U.N. Flu Czar Warns of Coming Flu Pandemic

The United Nations has begun a worldwide drive to counter the threat of a global flu pandemic. The U.N.'s new avian flu czar, Dr. David Nabarro, will head up the drive to contain the disease and prepare for its possible jump to humans.

The avian flu virus is spread by chickens, ducks and other birds and has been a problem in Southeast Asia for several years, killing at least 65 people in four Asian countries since 2003. With strains of the virus found in humans, there has been growing concern among U.S. officials about the possibility of a pandemic.

In a news conference announcing the U.N. effort, Nabarro, the top health crisis official at the World Health Organization, warned that the potential threat could kill as many as 150 million humans if the world does not take action to contain or prevent the spread of the disease. He addressed several of the most pressing questions related to the bird flu threat to humans:

Q: What's the threat?

Nabarro said he was "certain" that there will be a flu pandemic sometime soon – and that the range of deaths could be anywhere from 5 million to 150 million. He said it was up to the world whether "the next pandemic leads us in the direction of 150 million deaths or in the direction of 5 million deaths."

Q: How can the U.N. – and the rest of the world – prevent a catastrophic bird flu outbreak?

Nabarro said his job was to help governments make the difficult political decisions they will have to make in order to prepare their populations for a pandemic.

"The challenge of my work is to go alongside governments as they start to get ready to make difficult decisions. What's in it for them? … To convince them that they are making tough decisions on behalf of all of humanity. What happens in a county in Korea could have an impact on the fate of the whole world. The trick is to get countries to have extraordinary political courage in the face of a global challenge and try to get 100 percent international transparency."

Nabarro said he had been invited to the State Department to participate in the avian flu initiative announced by President Bush two weeks ago. He said Bush's initiative will be a huge success if it can help give all the world's governments the political will to take the necessary steps ahead of a pandemic.

President Bush has announced an international partnership aimed at preventing an avian flu pandemic. The initiative is geared to increase global communication on the flu, with an emphasis on countries that face outbreaks sharing details and providing samples to the World Health Organization. The U.S. also plans to hold strategic international talks to plan against flu pandemic.

Tamiflu

Nabarro spoke extensively about how Tamiflu was the "only medicine we've got" – but that "we don't know how well it works." He said there were nowhere near enough doses because the production capacity was not yet high enough.

He said part of his job would be to work with Tamiflu's maker, the pharmaceutical giant Roche, to ensure more of the drug is made, distributed, and set aside for first responders. One of the lessons of SARS (Severe Acute Respiratory Syndrome, a respiratory illness that broke out briefly in China in 2004, infecting nine people and killing one person) was the need to make sure health care workers who will be rushing to outbreaks have enough medication for themselves, he added.

Q: What's the nightmare scenario?

Nabarro said the nightmare scenario would occur if a pandemic began in a refugee community: "If an outbreak starts in Khartoum, or in Darfur – if it was in refugee communities, we would be seeing something cataclysmic for humanity. Nightmare scenario: pandemic takes root in the least well-served and perhaps most crowded areas."

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