UN names global coordinator for flu threats

Sep 29, 2005 (CIDRAP News) – The United Nations today signaled a new level of concern about avian influenza and the risk of a flu pandemic by naming a special coordinator of all UN responses to the situation.

Dr. David Nabarro, a British public health expert with the World Health Organization (WHO), was named to the new job of "UN system coordinator for avian and human influenza."

At a news conference, Nabarro, 56, said he was nearly certain that a pandemic will erupt soon and predicted it could kill anywhere from 5 million to 150 million people, according to a Reuters report.

News of Nabarro's appointment came as the WHO said further tests had confirmed earlier reports that a 27-year-old Indonesian woman who died Sep 26 had H5N1 avian flu.

Indonesian officials said on Sept 26 that the Jakarta woman and a 5-year-old girl who died last week both had tested positive, though test results for the girl were inconsistent. The WHO statement today didn't mention the girl.

Testing at the WHO reference laboratory in Hong Kong confirmed the woman's case, the WHO said. The agency said she had had contact with sick and dying chickens in her household shortly before she fell ill.

Nabarro calls pandemic very likely
Nabarro was appointed by UN Secretary-General Kofi Annan. In announcing the news, the WHO said, "The appointment is critical as the world is fast recognizing the risk of an imminent human influenza pandemic, and is taking steps to reduce the risk and to get prepared." Nabarro was described as one of the agency's most senior public health experts.

At the news conference, Nabarro warned it is "very likely" that the H5N1 virus will soon acquire the ability to spread readily from person to person, according to the Reuters report. "I am almost certain there will be another pandemic soon," he was quoted as saying.

He said that if the virus starts to spread, the nature of the world's response will determine whether it ultimately kills as few as 5 million or as many as 150 million, Reuters reported.

According to an Agence France-Presse (AFP) report, Nabarro warned that the world will have only "a matter of weeks" to respond after a pandemic begins to erupt and before it gets out of control. He said health agencies will have to fight the virus with the antiviral drug oseltamivir and the most potent vaccines available.

Nabarro said he would run a new UN office in New York that will begin working with governments, international agencies, health workers, and the drug industry, Reuters reported.

The story said he expressed particular concern about the possibility that migratory birds will spread avian flu to the Middle East and Africa. An outbreak in poor, war-torn parts of Africa, such as Sudan, could lead to "a nightmare scenario," he commented.

In the WHO announcement, WHO Director-General Dr. Lee Jong-Wook stated, "The world is responding [to the pandemic threat], and is moving quickly to get prepared. However, coordination of these efforts is critical to ensure all stakeholders are giving the best of what they have to offer, and that countries receive the support they urgently require."

Nabarro has held WHO leadership jobs dealing with malaria, environmental health, food safety and, most recently, crisis operations, the WHO said. His 30 years of experience includes work in community-level and government health programs, particularly in Asia, and in administering development assistance, managing scientific research, building development partnerships, and working with nongovernmental organizations.

Indonesian cases
In Indonesia, the 27-year-old Jakarta woman represents the fourth avian flu case that the WHO has recognized as confirmed. The government has cited a few other cases as confirmed or probable, including those of the 5-year-old girl and two young daughters of a 38-year-old man who died of avian flu in July.

A Reuters report today quoted Indonesian health officials as saying the country has more than 50 suspected avian flu cases. Three days ago officials had put the number of suspected cases at 34. The country has been on high alert for avian flu since Sep 19, when the government said the growing number of suspected cases represented an "extraordinary incident."

Meanwhile, an AFP report today quoted an Indonesian health official as saying the country has had a total of 63 confirmed and suspected avian flu cases so far this year. But the official, who spoke on condition of anonymity, said only 5 of the 63 cases were confirmed, while 9 were probable and the rest were suspected.

The WHO said today that, because of increased surveillance in the country, "growing numbers of people with respiratory symptoms or possible exposure to the virus are being admitted to hospital for observation and, when appropriate, treatment." Many of the patients don't have symptoms compatible with H5N1 infection, the agency said.

See also:

WHO statement on new coordinator
http://www.who.int/mediacentre/news/releases/2005/pr45/en/index.html

WHO update on Indonesian cases
http://www.who.int/csr/don/2005_09_29/en/index.html

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