PHA-Exchange> Avian Flu : Putting the needs of poor people at the centre of the world’s response to bird flu is crucial in defeating the epidemic

[UNNIKRISHNAN PV]

    FYI:
  
  
  One ‘flu’ over the chicken's nest   
      Putting  the needs of poor people at the centre of the world’s response to bird flu is  crucial in defeating the epidemic.
  
  Unnikrishnan PV, ActionAid International 
      Though  few humans have been infected so far, the World Health Organisation has projected that between 2  and 7.4 million people could die from a mild pandemic of avian flu. Experts warn that  except for the ability to spread efficiently and in a sustainable way between  humans, the H5N1 virus has already met all the prerequisites to start a  pandemic.
      It is  nearly impossible to stop a pandemic once it starts. Precautionary planning is  vital. But it must be done in a way that protects people’s wellbeing. That  requires looking at the social and economic implications of the virus, particularly  for poor people and poor communities in the developing world.
      Measures  to control the infection must be located in the context of the other multiple  hazards that poor communities face. Preparations to respond to the epidemic by placing countries on a  "war footing" can, for the poor, be as disastrous as the flu itself. 
      Chickens  are one of the main sources of food and income for millions of poor people in  developing countries. With images of mass slaughter of chickens – 300,000 have  just been despatched in India’s Maharashtra state alone –  panic is spreading in poor communities. To avoid rumour and anxiety, health  authorities need to provide simple, useful and practical information.
      The poor  must also be compensated economically for the loss of poultry. Since this will  be expensive, the generosity of the international community must supplement the  efforts of national governments. 
      Governments  must guarantee that people will not be displaced and evacuated without their  consent, in the name of bird flu preparation. During the SARS scare, human  rights groups complained that attempts were made to "clean up" slums  in the name of hygiene promotion. 
      Poor  people are already suffering disproportionately from the consequences of avian  flu. If the virus begins to spread from human to human, the poor will suffer  overwhelmingly.
      Public  health systems are the first line of defence in any epidemic. However, in many  developing countries these have been paralysed by budget cuts and the  privatisation of health care dictated by policies imposed by major aid donors  working to a conservative agenda. 
      At an  international level too, current trade rules are actively conspiring against  the needs of poor countries to protect their citizens. Tamiflu is currently the  only available medicine, but because of the patent regime imposed by the World  Trade Organisation it is expensive and beyond the reach of the poor. 
      Developing  countries should be allowed to take radical steps to protect their citizens and  ensure that public health is placed before the profit interests of  pharmaceutical companies. Health activists associated with the pressure group  Health Action International (Asia-Pacific) have  called for the temporary cancellation of Tamiflu patent rights, to ensure its  availability and accessibility.
      It is too  early to predict which countries are going to be badly hit. We do not even know  whether H5N1 bird flu will hybridise with the human influenza virus and begin  to spread from person to person. But if an epidemic develops, many factors will  hamper humanitarian intervention. 
      The flow  of relief goods into affected areas can be disrupted due to border closures,  quarantines and poor transportation systems. The powers of security forces –  police and military – which are likely to take over running essential services  will also need to be carefully monitored.
      What we  already know from experience of mass casualties in natural disasters is that  they leave a long trail of mortality and unending suffering amongst poor  people. Ensuring their safety, survival and recovery is crucial. How bird flu  is handled in poor communities may affect the outcome for the whole world.
      Dr.  Unnikrishnan works on health and humanitarian issues. He is  Emergencies and  Conflicts Advisor, International Emergencies Team,  ActionAid International (AAI). AAI works in over 45 countries  including 6 already affected by bird flu. 
  
  He is currently in Geneva, attending a UN- InterAgency meeting on Avian and Human Influenza Virus
                      
       
    
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://phm.phmovement.org/pipermail/phm-exchange-phmovement.org/attachments/20060222/7716ea28/attachment-0001.html>