How precaution can ease the economic disruption

Date: 06/04/06

According to the World Health Organisation (WHO) the recent outbreak of avian influenza fulfils just two of the three requirements necessary to be categorised as a fully-blown pandemic.

It is new and causes severe illness in humans, it spreads easily among them, but so far there has not been an efficient and sustained human-to-human transmission of the virus, the third prerequisite.

Nominally this puts H5N1 avian flu on a par with severe acute respiratory syndrome (SARS), which killed more than 1,000 people in a 2003 outbreak.

But David Nabarro, the UN's avian flu response co-ordinator, maintains that the concern about avian influenza is justified. He admits that H5N1 highlights difficulties in measuring a response to such threats.

"Whenever you work in public health on an issue where there is a risk that cannot easily be quantified, it is quite difficult then to decide what importance to give to that risk," he said.

For Nabarro the key principle is precaution. "If the issue that cannot be quantified is also something that potentially could be extremely serious and impact on the economies and the governance of the whole world, it would I believe be foolish not to draw people's attention to that risk," he said.

"We have had influenza pandemics in the past. We are going to have influenza pandemics in the future. These pandemics, however many people they kill, cause severe economic and social disruption and it is much better to be prepared for them than to be caught unawares."

The WHO estimates a pandemic could kill between 2 million and 7.4 million people worldwide, figures that would cause severe economic and social disruption by any standard.

With many workers absent the potential impact on the economy could be significant, according to a recent report from the International Monetary Fund.

But an increasing number of commentators are arguing that the risks of bird flu are being exaggerated and that there is a danger that such a high profile response could desensitise the public.

Yet there are also risks in failing adequately to address a potential pandemic, as the SARS outbreak demonstrated.

The Chinese government's decision to play down the significance of the SARS outbreak is widely thought to have exacerbated the spread of the virus, with international agencies initially underestimating the scope of the problem.

Nabarro is adamant the same should not happen again.

"It is totally correct that we draw people's attention to this risk and I wish that more people would pay attention to the warnings that are being given, because once the pandemic does start it is too late to prepare."

Comments by David Nabarro, the UN's avian influenza response co-ordinator, on the risks of a major outbreak of avian influeza and precautionary measures.
Article is part of a European Voice Special Report, 'Pandemics'.

• Primary Source

European Commission: DG Health and Consumer Protection: Animal Health & Welfare: Avian Influenza - introduction http://ec.europa.eu/comm/food/animal/diseases/controlmeasures/avian/index_en.htm

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