The H5N1 avian influenza virus is firmly established among animals in Asia and has begun to extend its reach into Europe. From 7-9 November, more than 400 animal and human health experts, senior policy makers, economists and industry representatives will gather in Geneva to work towards a global consensus to control the virus in domestic animals and prepare for a potential human influenza pandemic.
The disease in animals caused by the H5N1 influenza virus has resulted in the culling of at least 150 million birds in the last two years. H5N1 remains for the moment an animal disease, but the World Health Organization (WHO) has warned that H5N1 is a virus that has the potential to ignite a human influenza pandemic.
While no one can predict the timing or severity of the next influenza pandemic, governments around the world are taking the threat seriously. A series of international meetings held over the last ten weeks will culminate in the Geneva meeting. The meeting is co-organized by WHO, the Food and Agriculture Organisation (FAO), the World Organisation for Animal Health (OIE) and the World Bank. The goal of the meeting is to work towards a global consensus for controlling the disease in animals while simultaneously preparing for a potential human pandemic.
"This virus is very treacherous," says Dr Margaret Chan, Representative of the WHO Director-General for Pandemic Influenza. "While we cannot predict when or if the H5N1 virus might spark a pandemic, we cannot ignore the warning signs." Because influenza pandemics have typically caused enormous social and economic disruption, WHO is advising its member states to develop national strategies to cope with such a public health emergency, as well as coordinating with international partners to develop a comprehensive response.
The Geneva meeting will first consider how to contain the H5N1 virus in birds. "There is still a window of opportunity for substantially reducing the risk of a human pandemic evolving from H5N1 by controlling the virus at its source, in animals," says Joseph Domenech, FAO Chief Veterinary Officer. As the FAO expects avian influenza to reach the Middle East and Africa in the near future, it is essential that the global community and affected countries mobilize more resources to combat the virus, which is thought to be spread in part by migratory birds, before it becomes embedded in new regions.
Strengthening disease surveillance systems worldwide will also be high on the agenda at the Geneva meeting. Early detection and rapid response mechanisms are essential to tracking the evolution of the H5N1 virus. Therefore, delegates will also discuss ways to strengthen veterinary and human health services so that any H5N1 cases--in animals or humans--will be identified quickly. "This is crucial for the prevention of any future global crisis associated with emerging animal diseases potentially transmissible to humans," says Dr Bernard Vallat, Director-General of the World Organisation for Animal Health (OIE).
At the same time that animal control efforts are to be intensified, several critical issues related to potential human disease remain to be addressed. Meetings in the last several months have identified several key pandemic preparedness issues. For example, many countries are concerned about the lack of access to antiviral medicines and the antiquated production methods for human influenza vaccines. Communication with the public is also a critical issue. These and other topics will be on the agenda for the Geneva meeting.
The meeting comes after a recent gathering of experts in Geneva (2-3 November) to discuss the development of pandemic influenza vaccines. At present, at least ten vaccine developers in about as many countries are carrying out demonstration projects to develop and evaluate vaccines primarily against the H5N1 subtype. Participants expressed the need for continued sharing of technical information, strengthened international coordination of work related to pandemic influenza vaccines so as to avoid duplication of efforts, support to vaccine research initiatives in developing countries and integrating the science into the public health context.
"It's impossible to exaggerate how important pandemic preparedness is, and how dire the consequences would be for the entire world if some of the worst-case scenarios for a human influenza pandemic were to unfold," says James Adams, the World Bank's Vice-President for Operations Policy and Country Services, and head of the Bank's avian flu taskforce. The Geneva meeting will provide an opportunity for all international partners to mobilize the country commitment and financial resources needed to manage this global threat.
"For the first time in human history, we have a chance to prepare ourselves for a pandemic before it arrives," says Dr Chan. "It is incumbent upon the global community to act now.”
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