Asian
Bird Flu Threatens To
Trigger Worldwide Epidemic
By John Roberts
World Socialist
Website
06 February 2004
The
current outbreak of avian influenzapopularly known as bird fluin
a number of Asian countries is looming as a major international health
crisis. It has potentially catastrophic human and economic consequences.
While the full story is yet to be established, it is already clear that
economic backwardness, government cover-ups and an inadequate system
of international monitoring and response have all played a part in enabling
the emergence and spread of the disease.
The World Health
Organisation (WHO) was first notified of the disease by Vietnam in January.
WHO reported that, as of January 27, the country had eight confirmed
cases of infected people, nine possible cases and another
36 cases under investigation. The death toll was six but the figure
has now climbed to 10. The epidemic has spread to 28 of Vietnams
64 provinces and, according to government figures, an estimated 740,000
birds have died and almost three million have been slaughtered.
Outbreaks of the
disease in bird populations have now been confirmed in Vietnam, Taiwan,
Thailand, South Korea, Japan, Cambodia, Laos, Indonesia, Pakistan and
China. One of the most serious situations is in Thailand where the government
initially denied that the disease was present. Five people have now
died in Thailand bringing the overall regional toll to 16most
of them children. Thai officials have now confirmed that bird flu has
spread to at least 25 out of the countrys 76 provinces and more
than 10 million birds have been culled.
The disease has
had an immediate impact on exports from the affected countries. Thailand,
which is Asias largest exporter of poultry, has been hit with
import bans by Japan, the European Union and other countries. Thai exports,
half of which went to Japan, were valued last year at $1.25 billion.
As well as large agribusinesses such as the Charoen Pokphand Group in
Thailand, many small farmers throughout the region have been hard hit
by the outbreak.
The farmers not
only suffer economic hardship due to the loss of their stock but they
and their families are most at risk of contracting the disease. Typically
they live close to their poultry stocks, use primitive farming methods
and have poor access to veterinary services. Among the first to die
were a mother and her young daughter in the northern Ha Nam province
in Vietnam.
While the human
and economic losses are already substantial, health authorities are
worried that a modified strain of the virus could emerge that is transmissible
from human to human. At present, the human victims are all believed
to have contracted the disease through direct contact with the faeces
or other excretions of infected birds. But the longer the outbreak continues
and the greater the number of human victims, the higher the chances
of a modified strain that can be directly transmitted to other humans.
Such an occurrence could trigger a global pandemic, which could result
in millions of deaths.
The same strain
of the virus, known as H5N1, emerged for the first time in a human population
in Hong Kong in 1997. Its lethal character was demonstrated by the high
death rateof the 18 confirmed cases, six people died. In order
to contain the disease and prevent a modified version emerging, Hong
Kong authorities slaughtered the islands entire chicken population
of approximately 1.5 million birds in just three days.
The current outbreak,
however, is not confined to a relatively small area. It has spread to
several countries and to many areas where transport, communication and
veterinary and other services are very limited. As a result, the danger
of a modified virus emerging has multiplied significantly. Already two
Vietnamese sisters, who died after nursing their infected brother, are
under investigation as the first possible cases of human-to-human transmission.
Medical experts warn that it would take at least four months to develop
a vaccine to combat any new killer virus and far longer to produce and
distribute the vaccine.
Government cover-ups
Health experts are
still trying to understand where the latest outbreak of bird flu originated
and how it was able to spread to a significant number of countriesapparently
quite quickly. Government attempts, in Thailand and Indonesian in particular,
to cover up the outbreak in order to protect business interests have
only complicated the investigations. The consequent delay in warning
the public and taking measures such as culling chicken populations has
probably been a factor in enabling the disease to spread.
Thai Prime Minister
Thaksin Shinawatra has been widely condemned inside Thailand for failing
to acknowledge the outbreak of bird flu until January 23. Nimit Traiwanatham
told a Thai senate committee that the National Institute of Animal Health
had believed that avian influenza had been present in Thailand from
November. The government, however, suppressed the information. Officials
declared that the culling of some 850,000 birds was due to fowl
cholera.
The parents of one
of the victims have blamed the government for their sons death.
The boys mother, Chongrak Boonmanuj, said doctors at the Siriraj
Hospital confirmed her son had died of bird flu but told her not to
say anything about it as they were forbidden to speak about the disease.
The boys father, Chamnan, asked: The government knew, so
why didnt they tell the public so that we could protect ourselves?
The governments
actions allowed the countrys chicken exportersnotably the
huge Charoen Pokphand Group, known simply as CP inside Thailandto
make short-term windfall profits as the price of poultry jumped to more
than $2,400 per tonne from around $1,700-$1,800. Thai consumer groups
have pointed to the close connections between CP and the government,
noting that Commerce Minister Wattana Muangsook is the son-in-law of
CP founder and chairman Dhanin Chearavanout.
The January 29 issue
of the Far Eastern Economic Review reported CP executive vice-president
Sarasin Viraphol saying: There is still no evidence that we have
avian flu in Thailand... We are likely to emerge a winner rather than
a loser from this episode. In the February 5 issue of the same
magazine, Sarasin was forced to concede that his company and Thai livestock
officials were aware of an outbreak of avian flu in Nakorn Sawan province
as far back as November. He claimed that officials thought the outbreak
was localised and containable.
In Indonesia, the
Director-General for the Development of Animal Husbandry Sofjan Sudardjat
insisted as late as January 24in line with government pronouncementsthat
the avian influenza strain H5N1 was not present in Indonesia. The government
claimed that the deaths of millions of chickens were due to the Newcastle
Disease, which is not transmittable to humans.
On January 25, however,
Sudardjat admitted that avian influenza had broken out on Java in late
August and spread throughout the country. His statement confirms claims
by veterinarians that the government had known of the presence of bird
flu since at least November but had sided with poultry industry representatives
in denying its existence.
Even after admitting
the presence of the disease, Indonesian officials initially resisted
any large scale culling of the countrys poultry stocks. On January
28, agriculture official Tri Akoso told a conference in Bangkok of Asian
nations, the European Union and international agencies that the mandatory
killing of birds was impractical.
WHO chief influenza
virologist Klaus Stohr said in Geneva on January 23 there was a
window of opportunity here to control the disease before it takes global
proportions. The actions of the Thai and Indonesian governments
have helped narrow that window.
Inadequate resources
In attempting to
track and control the spread of the disease, WHO is also hampered by
the lack of adequate resources both in the countries where the outbreak
has occurred and more broadly internationally. Hundreds of millions
of poor farmers and peasants live in close proximity with their flocks
and depend on poultry production for their survival, often in remote
areas. Unlike in the West where poultry production is largely concentrated
in huge enterprises, the decentralised production in Asia countries
poses enormous problems for controlling any outbreak.
Even in areas where
the disease has been identified, inadequate protection for those involved
in culling also poses dangers. WHO has warned that unless these workers
are adequately protected by vaccinations against human influenza and
protective clothing then the culling operation may well provide the
human incubators for a deadly strain. WHO has asked southern hemisphere
nations to surrender some of their stocks of influenza vaccines being
assembled for the next southern winter so culling workers can be inoculated.
The response of
the major industrialised countries has generally been muted. Chicken
imports have been banned but few funds volunteered to assist more backward
countries in containing and eliminating the disease. Agencies such as
WHO are also under-resourced.
WHO spokesman Dick
Thompson told the New York Times: There are big holes in the global
public health network to monitor the many animal diseases that have
implications for humans. The world needs to understand how much of a
stake it has in animal diseases in third world countries. WHO
studies some animal diseases but governments are not required to report
outbreaks to the organisation.
According to the
newspaper, Experts say a number of steps are needed to improve
surveillance of animal diseases. They include better laboratory facilities,
less costly diagnostic tests and sharing more information among international
health agencies.
The end result of
government cover-ups and the lack of adequate monitoring and research
is the outbreak of a disease that has already claimed a number of lives
and devastated the livelihoods of many small farmers. More ominously,
it has the potential to trigger a worldwide epidemic that, as one expert
warned yesterday, could be 1,000 times worse than SARS.