<div><b><span style="font-size: 13.5pt; font-family: Arial;" lang="EN-GB">FYI:<br> </span></b></div> <div><b><span style="font-size: 13.5pt; font-family: Arial;" lang="EN-GB"><br> One ‘flu’ over the chicken's nest </span></b><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><b><span style="font-family: Arial;" lang="EN-GB">Putting the needs of poor people at the centre of the world’s response to bird flu is crucial in defeating the epidemic.<br> </span></b></div> <div><b><span style="font-family: Arial;" lang="EN-GB">Unnikrishnan PV, ActionAid International <span style=""></span><span style="color: red;"></span></span></b><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">Though few humans have been infected so far, the World Health Organisation</span><span style="" lang="EN-GB"> </span><span style="font-family: Arial;" lang="EN-US">has projected that between 2 and 7.4 million people
could die from a<i> mild</i> pandemic of avian flu. E</span><span style="font-family: Arial;" lang="EN-GB">xperts 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.</span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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.</span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">Measures to control the infection must be located in the context of the other multiple hazards that poor communities face.</span><span style="" lang="EN-GB">
</span><span style="font-family: Arial;" lang="EN-GB">Preparations to respond to the epidemic by placing countries on a "war footing" can, for the poor, be as disastrous as the flu itself.</span><span style="" lang="EN-GB"> </span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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 </span><st1:country-region><st1:place><span style="font-family: Arial;" lang="EN-GB">India</span></st1:place></st1:country-region><span style="font-family: Arial;" lang="EN-GB">’s </span><st1:place><span style="font-family: Arial;" lang="EN-GB">Maharashtra</span></st1:place><span style="font-family: Arial;" lang="EN-GB"> state alone – panic is spreading in poor communities. To avoid rumour and anxiety, health authorities need to provide simple, useful and
practical information.</span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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. </span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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. </span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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.</span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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. </span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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. </span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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 <span style="color: red;"><span style="color: rgb(0, 0, 0);">(Asia-Pacific)</span> </span>have called for the temporary cancellation of Tamiflu patent rights, to ensure its availability and accessibility.</span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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. </span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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.</span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB">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.</span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><b><span style="font-family: Arial;" lang="EN-GB">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. <br> </span></b></div> <div><b><span style="font-family: Arial;" lang="EN-GB">He is currently in Geneva, attending a UN- InterAgency meeting on Avian and Human Influenza Virus</span></b><span style="" lang="EN-GB"><o:p></o:p></span></div> <div><span style="font-family: Arial;" lang="EN-GB"> </span><span style="" lang="EN-GB"> </span><span style="" lang="EN-GB"><o:p></o:p></span></div> <div class="MsoNormal"><span style="" lang="EN-US"><o:p> </o:p></span></div>