9 November 2005
Ladies and gentlemen,
Thank you for making this a remarkable and productive meeting. The world has been watching and listening as, over these three days, the scale of the challenges has emerged. The international solidarity to confront these threats is clear. The urgency of acting now is felt by us all. Precise recommendations for action have emerged. Equally, precise offers of help and support have been put forward, by both developing and industrialized countries.
I will now review the central points that have come out of the meeting. Next I will outline an integrated programme of action which responds to the issues raised.
1. Minimizing the threat at source to both animal and human populations through rapid reduction of the viral burden of H5N1 is essential. This entails timely notification of outbreaks in birds, poultry culling and vaccination as indicated, including "backyard" flocks, and provision of appropriate compensation for farmers.
2. "Early warning" and surveillance systems for animal and human influenza are critical to effective response. The current window of opportunity to intervene is measured in days. Transparent and immediate reporting is essential.
3. The introduction of avian infection with H5N1 to other countries is predicted, following the patterns of migratory birds, and as a result of production systems and market practices. Other strains of avian flu are also an ongoing and emerging threat and must be monitored. Strengthened veterinary services are a crucial aspect of detection and response. Open sharing of virus samples is essential. Quality assured animal vaccines produced to international standards should be used in healthy poultry when appropriate.
4. At present many governments are not ready to cope with outbreaks, still less a pandemic. Preparedness is vital in every country, in every Region. Integrated country plans will build on and strengthen existing systems and mechanisms. They will be comprehensive, costed, and evaluated. Response mechanisms should be rehearsed through simulation exercises. These plans will include protection of vulnerable groups such as children, refugees and displaced populations.
5. Resources needed to slow down or contain the emergence of a pandemic are insufficient. Supplies of antiviral drugs currently do not meet potential demand. Issues remain of equitable access to medicines and deployment of stockpiles.
6. A universal non-specific pandemic vaccine may be the ultimate protective solution for human influenza. "Smart" solutions are being investigated. Issues of technology transfer, resolution of licensing and regulatory obstacles, sustained use of good manufacturing practices and pre-qualification are under discussion. Predictable, increased orders for seasonal flu vaccine will support greater manufacturing capacity, including in developing countries.
7. Communications. The recent series of high-level meetings on avian influenza and human pandemic influenza have successfully created a shared agenda. The public needs clear, regular, reliable information. Civil society, nongovernmental organizations and other community groups must be involved.
8. A rich array of resources is potentially available to support government and institutional efforts. Countries that have successfully controlled outbreaks of avian influenza are prepared to help others.
9. Mechanisms for donor support are in place. There is broad commitment to minimize transaction costs of international support through alignment and harmonization. International support to country plans should supplement national resources, as well as existing donor resources, and should target resource-poor countries.
10. Investments are urgently needed at national level - potentially reaching 1 billion dollars over the next three years. An additional 35 million dollars is needed immediately to support high priority actions by technical agencies at the global level over the next six months.
The 10 points I have outlined need detailed and concrete actions. This meeting has identified a series of integrated actions that will start straight away.
1. Support the development of integrated national plans for avian influenza control and human pandemic influenza preparedness and response.
2. Assist countries in aggressive control of avian influenza in birds, and deepen the understanding of the role of wild birds in virus transmission.
3. Nominate "rapid response" teams of experts to support epidemiological field investigations.
4. Strengthen country and regional capacity in surveillance, laboratory diagnosis, and alert and response systems.
5. Expand the network of influenza laboratories, with regional collaborative systems for access to reference laboratories.
6. Establish and integrate multi-country networks for the control or prevention of animal trans-boundary diseases, and regional support units as established in the Global Framework for the Progressive Control of Trans-boundary Animal Diseases.
7. Expand the global antiviral stockpile, and prepare standard operating practices for its rapid deployment to achieve early containment.
8. Assess the needs and strengthen veterinary infrastructure in line with OIE standards.
9. Map out a global strategy and work plan for coordinating antiviral and influenza vaccine research and development, and for increasing production capacity and equitable access.
10. Put forward proposals to the WHO Executive Board at its 117th meeting for immediate voluntary compliance with relevant articles of the International Health Regulations 2005.
11. Finalize detailed costing of country plans and the regional and global requirements to support them, in preparation for the January pledging meeting to be hosted by the Government of China.
12. Finalize a coordination framework building on existing mechanisms at the country level, and at the global level, building on international best practices.
This is a challenging agenda which will require all our best efforts.
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