Avian influenza is a viral asteroid on a collision course with humanity. Since the horrific autumn of 1918, when a novel influenza killed more than 2 percent of humanity in a few months, scientists have dreaded the reappearance of a wild flu strain totally new to the human immune system.
The flu subtype known as H5N1, which claimed its first victims in Hong Kong in 1997, is that nightmare come true. Now endemic in waterfowl and poultry throughout East Asia, it is the most lethal strain of influenza ever seen, killing chickens, people and even tigers with terrifying ease.
Although avian flu officially has taken fewer than 100 human lives so far (mainly farmers and their children in daily contact with poultry), most experts believe that H5N1 is on the verge of acquiring the new genes or amino acids that would enable it to travel at pandemic velocity across a densely urbanized world, with the potential, warns the World Health Organization, to cause 20 million deaths.
Since early spring, moreover, all the biological weather vanes have been pointing in the direction of imminent pandemic. In Vietnam the virus has suddenly increased its transmissibility, with several likely human-to-human cases. In China, where officials now admit that more than 1,000 migratory birds have died, there are unofficial Internet reports–strongly denied by Beijing–of 120 related human fatalities. In an unprecedented collaboration to sound the tocsin, Nature and Foreign Affairs have recently devoted special issues to the “plausible scenario” of a pandemic that kills millions and wrecks the global economy.
Governments have had ample warning, unlike the surprise of HIV/AIDS, that a new plague is coming. Indeed, Washington has had almost nine years to heed the advice of top influenza experts and mobilize the nation’s resources to battle H5N1 in Asia and at home. The Bush Administration’s failure to do so makes “homeland security” into a sick joke whose punch line may be a repetition of the 1918 catastrophe.
This past December 3, Secretary of Health and Human Services (HHS) Tommy Thompson held a press conference to announce his resignation. His tenure ended with a note of frankness rare in the Bush era. Unlike the previous seven Cabinet members purged in the President’s postelection housecleaning, Thompson, according to the New York Times, “gave candid, unexpected answers to questions posed to him.” Asked what worried him most, Thompson cited the threat of a human flu pandemic. “This is a really huge bomb that could adversely impact on the healthcare of the world,” killing 30 million to 70 million people, he said.
The Secretary, of course, spoke with the authority of someone with access to the best medical intelligence in the world, but reporters were undoubtedly surprised that Thompson was so alarmed about a peril that his department, with its $543 billion annual budget–a quarter of the federal total–had done so little to address. In the 2005 fiscal year, for example, Thompson had allocated more funds to “abstinence education” than to the development of an avian influenza vaccine that might save millions of lives. This is but one example of the way that all Americans, but especially children, the elderly and the uninsured, have been placed in harm’s way by the Bush regime’s bizarre skewing of public-health priorities. On Thompson’s watch, HHS and the Pentagon spent more than $12 billion to safeguard national security against largely hypothetical threats like smallpox and anthrax, even as they pursued a penny-pinching strategy to deal with the most dangerous and likely “bioterrorist”: avian influenza. The Administration’s lackadaisical response to the pandemic threat (despite Secretary Thompson’s personal anxiety) is only the tip of the iceberg. Over the past generation, writes Lancet editor Richard Horton, “the U.S. public-health system has been slowly and quietly falling apart.”