measures.

Preparedness, of course, is much more than communication of information. Preparedness for a pandemic requires the establishment of infrastructure and capacity, a process that can take years.

In the area of animal health, for example, the United States, along with many of you in the audience today, is working on the ground to strengthen national veterinary services. The U.S. Department of Agriculture (USDA) and Agency for International Development (USAID) have provided expertise and funding for the establishment of the FAO/OIE Crisis Management Center. As this Center grows, it will serve the global needs for immediate response support for avian influenza and other zoonotic diseases. USDA has trained approximately 500 veterinarians and diagnosticians from 96 affected and high-risk countries in veterinary epidemiology and avian influenza diagnostic protocols to support disease surveillance and, when avian influenza cases are confirmed, control measures.

As another example, USAID through FAO is developing Participatory Disease Surveillance/Participatory Disease Response teams with the Government of Indonesia. The PDS/PDR Project has established 12 pilot districts on Java Island, and will expand to 159 districts on Java, Bali, and Lampung to enhance rapid response to poultry outbreaks at the district level. Ultimately, the World Bank will fund districts on Sumatra Island, with AusAid funding programs in south Sulawesi Province.

To address the potential for a human pandemic, the U.S. Government is conducting research and development of vaccines and antivirals and amassing and pre-positioning stockpiles of medical and logistical supplies. We are collaborating with international partners to enhance early-warning and clinical surveillance systems, including building and improving infrastructure at the central, provincial, and local levels to provide timely notification of suspected outbreaks.

The U.S. Department of Health and Human Services (HHS) has provided funding to WHO to strengthen its Global Outbreak and Response Network (GOARN) to support surveillance and response in nations worldwide. HHS also has established a fund to ensure that laboratory specimens are shipped in a timely manner to reference laboratories for further diagnostic work and confirmation.

We are pleased to be working cooperatively with the member states of the African Union as U.S. Government programs for both avian influenza and pandemic preparedness continue and expand on this continent. We also consider it important for governments to collaborate within their regions on pandemic preparedness. In North America, for example, the Governments of Mexico, Canada and the United States are working collaboratively through the Security and Prosperity Partnership to prepare the North American Plan for Avian and Pandemic Influenza, which will have chapters covering pandemic influenza, avian influenza, emergency coordination, borders and transportation, and critical infrastructure protection.

Before I conclude, it is important to pay tribute to the eloquent leader in the world's battle against avian and pandemic influenza, the United Nations System Influenza Coordinator, Dr. David Nabarro. The U.S. Government strongly supports his leadership and his work to coordinate efforts within the United Nations System through consolidated funding appeals, progress reports on the global avian and human influenza threats, and related activities. We also commend the extensive work being done by FAO, OIE, WHO, UNICEF, UNDP, OCHA, WFP, UNHCR, the World Bank, International Federation of the Red Cross and Red Crescent Societies, non-governmental and private voluntary organizations, the business sector, and the many other international and regional organizations and banks engaged in this concerted, global effort.

Let me again thank our hosts for their work to organize this important event in the battle against avian and pandemic influenza. Preparedness and long-term capacity building requires collaboration on the international, regional, national, and community levels. As this conference demonstrates, global cooperation is essential to global success.

Released on December 7, 2006


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