Health Ministers Meeting on Global Pandemic Influenza Readiness

Ottawa, Canada
24 October 2005

Ministers and Colleagues.

I thank Canada for hosting this important “Global Pandemic Influenza Readiness” meeting.

First, I would like to make it crystal clear - also for the benefit of the media - what we are talking about today.

There are three kinds of influenza we are dealing with these days. The first is seasonal flu, for which a vaccine exists. I had my "flu shot" last week and I urge all of you to have yours. The second is avian flu, which affects birds. Over 140 million birds have been culled or have died of avian flu. Also, 120 people have been infected with avian flu through contact with poultry, of whom 62 have died. Thirdly, there is global pandemic influenza which we have seen three times in the past century but which we have not seen yet this century.

Our concern is that avian flu could become the source of the next human influenza pandemic.

The big question is: will there be a human influenza pandemic?

The short answer is: yes.

When will it come? I don’t know but it could appear anytime. That is what we are preparing for. That is why we are here.

Out of the six phases described by WHO, we are now in phase three. Phase six is full pandemic. In phase three a virus new to humans is causing infections, but that virus does not spread easily among humans.

The 62 confirmed deaths that have occurred so far in four countries in Asia have been caused by humans catching H5N1 - the virus causing the bird form of influenza.

So why are we raising the alarm?

Because, once a flu virus is able to infect humans easily and spread rapidly, it will cause a pandemic.

The information we have so far shows this bird flu virus to be gradually changing. Flu viruses are famous for their adaptability. Every time H5N1 infects an animal or human, it has the opportunity to change, and improve its transmissibility.

The next pandemic flu virus in humans is most likely to come from a development in this avian flu virus. It is spreading rapidly.

So, what needs to be done?
We have to reduce the risks:

Timely and transparent outbreak reporting, and minimizing infection in poultry, by culling infected flocks and fairly compensating farmers are crucial parts of the solution.

At the same time, we must reduce human exposure to the bird flu virus. This limits the opportunities for the virus to change. We also have to use the available vaccine against "normal" seasonal flu to its maximum extent to reduce opportunities for the avian flu virus and the seasonal flu virus to mix.

We have to make preparedness plans - in advance ^ Once the virus has gone pandemic it will be too late to prepare. There will only be time to react. Now is the time to put the plans in place. WHO has sent guidance to each country on what to do. But so far only around 40 countries are ready with a plan. Every government must be able to respond rapidly and effectively when the time comes.

Stockpiles of antivirals are one part of this picture. We must find ways of helping developing countries. Each country should have access to antiviral medication, whether procured independently, or provided through international collaboration in a stockpile.

We have to improve surveillance

Get early warning systems running in all affected and at-risk countries. These will warn us so that we can quickly dispatch the antiviral stockpiles and take other response measures that will stop or limit the spread of infection. We need a rapid and clear picture of what is happening.

All countries need to be able to detect, investigate and report cases without delay. That information has to be quickly produced, and shared freely among the international community. There was no advance warning for the three pandemics of the previous century. This time must be different.

Everyone needs to know what to do

Good communication is going to be a key to success or failure. In each phase, communication, especially risk communication, is vital. This is the best way to put populations on guard and help communities to act responsibly.

Resources need to go to vaccine development

The best protection of all is an effective vaccine. But this can only be made once the pandemic virus has emerged. We currently do not have a vaccine that we know will be effective. Nor is there sufficient manufacturing capacity at present. The world will need to produce billions of doses of safe vaccine when the time comes. This is a huge challenge. But much can be done to prepare. The lead time between the emergence of the virus and the production of the vaccine must be as short as possible to minimize the death toll.

There are no immediate and easy solutions to these issues. But they must be resolved.

No Government nor Head of State can afford to be caught off guard. The expected political, economic and social cost of a pandemic will be huge.

SARS taught some useful lessons. The economic cost of SARS has been estimated at $30 billion. Yet remember - there were fewer than 800 deaths throughout the whole outbreak.

In summary, there are several outstanding capacity and resource issues:
  • In surveillance. The needs are: better surveillance for disease in animals and humans; field investigations; diagnostic support; and incentives for people to report.
  • In production capacity. Antivirals may be able to help to contain infection in the event of a pandemic. But supplies of Tamiflu are currently inadequate.
  • Producers of vaccine against seasonal flu can only make enough for current demand - this is a fraction of what would be needed for production of global supplies of a vaccine against pandemic influenza.
  • The world needs a vaccine specific to pandemic influenza. Investment is needed in research, and in manufacturing capacity. I applaud the efforts and the progress made by the US NIH in their development of a prototype vaccine based on the H5N1 virus, which is now in clinical trials.

International collaboration is essential for success. We have to confront the capacity and resource issues, and we have to fill the gaps. This meeting gives us the opportunity to address these points. In Geneva from 7th to 9th November, at the meeting on avian flu and pandemic influenza, you will have the chance to take those concerns to the next stage.

This is the time to act.

Thank you very much.