# 1390
Dr. David Nabarro, Senior UN System Coordinator for Avian and Human Influenza, in an interview after the recent New Delhi conference made some comments which have garnered some headlines and have generated some controversy, as well.
First the report (bolding mine), then some discussion.
UN: Avian Flu Not as Serious as First Feared
By Faith Lapidus
Washington
19 December 2007Lapidus report - Download MP3 (1.11 MB)
Listen to Lapidus report
Delegates from 111 countries met in New Delhi, India, the first week of December to assess the progress in combating avian flu and the preparations for a human influenza pandemic. Two of the public health officials leading that effort summarized the results of the conference at a news briefing in Washington. As we hear from Faith Lapidus, they reported progress, but said there was still a long way to go.
David Nabarro, Senior UN System Coordinator for Avian and Human Influenza
Since it was first diagnosed in Asia in 1996, the virus that causes avian influenza, or bird flu, has forced the destruction of millions of infected poultry flocks in nearly 60 countries. More than 200 people have died after contracting the so-called H5N1 virus.
Bird flu is a problem that will likely be with us for some years to come, according to David Nabarro, senior coordinator for avian and human influenza at the United Nations. But citing data on the spread of the H5N1 virus from 146 nations, Nabarro emphasized the positive.
"The first thing to say is that the situation has changed, between 2004 and 2007, the rate at which new countries are being affected by H5N1 has reduced, we've got a bit of a plateauing [leveling out], the number of human cases, which act as a sentinel, has slightly decreased, and the human deaths have also decreased." He said that broad epidemiological evidence suggests that the H5N1 virus situation is not quite so serious.
The virus, however, is still being actively transmitted in at least six countries, and there are new reports (December 16) of human infection and death in Burma and Pakistan. At the Washington briefing, Nabarro stressed the importance of maintaining focus, funding and political will to keep H5N1 under control.
The statement that the headline focused on was, in my opinion, a fairly minor point. And it must be taken in context.
Three years ago, when H5N1 first resurfaced, there was genuine fear that it would erupt into a pandemic at any moment. In the Spring of 2006, when the virus quite suddenly appeared in 35 new countries in a matter of a couple of months, there was legitimate fear that it would spread around the globe by year's end.
Neither of these things happened.
In fact, 2007 has been a less eventful year for the virus than was 2006. We've seen fewer outbreaks, fewer human infections, and fewer deaths.
So, epidemiologically speaking, the virus isn't progressing as rapidly as first feared. Dr. Nabarro is right.
Which isn't to say that the threat of a pandemic has gone away. It hasn't. The virus remains endemic in many nations, and out of control in at least 6 countries. It continues to mutate, and infect other species.
The fact that it is spreading at a slower rate, while certainly good news, doesn't mean we have been spared from a pandemic. It simply points out how little we understand about how pandemic viruses behave.
Dr. Nabarro's main point, however, is saved until the end of the story. Where he tells us what our greatest threat really is.
While acknowledging the threats posed by war and global warming, Nabarro insisted that the biggest danger mankind faces today is almost invisibly small.
"It's microbes, particularly microbes that come from the animal kingdom, that represent one of the greatest threats to humanity and certainly even to its survival as we know it.
Our knowledge about how pandemic strains evolve, and how pandemics start, is pitifully small. So it is no surprise when early predictions on how a virus will behave turn out wrong. The lead up to next pandemic will be the first time such an event is studied scientifically as it happens.
Hopefully, in the run up to the Pandemic-After-Next, this data will ensure we won't make the same kind of rookie mistakes in predicting the spread of that virus.
