As
the threat of a pandemic (global epidemic) of avian influenza
grows, Red Cross and Red Crescent Societies are strengthening
their position to prepare for and respond to this outbreak.
The issue was highlighted at the current 7th European Red Cross
and Red Crescent Conference in Istanbul. In this interview,
Dr. Pierre Duplessis, the International Federation’s Special
Envoy on Avian Influenza, describes an increasingly important
pandemic preparedness role for National Societies, as auxiliaries
to their government.
Q. How would you describe the current situation
in regard to avian influenza in the world?
There is no doubt that the pandemic will take place, as we see
how the avian influenza virus (H5N1 virus) manifests itself
at regular intervals of 15-50 years. We know that currently
the virus has reached a pandemic state among animals, with the
occasional infection of human beings. However, the virus is
active, aggressive and capable of mutating, which presents a
serious threat for people.
Q. Why do we speak about a pandemic while there
are only a few cases of infection in human beings?
Influenza viruses are very unstable. They can be highly contagious
and develop resistance to available treatments, spreading rapidly
through regional and global populations. If we take the United
States, for example, in 1918 the influenza virus needed only
three weeks to spread through the entire country.
The World Health Organization (WHO) declared an alarming pre-pandemic
stage of alert, which signals that the virus is on the edge
of changing from animal to human. An even greater concern is
that the H5N1 virus could develop the capacity to be transmitted
easily between humans. Because the world population would have
no immunity to the virus, this could spark a pandemic. It is
impossible to predict the likelihood of this happening.
It would be irresponsible not to prepare.
Q. What is the geographical spread of the virus?
The avian influenza virus H5N1 has caused the death or destruction
of millions of birds in Asia, Europe, and the Middle East. According
to the WHO, the virus has also infected humans in eight countries
- Azerbaijan, Cambodia, China, Indonesia, Iraq, Thailand, Turkey,
and Vietnam - causing 186 human cases and more than 105 deaths.
The virus is now most active in Indonesia, with a very high
fatality rate there of 80%. In other countries, this figure
is about 30%.
The most severe of the three influenza pandemics in the last
century was the “Spanish flu” in 1920, which resulted
in a two-year toll of 50-100 million deaths worldwide, in other
words, between 2.5% to 5% of the world's population. Important
outbreaks also occurred in 1957 and 1968. Concerns about H5N1
have grown recently as the virus has spread to birds in at least
45 countries.
Q. Why is this issue so important for Europe?
It is a growing concern here. The virus is already in Europe,
and it is moving on. If we look at the pattern of propagation
of avian influenza we can see the route. It starts in China,
goes south to India, then on to African countries and north
to Europe. It starts to affect Europe through former Soviet
countries, including Russia, where 1.7 million birds were killed
in recent years. Birds flying from that region are now found
in Eastern Europe. Apart from health threats the epidemic among
birds is a logistical nightmare.
Q. Who are the groups most at risk?
Statistics show that people under 40 are more likely to get
infected. Risk groups would include children with little immunization,
elderly people who are sick, people suffering from immunity
diseases. Vaccination can save many lives.
Q. Why should the Red Cross be involved?
We have capacity and experience in disaster management and disease
outbreaks. We have national response teams, networks of various
specialists in disaster management, first aid, psychosocial
support, community-based programmes and volunteers. We know
how to protect our staff. We can ensure service continuity.
We also have a specific role supporting the government.
Q. How should we prepare?
Today we know that the pandemic will most probably happen. We
have the chance and time to prepare, by making contingency plans,
speaking to governments and spreading information. Doing all
that develops discipline and organizational skills applicable
in any circumstance. Contact your government. Sign agreements.
Make sure you participate in protocol. To avoid chaos when the
government will turn to us for help, build proper relations
now. In case of mass danger people will turn to us, they will
expect response and we’ll have to provide it.
We must take this opportunity now! During pandemics, Red Cross
Red Crescent workers will be capable of complementing the work
of other professionals.
Q. What is the Federation role?
The Federation will support National Societies, map their activities,
coordinate their action, help mobilize resources and be their
special envoy on the issue.
Q. What would you say in conclusion?
Public preparedness will strengthen Red Cross Red Crescent Societies’
capacity to respond to outbreaks in general. What will be critical
are: new response capacities, better partnerships, long term
commitments and community involvement. Even if H5N1 does not
spark the next influenza pandemic, all preparedness efforts
will help improve the public health response to other health
emergencies. Red Cross Red Crescent Societies have a responsibility
to prepare for the possibility of a pandemic. With all the information
in hand we must take action, now.
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Dr. Pierre Duplessis, the International Federation’s
Special Envoy on Avian Influenza, describes an increasingly
important pandemic preparedness role for National Societies,
as auxiliaries to their government. (p15766)
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