New flu pandemic could kill up to 150 million people

A top UN public health expert warned yesterday that a new flu pandemic is expected at any time and could kill anywhere between five million and 150 million people – depending on action taken now to control the bird flu epidemic sweeping through Asia.

Dr David Nabarro of the World Health Organisation called on governments to take immediate steps to address the threat at a news conference following his appointment as the new UN co-ordinator for avian and human influenza.

“We expect the next influenza pandemic to come at any time now, and it’s likely to be caused by a mutant of the virus that is currently causing bird flu in Asia,” he said.

The H5N1 strain of bird flu has swept through poultry populations in Asia since 2003, infecting humans and killing at least 65 people, mostly poultry workers, and resulting in the deaths of tens of millions of birds. The virus does not pass from person to person easily but experts believe this could change if the virus mutates.

Nabarro said with the almost certainty of another flu pandemic soon, and experts saying there is a high likelihood of the H5N1 virus mutating, it would be “extremely wrong” to ignore the serious possibility of a global outbreak.

“The avian flu epidemic has to be controlled if we are to prevent a human influenza pandemic,” Nabarro said.

The 1918 flu pandemic killed more than 40 million people, and there were subsequent pandemics in 1957 and 1968 which had lower death rates but caused great disruption, he said.

In a new pandemic, Nabarro said, “the range of deaths could be anything between five and 150 million which is a range that’s often quoted at me”.

“I believe the work we’re doing over the next few months on prevention and preparedness will make the difference between, for example, whether the next pandemic leads us in the direction of 150 (million) or in the direction of five (million),” he said.

“So our effectiveness will be directly measured in lives saved and the consequences for the world,” Nabarro said.

Nabarro, who is taking a leave as WHO’s executive director for sustainable development and health environments, said Asian leaders met with Secretary-General Kofi Annan during the recent UN summit and asked for UN assistance in co-ordinating the response to the bird flu epidemic.

Annan decided to set up an office in New York to co-ordinate UN efforts and ensure that the UN system supports local, national, regional and global preparations for a potential human flu pandemic to reduce the human toll and global disruption, according to an announcement by UN spokesman Stephane Dujarric.

Nabarro said his efforts will focus on prevention, preparedness, and response to a potential pandemic.

He listed key challenges as making sure governments give the issue the right level of attention, communicating “the right level of concern without panic”, examining the effectiveness and supply of flu vaccines, and mobilising funds to ensure adequate supplies.

He said the number of deaths in a pandemic will depend on where it starts, how quickly the international community finds out, and the timing and quality of the response to the pandemic.

There are some countries where health systems are extremely limited, where there are often delays in transferring health information from local communities to capitals, and where openness to international assistance may not be welcome, he noted, without giving any names.