Global avian influenza controls must be scaled up now

Abstract

There are few comforts to take from the alarmingly rapid spread of avian influenza in Turkey and the proliferation of human H5N1 infections—which as of Jan 17 numbered 20 cases across nine of the country's 81 provinces. But one important benefit of the now daily revelations about the virus' conquests is that attention is being lavished on this threat at a time when it is most needed: when donors start to talk about money. On the eve of the 2-day International Pledging Conference on Avian and Human Influenza in Beijing, Jan 17–18, the World Bank promised US$500 million towards an estimated target of $1·2 billion to $1·4 billion needed to boost global efforts to stop the spread of avian influenza and ward off a human pandemic. The EU, which is co-hosting the conference with the World Bank and the Chinese Government, added $100 million to this pot. Conference organisers are confident these gestures will prompt other funders to follow suit this week. Although Turkey's plight is unlikely to have held much sway in the deliberations among big donors, for other delegates it should reinforce the necessity of a strong global response. A restatement of rich nations' commitment to helping poorer countries is especially important now since global momentum at the end of last year was in danger of waning after some commentators took the scarcity of human infections as an indication that warnings of mass casualties were an overreaction. The announcement last week that virus samples from Turkey's first human deaths from H5N1 have mutations that might make transmission from birds to human beings (although not between human beings) easier should alert critics to the veracity of the threat. Worryingly, though, the spread of the virus in Turkey also indicates that the efforts to control avian influenza in birds are not working as well as hoped. Donors in Beijing need to acknowledge that global control efforts—and the funds to support them—need to be scaled up now to address this failure. But Turkey's experience should also remind all nations that the status of preparations to protect human health remains an immediate, and serious, concern.