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West reacted too slowly to bird flu, specialists say

HANOI -- Western countries failed to respond adequately to bird flu until the more deadly strain of the virus spread to Europe, missing the chance to control the disease while it was confined to Southeast Asia, specialists in the region say.

''The donors are late in the game," said Anton Rychener, the Hanoi representative of the UN Food and Agriculture Organization, which is part of an international emergency effort to help Vietnam control the virus over the next six months. ''If the same reactions that we have today would have been taken a year ago, a spread beyond Southeast Asia could have been avoided."

Patrice Gautier, head of Veterinarians Without Borders in Vietnam, said: ''It's two or three years late. What we recommended two years ago, we're just receiving the funding to do now."

On Nov. 7 in Hanoi, European Union Health Commissioner Markos Kyprianou acknowledged the slow reaction. ''The EU should have reacted more quickly to help Southeast Asia to tackle the problem," Kyprianou said during talks with Vietnam's agriculture minister, Cao Duc Phat. ''It's better late than never."

Today, Asian officials say, international donors are largely meeting Asian countries' needs on bird flu. A conference of donors, agencies, and affected countries in Geneva this month agreed on a massive international response to the disease.

''The cooperation from the international community has been extraordinary," said Noureddin Mona, the FAO's representative in Beijing.

Donors are providing laboratory equipment for virus detection as well as syringes and protective gear for campaigns to vaccinate hundreds of millions of poultry in Vietnam and Indonesia. In China and Thailand, which are funding their flu-control efforts, Western countries are providing technical advice on surveillance systems for detecting human outbreaks, crucial to determining whether the virus has mutated into a form easily transmissible between humans.

The United States is training Asian doctors and veterinarians, and buying stocks of the antiviral drug Tamiflu to be distributed to local populations in case of a human-to-human outbreak. It has also launched education programs to teach more hygienic practices to Asia's small-scale poultry farmers, who often live in close contact with their birds.

But by now, specialists say, the H5N1 virus has become endemic -- widespread and ineradicable -- in Asian poultry. Had there been more help during the virus's initial outbreaks in 2003 and 2004, containment efforts would have been more successful, they said.

''If there had been more support to the government of Indonesia to intervene when avian flu first presented as a problem in poultry, it might have been easier to control," said veterinarian Christine Jost, a technical adviser to FAO in Indonesia.

The H5N1 virus epidemic in birds began in late 2003 in Thailand and Vietnam. By January 2004, the FAO and the World Health Organization were calling for substantial funds and technical assistance for affected countries. They warned that local countries lacked the capacity to contain the disease on their own.

The more widespread the H5N1 epidemic in animals, the greater the risk that the virus will mutate into a form easily transmissible between humans, leading to a global human pandemic that could cause millions of deaths.

But Western countries were slow to respond while that strain of the virus remained in Southeast Asia. Few donors made large commitments until this fall, when migratory birds brought the deadly virus strain to Europe.

A comparison of donations from before and after the disease reached Europe highlights the concern. As of May, according to figures from the UN Development Program, donor commitments to Asian countries for fighting bird flu totaled $32 million.

While complete figures are unavailable for November, the total has grown exponentially. The World Bank has made $500 million in grants and loans available. In October, President Bush outlined a $7.1 billion pandemic influenza preparedness plan, including $251 million for international efforts, though US officials were unable to specify how much would go to Asia.

Smaller donors stepped in as well: the Netherlands, which gave no money to Vietnam to fight bird flu in 2004, donated 1 million euros to Vietnam's emergency plan starting last month.

Australia has committed $45 million to Asian countries, and intends to give $100 million more. In Australia's case, however, the turning point seemed to be revelations of widespread H5N1 in Indonesia starting early this year.

If such help had been available by the time of the second major H5N1 outbreak last winter, it would have been more effective, Bui Quang Anh, head of Vietnam's Department of Animal Health, said in an interview last week. ''We needed funds for culling chickens," Anh said.

At that time, animal health workers were battling the virus by culling all poultry within a 2-mile radius of each outbreak. But Southeast Asian governments lacked the money to compensate farmers for their destroyed birds, making farmers reluctant to report infections.

Part of the problem, Jost said, was that bird flu attracted little attention until humans became infected. Rychener, of the FAO's Hanoi office, said the lack of interest was more geographical.

''Once it hit the West, it was a problem. When it was lingering in Asia for two years, it didn't command attention," he said.

The delayed response of Western donors was also caused in part by the problem's complexity. Until countries have comprehensive national plans for responding to avian flu, it is difficult for donors to know how they can assist.

Vietnam began to work out its comprehensive national response with international agencies and donors in February.

Vietnam's first six-month emergency stage of the comprehensive plan was not signed until Oct. 13.

The government hopes to have a long-range strategy ready by December, at which point it will request more assistance.

Indonesia, meanwhile, still lacks a comprehensive national bird flu strategy. On Dec. 1, the government is set to begin three weeks of meetings with international advisers to develop a plan.

Pop-up GLOBE GRAPHIC: The reach of bird flu
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