http://www.nytimes.com/2005/09/19/health/19flu.html
By ELISABETH ROSENTHAL
Published: September 19, 2005
International Herald Tribune
ROME, Sept. 18 - As World Health Organization officials repeat warnings about the potential for a deadly bird flu pandemic, wealthier countries are redoubling efforts to buy an experimental vaccine and antiviral drugs in the hopes of protecting their citizens from infection.
At the United Nations on Wednesday, President Bush proposed an "international partnership" to combat the disease, and the United States announced last week that it had placed orders for $100 million worth of a promising but technically unlicensed vaccine that is under development by the French drug maker Sanofi-Aventis.
"We cannot afford to face the pandemic unprepared," Lee Jong Wook, the director of the World Health Organization, said Thursday at the United Nations.
The health agency and the European Union have been urging countries for months to prepare for the possibility of a human pandemic caused by the bird flu virus, even as they have acknowledged that there is no current risk. The virus, A(H5N1), which has killed millions of birds, only rarely infects humans and does not normally spread from person to person - a basic requirement for human epidemics.
But scientists are worried that it could someday acquire that ability through one of several biological processes. In the wake of the unprecedented damage caused by Hurricane Katrina, calls for better disaster planning against disease seem to have taken on new urgency.
Roche Pharmaceuticals was struggling to fill huge recent orders from 30 countries for antiviral drugs, placed as part of disaster planning, said Martina Rupp, a spokeswoman for the company. Those countries include Australia, France, England, Singapore and South Korea.
"We have learned in the past weeks that bad things can happen very fast," said Michael O. Leavitt, the secretary of health and human services, as he explained the need for the new partnership to fight bird flu.
Specialists say planning for the possibility of a worldwide pandemic is difficult because the vaccines are novel and the drugs have not been used in this capacity before.
But as countries spend tens of millions of dollars to prepare for bird flu, they are investing in uncertain and untested strategies, WHO officials acknowledge.
The basic problem is that the A(H5N1) virus has not changed in a way that would allow for widespread human infection. What is more, health officials said they would not know precisely how to combat the virus until after it mutated, when they would be able to study its composition and how deadly it was.
"We know we're overdue for an influenza pandemic strain, and we know it will occur, but we don't know when or even exactly what virus will cause it," said Dick Thompson, a WHO spokesman. "It is possible that the virus won't be H5N1 at all or that this virus will change in a way so that the vaccine under development doesn't work against it."
He said the health agency would not comment on whether it was rational for countries to spend so much on medicine orders. But, he added, "We think it is wise because it encourages the companies to do the research and development on this very difficult problem."
The bird flu virus has two characteristics that make it capable of igniting a pandemic. It is a new virus, so humans have no defenses against it. It produces severe disease, killing about half of those infected, almost all through contact with sick birds.
"H5N1 has pandemic potential but it is not a pandemic virus," Mr. Thompson said, because it does not spread easily among humans.
But flu viruses are prone to mutation and exchanging genetic material when they infect an animal together. So one big fear is that an ordinary human flu virus and the bird flu virus could mix genes, creating a new type of lethal human bird flu virus............