Avian Influenza & Human Pandemic Influenza

Yesterday, we opened the session with our collective expressions of urgency about outbreaks of avian influenza in birds and the potential for a human pandemic.

Reflecting this concern, on September 14 of this year, President George Bush launched an International Partnership on Avian and Pandemic Influenza in a speech during the Leaders Summit of the UN General Assembly. As stated in the core principles of the Partnership, the partners are :

"...committed to protecting human and animal health as well as mitigating the global socioeconomic and security consequences of an influenza pandemic. The partnership seeks to work with all concerned states to limit the spread of H5N1 avian flu and any other highly pathogenic influenza strain by taking all necessary steps to prevent, prepare for, and respond to the growing threat."

In short, the five primary goals of the International Partnership are to:

• Elevate the avian influenza issue on national agendas;
• Help coordinate efforts among donor and affected nations;
• Mobilize and leverage resources;
• Increase transparency in disease reporting and the quality of surveillance; and,
• Build local capacity to identify, contain and respond to an influenza pandemic.

The first meeting of the Partnership took place on October 6-7 in Washington, DC, hosted by the U.S. Department of State. The meeting involved top foreign affairs, health and agriculture officials from 88 countries, as well as representatives from eight international organizations, including the World Health Organization, the Food and Agricultural Organization and the World Organization for Animal Health.

The meeting's main objective was to affirm the commitment of participating countries at the highest levels to work together in combating avian and pandemic influenza and to identify priority areas for further action. Three general topic areas were covered: surveillance and prevention; preparedness, planning and outreach; and response and containment of avian influenza.

The Partnership is clearly designed to supplement and give the highest level of political commitment to ongoing and planned international and regional efforts and support the work of the relevant international organizations, including the World Health Organization (WHO), the World Organization for Animal Health (OIE), and the United Nations Food and Agriculture Organization (FAO).

In the October meeting, five recurring themes emerged:

1. That increased cooperation among countries and with the international organizations is indeed essential in order to avoid duplication and recognize ongoing efforts;
2. That transparency includes not only identification of disease, but also the need for countries to be open in assessing their own capabilities and deficiencies;
3. It is critical to develop effective and culturally relevant communications strategies for reaching out to the broader population to raise public awareness and induce behavior change;
4. Every effort should be made to promote early voluntary implementation of the revised International Health Regulations; and,
5. We must look beyond the technical animal and human health aspects towards effective economic and social responses.

The Senior Officials also highlighted the link between animal health and public heath and urged support for controlling avian influenza at its source--birds. The role of wild migratory birds as reservoirs of highly pathogenic avian influenza makes the threat a global veterinary issue.

Moreover, the discussions at the Senior Officials Meeting in October revealed the need for follow-up dialogue on the subjects of (1) stockpiles, (2) vaccine development, manufacturing capacity and distribution, and (3) rapid response and containment.

 In discussing stockpiles, including vaccines and anti-virals, the officials identified specific policy issues associated with research, production capacity (notably surge capacity), and distribution. These issues were among the topics of discussion at the meeting of Health Ministers hosted by Canada in Ottawa, October 24-25.

In discussing vaccine development, the officials addressed incentives for the private sector that will encourage the rapid development and production of vaccines, coordinating national regulatory requirements and standards, and developing a comprehensive strategy for vaccine research and development that engages the academic, public and private biomedical research community. Work in this area is progressing. The WHO brought together vaccine researchers from around the world in Geneva last week to compare notes and coordinate their efforts. We look forward to a meeting of regulators to follow.

My colleague will say a few words about rapid response and containment which was addressed in the follow on APEC Meeting hosted by Australia in Brisbane, October 31-November 1.

The International Partnership is integral to the new U.S. National Strategy for Pandemic Influenza announced by the President on November 1 and discussed here yesterday. As the President put it, "The first part of our strategy is to detect outbreaks before they spread across the world. In the fight against avian and pandemic flu, early detection is our first line of defense. "

In the spirit of the International Partnership, the President requested $251 million from our Congress to help our foreign partners train local medical personnel, expand their surveillance and testing capacity, draw up preparedness plans, and take other vital actions to detect and contain outbreaks. In addition, our comprehensive commitment to vaccine research and development will serve the broader global community.

President Bush noted that "to respond to a pandemic, members of the international community will continue to work together. An influenza pandemic would be an event with global consequences, and therefore we're continuing to meet to develop a global response. We've called nations together in the past, and will continue to call nations together to work with public health experts to better coordinate our efforts to deal with a disaster." I thank all nations of the partnership that are joining us in this political commitment to addressing the threat.