October 26, 2005
No Thai Flu
While we're all awaiting the special prosecutor's indictments, perhaps my few gentle readers will spare me a few moments to consider Thailand's successful program to curb its Avian flu outbreak.
A little over a year ago, Thailand was the epicenter of this feared pandemic, which officials from the World Health Organization to the White House Oval Office have warned could take millions of lives. Indeed, the WHO has called this pandemic "inevitable, and possibly imminent."
Yet Thailand has shown that countries need not be prisoner to such fear-mongering. The first report that the deadly H5N1 avian flu virus had spread to Thailanders occurred in January 2004. By October, 17 people had been infected, 12 of whom died, a frightening 70 percent mortality rate.
The Thai government immediately instituted a coordinated response plan that involved the national health agencies, local public health and veterinary workers and village health volunteers. They systematically communicated information to the public about the risks and symptoms of the disease and simultaneously launched a nationwide surveillance program.
Health care facilities throughout the country were instructed to isolate potential cases. Anyone with traditional flu was immediately tested and if their flu strain could not be identified, they were treated with potent antivirals. The government also launched a crash program to root out the virus among its chicken flocks, appropriating hundreds of millions of dollars to the effort -- a significant commitment for a middle-income country.
The results of this program were reported this week in PLoS Medicine (this is the free online medical journal). There have been no reported cases of avian flu in Thailand this year.
It's instructive to compare this response to the U.S. response so far. The newspapers here are filled with accounts of U.S. government efforts to stockpile tens of millions of doses of Tamiflu, the one drug known to be effective against H5N1 avian flu. The threat of seizing Roche's patent on the drug hangs in the air. Roche, responding to this threat to its bottom line, is gearing up to meet the demand (and wouldn't you when billion dollar government contracts were in the offing?).
Meanwhile, I've yet to read a single report documenting the government's public health preparations. Yet if Thailand is any example, appropriate public health measures would make isolating the first appearances of the dreaded disease a relatively manageable enterprise. It makes more sense to me than stockpiling drugs to fight an "inevitable" pandemic.