(World Health Organization HQ, Geneva)  – H5N1 influenza is what keeps people here up at night.  The flu strain is deadly to humans on an order of magnitude greater than any other flu virus in history, including the Spanish flu pandemic of 1918.  It kills approximately 60% of the people it infects.  Just to put that figure in perspective: seasonal flu kills about 0.1% of the people it infects; Spanish Flu killed about 2.5% of people infected.

“Outbreak of influenza is the most worrisome thing,” says Dr Keiji Fukuda the Assistant Director-General for Health Security and Environment at the World Health Organization. “H5n1 is almost a unique virus. Very few viruses are capable of killing like that.”

So far, the virus has only infected humans who have caught it from infected animals, mostly poultry. It has not made the jump from human-to-human transmission.  Humanity has time to prepare and respond. That’s where the World Health Organization comes in.

The first task is worldwide monitoring of suspected cases. Everyday, all day, staffers at the WHO’s operations center monitor media reports and sort through information sent to them from national health ministries. When a case might be credible, staff alerts a network of health workers,  setting into motion a series of procedures along pre-established guidelines.

This system, called the “International Health Regulations” was created in response to the 2003 SARS outbreak. Members of the WHO, which include every UN member state, realized that ad hoc response to the SARS outbreak undermined the international community’s’ ability to effectively create a coordinated, international response the SARS outbreak. So, when the dust settled two years later member states created this system for monitoring and responding to global health emergencies.

The International Health Regulations range from expediting visa requests for foreign epidemiologists, to setting up secure phone lines to share sensitive information across governments, to establishing protocol for the hygienic burying of victims.  From a political standpoint, the fact that every country has bought into this system means that the response can truly be global.

This brings us to monitoring and response to H5N1.  The last case detected and reported through WHO’s monitoring system occurred in Indonesia, about 10 days ago. The victim was a two year old boy whose parents are quail egg vendors. A week earlier, Egyptian authorities alerted the WHO to a suspected case of H5N1 that killed a 26 year old women.  In Egypt, the US Centers for Disease Control provided some technical support to local officials through its regional office, per the IHR. Also according to the IHR, the World Health Organization updates the private sector and scientific bodies (like the US National Institutes for Health) about latest strains so that potential vaccines can be developed.

Two recent scientific studies demonstrated that H5N1 can develop a mutation enabling its transmission between humans. That mutation has only been created in laboratories, and has not yet occurred in nature. If and when it does, the world will turn to the World Health Organization to contain the outbreak and manage a global response.

Preventing the apocalyptic outbreak of H5N1 is just one of many reasons why we need a strong World Health Organization.

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