Amid growing concern that the world may be on a collision course with a deadly avian flu pandemic, health officials from about 80 countries are meeting in Washington today to map a collaborative strategy for minimizing the deaths and disruption an outbreak might wreak.
The meeting, hosted by the State Department, marks the beginning of a major international trust-building project that U.S. officials said must be successful if scientists and public health officials are to have a fighting chance of quenching a nascent outbreak before it goes global.
"Pandemics are diseases without borders and that's why we're focusing our attention on them," said William R. Steiger, the Department of Health and Human Services' point person for international health, in an e-mail yesterday. "We know that a threat against one nation is a threat against the world."
Today's meeting is part of a flurry of activity in the United States and abroad, all spurred by evidence that a strain of bird virus endemic in Southeast Asia is accumulating mutations that could ease its lethal spread from person to person.
Scientists fear that such a virus could rapidly circle the globe and leave tens of millions or even hundreds of millions of people dead.
President Bush is scheduled to meet with drug company executives today to discuss strategies for developing new and speedier methods for making flu vaccine. Current techniques take many months to ramp up -- a time scale that is acceptable for the routine annual production of vaccines but that would be wholly inadequate if a rapidly spreading and especially deadly strain of avian flu were to erupt.
Vaccine-makers have expressed concern about liability issues and other financial risks inherent in quick production and emergency distribution of new and relatively untested vaccines.
On Capitol Hill, legislators are starting to focus on several bills that take aim at the looming threat. Some, including the Bioshield II Act, attempt to address the need for better flu vaccines, while another, the Pandemic Preparedness and Response Act, would support the federal stockpiling and distribution of drugs and vaccines, improve international surveillance for outbreaks and strengthen domestic public health infrastructures.
Federal officials also said yesterday they are very close to releasing a final draft of a national pandemic preparedness plan, a long-awaited blueprint that would address such important but sensitive issues as when to impose quarantines, under what conditions certain public health duties ought to be turned over to the military and how best to distribute antiviral medicines or prototype vaccines to those at greatest risk.
"What we need to be doing now is the basic planning of how we get our communities through 12 to 18 months of a pandemic," said Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy.
"Ninety-five out of 100 will live," Osterholm said. "But with the nation in crisis, will we have food and water? Are we going to have police and security? Will people come to work at all?"
Such questions may sound hysterical, Osterholm acknowledged, noting that there has been some political backlash lately against Health and Human Services Secretary Mike Leavitt and others who have begun to openly raise alarms.
"But I have to give Secretary Leavitt a lot of credit," Osterholm said. "Someone has to stand up with intellectual and personal honesty and say we have some serious challenges ahead of us."
As part of the process of encouraging other nations to draft preparedness plans -- and to help build the communication channels that would be central to a globally coordinated response -- Leavitt is scheduled to travel to Asia tomorrow. Over 10 days he will meet with top officials in Vietnam, Laos, Cambodia, Thailand and Indonesia, said HHS spokesman Bill Hall.
The goal, Hall said, "is to solidify relationships and express the importance of transparency in surveillance and the sharing of data." Leavitt has previously said he hopes to reach agreements that would provide testing and other medical technologies to nations in need.
That theme of international cooperation ranks high among the topics to be discussed at the meeting today. Many world leaders are less than confident that the governments of some of the most vulnerable nations are willing or even able to tell the world quickly about outbreaks that may emerge within their borders.
With researchers agreeing that the only hope for containing an outbreak is to act very quickly, political trust and candor can be as important as scientific advances.
At a briefing for reporters yesterday at which several senior government officials spoke on the condition of anonymity in deference to comments to be made later that evening by Leavitt, an official from the U.S. Agency for International Development said the agency considers avian flu to be its "number one priority," more important even than relief efforts in Iraq and other regions.
Asked if the United States would be willing to dip into its drug and vaccine reserves to supply a stricken Asian nation, an HHS official answered in the affirmative -- on the condition that the country was prompt and honest in its reporting.
"Without that kind of early cooperation, we will pull back to the next firebreak," the official said, apparently referring to U.S. borders. "We have to protect ourselves."