Greetings.

Two stories dominate media coverage today of AI: the meeting in Jakarta (and the conflicting stories coming out of there as to whether or not there has been human to human transmission), and the fact that China may actually have had its first human case of H5N1 infection two years earlier than thought. The Indonesia meeting and the stories coming out of there have been covered close to 400 times in English, Spanish, French and German media combined (moderate-ish coverage), while the Chinese story has been covered 200 times.

Indonesia

• An Associated Press story from the sidelines of the meeting reports WHO experts as saying that the north Sumatra Cluster's index case was probably infected by sick birds and then spread the disease to six family members
• A Xinhua story quotes the Indonesian health minister as saying there was no h2h transmission, saying instead that H5N1 was spread from animal to human. Note that this statement comes even after her boss - the Coordinating Minister for People's Welfare - made a public statement last week that there was human-to-human transmission.
• A further article highlights the fact that ignorance has played a major role in people's contracting of the disease
• And a feature from Reuters confirms the above, saying that the AI threat barely raises a stir in villages in the country
• The Indonesian Govt is asking, in conjunction with this meeting, for $50m over the next three years to establish a system to help fight AI in poultry
• While FAO supports Indonesia's efforts to raise this money from donors.
• Meanwhile, Indonesia has confirmed its 51st human case of H5N1 infection, a 13 year-old boy from south Jakarta who died on 14 June.

You will see in the attachment that a number of countries (e.g., Malaysia, Costa Rica, Benin are coming out with statements to the effect that their country is AI-free. This must indicate that there is a need, or at least governments feel there is a need, to reassure their citizens on this account.

Awareness and discussion of AI also seems to be growing elsewhere in Africa(see below).

Meanwhile, other countries are publicly stepping up their efforts to take precautionary measures against the threat of AI:

• ASEAN health ministers met in Rangoon to better coordinate their fight against AI and other pandemic threats to the region
• Malawi and Zambia among other southern African countries, are on AI alert and Africa's Anglophone conference on AI epidemiology and wild bird sampling is currently being held in Malawi to prepare pandemic preparedness and response measures, including compensation for losses of domestic poultry in order to encourage people to come forward and report suspected cases of AI. These countries, although not yet affected by AI, realize that because of the nearness of the Rift Valley and because of migratory bird patterns, that they are at risk. They have started allocating national resources for AI and have met with international donors to indicate the need for further resources.
• Ghana's ministry of food and agriculture has set up regional and district task forces on Avian Influenza to create the awareness and monitor the situation should there be an outbreak of the disease in the country.
• Cameroon also is making renewed calls to the public to remain vigilant concerning AI surveillance and reporting.

And Latin American countries are examining what has happened to the consumption and price of poultry in European countries in order to know what to expect in their own markets if and when AI reaches them (Argentina, Uruguay, Brazil, for example). They realize that there may be an initial drop in poultry consumption but that, the European experience has been that these prices will eventually rebound.

On another issue which should be noted, the Director of China's National Centre on Influenza says that there is not yet any conclusive proof of h2h AI transmission - although, he does admit, this does not exclude, and we cannot predict, that h2h may occur in the future and that we may be faced one day with a human pandemic

• He also said that the genetic sequence of the virus found among Chinese people infected with H5N1 was different from that of the virus found in Viet Nam, Indonesia and Thailand. The H5N1 virus found in humans in China was a purely avian virus, he said.

David Nabarro at the Pacific Health Summit in Seattle, USA

• Since January, H5N1 avian influenza" -- the strain of bird flu experts have been most worried about -- "has moved into at least 30 new countries. That's double the number of infected countries we had in the preceding two and a half years. And you've also got an increased number of sporadic human cases and deaths. Indonesia is particularly worrisome. So, yes, we remain fearful the virus could change and become more efficient in terms of sustained human-to-human transmission. That would quickly become a pretty big problem. When I read reports from people saying this threat has been exaggerated or, with certainty, it's not going to happen, I just ask myself what's the basis of their information. ... I think it would be extremely foolish not to get prepared. We now have the opportunity."
• "Public health defences (such as disease surveillance and tracking) have been let down in many countries, and now we're playing catch-up. The fact that we've let down our defences is why it took us so long to come to terms with HIV/AIDS, and it may be why, in the last few years, we've had such a difficult time getting on top of outbreaks of infectious diseases. We are unlikely in our lifetime to tackle many of these with a single pill or vaccine. There have been some successes, but for the most part we're going to have to live with the threat of these diseases for our entire lives. We need to be investing in our defence against these diseases, everywhere."

Gregory Härtl