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Substantial Progress In Global Bird Flu Response

"Substantial Progress" in Global Avian Flu Response, Report Says

The world community has made progress in its response to avian influenza, according to a new United Nations-World Bank report whose results were announced in New Delhi December 4, the first day of the New Delhi International Ministerial Conference on Avian and Pandemic Influenza.

More than 600 delegates from 105 countries -- including 70 ministers from the public health and animal health sectors -- and 20 international and intergovernmental organizations convened to assess, review and exchange information on highly pathogenic H5N1 avian flu in animals and people.

The third global progress report, Responses to Avian Influenza and State of Pandemic Readiness, jointly produced by the U.N. System Influenza Coordinator and the World Bank, indicates progress in the initial -- emergency -- phase of the global response to H5N1 and threats to public health.

"While we have made progress during the years since the virus first appeared," Ambassador John Lange, head of the U.S. delegation and special representative for avian and pandemic influenza at the State Department, told the assembled delegates, "we now need to shift some of our efforts from the emergency phase of identifying human and avian outbreaks to a greater emphasis on long-term capacity building to improve animal and human health systems as they relate to" H5N1 and other emerging diseases.

The U.S. delegation includes senior representatives of the departments of State, Agriculture, Health and Human Services and Defense and the U.S. Agency for International Development.

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The government of India is hosting the meeting in collaboration with the International Partnership on Avian and Pandemic Influenza, launched by President Bush in 2005.


The U.N.-World Bank report covers developments over the past two years, with a focus on January-June 2007. It analyzes efforts made and financial assistance provided to date, and assesses progress in nations' capacities to respond to H5N1 and their preparations for the next influenza pandemic.

During 2006-2007, said U.N. System Influenza Coordinator David Nabarro, the number of human H5N1 cases and deaths has decreased.

"The general understanding," he said, "is that human cases are the sentinel of the overall load of virus in the animal community. This is circumstantial evidence that just at the moment in 2007 we can start to ask ourselves whether the continued intensive spread of H5N1 is perhaps slowing and we're beginning to see a situation where this threat has been brought under control."

In the majority of national situations, he said, it is possible now to bring outbreaks under control more effectively. Such progress is the result of efforts of hundreds of thousands of people who have been working tirelessly to achieve this result.

But the news is not all good. Since the most recent outbreak began in 2003, some 60 countries and territories have had H5N1 outbreaks in poultry or wild birds or both, according to the report. Continuous transmission of H5N1 occurs in some settings: the virus is considered entrenched (enzootic) in parts of Indonesia, Egypt, Nigeria and possibly parts of Bangladesh and China.

Challenges include the need to expand from short-term to sustained responses with increased focus on biosecurity in family and commercial poultry production systems, the importance of intensive responses where the virus is entrenched, the need for sufficient capacity at the country level for compliance with the revised International Health Regulations and the need for convergence in capacities for animal and human health.


During the meeting, whose theme is One World: United for Avian Influenza and Pandemic Preparedness, World Health Organization Secretary-General Dr. Margaret Chan called for avian flu preparedness to extend beyond the health sector.

"SARS taught us how much the world has changed in terms of its vulnerability to the consequences of a new disease," she said. "These consequences include massive economic and social disruption."

Preparedness must include plans to ensure business continuity and maintain essential services such as food production and distribution, transportation, communication, energy, finance and law enforcement, she said.

In the fight against H5N1, Lange said, the United States listed priority areas that call for systematic effort, including:

* Coordinating efforts where H5N1 is entrenched and enhancing biosecurity practices in poultry-rearing and marketing systems;

* Ensuring the international community can help an affected nation respond rapidly to an incipient human pandemic;

* Seeing that all countries can institute nonpharmaceutical interventions (social distancing) to mitigate the impact of a pandemic on communities before a vaccine is available;

* Helping relief agencies and others plan for enormous humanitarian assistance needs that could arise during a pandemic; and

* Ensuring that the Global Influenza Surveillance Network works efficiently and transparently for the benefit of global public health.

The government of Egypt will host the next international meeting in October 2008.


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