The chances that the avian flu virus will mutate into a form that can be transmitted from human to human is high enough for the World Health Organization (WHO) to classify the present situation as a “pandemic alert.” Should a pandemic break out it would likely do so in Asia. Therefore Japan needs to play an active role in preparing for such a possibility.
Two international meetings were recently held in Tokyo and Beijing on the issue of avian flu and a related flu pandemic. Twenty-three countries and six international organizations took part in the Japan-WHO joint meeting in Tokyo, with discussions focusing on an early response to the potential pandemic. The importance of early detection and reporting of the emergence of a new influenza was agreed upon and it was decided that each nation should develop its surveillance, epidemiological research and education capabilities.
More than 100 countries participated in the Beijing meeting to raise money to fight avian flu and to prepare for a possible pandemic. A total of $1.9 billion, including about $1 billion in grants, was offered in pledges over the next three years — a third more than the $1.2 billion to $1.4 billion the World Bank estimates is needed. Nearly half of the money will go to Asian countries such as Vietnam, Thailand, Indonesia and Cambodia, where the H5N1 avian-flu virus has infected humans.
Since 2003 nearly 150 people reportedly have been infected by H5N1 in these countries and in China and Turkey. At least 79 have died. Turkey is the latest country to report human infections, confirming its first two cases earlier this month. A total of 21 avian-flu infections and four deaths have been reported in this nation that bridges Europe and Asia, greatly alarming its neighbors to the west.
The genetic characteristics of H5N1 are undergoing a gradual transformation and it would surprise no one if the virus mutates into a form that can spread from human to human. Such an event could trigger a global pandemic, leading to millions of deaths. To prevent such a worst-case scenario, governments and health organizations must jointly move quickly to contain the mutated virus during the early stages of an outbreak when the number of infected people remains small. Restrictions on the movement of people and goods, and concentrated use of Tamiflu — believed to be the most effective flu drug — would help prevent the spread of the disease.
In December, the Japanese government announced that it will provide about $135 million by March 2006 to help Asian countries contain the avian flu and any related mutations. It will assist in the stockpiling of 500,000 courses of Tamiflu, and provide influenza test kits and personal protection equipment for 700,000 people. Japan will also train more than 100 health personnel from Asian countries annually for the next three years, and envisages cooperation in research.
The fight to contain a flu pandemic is a race against time. For containment operations by governments and international institutions to be effective, reports of flu virus mutations must be made within two weeks of discovery. To this end an international information network centering around the WHO should be formed. A WHO study reveals that in the roughly 70 human cases of avian flu in China, Vietnam, Cambodia, Indonesia and Thailand, it took an average of 16.7 days for a report to reach the WHO. The study suggests that Japan can do more to help construct information systems that are capable of quickly relaying reports from Asian villages, where the virus is mostly likely to infect humans, to the WHO.
In Japan, 43 prefectural governments have set up headquarters to counter the avian flu and a possible influenza pandemic. The Health, Welfare and Labor Ministry on Jan. 14 announced a plan to stockpile 25 million courses of Tamiflu, about 1.7 times more than the previous plan. It also raised the maximum death estimate of a flu pandemic from 170,000 to 640,000.
The 20th century witnessed three influenza pandemics, including the Spanish flu in 1918 that killed an estimated 40 million people. If the avian flu virus mutates into a form that can be transmitted from human to human, today’s developed transportation networks could rapidly convey it across borders via travelers and imported goods, especially food. Complacency and secrecy are as dangerous as the virus itself. All governments must maintain their vigilance and cooperate to guard against the threat. The words of Mr. Shigeru Omi, WHO secretary general for the Asian region, should be taken seriously: “In the fight against influenza, it is either everybody wins or everybody loses.”
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