Ms Chan Wenling and her friend-from-the-future are engaged in an exciting adventure to convince people to act together and save the world. While the story may be fictional, it is nevertheless intertwined with some factual information.
1_ Beijing 2006
The first International Ministerial Conference on Avian (Animal)
and Pandemic Influenza took place in Beijing in January 2006.
It was hosted by the Chinese government and co-sponsored
by the European Commission (the initiator of the conference)
and the World Bank.
The main outcomes of this event were:
- A global agreement (The Declaration of Beijing) endorsed at
the highest level by more than 100 countries and representatives
of international and regional organisations, agencies, the private
sector and civil society;
- A commitment to:
• Develop and implement integrated national plans at
country level to combat highly pathogenic avian influenza
(HPAI);
• Build a long-term strategic partnership between the
international community and the countries affected
or at risk;
• Share information and biological materials related
to HPAI;
• Increase cooperation on global research, including
research on vaccines and antivirals;
• Evaluate the results and the impact of these efforts.
- Pledges of assistance to combat HPAI amounting to a total
of $1.9 billion, of which approximately € 214 million was
provided by the European Union in the form of grants.
More information on the Beijing Conference is available at:
www.eeas.europa.eu/health/index_en.htm
in particular under: ec.europa.eu/world/avian_influenza
The outcome and impact evaluation of the Global Response
to avian influenza is available at
www.eeas.europa.eu/health/docs/health_grai_en.pdf
2_ P4 Laboratory
The acronym P4 stands for Level 4 pathogens and biosafety
agents, meaning micro-organisms with high pathogenic poten-
tial. P4 laboratories are very high-security compounds where
highly pathogenic, often very contagious and deadly infectious
agents are manipulated for research. Recent examples of pa-
thogens handled in P4 laboratories include the viral agent of
severe acute respiratory syndrome (SARS) – a coronavirus
– and the Ebola, Marburg, Lassa and Congo-Crimea viruses.
P4 labs are closed facilities with many layers of security, in-
cluding positive air pressure in the ‘space suits’ used by the
limited number of scientists authorised to work in the core
rooms of the compounds. There are fewer than 20 P4 labs
in the world.
3_ Ebola, Marburg, Lassa Viruses
Source/Adapted from: Wikipedia
They are the pathogens (viruses) responsible for hemorrha-
gic fevers, diseases characterized by damage to the interior
surface of blood vessels and the destruction of normal coa-
gulation mechanisms leading to internal haemorrhaging and
often death.
First recognized in Congo (formerly Zaire) in 1976, the Ebola
virus is responsible for Ebola hemorrhagic fever, which provokes
death in 50 to 90% of cases. There are various types
of Ebola viruses, some non-pathogenic in humans but fatal in
animals, and some extremely aggressive in humans. There is
no specific treatment for this disease.
Bats are considered as the most likely reservoir. In some cases
the disease can be transmitted to humans through gorillas,
chimpanzees or duikers (sub-Saharan antelopes), generally
through contact with carcasses of these animals, after which
the virus passes directly from human to human.
The Ebola virus is a potential agent for biological warfare. It is
also partly responsible for the decline in chimpanzee popula-
tions observed since 2003.The Lassa fever resembles Ebola,
has high infectious potential (up to 50% of the population in
affected areas) and spreads rapidly. It is responsible for deadly
epidemics, mainly in West Africa, where between 300,000 and
500,000 cases occur every year, with death tolls ranging from
5000 to 6000. The vector is a rat.
The Marburg virus is hosted by bats and until 2000 primarily
affected the Eastern and South African regions. Two major epi-
demics occurred in Congo (2000) and Angola (2005).
4_ Zoonoses
Zoonoses are diseases that can be transmitted from animals to
humans, and the reverse. They can be caused by bacteria, viru-
ses, fungi, parasites or non-conventional transmission agents
(like the prions responsible for Creutzfeldt-Jakob disease and
bovine spongiform encephalopathy (mad cow disease)).
Sixty-one percent of the human pathogens are commonly attributed
to have originated in animals and out of the emerging pathogens
-responsible for the so-called emerging infectious diseases, or
EIDs -, 75% are zoonotic. The number of EIDs is increasing
exponentially, with new ones diagnosed almost every year.
Better surveillance of diseases might partially explain this trend
but the main factor seems to be the increase in the size of hu-
man and animal populations, together with dramatic changes in
human and animal movements around the planet in the context
of globalisation.
Diseases do not know borders. Viruses and other agents benefit
from larger population reservoirs, more numerous contacts
between populations and various species and a strong boost to cir-
culation around the planet. At every instant, hundreds of thousands
of passengers are sitting on commercial flights, connecting
airports as if they were houses in the same village. Planes also
transport live animals (like one-day chicks), eggs, carcasses,
meat products, seafood, embryos and semen for breeding.
5_ One Health
‘One Health’ (OH) is an integrated approach to health that focuses
on the interactions between animals, humans, and their diverse
environments. It encourages collaboration, synergies and cross-
fertilisation between all professional sectors and actors in general
whose activities may have an impact on health.
6_ Destruction in Countries
In many countries of the world, particularly the poorest, hu-
man livelihoods are closely related to the health of animals.
Animals in good health are less likely to transmit diseases,
and their production can be optimised in given environments.
It is often forgotten that in addition to the human toll of slightly
more than 300 deaths (registered cases only) from the highly
pathogenic avian influenza epidemic, there was also an econo-
mic toll to poultry production, with over two hundred million
birds killed in order to contain the disease. The impact of these
measures on life conditions and the well-being of the poor in
particular has not been evaluated but must be enormous.
7_ Cross-Sectoral Cooperation:
Whole of Society Approach
Recent health crises (like SARS, the H5N1 epidemic and the
A(H1N1)2009 influenza pandemic) have demonstrated that
many more sectors were involved in health crisis prevention
and response than the ‘traditional’ health sub-sectors (human
and public health on the one hand, animal health on the other).
Sectors like the environment, wildlife, agriculture, transport,
media, and the schools, to name a few, are also key. Cross-
sectoral cooperation aims at involving all relevant professional
sectors in a common goal, in this case, health crisis preven-
tion and where necessary, response, along with encouraging
a contribution to global health. The experiences of H5N1 and
H1N1 have also shown that efforts towards better health
should not be limited to specialists but should involve society
as a whole, including political leaders, opinion-makers, tea-
chers, and citizens in general.
8_ Pandemic readiness
While pandemic preparedness refers to efforts to prevent, ma-
nage and mitigate the effects of a pandemic, pandemic readi-
ness refers to an ongoing status in which all sectors of society
are continuously ready for a pandemic, or indeed any major
health risk with the potential to disrupt normal life. The global
response to the H5N1 and A(H1N1)2009 influenzas resulted
in a fair level of pandemic readiness in some countries, while
more work is required in others.
9_ Communication:
Explain Uncertainty
Communication has been a challenge during the H5N1 and
A(H1N1)2009 crises. In spite of many efforts, it is often perceived
as insufficient and sometimes contradictory.
Health risks are changing with globalisation, and new strate-
gies – including better global coordination – must be designed
and agreed upon for communication efforts. One way forward
is probably through better explanation to the public and front-
line professionals that ‘the experts do not know it all’ and that
in fact they often ‘do not know.’ Although this may complicate
the life of political decision-makers, candid statements on
what is certain and what is not clearly known might increase
confidence in times of crisis, and avoid the ‘damned if you do,
damned if you don’t’ phenomenon.
Download op de pagina zoeken (160 Megabyte past niet op de website).
