No country is properly prepared for a bird flu pandemic, the U.S. health secretary said in Indonesia on Monday, adding that efforts were being stepped up to boost a network of surveillance to detect the virus.
Mike Leavitt was speaking after visiting four other nations in Southeast Asia in the past week, a region where more than 60 people have died from the H5N1 strain of avian influenza and the most likely epicenter of any human pandemic.
“It would be my assessment that no nation is adequately prepared for a pandemic avian flu. (However) I believe that most nations are improving and preparation is increasing,” Leavitt said after meeting President Susilo Bambang Yudhoyono.
“We are working with our neighbors and friends from around the world to create a network of surveillance so that we can as quickly as possible determine when or if the virus becomes rapidly transmittable between humans.”
Singapore is preparing isolation wards in hospitals and stockpiling medicines to tackle a possible outbreak of bird flu in the densely populated city-state, Health Minister Khaw Boon Wan said on Monday.
He said the government had stepped up preparations by planning possible outbreak scenarios and response exercises, as well as increasing stocks of anti-viral medication.
“We started early so that was quite helpful. As first mover, I think we have some advantage and we’ve built up quite a significant” stock of antiviral drugs, Khaw said in parliament.
He said Singapore, with a population of 4.2 million, would probably have achieved its target of having enough medicines to treat one quarter of the population by sometime next year.
“A major disease outbreak such as a flu pandemic will be very costly in terms of human lives as well as economic losses.”
Concerns have grown in Europe in recent days after tests confirmed the disease in poultry in Romania and Turkey, triggering a surge in global demand for antiviral medication such as Tamiflu and Relenza that offer the best hope of holding a bird flu pandemic at bay.
Tamiflu is manufactured by Swiss drug giant Roche Holdings AG and Relenza was developed by Australia’s Biota Holdins and is marketed by GlaxoSmithKline Plc.
Singapore is one of the most densely populated countries in the world and experts have warned of serious consequences in the event of human-to-human transmission.
In June, the health ministry unveiled its plans for an outbreak of the H5N1 avian flu strain and said it could resume health screening of all visitors, as during the 2003 SARS crisis, quarantine suspected victims and deter citizens from travelling to countries which had outbreaks of bird flu.
Bird flu has ravaged poultry in large parts of Asia since 2003, killing at least 65 people, mostly in Vietnam and Thailand. Millions of birds have been culled to stop the spread of the disease, but officials in the region have long complained of a lack of funds for testing and vaccinating poultry.
Most of the human deaths have been linked to contact with sick birds. But the World Health Organization has said that the virus could mutate into a form that is more easily transmitted from human to human -- possibly triggering a pandemic reminiscent of the 1918 flu epidemic that killed tens of millions worldwide.
No human cases have been reported in Europe, but the World Health Organization said it was worried European countries might divert funding and attention away from Southeast Asia.
Leavitt, who has said fighting the disease at the farm level was a top priority, said surveillance was vital.
“If one thinks of the world as though it were a vast forest, if there is a spark in the forest and you are there to see it, you are able to simply snuff it out,” Leavitt said.
“However if it’s allowed to burn for an hour or two hours, it often becomes uncontainable. The only thing possible then is to try to move people or assets out of its way.”
Earlier, Jakarta’s Health Minister Siti Fadillah Supari said the United States would help Indonesia through laboratory upgrades, but was worried about urban concentrations of chickens.
She cited central Jakarta where she said there were 200 places where large numbers of chickens were being raised.
“This is a very serious problem. At first I could not imagine such a thing ... They also can’t,” she said, referring to the United States.
In the past week, Leavitt has traveled to Thailand, Cambodia, Laos and Vietnam to get information on the virus.
The United States has pledged $25 million to the region for training, supplies, lab equipment, village-based surveillance systems and public education.
There have been five confirmed cases of bird flu in humans in Indonesia since July, comprising three deaths and two people being treated.
Some health experts worry Indonesia is not showing enough urgency in tackling bird flu. There has been virtually no mass culling of chickens, while Indonesian officials note that countries such as Vietnam have had more deaths.
In Manila, the World Health Organization warned that attention should not drift from Southeast Asia as the virus showed up in birds in Europe.
“There’s a lot of anxiety (in Europe),” said Peter Cordingley, spokesman for the WHO in Manila.
“Quite clearly, the result of this could be that governments might focus on domestic preparedness and forget the fact that ground zero is Southeast Asia.”
Cordingley said the feared mutation of the virus into a form that is easily transmitted between humans was most likely to take place in Southeast Asia, where millions of birds have been culled in an attempt to limit the disease’s spread.
Experts say the fight against bird flu in Asia is being hampered by huge differences in wealth between countries.
Some countries still have no stockpiles of the expensive anti-viral drugs that could help limit a human pandemic and have poor public health infrastructure.