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Dr. Anthony Fauci
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20 November 2005
Health Experts Urge All-Out Effort To Ward Off Bird Flu Pandemic, November 20, 2005 (Preparations seen as vital though broad spread is deemed unlikely)
By Ralph Dannheisser
Washington File Special Correspondent
Washington -- The strain of bird flu virus that has struck several Asian and European countries, H5N1, is unlikely to develop into a pandemic in the human population, but scientists and world leaders still must prepare for the worst, a leading U.S. expert on infectious diseases says.
"Likely it’s a low probability" that the H5N1 virus will cross over to humans on a wide scale, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases of the National Institutes of Health, said November 20 on NBC’s "Meet the Press" television interview program.
But Fauci warned that "when you’re dealing with preparing for something in which the consequences are unimaginable, you must assume, A, the worst-case scenario and, B, that it’s going to happen."
"If it doesn’t happen, that doesn’t mean that preparedness went to waste, because sooner or later it’s going to happen," Fauci said. "It could be a couple of years from now; it could be 15 or 20 years from now. We have to have a structure in place that allows us to get the drugs, that gets the vaccine…We’re not there yet," he observed.
The same message of a need to prepare now for a worst-case scenario was delivered by other guests on the program: Michael Leavitt, secretary of the U.S. Department of Health and Human Services; Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention; and Dr. Michael Ryan, director of the World Health Organization’s pandemic response department.
"Pandemics happen," Leavitt said. "They’ve happened in the past; they’ll happen in the future." Although [w]e’re better prepared today than we were yesterday," he said, "[w]e’re not as prepared as we need to be."
The current outbreak of bird flu that has swept through flocks in several Asian and European countries has brought with it 130 reported cases in humans. Of that number, 67 have died -- the majority of those in Vietnam, and others in Indonesia, Thailand, Cambodia and China.
Only two of those cases appear to have involved human-to-human transmission, the route that could escalate into a pandemic.
Ryan urged intensified efforts, particularly in developing countries, to build a global alert and response system. Great strides have been made, he said, but he cautioned it would take "at least another six months to a year to ensure that we have adequate, sensitive and responsive surveillance systems in these countries."
"The reality is that, in many countries, surveillance systems are weak. We need to know when this pandemic virus emerges and we need to know quickly. We need to know to give the rest of the world lead time," he said.
Ryan deemed it "absolutely crucial that the early warning systems in the countries in Asia, particularly, who have this avian disease, are in place."
At the same time, the public health officials observed, efforts must continue to develop -- and produce in large quantities -- a vaccine that will be effective against this new virus.
Fauci noted that a vaccine developed from a virus isolated from a Vietnamese patient is in clinical trials, and has been shown to be safe and seemingly protective. "The critical issue, and this is the constraining issue, is that we don’t have the vaccine production capacity at this time to make enough vaccine for the people who might need it. That’s really the problem," he said.
Indeed, Leavitt estimated that the capacity to produce 300 million vaccine doses -- enough to immunize the entire U.S. population – will not be available for three to five years. Once the capacity was established, "it would take us about six months to have enough doses to protect Americans," Gerberding estimated.
Leavitt blamed the capacity problem on policies that have allowed the vaccine manufacturing industry to "diminish to a point they don’t have the ability."
"We have to do nothing short of rebuild[ing] that industry." he declared.
The issue of a potential human influenza pandemic was a focus of discussion at the just-concluded Asia-Pacific Economic Cooperation (APEC) leaders’ meeting in South Korea. Leaders of APEC’s 21 member economies approved a global initiative, co-sponsored by the United States, aimed at improving readiness for the growing threat that avian influenza poses. (See related article.)
For more information, see Bird Flu (Avian Influenza).
