press conference bY Senior United Nations system influenza coordinator

Although capacity to respond to outbreaks of avian influenza had improved dramatically over the past years, it was no reason for complacency -- pandemic preparedness against mutant viruses still needed to be maintained and improved around the world, Dr. David Nabarro, Senior United Nations System Coordinator for Avian and Human Influenza, told correspondents today.

Introducing the “Third Global Progress Report on Responses to Avian Influenza and State of Pandemic Readiness” at a Headquarters press briefing, Dr. Nabarro, who compiled the survey in cooperation with the World Bank, said the report was based on information received from 146 countries, data from case studies done in 20 countries and expert interpretations.  He told reporters that it would provide information to the fifth ministerial conference on the issue, to be held next week in New Delhi, India, in which some 92 countries -- 60 at the Ministerial level -- would participate, as well as 23 international and regional organizations.

Over the last 100 years, the world had been affected by three influenza pandemics, the 1918 one being the most severe, Dr. Nabarro said.  Those pandemics had been caused by mutant viruses carried by birds and animals that jumped to humans and were then transmitted from human to human.  It was, however, not known when mutations occurred.  The current outbreak, caused by the H5N1 virus, was the most serious avian influenza virus known, and resulted in a quick and “extremely unpleasant” death.  Worse, the virus kept evolving.  Wild fowls could carry it without any sign of infection.  The highly pathogenic HPAI (a strain of H5N1 carried by birds) had been reported in 16 countries in 2005, mostly in South-East Asia, in 55 countries in 2006 and in 60 countries in the current year, he added.

The virus, once it entered bird populations, had to be dealt with quickly, Dr. Nabarro said, otherwise it would lead to widespread loss of bird-life.  Most countries had been able to upgrade their veterinary services, to quickly detect cases, to stamp it out, to implement longer-term improvements in poultry-farming practices and also to encourage people to keep a distance from sick birds.  There were still some six countries where the virus was believed to be enzootic (continuously present); the most obvious one being Indonesia -- the fourth most populated nation in the world with some 1.5 billion poultry.  The virus was being continuously transmitted there in at least half the country’s districts.

“We have some major anxieties about the extent to which countries’ pandemic preparedness plans are really capable of being operationalized,” said Dr. Nabarro, adding that sectors other than health needed to be brought aboard, as a pandemic also had socioeconomic implications.  He was also concerned about the degree by which countries were working together in pandemic preparedness.  Some might be looking after their own interest only, anticipating that it would be “for others to deal with theirs”.  Viruses, however, knew no borders.  They would spread to all countries and to all people of the world, putting everyone at risk.

Over the last few years, billions of doses of vaccine had been injected into poultry to prevent the spread of avian influenza, Dr. Navarro went on to say.  Veterinary services were being upgraded.  Poultry production systems had been improved.  Millions of poultry had been and were being culled.  Hundreds of thousands of people had been engaged in that work and whole communities had been mobilized.  Nearly all the countries of the world had started to develop pandemic preparedness plans and nearly 20 per cent of them had engaged in related exercises.  But there was still a way to go to ensure “full solidarity” between countries in pandemic preparedness, whether it was sharing protocols, viral samples or ensuring that all the different parts of governments and international processes were resilient enough to deal with the effects of a pandemic when it arrived.

Responding to questions, Dr. Navarro said the spread of avian influenza from 2005-2006 was mainly due to the fact that water fowl in northern China and Siberia had been infected before they migrated south.  The dramatic movement of the virus into the Middle East, Europe and Northern Africa -- from where it spread into parts of Western Africa -- was due to wild fowl mingling with poultry.  After that, the virus then spread through trade.  Countries could, however, close down borders and start culling, which restricted the spread of the virus.  There had not been a big wild bird movement in the 2006-2007 winter.

When asked about where the virus was enzootic, he said Indonesia was problematic as it was difficult to contain the virus due to the country’s geographical situation.  In the other countries it was present only in some parts.  Those were:   Bangladesh; Viet Nam -- especially among the duck population; Egypt -- mainly in the north; Nigeria -- also in the north; and China, where the geographical area where the virus was present was shrinking due to concerted efforts.  In those areas where the virus was enzootic, there was a risk that it would jump to wild birds.  If those wild birds started migrating, the virus might “spread like a fire”.

The reason the infections in northern Nigeria had not caused a pandemic in Western Africa was the strong response by both the federal and local governments, he continued.  The country’s President, Umaru Musa Yar'Adua, had established a bird flu centre in his presidential palace.  Neighbouring countries also exerted controls.

The warning about another human influenza pandemic had come from the World Health Organization (WHO) 2007 World Health Report, Dr. Nabarro responded to another question.  It was based on historical experience.  The 2005 H5N1 virus had similarities to the 1918 virus, and that had raised concerns about mutations.  Some thought that sooner or later it was likely that it would cause a human pandemic.  The risk of that happening had been reduced, however, although the risk of another influenza pandemic persisted.

Asked about Indonesia’s concerns vis-à-vis the sharing of virus strains, he said that country wanted access to vaccines developed from such strains if it was to share them.  It had massive problems with one human infection every 10 days.  Although most States and companies had acted responsibly in that regard, there was a need for a mechanism to link the provision of virus samples with access to vaccines.  Such a mechanism had to be developed by political negotiations, which were ongoing.

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For information media • not an official record