The False Bird Flu Scare

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Something here from The Nation's writer on the medical world.

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The False Bird Flu Scare

by Dr. Marc Siegel

 

 

In 2003 concerns about the SARS coronavirus prompted the Centers for

Disease Control (CDC) to work with the World Health Organization to

encourage reporting and isolation of cases and contacts while at the

same time cordoning off parts of Asia and Toronto. Health officials

spoke publicly of a new era of cooperation. But the media-saturated

advisories and pronouncements resulted in the loss of billions of

tourist dollars to the Asian and Canadian economies. Ultimately, SARS

infected about 8,400 people worldwide. There was never any objective

evidence that regional quarantine helped squelch the virus, and

follow-up studies found SARS to be not nearly as infectious as had been

originally thought. Yet public health officials continued to speak of

that global action as an unqualified success.

 

The same pattern of CDC/WHO involvement has been followed in the

US-fueled worldwide overreaction to H5N1 avian influenza. This bird flu

cannot routinely affect humans in its current form (114 deaths to date

in nine years). But the priority being placed on it as a potential

threat to humans is obscuring diseases that are already worldwide

killers: malaria, which kills more than 1 million people a year;

tuberculosis, more than 2 million; and HIV/AIDS, more than 3 million. As

the worldwide health network grows, promoted by US healthcare officials

but involving public health agencies all over the world, I am concerned

that there will be a simultaneous export of the American obsession with

certain diseases while others are excluded.

 

Worldwide spending on AIDS was $8.3 billion in 2005, with almost half of

this coming from George W. Bush's Emergency Plan for AIDS Relief. But a

2005 WHO/UNAIDS report estimates that AIDS treatment coverage is $18

billion below global needs for 2005-07, with a projected $22 billion

annual requirement by 2008. The WHO has not come close to its goal of

treating 3 million AIDS patients by the end of 2005. Currently just over

a million are receiving antiretroviral therapy.

 

Meanwhile, here in the United States, Bush has proposed cutting $15

million in AIDS research at the National Institutes of Health, while

increasing funds for studying avian flu and bioterrorism.

Bush's proposed 2007 budget calls for increasing by 0.3 percent funding

for the NIH's Institute of Allergy and Infectious Diseases. The money

will be targeted for avian flu and biodefense. Bush is also calling for

a 6.2 percent increase for other NIH biodefense projects, according to

the American Association for the Advancement of Science's analysis of

the President's budget. This is in addition to the $5.6 billion already

being largely wasted on Project Bioshield, which is supposed to help

provide medical countermeasures against a chemical, biological,

radiological or nuclear attack, with much more to come in Bioshield II.

Almost $1 billion has gone to the manufacture of 75 million doses of

anthrax vaccine, for example, despite the fact that anthrax is not

contagious and has not recurred since the twenty-two cases in 2001

thought to be linked to terror.

 

Some public health officials have argued that avian flu should be at

least as high a priority as AIDS because of the theoretical worst case,

in which it could cause a severe human pandemic, but it is not even

clear that the money allocated for bird flu will be used effectively for

real prevention. Ron De Haven of the Animal and Plant Inspection

Service of the Department of Agriculture says that although H5N1 is

still a major threat to birds, only $4.4 million of his department's

$1.1 billion budget for 2005-06 was earmarked for biosecurity outreach,

to keep infected birds from coming here. And though $3.6 billion has

already been approved for emergency pandemic preparedness against bird

flu, with an additional $2.6 billion proposed, Dr. Andrea Gambotto, the

creator of a new bird flu vaccine using modern genetic techniques

(adenovirus) that has been effective in mice and birds, has been unable

to get NIH funding to test this vaccine in humans. Newer approaches

could lead to more potent vaccines with a quicker turnaround time--a

much more effective tool for reacting to a pandemic as it is happening

than current attempts to anticipate one that may never happen. But the

President's new budget cuts 4.5 percent from the CDC's core programs

while adding no funds for NIH. There is clearly no priority for key

research programs. It is true that as part of his " worst case " pandemic

flu preparedness plan announced in May, Bush awarded $1 billion in

contracts to vaccine manufacturers to upgrade flu vaccine technology

over the next five years. Of course, there is no guarantee that this

goal will actually be met or that the money will reach the right hands.

 

Overseas, the biggest health problems that could benefit from our

attention are malnutrition and the lack of clean water and proper

sewage. Diseases like schistosomiasis and malaria thrive because of poor

public health conditions. But our outreach does not emphasize them. Our

public health system appears to be much more concerned about a disease

like bird flu transforming into something that could threaten us than it

does in helping the world with diseases that already threaten poor

people everywhere. More than 16 million people die every year of

malnutrition. Eight hundred million people worldwide currently suffer

from hunger and malnutrition. How many people who survive mainly on

poultry will have this food taken from them if worldwide health

authorities--their perceived need to act in a hurry fueled by media

reports--continue to kill domestic fowl indiscriminately whenever H5N1

appears?

 

A TV movie that aired in May, Fatal Contact: Bird Flu in America,

capitalizes on fear by depicting a crippling loss of basic services and

mass graves. This movie wasn't made in a vacuum--many scientists and

journalists have been doomsaying on bird flu to such an extent that they

have created a fear terrain even Disney could exploit. Sadly, hyperbole

is not a method of discourse exclusive to TV drama; a public health blog

for bird flu fanatics recently suggested the United States should pull

out of Iraq and use the resources we save for bird flu preparation. On

the surface this sounds like a terrific idea. On further reflection, it

seems clear that going into Iraq in the first place was based on the

same kind of argument--in which a remote but scary risk is exaggerated

so it appears to be looming--that has characterized the public health

reaction to bird flu.

 

Dr. Marc Siegel is a practicing internist and an associate professor of medicine

and a fellow in the Master Scholars Society at New York University School of

Medicine. He is a weekly columnist for the New York Daily News, a frequent

contributor to the Los Angeles Times, the Washington Post and The Nation. He is

a member of the board of contributors at USA Today. He appears frequently on

CNN, the Fox News Channel, and the NBC Today Show. He is the author of False

Alarm: the Truth About the Epidemic of Fear and most recently, Bird Flu:

Everything You Need to Know about the Next Pandemic (Wiley).

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This article can be found on the web at:

 

http://www.thenation.com/doc/20060605/siegel

 

 

 

 

 

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