Discoveries of new cases of bird flu (avian influenza) of the deadliest strain known so far among wild fowl and poultry ? A/H5N1 ? are spreading like wildfire.
By Arne Johansson, CWI Sweden

In February 2006 alone cases were found for the first time in about 20 new countries in Asia, Europe and Africa. At the World Economic Forum in Davos a panel of industrialists and experts named the potential of the bird flu virus to mutate and trigger a new flu pandemic that could kill millions of people the number one most urgent threat to the world ? before terrorism and a new oil price shock [Global Risks 2006].

But so far less than 100 people have died of the virus in the last few years, compared to an annual mortality of 3 millions in hiv-related diseases, 2 millions in malaria and 1 million in tbc. So why are the alarm bells ringing? Well, in Europe consumersŽ fear of catching a potentially lethal virus have already spelt a catastrophe for the poultry industry, with estimates of 30,000 job losses in Italy. Despite the fact that properly cooked meals cannot transmit the virus to people, chicken consumption has collapsed with 95% in Greece, 80% in Italy and 30% in France, according to reports from farmersŽ associations. That was before the new outbreak among French turkeys will make the panic even worse, since it mean that the attempt to protect domestic birds have failed even in France, Europe?s leading producer of poultry.

The many cases of bird flu among swans, gulls and other wild fowl in the German Baltic Island of Rügen also indicate that it is only a matter of a short time before cases will be found all over Northern Europe and Scandinavia as well. However, it is the large outbreaks in poor countries with poor medical or veterinary infrastructures, without laboratories for the necessary tests or anti viral vaccines that should be the mayor concern. Especially alarming are reports of wide spread outbreaks in countries like Nigeria and Egypt ? together with the fresh warnings of a new wave in provinces of China all over again. The latest reports now also indicate the spread of the virus to Niger and possibly Kenya. A continental spread in Africa, with 80% of its poultry in small-scale backyards, will be a nightmare ? nearly impossible to monitor.

200 million farm birds killed

Already at least 200 million chickens, ducks, turkeys and geese have been killed by the flu or culled in attempts to isolate the virus. According to the World Health Organization (WHO) ?never before have a bird flu caused such enormous consequences for agriculture ? from large commercial farms to the roots of rural subsistence agriculture. In several affected countries, 50% to 80% of poultry are raised in small rural households where they provide a source of income, around 30% of total dietary protein, and an ?assurance policy? for raising cash when medicines need to be purchased.?

Apart from the catastrophe the highly virulent H5N1 virus spells for poor farmers and workers in the poultry industry, it has also alerted the world for the real danger that the virus could mutate to trigger a new deadly pandemic. According to the World Health Organization (WHO) even a mild scenario could kill 2-7,4 millions of people, while a worst-case scenario, that cannot be ruled out, could take the life of 150 millions of people.

So far the known cases of infected people are very low, and in most cases clearly related to physical contact with sick birds or dust from the soil that has been contaminated by the birds excremities. But the high mortality rates among the recorded cases of infected people ? over 50% ? is of great concern, as well as some suspicious clusters of cases and the real possibility that the virus can mutate and cause a deadly influenza pandemic.

According to the WHO a pandemic can develop in two ways from the inherently unstable genome of the bird flu virus. The first way is through a ?reassortment? event ? like mixing of cards ? in which genetic materiel is exchanged between human and avian (bird) viruses when a human or a pig is co-infected with both. A new pandemic virus could then suddenly appear with explosive spread. The other possible mechanism could be through a more gradual process of adaptive mutations of the bird flu virus during subsequent infections of humans. Growing clusters of infected family members would be a dangerous warning sign that a pandemic could be about to explode. Either way the mayor problem would be the lack of human immunity to such a new virus, and the time it will take to develop, produce and distribute an affordable vaccine.

Pandemic?

How serious is the danger of a pandemic? Well, the authorities do their best to play down the risks in order to reduce panic ? and in doing so take comfort by the fact that the H5N1 has not triggered a pandemic so far. But, as an article in the New Scientist point out, experts consider that it is not a question ?if? a new pandemic will develop, but rather ?when? (triggered by H5N1 or another strain of bird flu) ? and if the world then will be prepared to face the consequences. And, despite all assurances to the contrary, everything points to dangerous inaction among capitalist pharmaceutical monopolies and neo liberal ?let go?- attitudes among governments.

Human flu pandemics, triggered by mutations of highly contagious category A bird flu virus mutations, with pigs or other mammals as a transmission belt or directly in human bodies, has appeared every 10-50 years through recorded history since the 16th century. They typically spread very quickly to all parts of the world in 2 or 3 waves and cause illness in 25-30% of the total world population, before they disappear. Even in past centuries they spread around the globe within less than a year. Our normal ?human? flues are the pale remnants of previous flu pandemics, dampened by human immunity, although their annual death toll is in the order of 250,000-500,000.

According to the WHO the appearance of the H5N1 strain has now raised the risk of a potentially new pandemic to its highest level since 1968. And if it does not happen now, it will probably happen later.

In its January 2006 report ?Avian influenza ? assessing the pandemic threat? the WHO claim that:

? Never before have so many countries been so affected by an avian influenza virus in its deadliest form. And this deadly strain is now believed to be firmly entrenched (endemic) in China and parts of South East Asia, where it has also mutated into different variants.

? It is already an agricultural catastrophe.

? The H5N1 strain has ?a documented ability to pass directly from birds to humans?, while it was previously believed that there would have to be an intermediate stage through pigs. And ?never before have any avian influenza caused such extremely high fatality in humans? ? taking its heaviest toll among previously healthy children and young adults. However, the mortality rate could be exaggerated if there would exist many undetected cases.

? ?There is also some disturbing new findings about he evolution of the virus that suggest a deepening threat.?

One disturbing fact is that some variants of H5N1 seem to have developed resistance to the main anti viral drug, tamilflu. Another is that human cases in Turkey appear to indicate that the virus there has begun to adept more easily to human cells.

1996-97

The new bird flu H5N1 first appeared among chicken and ducks in the Hong Kong region and southern China in 1996-97 ? together with 18 diagnosed cases of infected people, of who 6 died. The fear of a pandemic caused the culling of 1,5 million domestic birds in the Hong Kong Special Administrative Region, since the virus was thought to have begun mutate in a dangerous fashion.


After a period of relative quiet new large-scale outbursts followed throughout South East Asia from 2003 onwards. In Vietnam 3 million chickens were infected in 400 outbreaks 2004. In Thailand 11 million domestic birds throughout 32 provinces caught the bird flu. Even 147 tigers in Thai zoos ? more than a third of the total number ? caught the flu.
Both in Vietnam and Thailand there were also a growing number of human cases. Two Vietnamese sisters were among the first suspected cases of a human-to-human transmission. When this was also suspected to have taken place in a Thai family, it led to a massive door-to-door search in the region that involved one million volunteers.
For poor farmers in Asia, where 120 millions of domestic birds were killed or culled just in three months 2004 and many more since, the flu has spelt a disaster. And in China outbreaks have been reported from more than half of all provinces.


During 2005 the virus also was spread by wild waterfowls to Russia, Kazakhstan, Balkan countries and Turkey. Ever more cases are reported ? in Indonesia, Iraq and ever more European states, as well as in Nigeria, Egypt and India etc.


Until last year it was thought that wild fowls only could carry and contaminate domestic birds with less virulent forms of bird flues ? even if these then could mutate to more aggressive viruses. Once the virus has been rooted among domestic birds local spread takes place through the trade with birds, contaminated trucks and so on. Evidence is now abundant that many species of migratory wild fowls ? and in particular waterfowls ? can spread even the highly virulent H5N1 virus along their migratory paths, over long distances. Many birds that carry the highly virulent virus will not themselves become sick and die. Even domestic ducks carry the virus without becoming sick themselves.

Migratory paths


The examination of a mass death of 6000 wild fowls in the Chinese Qinghai lake in the spring of 2005 prove that it is nearly exactly the same strain of the H5N1 virus that has been found along the migratory paths of the birds to Russia and the Donets delta, from where other water fowls have carried the same kind of strain of the virus along their migratory paths to Turkey, Egypt and Nigeria.
A plausible explanation why the virus place of birth seems to be southern China is that the country?s rapid and reckless urbanization, while forests and wetlands shrink, causes migratory water fowls to gather closer together as well as closer to human habitation and to China?s 14 billion poultry. According to Dr. Judie Hall, a WHO representative in Beijing, as much as 70% of the world?s waterfowl come to visit China. This increases the chances of a virus spreading from one species to another. Also, the growth of China means a huge rise in chicken consumption, while chicken is frequently slaughtered in very unhygienic ways. At the same time China?s rural health care and veterinary system is torn asunder by capitalist counter-revolution. While the majority of China?s 1,3 billion people still live in rural areas none of them has medical insurance.


Since 1959 there exists proof that various strains of bird flues (H5, H7 or H9) have been transmitted to people at least some ten times, in the beginning with mild viruses. But it is only with the outbreaks of H5N1 in 1997 and again since 2003 that people have become seriously ill. Despite attempting isolation, vaccination and mass culling of birds it is only in South Korea and Japan that the H5N1 virus appears to have been stopped, at least for the time being, although the virus have appeared in waves on the Asian continent with periods of very few cases in between.


However, the virus now is endemic in China and South East Asia. And the rapid spread of the virus with mass outbreaks in many regions of the world that lack effective health care, veterinaries and labs and where poor people in the country side depend on their chicken and ducks in their back yards, can only increase the risk of a pandemic.

142 million human deaths?


Despite the fact that the first known outbreak of the bird flu in Nigeria took place in a large chicken farm in the state of Kaduna, owned by the sports minister in Nigeria?s government, where 40,000 chickens died, it took four weeks before it could be confirmed by an Italian lab that it was in fact H5N1. Since the Nigerian government will not pay compensation to farmers before H5N1 is clearly proved, poor farmers are said to eat or sell their sick birds for a third of the price rather than allow them to be culled. Already the virus has caused large outbreaks in several more Nigerian states, and is probably already spreading over the African borders. Even a relatively mild pandemic along the lines with the last two ? the Asian flu of 1957 (of the strain H2N2) and the Hong Kong flu (H3N2) of 1968 ? could kill 2-7,4 millions of people, according to the WHO. Unfortunately, it is scientifically possible that it could become much worse.


The high mortality rate among previously healthy children and young adults among people that has caught the unusually virulent H5N1 has reminded about the Spanish disease (H1N1) of 1918. That disease, with its first outbreak among American troops, is believed to have killed 50 million people around the world ? three times the number killed directly by the first world war. 10 million were killed in India alone. Australian experts warn that a new pandemic in a worst case scenario, with a similar mortality rate as in the Spanish disease, 2,5 per cent, in today?s world could kill 142 million people ? with devastating economic and social consequences that could cost the world 4400 U.S. dollars ?equal to 10,7 per cent of the worlds GNP.


A panel at the World Economic Forum in Davos named bird flu as the number one global threat. Even a study by the U.S. Congressional Budget Office spells out the possibility that a new pandemic can develop that could kill 2,5 per cent of the 30 per cent of the U.S. population that would be likely to catch the flu. Senate Majority Leader Bill Frist in December 2005 warned that this could cost the economy 700 billion dollars and an economic loss of 5 per cent of the U.S. GNP, ?brought on by fear and confusion?.


An article in Newsweek quoted a recent U.S. Homeland Security advisor, Richard Falkenrath, Oct. 31 2005, to say: ?It?s a bigger threat than terrorism. In fact it?s bigger than anything I dealt with when I was in government?. One makes a threat assessment on the basis of two factors: the probability of the event, and the loss of life if it happens. ?On both counts, a pandemic ranks higher than a major terror attack, even one involving weapons of mass destruction. A crude nuclear device would probably kill hundreds of thousands. A flu could easily kill millions?, the article concludes.


But, as the Newsweek article point out, the total funding request for influenza-related research 2005 was about 119 millions dollars, while the U.S. spent over 10 billion dollar to research and develop ballistic-missile defences ? behind the excuse to protect Americans against a threat, that in reality appear non existent. ?We are spending 4.5 million dollars a year on R&D ? drawings! ? for the Pentagon?s new joint strike fighter. Do we have our priorities right?? And Falkenrath is right in his conclusion that if a bad case pandemic would happen today ?the government would be mostly an observer, not a manager?.

Global drugs industry


The key in order to try to stop an emerging pandemic ? something that will be extremely difficult to do ? would be to act within 21 days in order to stop a cluster of human cases to expand beyond 40 sick people, through curses of tamilflu (oseltamivir), while the area is isolated and schools, workplaces, traffic etc would be closed.


Some countries have begun to stock pile tamilfu for their populations. Tamilflu was first developed by the U.S. Company Gilead Sciences in collaboration with Roche. Something that now will enrich Donald Rumsfeld, who according to Wilkipedia is a mayor owner of Gilead Sciences. However, once a pandemic brake out a new vaccine will have to be developed and tested ? something that will probably require a period of 3-6 months, while the first wave of the virus could sweep around the world in 3 months.

Unfortunately, there only exist a few drug companies in only 15 countries with the ability to produce at best 750 millions of curses annually. At the same time probably two curses will be required in order to make a person immune to the new virus. This means that the world with today?s capacity can only produce a vaccine for 6% of the world?s population. Capitalisms patent- and profit system would be a deadly barrier.
In the U.S. Bush is said to be prepared to spend 7,1 billion dollars in order to stock pile tamilflu and build new capacity with the ability to produce 600 million curses of a new drug ? yet little of that has materialized so far. At the same time the U.S. citizens are advised to prepare for isolation during a pandemic through stockpiling of canned food, battery radios etc.


Many European countries are also queuing to place orders of tamilflu, which they will have to wait for very long. As usual under capitalism the lack of resources are worst where the need is biggest. In a Beijing fund raising meeting last month governments promised to contribute some 1.9 billion dollars to poor countries, something that will be completely inadequate even in the rare chance that the promises will be fulfilled.


In Sweden authorities claim that the state of preparedness is good. But while that may be the case in the small Swedish agriculture, which is not the case if a pandemic would take place. Since there is no capacity to produce a new vaccine, a Swedish expert last week warned against any trust in the monopolies and called for the urgent construction of a state owned factory.


The government has responded that it has initiated negotiations with capitalist producers in order to support the building of a Swedish or possibly a Scandinavian factory. But, according to a Swedish Daily, Dagens Nyheter, such a factory will take five years to build after a possible deal.


It is clear that the threat of a pandemic cannot be neglected, and that it produces new strong arguments for a socialist programme to tackle the threats against humanity.

The CWI calls for:


? Abolition of patent and profit restrictions in health care and pharmaceutical industries ? for immediate nationalisation, under democratic control of workers and medical expertise.


? Massive plan for R&D, production and distribution of effective and cost free drugs against pandemic threats, hiv, malaria, tbc etc.


? Global democratic plan for expansion of health care under control of trade unions, patient organizations etc.


? For global socialism and the end of militarism and capitalist parasitism.