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Analysis: U.N., bird flu preparation

By WILLIAM M. REILLY, UPI U.N. Correspondent

UNITED NATIONS, Nov. 4 (UPI) -- The United Nations took time out this week to study ways the global institution and its specialized agency -- and others -- were preparing to confront the possibility of a potentially devastating human bird flu pandemic.

Several member nations and representatives of the World Health Organization and the Food and Agriculture Organization joined in a discussion Thursday in the U.N. Economic and Social Council at U.N. World Headquarters in New York to lay out a blueprint for immediate preventive and mitigating action.

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Preceding the ECOSOC meeting, U.N. Secretary-General Kofi Annan addressed the Time Global Health Summit across town in New York.

No one was able to predict the risk of a possible mutation of the H5N1 virus into a human pandemic, nor its death toll, which has been estimated in the scores of millions.

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Annan said merely stockpiling antiviral medicines does not constitute a strategy and highlighted seven priorities to combat the virus's threat.

These included greater investment in veterinary infrastructure to halt the spread of the virus among birds; changing the habits of people living in close proximity with animals; identifying what is needed to keep countries running in case of a pandemic; scaling up production of antiviral medicines for all who need them; fostering transparency and cooperation on science and research; communicating vital facts about the virus to avoid the "silence is death" syndrome; and mobilizing political leadership at the highest level.

"We do not know yet whether the current strain of avian flu will cause a human pandemic," Annan told the Time summit, a three-day event in New York held to discuss key health issues. "But we do know what a human pandemic is.

"We do know the tolls taken by previous pandemics -- from the flu of 1918 to the AIDS crisis of our time," he continued. "We do know what happens when millions of people die, and millions more are infected; when health systems are overburdened and overwhelmed; when families, communities and whole societies are devastated; when transport and trade, education and other services are disrupted or cease to function; when the economic and social progress of nations risks being reversed."

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Said Annan, "Whatever we may not know about the future course of H5N1, we do know this: once human-to-human transmission has been established, we would have only a matter of weeks to lock down the spread before it spins out of control. That is why the international community must take action now."

His remarks served as a prelude to the ECOSOC event where the U.N. body's President, Ambassador Munir Akram of Pakistan, proposed quickly establishing a fund to help developing countries take preventive action and compensate farmers and producers for the cost of culling poultry.

The ECOSOC meeting itself was held in preparation for a Nov. 7-9 meeting of more than 400 animal and human health experts, senior policy-makers, economists and industry representatives in Geneva, Switzerland, to work toward a strategy to control the virus in domestic animals and prepare for a potential human influenza pandemic.

"The situation calls for collective action -- for more support for global public goods like investment and research in vaccines and for actions that would ensure that the entire world shares in the burden and costs of prevention," Akram said.

Compensation for losses is considered particularly important by experts not only to avoid crippling economic damage, but to give farmers and others incentives to report new flu cases.

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"The U.N. system needs to re-task itself to aid prevention against a pandemic and support the needs of developing countries," the Senior U.N. System Coordinator for Avian and Human Influenza David Nabarro told the session.

Speaking for the FAO, Assistant Director-General Louise Fresco said the cost of prevention at source among animals would be about $425 million, but only $30 million has been made available so far.

"Now that $425 million, we know from experience, is peanuts usually compared to the costs which you will have when you have to eliminate entire poultry sectors," she told reporters after the meeting.

Ever since the first human case of bird flu, linked to widespread poultry outbreaks in Vietnam and Thailand, was reported in January last year, health officials have warned H5N1 could evolve into a global influenza pandemic if it combines with a form of influenza that is transmissible between humans. The so-called Spanish flu pandemic of 1918-1920 was estimated to have killed from 20 million to 40 million people worldwide.

But WHO official Dr. David Heymann, said, "The risk is there, it's a true risk, but it can't be quantified."

Heymann, representing WHO Director-General Lee Jong-wook, was asked by reporters about the potential human toll and said no one could quantify the risk.

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"There is no estimate of deaths because it's not possible," he said. "This virus can become more virulent as it mutates, more strong; it can become less virulent.

"It can pick up human transmissibility or it can't pick up human transmissibility. No one knows, no one can give you that answer. So the risk is there, it's a true risk, but it can't be quantified."

In the present outbreak there have so far been more than 121 reported human cases, 62 of them fatal, all in South-East Asia, but no human-to-human transmission.

Official estimates say about 150 million birds have died or been culled in an effort to curb spread of the flu.

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