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The International Response to Highly Pathogenic Avian Influenza: Science, Policy and Politics [STEPS, excertps]
The International Response to Highly Pathogenic Avian Influenza: Science, Policy and Politics
Ian Scoones and Paul Forster
[Free full text: http://www.steps-centre.org/PDFs/Avi...0w%20cover.pdf ]
1. INTRODUCTION
On June 11th 2008 another outbreak of highly pathogenic avian influenza (H5N1) was reported in Hong Kong ? the site of the first reported human deaths from this virus in 1997. Media reports portrayed the possibility of a major catastrophe. Anxious citizens stopped eating chicken. With China hosting the Olympics in a matter of weeks, concerns were raised in the highest circles about the consequences of an outbreak ? for world profile and for business. Politicians wanted firm action. On June 20th, officials proposed a package of US$128 million to put the small-scale poultry sector and wet markets out of business. Traders have rejected the proposal, and many consumers argue that the alternative frozen supermarket chickens are not what they want. Others argue that attempts at regulating imports and banning wet markets are futile. Informal, unregulated trade abounds, and with South China being a known, if poorly reported, hot spot of avian influenza virus circulation, the chances of keeping Hong Kong free of the disease are very small indeed. Yet, sceptics argue that the proposed measures are more about political grandstanding and public relations than sensible, science-based control policies. They argue that the net consequences for farmers?, traders? and poorer consumers? livelihoods will be negative, with only the ell-connected large suppliers and supermarkets benefiting. But, given the fears around viral mutation into a form capable of efficient human-to-human transmission, others conclude that precaution, even if drastic, is the most appropriate route1.
This example highlights the complex trade-offs involved in policy processes around avian influenza. These are intensely political, pitting different interests and groups of actors against each other. Public image, business interests and poor people?s livelihoods are all involved in a complex mix. And the science often is so uncertain that firm decisions based on exact predictions and precise measures are impossible.
Judgements ? normally political judgements ? are made, and these are necessarily highly contextual. Media pressure, political effectiveness, implementation capacity and geopolitical positioning all come into the picture.
Thus, in order to understand the politics of the international policy response to avian influenza, we must explore an intersecting story of virus genetics, ecology and epidemiology with economic, political and policy machinations in a variety of places ? from Hong Kong to Washington, to Jakarta, Cairo, Rome and London.
This paper offers one, necessarily partial and incomplete, view of the story over the last decade ? and particularly the last few years when over $2 billion of public funds have been mobilised. It is a fascinating and important story. It is important because the HPAI story is seen by many as a ?dress rehearsal? for a major pandemic emerging from a zoonotic disease, whereby a combination of viral genetic change and ecological circumstance results in transmission of a new disease among humans, with devastating consequences.
The 1918 human influenza pandemic killed at least 50 - 100 million people globally2.
Estimates for future pandemics vary widely, but a simple calculation sees three times that number given the world?s increased population3. And we are of course in the midst of the catastrophic
pandemic of HIV/AIDS which had its origins as a zoonosis, and which, for a range of reasons, was not spotted early enough and spread widely. Between 1940 and 2004 over 300 new infectious diseases emerged, some 60 per cent of which were zoonoses from animals4. That a pandemic influenza strain has not yet emerged from the H5N1 virus currently circulating, at least at the time of writing this paper, is no reason for complacency.
An influenza pandemic will happen, it is argued convincingly - some time, somewhere - and we had better be ready for it. For this reason, exploring the successes and failures of the avian influenza response to date is an important task.
The avian influenza response story is fascinating because it offers insights into some wider dilemmas surrounding animal health, production and trade, public health, emergency responses and long-term development, and the global governance of all of these. As with many high-profile policy debates, there are multiple, competing policy formulae and diverse, sometimes conflicting, intervention responses. There are a vast range of actors, associated with numerous networks, often cutting across sectoral boundaries, public/private divides and local, national and global settings.
Avian influenza has caused a massive mobilisation of public funds, involving numerous agencies and resulting in countless initiatives, programmes and projects. Yet there has been often remarkable collaboration across what had previously been deep organisational and professional divides. There has also been a range of organisational innovation and experimentation. These offer important insights into what to do ? and indeed what not to do ? in the future.
In other words, the avian influenza response offers some important perspectives on some of the ?big issues? of the moment. These include, for example, how to respond to uncertain threats which have transnational implications; how to cut across the emergency-development divide, making sure crises result in longer term responses as well as dealing with immediate needs; how to balance interests and priorities between ensuring health and safety as well as livelihoods; how to operate effectively in a complex multilateral system, within and beyond the UN; what a commitment to ?security? in health and livelihoods really means in practice; and much, much more.
These are of course all massive, and highly contentious, issues, and this paper will not provide any neat and tidy answers. What it aims to do instead is, through an analytical lens which looks at the politics of policy processes, shed light on these issues, sharpening the questions raised and the trade-offs implied. As the global avian influenza response moves towards a bigger, overarching ?One World, One Health? agenda, focusing on the intersections of animal, human and ecosystem health proposed at the December 2007 Delhi inter-ministerial meeting5 and being
elaborated for the 2008 Sharm El-Sheikh international ministerial conference, these issues become even more pertinent. We are interested in asking: given the lessons of the international response to date, what should be the features of an effective, equitable and resilient response infrastructure at the international level? In essence, what should a ?One World, One Health? initiative look like in practice?
(...)
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1 Economist June 28 2008, http://www.economist.com/world/asia/...y_id=11622415; see http://www.info.gov.hk/info/flu/eng/index.htm
2 Johnson and M?ller (2002). As the iconic event of the past century, around which much media and policy discussion has centred, the 1918 pandemic has been the subject of intense research, ranging from social histories to technical assessments (cf. Morens and Facui 2007; Taubenberger and Morens, 2006; Taubenberger et al 2005).
3 Murray et al (2007) offer a more sophisticated analysis.
4 See, for example: Woolhouse 2008; Jones et al, 2008; Webster et al 2007; Woolhouse and Gaunt 2007; Woolhouse and Gowtage-Sequeria 2005; Woolhouse et al, 2006; Webster 2002.
5 See Wildlife Conservation Society 2004, http://www.wcs.org/sw-high_tech_tool...thscience/owoh for an early exposition of the ?One World, One Health? concept. See also http://www.oneworldonehealth.org/ and http://www.wcs.org/5060651 for details of the ?Manhattan Principles?.
6 For date to 10 September 2008, see: http://www.who.int/csr/disease/avian.../en/index.html. For useful reviews, see MacKellar (2007) and Parry (2007).
7 World Bank (2005); (2005a); McKibben and Sidorenko (2006).
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The International Response to Highly Pathogenic Avian Influenza: Science, Policy and Politics
Ian Scoones and Paul Forster
[Free full text: http://www.steps-centre.org/PDFs/Avi...0w%20cover.pdf ]
1. INTRODUCTION
On June 11th 2008 another outbreak of highly pathogenic avian influenza (H5N1) was reported in Hong Kong ? the site of the first reported human deaths from this virus in 1997. Media reports portrayed the possibility of a major catastrophe. Anxious citizens stopped eating chicken. With China hosting the Olympics in a matter of weeks, concerns were raised in the highest circles about the consequences of an outbreak ? for world profile and for business. Politicians wanted firm action. On June 20th, officials proposed a package of US$128 million to put the small-scale poultry sector and wet markets out of business. Traders have rejected the proposal, and many consumers argue that the alternative frozen supermarket chickens are not what they want. Others argue that attempts at regulating imports and banning wet markets are futile. Informal, unregulated trade abounds, and with South China being a known, if poorly reported, hot spot of avian influenza virus circulation, the chances of keeping Hong Kong free of the disease are very small indeed. Yet, sceptics argue that the proposed measures are more about political grandstanding and public relations than sensible, science-based control policies. They argue that the net consequences for farmers?, traders? and poorer consumers? livelihoods will be negative, with only the ell-connected large suppliers and supermarkets benefiting. But, given the fears around viral mutation into a form capable of efficient human-to-human transmission, others conclude that precaution, even if drastic, is the most appropriate route1.
This example highlights the complex trade-offs involved in policy processes around avian influenza. These are intensely political, pitting different interests and groups of actors against each other. Public image, business interests and poor people?s livelihoods are all involved in a complex mix. And the science often is so uncertain that firm decisions based on exact predictions and precise measures are impossible.
Judgements ? normally political judgements ? are made, and these are necessarily highly contextual. Media pressure, political effectiveness, implementation capacity and geopolitical positioning all come into the picture.
Thus, in order to understand the politics of the international policy response to avian influenza, we must explore an intersecting story of virus genetics, ecology and epidemiology with economic, political and policy machinations in a variety of places ? from Hong Kong to Washington, to Jakarta, Cairo, Rome and London.
This paper offers one, necessarily partial and incomplete, view of the story over the last decade ? and particularly the last few years when over $2 billion of public funds have been mobilised. It is a fascinating and important story. It is important because the HPAI story is seen by many as a ?dress rehearsal? for a major pandemic emerging from a zoonotic disease, whereby a combination of viral genetic change and ecological circumstance results in transmission of a new disease among humans, with devastating consequences.
The 1918 human influenza pandemic killed at least 50 - 100 million people globally2.
Estimates for future pandemics vary widely, but a simple calculation sees three times that number given the world?s increased population3. And we are of course in the midst of the catastrophic
pandemic of HIV/AIDS which had its origins as a zoonosis, and which, for a range of reasons, was not spotted early enough and spread widely. Between 1940 and 2004 over 300 new infectious diseases emerged, some 60 per cent of which were zoonoses from animals4. That a pandemic influenza strain has not yet emerged from the H5N1 virus currently circulating, at least at the time of writing this paper, is no reason for complacency.
An influenza pandemic will happen, it is argued convincingly - some time, somewhere - and we had better be ready for it. For this reason, exploring the successes and failures of the avian influenza response to date is an important task.
The avian influenza response story is fascinating because it offers insights into some wider dilemmas surrounding animal health, production and trade, public health, emergency responses and long-term development, and the global governance of all of these. As with many high-profile policy debates, there are multiple, competing policy formulae and diverse, sometimes conflicting, intervention responses. There are a vast range of actors, associated with numerous networks, often cutting across sectoral boundaries, public/private divides and local, national and global settings.
Avian influenza has caused a massive mobilisation of public funds, involving numerous agencies and resulting in countless initiatives, programmes and projects. Yet there has been often remarkable collaboration across what had previously been deep organisational and professional divides. There has also been a range of organisational innovation and experimentation. These offer important insights into what to do ? and indeed what not to do ? in the future.
In other words, the avian influenza response offers some important perspectives on some of the ?big issues? of the moment. These include, for example, how to respond to uncertain threats which have transnational implications; how to cut across the emergency-development divide, making sure crises result in longer term responses as well as dealing with immediate needs; how to balance interests and priorities between ensuring health and safety as well as livelihoods; how to operate effectively in a complex multilateral system, within and beyond the UN; what a commitment to ?security? in health and livelihoods really means in practice; and much, much more.
These are of course all massive, and highly contentious, issues, and this paper will not provide any neat and tidy answers. What it aims to do instead is, through an analytical lens which looks at the politics of policy processes, shed light on these issues, sharpening the questions raised and the trade-offs implied. As the global avian influenza response moves towards a bigger, overarching ?One World, One Health? agenda, focusing on the intersections of animal, human and ecosystem health proposed at the December 2007 Delhi inter-ministerial meeting5 and being
elaborated for the 2008 Sharm El-Sheikh international ministerial conference, these issues become even more pertinent. We are interested in asking: given the lessons of the international response to date, what should be the features of an effective, equitable and resilient response infrastructure at the international level? In essence, what should a ?One World, One Health? initiative look like in practice?
(...)
-
1 Economist June 28 2008, http://www.economist.com/world/asia/...y_id=11622415; see http://www.info.gov.hk/info/flu/eng/index.htm
2 Johnson and M?ller (2002). As the iconic event of the past century, around which much media and policy discussion has centred, the 1918 pandemic has been the subject of intense research, ranging from social histories to technical assessments (cf. Morens and Facui 2007; Taubenberger and Morens, 2006; Taubenberger et al 2005).
3 Murray et al (2007) offer a more sophisticated analysis.
4 See, for example: Woolhouse 2008; Jones et al, 2008; Webster et al 2007; Woolhouse and Gaunt 2007; Woolhouse and Gowtage-Sequeria 2005; Woolhouse et al, 2006; Webster 2002.
5 See Wildlife Conservation Society 2004, http://www.wcs.org/sw-high_tech_tool...thscience/owoh for an early exposition of the ?One World, One Health? concept. See also http://www.oneworldonehealth.org/ and http://www.wcs.org/5060651 for details of the ?Manhattan Principles?.
6 For date to 10 September 2008, see: http://www.who.int/csr/disease/avian.../en/index.html. For useful reviews, see MacKellar (2007) and Parry (2007).
7 World Bank (2005); (2005a); McKibben and Sidorenko (2006).
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