Lee Warns PAHO Member Countries on Pandemic Flu

Addressing the Pan American Health Organization's Directing Council in September, LEE Jong-wook, director-general of the World Health Organization (WHO), urged PAHO member countries to work together and individually to prepare for a potentially catastrophic influenza pandemic.

Lee said a pandemic was inevitable, though of uncertain timing, and that it could exact enormous social and economic costs globally. Though no one knows if H5N1 will turn out to be the next pandemic virus, it is certain that "there will be another human influenza pandemic," Lee told the ministers.

"I [have] warned that no government, head of state, or minister of health can afford to be caught off guard. There is a storm brewing that will test us all. We must anticipate it and prepare to the very best of our combined ability. Failure to take this threat seriously and prepare appropriately will have catastrophic consequences."

Concerns about the potential for an influenza pandemic have heightened in recent weeks as highly pathogenic H5N1 influenza in birds has spread from Asia to Central Europe and Turkey. The threat of a pandemic has received increasing coverage in the news media in Europe and the Americas, raising public concerns and questions about measures needed to prepare for such a development.

Lee urged the ministers of health and other delegates from across the Americas to ensure that their countries all have pandemic preparedness plans and reminded them that WHO has offered help in developing such plans.

"The WHO guidelines recently sent to you all set out the phased steps that need to be taken to prepare," he said.

He also called on the region's health leaders to support the International Partnership on Avian and Pandemic Influenza launched by U.S. President George W. Bush at the United Nations General Assembly in New York in September.

"This initiative needs full international cooperation if it is to fulfill its aims. I ask you all to sign up and to give it your active support."

Success will depend on collaboration between the health and agriculture sectors, Lee added, noting that WHO is working with the Food and Agriculture Organization and the World Organization for Animal Health to control avian influenza outbreaks in Asia, where the H5N1 virus is endemic.

Veterinary health workers in China vaccinate poultry against avian influenza. Despite the spread of H5N1 to Europe, international health officials say the focus of pandemic prevention efforts should remain in Asia, where conditions are ripe for the emergence of a human pandemic virus. © WHO/P.Virot

"These countries will need international political and financial support to take the drastic steps needed, such as to cull and compensate. Poor farmers will need incentives to sacrifice their means of livelihood. Can we provide that support? We must. There are international mechanisms now in place to start this process. They need the backing and active engagement of your governments," Lee told the members of PAHO's Directing Council.

Lee's warning came just a few weeks before H5N1 was detected for the first time in birds in Turkey, Romania, and Croatia. WHO confirmed that the virus's introduction into Central Europe and Turkey increased the risk of human exposure but said this should not divert attention from areas where H5N1 is already endemic in birds.

"The problem is still focused in Asia," Mike Ryan, WHO's director of communicable disease surveillance and response, told reporters during an Oct. 17 teleconference.

Ryan characterized the virus's appearance in Romania and Turkey as "two small introductions into Europe" and said the possibilities for containing further spread there were good "with all of the resources we have at hand."

In contrast, he said, "the scale of the problem in the Asian world is actually very difficult."

PAHO Director Mirta Roses echoed Lee's pandemic warning in Spain after attending the Ibero-American Summit in Salamanca in mid-October.

"We should not be over-alarmed, but we should be alert," she told the EFE news agency during a visit to Valencia. "The responsible thing for society and the authorities is to prepare themselves to mitigate whatever impact might occur and not to wait until it happens and then regret the results."

"We should not get panicked; we should get active," she said.