Ian Boyne
ATTENTION TO matters like natural disasters and infectious diseases are usually left to specialists in arcane fields, or to wild-eyed Jeremiahs or religious fanatics whose adrenaline goes up with every titillating discussion about the end of the world and Armageddon.
But, after the Asian Tsunami, devastating Katrina and now Rita, the attention of millions around the world thanks to satellite and 24-hour news television is focused on how these tragedies can change everything. Human beings, even those planners who are specifically charged with paying keen attention to these matters, don't usually pay much attention to unfolding threats and potential hazards until they are upon us.
From the 1960s especially, dire warnings have been going out and frightening scenarios have been painted by environmentalists and others about the consequences of our rape of the earth would have. Few people listened. It took decades before the environmental movement was taken seriously, and today, thanks to the persistent efforts of some dedicated souls and tireless activists, environmental concerns are on the front-burner.
Katrina will focus the minds of many persons wonderfully. But humanity seems to have this deadly tendency not to take threats seriously until they have materialised.
HIV/AIDS DISEASE
When the HIV/AIDS disease first came to public attention in the early 1980s, many did not take it seriously as a potential epidemic, let alone the pandemic it has now become. It took Sub-Saharan Africa a full two decades to face the facts of AIDS after millions of deaths. The myopia was not limited to Africa but manifested itself in the developed countries, too.
Now the world is on the verge of a major flu pandemic and the world's richest country, the United States, as well as other developed states are not paying nearly as much attention to this looming pandemic as they ought to. Increasingly, however, major media organs have been giving attention to this threat, with America's most influential journal, Foreign Affairs, devoting its July/August issue to the theme of 'The next pandemic'.
"Scientists have long forecast the appearance of an influenza virus capable of infecting 40 per cent of the world's human population and killing unimaginable numbers. Recently a new strain, the H5NI avian influenza, has shown all the earmarks of becoming that disease," opens Foreign Affairs with an article by the Senior Fellow for Global Health at the Council on Foreign Relations, Laurie Garrett. The strain first appeared in China in 1997 and has sent alarm bells among scientists all over the world. The alarms are so loud now that the important North American and European media cannot ignore them.
The September 19 issue of Businessweek has a cover story on, 'The next big one', looking at the avian flu, among other such threats such as a major earthquake in California. The respected British weekly the Economist, in its August 6-12 issue, has both an editorial and a report on 'Preparing for a flu pandemic', and the prestigious Scientific American devotes its September, 2005, issue to the global threats, including 'The new face of disease', in a cover titled, 'Crossroads for planet Earth'.
NO APOCALYPTIC RAG
When these serious media begin to devote priority attention to an issue, we had better sit up. The readings in Foreign Affairs, no apocalyptic rag, are chilling and nightmarish: There could be 16 million deaths in the United States from this flu and 80 million illnesses. "The entire world would experience similar levels of viral carnage and those areas ravaged by HIV and home to millions of immuno-compromised individuals might witness even greater death tolls. Some countries might impose disruptive quarantines or close borders and airports, perhaps for months."
Continuing, Garrett says, "No doubt the world's stock markets would teeter and perhaps fall precipitously. Aside from economies, the disease would likely directly affect global security, reducing troop strength and capacity for armed forces and police world-wide."
The majority of the world's Governments have no infrastructure to deal with any such pandemic. The Director for the Centre for Infectious Disease Research and Policy, Michael T. Osterholm, is even more graphic and spine-chilling in his article titled, 'Preparing for the next pandemic'. He projects that if the general comparisons with the 1918-19 Spanish Flu are accurate, up to 360 million deaths could be recorded after this pandemic has wreaked its murderous toll.
Says he in the Foreign Affairs special issue looking at the next pandemic: "In short order, the global order would shut down. Border security would be made a priority especially to protect potential supplies of pandemic-specific vaccines from nearby desperate countries. Over the course of a year, over 50 per cent of populations could become ill. There would be major shortages in all countries of a wide range of commodities, including food, soap, paper, and light bulbs, gasoline, parts for repairing military equipment and municipal water pumps and medicines. Many industries not critical to survival 'electronics, automobile and clothing, for example' would suffer or even close. Activities that require close human contact school, seeing movies in theatres or eating in restaurants would be avoided, maybe even banned."
In short, civilisation as we know it would come to an abrupt rupture. Some might hiss their teeth and say these writers need to consult a psychiatrist rather than be allowed to project their neuroses on the public, trading in fear and hysteria. But so were the dire warnings received by some of what a category five hurricane could do to the Gulf Coast of the United States, when they were made three years ago. Twenty-five million people have already died from HIV/AIDS and 40 million are infected now. In the early 1980s that would have been dismissed as doomsday. Perhaps humanity will someday finally justify the possession of a will and consciousness as a species! But isn't it easy to just develop a vaccine to deal with this flu before it becomes a serious global threat? This is where the story really gets chilling. Foreign Affairs informs that the total number of companies willing to produce influenza vaccines has plummeted from over two dozen in 1980 to a handful today. The pharmaceutical industry spends very little on research for what has traditionally been considered the diseases of poor developing countries.
So, while the market for pharmaceuticals was US$337.3 billion in 2003, the entire market for all vaccines from polio to measles to influenza was just US$5.4 billion just two per cent of the original demand. Unlike chemical compounds, vaccines are difficult to make and can easily become contaminated. So the production of influenza vaccines hold particular drawbacks for companies. Because flues are seasonal, a new batch has to be produced each year. Flu vaccines can't be stockpiled for another year in case sales are disappointing.
Another particular difficulty with the avian influenza is that it is 100 per cent lethal to chickens including chicken eggs. It took researchers five years of intense work to grow the 1997 version of the H5NI virus on eggs without killing them.
DEADLY INFLUENZA
But says Garrett in his article, "The scarcity of the flu vaccine is actually of little relevance to most of the world. Even if pharmaceutical companies managed to produce enough vaccine in time to save some privileged lives in Europe, North America and Japan and a few other wealthy countries, more than six billion people in developing countries would go unvaccinated." What a bewildering prospect!
Garrett says coldly but realistically: "Resources are so scarce that both wealthy and poor countries would be foolish to count on the generosity of their neighbours during a global outbreak. In the event of a deadly influenza pandemic, it is doubtful that any of the world's wealthy nations would be able to meet the needs of their own citizenry much less those of other countries." Every year the United States plans for 185 million vaccine doses. If that guess is wrong any year and all Americans rather than the usual suspects (the young, the old and the immuno-compromised) are involved, America would need 300 million doses. This is what the entire world produces in one year.
IMPACT OF THE FLU
"There would be a global scramble for vaccine," says Garrett. Very little vaccine is actually made in the United States and governments might block access to their exports. Would America use its military force to get its needed vaccines or would it just vaccinate heads of state and other leading members of the elite? Chaos of unimaginable, Biblical proportions would break out.
Says Businessweek in its report of September 19, 2005 sub-titled, 'Little could be done to contain a deadly Avian flu outbreak': "Even if a vaccine is developed it would take six months to produce one tailored to the viral strain causing the pandemic and the world's extremely limited vaccine production capacity means only 14 per cent of the global population could be inoculated within a year."
Says Businessweek: "Most experts predict that an avian flu outbreak in the United States would overwhelm hospitals, decimate workforces and throw transportation and supply chains into chaos." The non-profit organisation Trust for America's Health in a paper issued in June this year (A killer flu?) estimates that the impact of the flu pandemic on the U.S. economy would be a staggering US$166.6 billion due to death and lost productivity, excluding other 'disruptions to commerce and society'.
The World Health Organisation has issued its grim warnings and the director of the organisation's communicable diseases department has said, "Whether the avian influenza pandemic will occur, that is not the question anymore." The same has been said by Osterholm in his Foreign Affairs article: 'It's definitely coming'. Says the British Economist in its August 6-12 editorial: "Given how much money rich countries have spent on preparing for bioterror attacks, it is surprising how little attention they have paid to the possibility of a flu pandemic which would probably kill more people."
Osterholm also advises that, "Even if an H5N1 pandemic is a year away... major campaigns must be initiated to prepare the non-medical and medical sectors. Pandemic planning must be on the agenda of every school board, manufacturing plant, investment firm, mortuary, state legislature and food distributor."
While we in Jamaica are imm-ersed in our usual parochial interests and infighting, we had better take stock of these global trends.
Ian Boyne is a veteran journalist. You can send your comments to ianboyne1@yahoo.com or infocus@gleanerjm.com.
