October 24, 2008—Although most countries have been planning for a possible avian influenza pandemic, many response strategies have not been adequately tested and might be invalid once the next pandemic actually starts, Dr. David Nabarro, United Nations system influenza coordinator, told correspondents at a recent press conference.

Introducing the “Fourth Global Progress Report on Responses to Avian Influenza and State of Pandemic Readiness,” Nabarro said the continuing lack of preparedness remained a cause for concern, especially since the report came on the heels of a World Bank study released earlier this month that suggested that the economic cost of a worldwide influenza pandemic could top $3 trillion. That would be equivalent to a global loss in gross domestic product of nearly 5%.

“When planning for an extraordinary concern like an influenza pandemic, it’s not enough just to have written a plan and have everybody signing off on it,” said Nabarro. “You also have to check it, test it and make sure that it works, and then revise [it] on the basis of assimilation”.

Of the 148 countries that provided data for the report—which was produced jointly by the United Nations and the World Bank—53% said they had tested their plans in the last 12 months, but only one-quarter had done so at all levels of government. Furthermore, only 38% had incorporated lessons learned from testing the plans into revising them, Nabarro said.

He added that the threat of an influenza pandemic was still the same as it was three or four years ago. Although nations were concentrating on one particular “bird flu” virus that might be the cause of the next influenza, any influenza virus could cause a pandemic, and no one could say for certain when the next pandemic would come, where it would start, or how severe it might be. Preparedness should be done by and among governments, and should engage the private sector, civil society, the media and other international bodies, added Nabarro.

Highlighting other sections of the report, he said the world had been battling “bird flu” caused by the highly pathogenic H5N1 avian influenza type A virus for the last five years. That was because it had caused major problems in poultry systems, and could possibly mutate into a form easily and rapidly transmissible between humans. Sustained transmission of the virus among humans, however, had not yet occurred, although there had been several hundred sporadic human cases.

No countries had reported that their poultry were newly infected by the H5N1 avian influenza virus in the first nine months of 2008, as compared with four in the same period last year. Only 20 countries that had previously reported infections experienced outbreaks between January and September 2008, down from 25 in the corresponding 2007 period. Nabarro expressed concern with the situation in Nigeria—which had recently announced its first H5N1 outbreak in nearly 10 months—and also in nearby Togo, which also had a recent outbreak.