A highly pathogenic strain of avian influenza native to southeast Asia is the most likely source of the world's next flu pandemic. Experts agree that the consequences could be devastating. Repeated warnings continue to be ignored by the international community, so this week's Nature devotes its News Feature and Commentary pages to avian flu, the risks we face and how badly prepared we are to deal with it.
A human flu pandemic could cause 20% of the world's population to become ill. Within months, close to 30 million people would need to be hospitalized, a quarter of whom would die. This is one of the more optimistic estimates, say Albert Osterhaus and colleagues in their Commentary, which calls for a permanent global task force for influenza, rather than relying solely on the ad hoc teams created during virus outbreaks.
But this is not only about death and disease as Michael T Osterholm points out in his Commentary, the world is heading towards a global economic disaster unlike anything we've seen during other public health crises. The world economy is not threatened by diseases such as HIV, malaria or tuberculosis, despite their devastating effect on local communities. The global panic created by flu will be different. Osterholm calls for bold leadership by the G8 and action at all levels: "We must demand nothing less than an international effort to develop a new type of influenza vaccine that can be manufactured on a much shorter timescale."
Robert Webster and Diane Hulse also argue for better vaccines but for poultry, where there is still a chance we may be able to control the spread of the disease and so buy ourselves some time. Like Osterhaus, they argue for much greater harmonization between the public health sector and global agricultural authorities, and call for a single international standard for both animal and human vaccines to make poultry vaccination more attractive and reliable.
In two further Commentary articles, Anthony S Fauci looks at how the US research enterprise is gearing up its efforts and David Ho investigates how SARS was a wake-up call for China, and how sufficiently prepared it is for other major microbial threats. Until Monday's announcement of a population of infected geese, the last confirmed case of avian flu in China occurred last July and as yet no human cases have been confirmed in the country.
The five Commentaries are by experts in various fields, they all agree that time is running out for the international community to take action that will limit the devastation of a pandemic.
Two News Features further investigate the current capacity to produce a vaccine against a pandemic strain and how adequate global stockpiles of antiviral drugs would prove to be in the event of an outbreak. Efforts are currently inadequate and the answers to several key questions such as how drugs could slow the spread of a pandemic are unknown.
Nature's editorial reinforces the facts that efforts are currently far from united: Unless the international community now moves decisively to mitigate this pandemic threat, we will in all probability pay heavily within a few years. Then, hard questions will be asked as to why we were not prepared.�
Finally, the opening News Feature was written in consultation with experts who would be called upon to deal with a real situation. Using fictional hindsight to describe a pandemic as it unfolds through a journalist's weblog, this is fiction but not fantasy, and it throws the issues into starker, sobering relief.
[email protected] rounds up all of Nature's recent coverage in this area; hosting a bird flu focus that includes a comprehensive timeline of events plus key research papers and additional news.
This week, Nature, the journal Foreign Affairs in collaboration RiSci (the Royal Institution World Science Assembly) are also launching an initiative bringing together many of the world's leading scientists with politicians and industry leaders from around the globe. As well as publishing special issues of Nature and Foreign Affairs, the 'Pandemic Preparedness Project' will hold emergency meetings and briefings aimed at 'cross-fertilizing' science, government and business planning across national borders in order to prepare to meet a global pandemic.
CONTACTS
Albert Osterhaus (Erasmus Medical Centre, Rotterdam, Netherlands)
Tel: +31 104 088 066; E-mail: [email protected]
Michael T Osterholm (University of Minnesota, Minneapolis, MN, USA)
Tel: +1 612 626 6770; E-mail: [email protected]
Robert Webster (St Jude Children's Research Hospital, Memphis, TN, USA)
Tel: +1 901 495 3403; E-mail: [email protected]
Anthony Fauci: (National Institutes of Health, Bethesda MD, USA)
Tel: +1 301 496 2263; E-mail: [email protected]
David Ho (Aaron Diamond AIDS Research Center, New York, NY, USA)
Tel: +1 212 725 0018; E-mail: [email protected]
For background information or to speak to journalists involved in the News Features or Commentaries please contact:
Ruth Francis, Senior Press Officer, Nature
Tel: +44 20 7843 4562; E-mail: [email protected]
