19 October 2005 Stephen Soldz
No one knows if or when an avian flu pandemic will hit the world. But we do know that this is a serious possibility, and that the consequences could be catastrophic: tens to hundreds of millions dead worldwide; millions dead in the US; economic damage that could lead to another major depression as workers die and others cease working out of fear and the need to take care of ill family members. Perhaps starvation would set in as the economy slowed and transportation ceased for large infected areas.
Given these possibilities, one would think that any government would make preventing and preparing for this potential catastrophe a major priority. It's therefore nice to see that, for the Bush administration, avian flu is a priority. However, the priority isn't preparing for it, but preparing to spin the government's failure to prepare.
Take this new article on U.S. Health and Human Services Secretary Mike Leavitt's trip to Asia, the origin of this disease (Official: Preventing Pandemic Impossible). Secretary Leavitt of the "see no obstacles" Bush administration proclaims defeat in advance.
"Can we create a network of surveillance sufficient enough to find the spark when it happens, to get there fast enough?" he said. "The chances of that happening are not good."
But will the US do all it can to prevent the spread of the disease? A no-brainer would be for the US and other wealthy nations to set up a fund to reimburse livestock breeders whose birds become infected. Since breeders sometime hide ill birds because of fears of economic devastation if they are detected and the rest of the breeder's stock is culled, common sense would indicate that the world has an interest in making sure that this compensation is more than adequate. So is the US moving full steam ahead to create such a fund? The Secretary made it clear the US intended to do little:
"He said the U.S. government was considering ways to help offset the economic loss to Asian farmers forced to slaughter infected flocks, but help would be limited. Without subsidies, poor farmers resist killing their sickened livestock."
While prevention is the best hope for the world, once a pandemic starts, public health strategies for coping are three-pronged: vaccination, use of antiviral drugs, and quarantine.
As for vaccination, some efforts seem to be underway. Thoughtfully, the "United States may help finance some of the $100 million production burden." "May?" "Some of the burden?" This hardly seems like an all out effort to prepare for potential catastrophe. And let's not forget that that $100 million price tag is for vaccine for the United States only. Other wealthy industrial countries also will make preparations to vaccinate at least some of their populations. But what of the several billion people living in countries too poor to shoulder this cost on their own? Evidently they are simply to be left to get infected and die in their millions. In addition to the immorality of this, it will be a disaster for prevention in the United States and the other industrial countries. An epidemic left unchecked in large parts of the world will be a breading ground for the virus and for the development of modified forms of the virus from which we may be less protected by vaccine. So any reasonable strategy for dealing with the virus would be based upon considering the entire world as an interconnected system. Reasonable, but not, evidently, for the Bush administration.
Another important tactic is preparing stockpiles of antiviral drugs, such as Tamiflu, to treat people when they become infected. While there is concern that avian flu strains may be developing resistance to some of these drugs, stockpiling them is indeed a good fallback in case a pandemic can't be stopped. So is the Bush administration doing all it can to get as many doses of these drugs as possible? These drugs are protected by patent, interfering with the ability of multiple companies to devote their resources to manufacturing them. United Nations Secretary General Kofi Annan has made the obvious suggestion that these patents be suspended in the interests of protecting millions of people. Secretary Leavitt's response is that U.S. intellectual property rights would not allow such action. No urgent call for suspending those rights in an emergency from the administration that has deemed virtually no human right worth protecting as it pursues its GWOT (Global War on Terror).
As for quarantine, the Secretary says the country isn't ready, but hasn't outlined a detailed approach to make it ready. Obviously, such an approach should be developed in close coordination with the career professionals in the Centers for Disease Control and Prevention and state public health agencies whose job it is to protect the public from health dangers. However, President Bush's main idea was to propose giving the key role in imposing quarantines to the military, those experts in preserving the health of the public. As usual, the administration is more concerned with using the potential crisis to advance its agenda of militarizing American society than with actually preventing or coping with the crisis.
Never fear, however. Should a pandemic hit these shores Secretary Leavitt has already outlined the administration's excuse. It's all the fault of those other people, those individuals, families and public officials who were too shortsighted to prepare:
"People have not exercised adequate personal preparedness to last more than three or four days in their normal environment without going to the store," he said. "What's the responsibility of communities? What's the responsibility of families? Is it important that the mayor of a small town be thinking about a decision between Tamiflu and a swimming pool?"
I guess all that's needed is to trade in that swimming pool for a stock of the (unavailable) Tamiflu. If you don't, the catastrophe, should it occur, is your fault, just as those selfish people in New Orleans are responsible for their suffering as they refused to evacuate and their local officials neglected to ask for FEMA's assistance.
Stephen Soldz, a public health researcher and psychoanalyst, is Director of the Center for Research, Evaluation, and Program Development at the Boston Graduate School of Psychoanalysis. He is a member of Roslindale Neighbors for Peace and Justice and founder of Psychoanalysts for Peace and Justice. He maintains the Iraq Occupation and Resistance Report web page.
http://www.zmag.org/content/print_article.cfm?itemID=8962§ionID=57
