We at the World Health Organization believe that the world is now in the gravest possible danger of a pandemic. I will come to the reasons for this, but I would like first to briefly share with you a likely scenario if and when the avian-influenza virus now circulating in poultry does develop pandemic potential among humans.
You will no doubt have seen some of the estimates of how many people might die in a pandemic. For me, those numbers are academic. The important thing is that if the virus becomes highly contagious among humans, the health impact in terms of deaths and sickness will be enormous, and certainly much greater than SARS. Hospitals, in particular, will come under great strain. The normal functions of society will be disrupted because so many people will be off work sick or too afraid to go to work. The economic costs will be very high.
This is why we are urging all governments to work now on a pandemic preparedness plan--so that even in an emergency such as this they will be able to provide basic public services such as transport, sanitation, and power.
Let me now set out four reasons why we believe a pandemic is highly likely.
The first is that that influenza pandemics occur every 20 to 30 years. The last pandemic was nearly 40 years ago, so, by this measure, one is now overdue.
Secondly, the virus is now firmly entrenched in many parts of Asia. For example, in Viet Nam, despite all the best efforts of the authorities, we are seeing a similar pattern to this time last year, when the situation became serious around the Lunar New Year.
The third reason is that the virus is proving to be very versatile and very resilient. It is now being found in animals--such as cats and tigers--that were not previously considered susceptible to influenza viruses. Not only that, it is more pathogenic than the strain found in Hong Kong in 1997. This suggests that the virus is evolving in ways that increasingly favor the start of a pandemic.
Lastly, we now know that domestic ducks are playing a silent role in the transmission of the virus. Ducks are spreading the virus without showing any signs of illness. The public-health implications of this are very serious. How can people avoid exposure to the virus when they don't know which ducks are infected and which are not?
So, these are the four reasons that we believe the world is in serious danger of an influenza pandemic.
The longer the virus is circulating in animals, including chickens and ducks, the greater the risk of human cases--and, consequently, the higher the risk of a pandemic virus emerging through genetic changes in the virus.
Of course, infections in ducks and other animals are a matter for our colleagues in the FAO and OIE. But I am sure everyone shares my view that these worrying developments mean we must all work together to make sure that what is happening in the animal world does not spill over and cause health emergencies in humans.
To prevent this happening, I believe it is time for us to pool our organizations' strengths to reduce the risk to humans along the whole length of the food-production chain--from farm to table.
I am not an expert in animal matters, but common sense tells me that there are a number of areas where we can make recommendations to our member states. For example, in collaboration with national animal and public health authorities, we should examine the risk to humans from dangerous agricultural practices such as raising chickens, ducks, pigs, and other animals together--often in unsanitary conditions and normally with no barriers between them and humans.
Another example is wet markets, where animals that would not normally encounter each other in the wild are kept close to each other and are often slaughtered on the spot--normally with very little regard for hygiene.
We know that practices such as these can set the scene for the emergence of new zoonoses.
Together with our member states, we at FAO, OIE, and WHO can be a catalyst for change in the crucial area of interface between humans and animals. We can help set out the best practices for the production, distribution, processing, and marketing of animals for food. We can also raise community awareness of high-risk behavior, both for people who work with animals and for general members of the population.
What we must be striving for in our work is a balance where humans can live safely with animals. This cannot be just a utopian aim. It is vital that we achieve this objective as quickly as possible. If we do not, I fear that more threats such as SARS and avian influenza will emerge from the animal world to endanger global public health.
