Bird flu, AIDS, provide contrast in reaction speeds

By J.T. Nguyen dpa Dec 21, 2005, 6:58 GMT

New York - If ever there was a vivid contrast between world reaction to diseases, it became apparent this year.

Less than a year after the spectre of a global avian flu epidemic first arose, the world's medical and political infrastructure was in high gear to head off a disease that has not yet even learned the art of human-to-human contagion.

But nearly 25 years and 25 million deaths after the discovery of the AIDS virus, the world is still trying to scrimp together enough money to prevent and treat Acquired Immunity Deficiency Syndrome (AIDS) - a disease that is worst in poverty-stricken African countries.

The disparity throws a spotlight on how economic considerations drive the world's reaction to disease. Among health advocates, government officials and United Nations experts, it's an open secret why wealthier countries have paid greater and more immediate attention to bird flu - which has killed barely about 70 humans - than they did to HIV/AIDS.

Bird Flu could slice away 5 per cent of U.S. economic production as a direct and indirect consequence of a bird flu epidemic, and U.S. Senate majority leader Bill Frist has put a U.S. price tag of 675- billion-dollar on it.

President George W. Bush has pledged 7 billion dollars for vaccine research in the U.S., and a small token of 250 million dollars to help other countries contain the flu.

AIDS has less of a constituency not only because of its slow moving diagnosis and spread, but also because its economic impact is felt hardest in poorer countries, where it is wiping out the young, skilled labour adults vital to raising the next generation. In the U.S. and Europe, on the other hand, AIDS was mainly transmitted among homosexuals.

Finding an effective anti-AIDS cure has eluded the best health laboratories in the world, and research only began gearing up in the mid 1990s. The Global Fund to fight HIV/AIDS, tuberculosis and malaria was created only in 2000.

An estimated 40.3 million people now live with the AIDS virus, including 5 million new infections in 2005, and AIDS deaths could only peak in mid-century.

The avian flu first struck Asia in 2003, and has been carried to wild and domestic bird flocks by migratory birds as far as their wings can fly. It has claimed more than 70 human lives and resulted in the culling of tens of thousands of poultry.

To prevent an avian flu explosion, governments rushed to get licenses to produce anti-virals like oseltamivir, or tamiflu, and Asian are collaborating to produce generic tamiflu.

Richard Feachem, the executive director of The Global AIDS Fund, warns that the inexorable growth of the slower moving HIV/AIDS will still be seen as the 'greatest failure in public health policy and action of all time.'

Feachem says that either the world has done its best against a disease so 'intractable' that it defies human efforts, or 'we have done far too little, far too late.'

'The truth lies somewhere in between, but is much closer to the second proposition than the first,' Feachem said.

The Global Fund, established in 2000 by Secretary-General Kofi Annan, is the only effort with support from the world's seven richest industrialized nations. With assets of 8.6 billion dollars, it is committed to spending 4.4 billion dollars on 350 programmes in 130 countries to fight HIV/AIDS.

Feachem, who noted the disparity in attention given the two diseases, wondered whether it is because bird flu threatens more white people than black? Or is it because it could bring down the economies of North America, Europe and Asia?

Whatever the case, Feachem urges strenuous application of the lessons learned in fighting HIV/AIDS. Political leadership, technology and the full force of biological science must be mobilized to fight epidemics.

Failure, he says, would be hugely expensive compared to the amount spent to anticipate and head off a bird flu epidemic, for example.

Failure, in fact, is what the world's public health system is already confronting in the HIV/AIDS fight.

The South Africa-originated International Treatment Preparedness Coalition (ITPC), comprised of 600 activist groups in 100 countries, blames the failures on lack of national leadership in many countries - especially in the hard-hit Dominican Republic, India, Kenya, Nigeria, Russia and South Africa - and on severe shortage of healthcare workers. <!--page-->

The facts are dismal. In January, the World Health Organization (WHO) is expected to give details of its failed '3 by 5' AIDS initiative, which has missed its target by at least 50 per cent. WHO's goal had been to provide anti-retroviral treatment to 3 million HIV-infected people in five years ending in December 2005.

The ITPC blames red tape, pervasive stigma against AIDS patients, poor management and inadequate funding for the shortfall.

Taiwan on the other hand is an example of a wealthy country that has tackled both AIDS and bird flu with little outside help - mainly because China blocks its membership in WHO.

Dr. Steve Kuo, director of Taiwan's Center for Disease Control, says his government has been assisted by specialists from the United States, Australia and other Western nations.

'We provide anti-viral (HIV) treatment free to our patients, who number around 10,000' for the whole country, Kuo said. His government is gearing up for avian flu, using the experience of the SARS (Severe Acute Respiratory Syndrome) epidemic in 2003, when dozens of people died in Asia from eating infected animals.