WHO - Swine Influenza - Statements and statistics

[Giuseppe]

Re: WHO - Swine Influenza - Statements and statistics

WHO | Influenza A(H1N1) - update 10

Influenza A(H1N1) - update 10

2 May 2009 --

The situation continues to evolve. As of 18:00 GMT+1, 2 May 2009, 16 countries have officially reported 658 cases of influenza A(H1N1) infection.


Mexico has reported 397 confirmed human cases of infection, including 16 deaths. The higher number of cases from Mexico in the past 48 hours reflects ongoing testing of previously collected specimens.


The United States Government has reported 160 laboratory confirmed human cases, including one death.



The following countries have reported laboratory confirmed cases with no deaths -

• Austria (1),
• Canada (51),
• China, Hong Kong Special Administrative Region (1),
• Costa Rica (1),
• Denmark (1),
• France (2),
• Germany (6),
• Israel (3),
• Netherlands (1),
• New Zealand (4),
• Republic of Korea (1),
• Spain (13),
• Switzerland (1) and the
• United Kingdom (15).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders.

It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products.

Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.


Related links: Influenza A(H1N1) web site - Daily updates will be posted on this site.
-

<cite cite="http://www.who.int/csr/don/2009_05_02a/en/index.html">WHO | Influenza A(H1N1) - update 10</cite>

[Giuseppe]

Re: WHO - Swine Influenza - Statements and statistics

WHO | Influenza A(H1N1) - update 11

Influenza A(H1N1) - update 11

3 May 2009 --

As of 0600 GMT, 3 May 2009, 17 countries have officially reported 787 cases of influenza A(H1N1) infection.



Mexico has reported 506 confirmed human cases of infection, including 19 deaths. The higher number of cases from Mexico in the past 48 hours reflects ongoing testing of previously collected specimens.


The United States Government has reported 160 laboratory confirmed human cases, including one death.



The following countries have reported laboratory confirmed cases with no deaths -

• Austria (1),
• Canada (70),
• China, Hong Kong Special Administrative Region (1),
• Costa Rica (1),
• Denmark (1),
• France (2),
• Germany (6),
• Ireland (1),
• Israel (3),
• Netherlands (1),
• New Zealand (4),
• Republic of Korea (1),
• Spain (13),
• Switzerland (1) and the
• United Kingdom (15).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders.

It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

Canada on 2 May reported the identification of the A(H1N1) virus in a swine herd in Alberta. It is highly probable that the pigs were exposed to the virus from a Canadian farm worker recently returned from Mexico, who had exhibited flu-like symptoms and had contact with the pigs. There is no indication of virus adaptation through transfer from human to pigs at this time.


There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

Related links: Influenza A(H1N1) web site - Daily updates will be posted on this site.
-

<cite cite="http://www.who.int/csr/don/2009_05_03/en/index.html">WHO | Influenza A(H1N1) - update 11</cite>

[Giuseppe]

Re: WHO - Swine Influenza - Statements and statistics

WHO | Influenza A(H1N1) - update 12

Influenza A(H1N1) - update 12

3 May 2009 --


As of 1600 GMT, 3 May 2009, 18 countries have officially reported 898 cases of influenza A(H1N1) infection.



Mexico has reported 506 confirmed human cases of infection, including 19 deaths. The higher number of cases from Mexico in the past 48 hours reflects ongoing testing of previously collected specimens.


The United States Government has reported 226 laboratory confirmed human cases, including one death.



The following countries have reported laboratory confirmed cases with no deaths -

1. Austria (1),
2. Canada (85),
3. China, Hong Kong Special Administrative Region (1),
4. Costa Rica (1),
5. Denmark (1),
6. France (2),
7. Germany (8),
8. Ireland (1),
9. Israel (3),
10. Italy (1),
11. Netherlands (1),
12. New Zealand (4),
13. Republic of Korea (1),
14. Spain (40),
15. Switzerland (1) and the
16. United Kingdom (15).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders.

It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

Canada on 2 May reported the identification of the A(H1N1) virus in a swine herd in Alberta. It is highly probable that the pigs were exposed to the virus from a Canadian farm worker recently returned from Mexico, who had exhibited flu-like symptoms and had contact with the pigs. There is no indication of virus adaptation through transfer from human to pigs at this time.


There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

Related links: Influenza A(H1N1) web site - Daily updates will be posted on this site.
-

<cite cite="http://www.who.int/csr/don/2009_05_03a/en/index.html">WHO | Influenza A(H1N1) - update 12</cite>

[Hoppit]

Re: WHO - Swine Influenza - Statements and statistics - Update 14

Influenza A(H1N1) - update 14

4 May 2009 -- As of 18:00 GMT, 4 May 2009, 21 countries have officially reported 1085 cases of influenza A (H1N1) infection.

Mexico has reported 590 laboratory confirmed human cases of infection, including 25 deaths.
The United States has reported 286 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1),
Canada (101),
China, Hong Kong Special Administrative Region (1),
Costa Rica (1),
Colombia (1),
Denmark (1),
El Salvador (2),
France (4),
Germany (8),
Ireland (1),
Israel (4),
Italy (2),
Netherlands (1),
New Zealand (6),
Portugal (1),
Republic of Korea (1),
Spain (54),
Switzerland (1)
and the United Kingdom (18).

It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

WHO advises no restriction of regular travel or closure of borders.

There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

Further information on the situation will be available on the WHO website on a regular basis.
Related links
Influenza A(H1N1) web site
Daily updates will be posted on this site.

http://www.who.int/csr/don/2009_05_04a/en/index.html

[sharon sanders]

Re: WHO - Swine Influenza - Statements and statistics

Welcome Hoppit!

[Hoppit]

Re: WHO - Swine Influenza - Statements and statistics

Thanks :-)

Nice community, doing a hard job!

kind regards from germany -
hoppit

[Hoppit]

Re: WHO - Swine Influenza - Statements and statistics Update 15

Influenza A(H1N1) - update 15

5 May 2009 -- As of 06:00 GMT, 5 May 2009, 21 countries have officially reported 1124 cases of influenza A (H1N1) infection.

Mexico has reported 590 laboratory confirmed human cases of infection, including 25 deaths.
The United States has reported 286 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths -
Austria (1),
Canada (140),
China, Hong Kong Special Administrative Region (1),
Costa Rica (1),
Colombia (1),
Denmark (1),
El Salvador (2),
France (4),
Germany (8),
Ireland (1),
Israel (4),
Italy (2),
Netherlands (1),
New Zealand (6),
Portugal (1),
Republic of Korea (1),
Spain (54),
Switzerland (1) and
the United Kingdom (18).

It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

WHO advises no restriction of regular travel or closure of borders.

There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

Further information on the situation will be available on the WHO website on a regular basis.
Related links
Influenza A(H1N1) web site
Daily updates will be posted on this site.

http://www.who.int/csr/don/2009_05_05/en/index.html

[Giuseppe]

Re: WHO - Swine Influenza - Statements and statistics

WHO | H1N1 influenza situation: Statement made at the Secretary-General?s briefing to the United Nations General Assembly on the H1N1 influenza situation (May 4, 2009)

Statement made at the Secretary-General?s briefing to the United Nations General Assembly on the H1N1 influenza situation


Via videoconference from Geneva, Switzerland
4 May 2009

H1N1 influenza situation

Dr Margaret ChanDirector-General of the World Health Organization

His Excellency, Mr Miguel d?Escoto Brockmann, President of the General Assembly, Mr Ban Ki-moon, Secretary-General of the United Nations and your staff, Excellencies, ladies and gentlemen,

First and foremost, let me thank Mr Secretary-General for inviting me to join this briefing. Let me thank the President for giving me this opportunity. I am speaking to you from the SHOC room in Geneva.

Our hearts go out to all people in all countries affected by the new H1N1 influenza virus.

Ladies and gentlemen,Let me try to give you an overview of the current situation, of where we stand right now, and where the world may be heading.

Influenza pandemics are caused by a virus that is either entirely new or not known to have circulated among humans in recent decades. This means, in effect, that nearly everyone in the world is susceptible to infection. It is this almost universal vulnerability to infection that makes influenza pandemics so disruptive.

Large numbers of people falling ill can be highly disruptive to economies and to the functioning of routine medical services.

As of right now, WHO has received reports of 1003 confirmed cases of H1N1 influenza from 20 countries on four continents. I wish to thank all countries reporting H1N1 cases to WHO for their cooperation and transparency.

All countries have acted in a very responsible manner. A special thank you goes to Canada and the USA who, alongside WHO, have assisted Mexico, especially with laboratory testing.

The world is in phase 5 now. This means that we need to maintain a high level of vigilance and monitor further international spread of the virus, and further spread in countries that are already reporting cases.

We do not know how long we have until we move to phase 6, which indicates we are in a pandemic. We are not there yet. The criteria will be met when we see, in one region outside North America, clear evidence of community-level transmission.

Although we face many uncertainties, we do know some things, which I want to share with you now.

Some of this knowledge comes from the behaviour of past pandemics. Other knowledge is specific to the new H1N1 virus and comes from the cases we are seeing in different countries and a look at the virus in the laboratory.

This helps us understand the situation, right now. However, experience during past pandemics warns us that the initial situation can change in many ways, with many, many surprises.

Historically, influenza pandemics have encircled the globe in two, sometimes three, waves. During the previous century, the 1918 pandemic, the most deadly of them all, began in a mild wave and then returned in a far more deadly one. In fact, the first wave was so mild that its significance as a warning signal was missed.

As we are seeing, the world today is much more alert to such warning signals and much better prepared to respond.

The pandemic of 1957 began with a mild phase followed, in several countries, by a second wave with higher fatality. The pandemic of 1968 remained, in most countries, comparatively mild in both its first and second waves.

At this point, we have no indication that we are facing a situation similar to that seen in 1918. As I must stress repeatedly, this situation can change, not because we are overestimating or underestimating the situation, but simply because influenza viruses are constantly changing in unpredictable ways.

The only thing that can be said with certainty about influenza viruses is that they are entirely unpredictable. No one can say, right now, how the pandemic will evolve.

This places health officials, at national and international levels, in the difficult position of needing to make far-reaching decisions urgently, yet without the kind of solid scientific back-up we normally like to have.

Ladies and gentlemen,

As you may know, several efforts have been made to estimate the impact of an influenza pandemic on the global economy today. These estimates vary greatly depending on the assumed virulence of the virus.

But all estimates agree on one point. The greatest disruption of the economy will come from the uncoordinated efforts of the general public to avoid infection. Again, it is incumbent upon us to issue advice and try to calm anxiety in the midst of great scientific uncertainty.

WHO is well prepared with plans that have been rehearsed, at headquarters and with its offices in all regions of the world. WHO is collecting information as the situation evolves and making this information public. Vigilance and solid data are critical at this stage.In terms of preparedness, the world is also fortunate to have the revised International Health Regulations. This treaty, which is designed to protect public health, also has provisions aimed at preventing undue interference with international trade and travel.

In this regard, let me make a strong plea to countries to refrain from introducing measures that are economically and socially disruptive, yet have no scientific justification and bring no clear public health benefit.

Rational responses are always best. They are all the more important at a time of economic downturn.

If this pandemic begins with a mild wave, this will give countries and industry an opportunity to build up stocks of vaccines, antiviral drugs, and other essential supplies.

But let me be frank. Global manufacturing capacity, though greatly increased, is still not sufficient to produce enough antiviral medication and pandemic vaccines to protect the entire world population in time.

This is the reality. But we can acquire the data that guides the wise and targeted use of these interventions, conserves supplies, and, in the case of antiviral medicines, reduces the risk of drug resistance.

An influenza pandemic is a global event that calls for global solidarity. As the chief technical and administrative officer of WHO, it is my job to do whatever is possible to ensure that developing countries are not left without protection.

It is my duty to help ensure that people are not left unaided simply because of the place where they were born. I am working aggressively and constantly with the pharmaceutical industry to ensure access to affordable drugs and pandemic vaccine, should that be required.

Again, let me thank all countries, and all partners, also within the UN system under the leadership of the Secretary-General, for helping us maintain our vigilance, as we gear up our response.

Thank you.
-

<cite cite="http://www.who.int/dg/speeches/2009/influenza_a_h1n1_situation_20090504/en/index.html">WHO | H1N1 influenza situation</cite>

[Niko]

Re: WHO - Swine Influenza - Statements and statistics

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 100%;" align="left"> Address to the ASEAN+3 Health Ministers? Special Meeting on Influenza A(H1N1)
Bangkok, Thailand
(Via videoconference)
8 May 2009


World is better prepared for influenza pandemic
Dr Margaret Chan
Director-General of the World Health Organization



Honourable ministers, distinguished participants, ladies and gentlemen,
Thank you for convening this special meeting of health ministers, and thank you for giving me an opportunity to address you.

Above all, thank you for your diligence all these years in tracking the H5N1 virus in humans and animals, in reporting and treating so many cases, and in dealing with so many tragic deaths.

For five long years, you have kept this avian virus under watch, and largely under control.

As we know today, the virus with the greatest pandemic potential, the H1N1 virus, has sprung up from another source, on another side of the world.

But H5N1 taught the world to expect a pandemic, and to plan for this event.

The world is better prepared for an influenza pandemic than at any time in history, thanks, in part, to your vigilance and diligence.

Years of alert and expectation mean that most countries now have preparedness plans. Vaccine manufacturing capacity has increased sharply.

Large stocks of antiviral drugs have been produced and procured.

Right now, treatment courses from the WHO stockpile are being shipped to more than 70 countries in the developing world.

We are, right now, gaining experience in the use of non-medical interventions, such as social distancing, to delay spread of the H1N1 virus.
WHO and its regional offices have tested their alert and response plans, also in operational exercises. We are prepared.

In addition, we have the backing of the greatly strengthened International Health Regulations.

This is a time of great uncertainty for all countries, and great pressure on ministers and ministries of health. The only certain thing that can be said about influenza viruses is that their behaviour is entirely unpredictable. No one can say how the current situation will evolve.

Countries will, quite rightly, want to do everything possible to prevent the arrival of the virus or, once in a country, to delay its further spread and thus flatten the epidemiological peak.

At the same time, it is important for countries to refrain from introducing economically and socially disruptive measures that lack solid scientific backing and bring no clear public health benefit.

The rational use of travel- and trade-related measures is always wise. It is all the more wise at a time of severe economic downturn.

Ladies and gentlemen,

On this occasion, let me make two additional requests.

First, do not drop the ball on monitoring H5N1. This virus is endemic in poultry in parts of the region. We have no idea how H5N1 will behave under the pressure of a pandemic.

Second, H5N1 has conditioned the public to equate an influenza pandemic with very severe disease and high mortality. Such a disease pattern is by no means inevitable during a pandemic. On the contrary, it is exceptional.

From past experience, ASEAN+3 countries know what it means to be at centre-stage during the outbreak of a new disease. We must battle misperceptions with the facts, and respond to the disease with the facts. I know you will help me on this front as well.

The decision to declare an influenza pandemic will fall on my shoulders. I can assure you, I will take this decision with utmost care and responsibility.

Thank you.

http://www.who.int/dg/speeches/2009/asean_influenza_ah1n1_20090508/en/index.html

[Niko]

Re: WHO - Swine Influenza - Statements and statistics

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 100&#37;;" align="left"> Opening remarks at the Intergovernmental Meeting on Pandemic Influenza Preparedness
Geneva, Switzerland
15 May 2009


Sharing of influenza viruses, access to vaccines and other benefits
Dr Margaret Chan
Director-General of the World Health Organization



Madam Chair, distinguished delegates, ladies and gentlemen,

I will be very brief. We are meeting at a critical time.

For five long years, countries in several parts of the world have been closely responding to outbreaks of H5N1 avian influenza in animals, and sporadic cases in humans.

I thank health officials, clinicians, and scientists in all these countries, and the many experts and laboratories located elsewhere, for their unflagging vigilance and diligence in keeping close watch over this virus.

Today, we know that a virus with great pandemic potential, the new strain of the H1N1 virus, has emerged from another source on another side of the world. This virus has quickly demonstrated its capacity to spread easily from one person to another, to spread widely within an affected country, and to spread rapidly to additional countries. We expect this pattern of international spread to continue.

This is a time of great uncertainty, and great pressure on governments, ministries of health, and WHO. I take it as my personal responsibility to keep the world informed, to adjust our recommendations as the situation evolves, and to prepare for a multiplicity of future scenarios.

Many critical measures are under way, for enhanced preparedness and for mitigation of the health effects. As I have consistently stated, gaps in response, coping, and mitigation capacities in different countries must be a top priority for WHO and the international community. We are all in this together.

Fortunately, countries with confirmed H1N1 cases have launched aggressive responses to the new virus. Their timely sharing of viruses for risk assessment and analysis, and for making seed vaccine is commendable.

We are getting new data daily, and we are beginning to get an early picture of the clinical spectrum and patterns of spread.

Outside Mexico, where the outbreak is not yet fully understood, the overwhelming majority of cases have been mild and self-limiting, with no need for treatment. Cases of severe or fatal infections have been largely, but not exclusively, confined to people with underlying chronic conditions.

We do not know if this partly reassuring picture will be maintained. Dr Fukuda will brief you fully on the current situation.

Apart from the intrinsic mutability of influenza viruses, other factors could alter the severity of current disease patterns, though in completely unknowable ways. Let me draw your attention to just two.

First, scientists are concerned about possible changes that could take place as the virus spreads to the southern hemisphere and encounters currently circulating human viruses, as the normal influenza season in this hemisphere begins.

Second, as all of you know, the H5N1 avian influenza virus is endemic in poultry in some parts of the world. It is out there, entrenched. No one can predict how the H5N1 virus will behave under the pressure of a pandemic.

As I said, we are meeting at a time of crisis that could have global implications. What the world needs most, right now, urgently, is information at all possible levels.

I wish you a most productive and fruitful meeting.


Thank you.

http://www.who.int/dg/speeches/2009/pandemic_influenza_preparedness_20090515/en/print.html

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[Niko]

Re: WHO - Swine Influenza - Statements and statistics

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 100&#37;;" align="left"> Remarks at the high-level consultation on pandemic influenza A(H1N1)
Geneva, Switzerland
18 May 2009


Pandemic threat deserves attention from all
Dr Margaret Chan
Director-General of the World Health Organization



Honourable ministers, distinguished experts, ladies and gentlemen,

I will be very brief. The prospect of an influenza pandemic rightly deserves the highest attention of governments, health ministries, public health officials, and industry.
Under the unique conditions of our highly mobile and closely interdependent societies, the threat of a pandemic deserves attention from many other sectors of government, and many other partners.

We are all under pressure to make urgent and far-reaching decisions in an atmosphere of considerable scientific uncertainty.

What we need most of all, right now, is information. We need information, at many levels of science, clinical medicine, and epidemiology, on the situation we are seeing today. We also need information to construct possible scenarios for the future. This, too, helps us assess and manage risks, and guides preparation measures.

I have convened this consultation to gather and share information.

We are fortunate that the countries with the most confirmed cases to date have already learned so much, and shared so much. All countries profit from this expression of solidarity.

Apart from safeguarding health, governments and health ministries need information for reliable communications with their citizens.

We have lived for five long years under the threat of a pandemic caused by the lethal H5N1 avian influenza virus. This has left our world better prepared, but also very scared.

The job of managing public perceptions and behaviours also falls on our shoulders. We need to warn the public when necessary, but reassure them whenever possible. This is a difficult balancing act.

I hope this consultation will clarify some issues at a time of great scientific uncertainty, yet tremendous pressure to make the right decisions.

I am now asking Dr Keiji Fukuda, our ADG for health security and the environment, and Dr John Mackenzie, who chairs the WHO Emergency Committee, to give you an overview of the current situation.

They will be followed by experts from Mexico, the United States of America, and Canada, who will further set the stage for your discussions by sharing their experiences to date.

Thank you.

http://www.who.int/dg/speeches/2009/influenza_h1n1_consultation_20090518/en/index.html

[Niko]

Re: WHO - Swine Influenza - Statements and statistics

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 100&#37;;" align="left"> Address to Sixty-second World Health Assembly
Geneva, Switzerland
18 May 2009


Concern over flu pandemic justified
Dr Margaret Chan
Director-General of the World Health Organization



Mister President, honourable ministers, excellencies, distinguished delegates, Dr Mahler, ladies and gentlemen,

Over the past three decades, the world has, on average, been growing richer. People have, on average, been enjoying longer and healthier lives.

But these encouraging trends hide a brutal reality. Today, differences in income levels, in opportunities, and in health status, within and between countries, are greater than at any time in recent history.

Our world is dangerously out of balance, and most especially so in matters of health. The current economic downturn will diminish wealth and health, but the impact will be greatest in the developing world.

Human society has always been characterized by inequities. History has long had its robber-barons and its Robin Hoods. The difference today is that these inequities, especially in access to health care, have become so deadly.

The world can be grateful that leaders from 189 countries endorsed the Millennium Declaration and its Goals as a shared responsibility. These Goals are a profoundly important way to introduce greater fairness in this world.

Populations all around the world can be grateful that health officials are recommitting themselves to primary health care. This is the surest route to greater equity in access to health care.

Public health can be grateful for backing from the Commission on Social Determinants of Health. I agree entirely with the findings. The great gaps in health outcomes are not random. Much of the blame for the essentially unfair way our world works rests at the policy level.

Time and time again, health is a peripheral issue when the policies that shape this world are set. When health policies clash with prospects for economic gain, economic interests trump health concerns time and time again. Time and time again, health bears the brunt of short-sighted, narrowly focused policies made in other sectors.

Equity in health matters. It matters in life-and-death ways. The HIV/AIDS epidemic taught us this, in a most visible and measurable way. We see just how much equity matters when crises arise.

Ladies and gentlemen,

The world is facing multiple crises, on multiple fronts.

Last year, our imperfect world delivered, in short order, a fuel crisis, a food crisis, and a financial crisis. It also delivered compelling evidence that the impact of climate change has been seriously underestimated.

These crises come at a time of radically increased interdependence among nations, their financial markets, economies, and trade systems. All of these crises are global, and all will hit developing countries and vulnerable populations the hardest. All threaten to leave this world even more dangerously out of balance.
All will show the consequences of decades of failure to invest in health systems, decades of failure to consider the importance of equity, and decades of blind faith that mere economic growth is the be-all, end-all, cure-for-all. It is not.

The consequences of flawed policies show no mercy and make no exceptions on the basis of fair play. As we have seen, the financial crisis has been highly contagious, moving rapidly from one country to another, and from one sector of the economy to many others.

Even countries that managed their economies well, did not purchase toxic assets, and did not take excessive financial risks are suffering the consequences. Likewise, the countries that contributed least to greenhouse gas emissions will be the first and hardest hit by climate change.

And now we have another great global contagion on our doorstep: the prospect of the first influenza pandemic of this century.

Ladies and gentlemen,

For five long years, outbreaks of highly pathogenic H5N1 avian influenza in poultry, and sporadic frequently fatal cases in humans, have conditioned the world to expect an influenza pandemic, and a highly lethal one. As a result of these long years of conditioning, the world is better prepared, and very scared.

As we now know, a new influenza virus with great pandemic potential, the new influenza A (H1N1) strain, has emerged from another source on another side of the world. Unlike the avian virus, the new H1N1 virus spreads very easily from person to person, spreads rapidly within a country once it establishes itself, and is spreading rapidly to new countries. We expect this pattern to continue.

Unlike the avian virus, H1N1 presently causes mainly mild illness, with few deaths, outside the outbreak in Mexico. We hope this pattern continues.

New diseases are, by definition, poorly understood when they emerge, and this is most especially true when the causative agent is an influenza virus.

Influenza viruses are the ultimate moving target. Their behaviour is notoriously unpredictable. The behaviour of pandemics is as unpredictable as the viruses that cause them. No one can say how the present situation will evolve.

The emergence of the H1N1 virus creates great pressure on governments, ministries of health, and WHO to make the right decisions and take the right actions at a time of great scientific uncertainty.

On 29 April, I raised the level of pandemic influenza alert from phase 4 to phase 5. We remain in phase 5 today.

This virus may have given us a grace period, but we do not know how long this grace period will last. No one can say whether this is just the calm before the storm.

Presence of the virus has now been confirmed in several countries in the southern hemisphere, where epidemics of seasonal influenza will soon be picking up. We have every reason to be concerned about interactions of the new H1N1 virus with other viruses that are currently circulating in humans.

Moreover, we must never forget that the H5N1 avian influenza virus is now firmly established in poultry in several countries. No one can say how this avian virus will behave when pressured by large numbers of people infected with the new H1N1 virus.

Ladies and gentlemen,

The move to phase 5 activated a number of stepped up preparedness measures. Public health services, laboratories, WHO staff, and industry are working around the clock.

A defining characteristic of a pandemic is the almost universal vulnerability of the world’s population to infection. Not all people become infected, but nearly all people are at risk.

Manufacturing capacity for antiviral drugs and influenza vaccines is finite and insufficient for a world with 6.8 billion inhabitants. It is absolutely essential that countries do not squander these precious resources through poorly targeted measures.

As you heard this morning, we are trying to get some answers to a number of questions that will strengthen risk assessment and allow me to issue more precise advice to governments. Ideally, we will have sufficient knowledge soon to advise countries on high-risk groups and recommend that efforts and resources be targeted to these groups.

I have listened very carefully to your comments this morning. As the chief technical officer of this Organization, I will follow your instructions carefully, particularly concerning criteria for a move to phase 6, in discharging my duties and responsibilities to Member States.

While many questions do not have firm answers right now, I can assure you on one point. When WHO receives information of life-saving importance, such as the heightened risk of complications in pregnant women, we alert the international community immediately.

To date, most outbreaks have occurred in countries with good detection and reporting capacities. Let me take this opportunity to thank the governments of these countries for the diligence of their surveillance, their transparency in reporting, and their generosity in sharing information and viruses.

An influenza pandemic is an extreme expression of the need for solidarity before a shared threat. We are fortunate that the outbreaks are causing mainly mild cases of illness in these early days.

I strongly urge the international community to use this grace period wisely. I strongly urge you to look closely at anything and everything we can do, collectively, to protect developing countries from, once again, bearing the brunt of a global contagion.

I have reached out to the manufacturers of antiviral drugs and vaccines. I have reached out to Member States, donor countries, UN agencies, civil society organizations, nongovernmental organizations, and foundations.

I have stressed to them the absolute need to extend preparedness and mitigation measures to the developing world. The United Nations Secretary-General is joining me in these efforts, which are tireless.

Ladies and gentlemen,

As I said, equity in health matters in life-and-death ways. It matters most especially in times of crisis.

The world of today is more vulnerable to the adverse effects of an influenza pandemic than it was in 1968, when the last pandemic of the previous century began.

The speed and volume of international travel have increased to an astonishing degree. As we are seeing right now with H1N1, any city with an international airport is at risk of an imported case. The radically increased interdependence of countries amplifies the potential for economic disruption.

Apart from an absolute moral imperative, trends such as outsourcing and just-in-time production compel the international community to make sure that no part of the world suffers disproportionately. We have to care about equity. We have to care about fair play.

These vulnerabilities, to imported cases, to disrupted economies and businesses, affect all countries. Unfortunately, other vulnerabilities are overwhelmingly concentrated in the developing world.

On current evidence, most cases of severe and fatal infections with the H1N1 virus, outside the outbreak in Mexico, are occurring in people with underlying chronic conditions. In recent years, the burden of chronic diseases has increased dramatically, and shifted dramatically, from rich countries to poorer ones.
Today, around 85% of the burden of chronic diseases is concentrated in low- and middle-income countries. The implications are obvious. The developing world has, by far, the largest pool of people at risk for severe and fatal H1N1 infections.

A striking feature of some of the current outbreaks is the presence of diarrhoea or vomiting in as many as 25% of cases. This is unusual.

If virus shedding is detected in faecal matter, this would introduce an additional route of transmission. The significance could be especially great in areas with inadequate sanitation, including crowded urban shantytowns.

The next pandemic will be the first to occur since the emergence of HIV/AIDS and the resurgence of tuberculosis, also in its drug-resistant forms. Today’s world has millions of people whose lives depend on a regular supply of drugs and regular access to health services.

Most of these people live in countries where health systems are already overburdened, understaffed, and poorly funded. The financial crisis is expected to increase that burden further, as more people forego private care and turn to publicly-financed services.

What will happen if sudden surges in the number of people requiring care for influenza push already fragile health services over the brink? What will happen if the world sees the end of an influenza pandemic, only to find itself confronted, say, with an epidemic of extensively drug-resistant tuberculosis?

We have good reason to believe that pregnant women are at heightened risk of severe or fatal infections with the new virus. We have to ask the question. Will spread of the H1N1 virus increase the already totally unacceptable levels of maternal mortality, which are so closely linked to weak health systems?

Ladies and gentlemen,

In the midst of all these uncertainties, one thing is sure. When an infectious agent causes a global public health emergency, health is not a peripheral issue. It moves straight to centre stage.

The world is concerned about the prospect of an influenza pandemic, and rightly so. This Health Assembly has been shortened for a good reason. Health officials are now too important to be away from their home countries for more than a few days.

Much is in our hands. How we manage this situation can be an investment case for public health.

The world will be watching, and one big question is certain to arise. Are the world’s public health services fit-for-purpose under the challenging conditions of this 21st century? Of course not. And I think the consequences will be quickly, highly, and tragically visible. Now comes the second question. Will something finally be done?

At the same time, we cannot, we dare not, let concerns about a pandemic overshadow or interrupt other vital health programmes. In fact, many of the issues you will be addressing this week, or have addressed in recent sessions, concern exactly the capacities that will be needed during a pandemic, or any other public health emergency of international concern.

The health sector cannot be blamed for lack of foresight. We have long known what is needed.

An effective public health response depends on strong health systems that are inclusive, offering universal coverage right down to the community level. It depends on adequate numbers of appropriately trained, motivated, and compensated staff.

It depends on fair access to affordable medical products and other interventions. All of these items are on your agenda. I urge you, in particular, to complete work under the item on public health, innovation and intellectual property. We are so very close.

The International Health Regulations, also on your agenda, give the health sector an advantage that financial managers, at the start of last year’s crisis, did not have when faulty policies precipitated a global economic downturn. The International Health Regulations provide a coordinated mechanism of early alert, and an orderly system for risk management that is driven by science, and not by vested interests.

I must remind you. We need to finish the job of polio eradication, as guided by the ongoing independent evaluation. I must also remind you that this job is already providing solid benefits as we reach for the goal of ridding the world of a devastating disease.

Right now, the vast surveillance networks and infrastructure in place for polio eradication are being used to step up surveillance for cases of H1N1 infection, especially in sub-Saharan Africa and the Asian sub-continent.

The proposed programme budget is also on your agenda. WHO is prepared to lead the response to a global public health emergency. Our services, in several areas, are strained, but we are coping. We need to be assured that we can continue to function well, especially if the emergency escalates.

Ladies and gentlemen,

I have a final comment to make.

Influenza viruses have the great advantage of surprise on their side. But viruses are not smart. We are.

Preparedness levels, and the technical and scientific know-how that supports them, have advanced enormously since 1968. We have the revised International Health Regulations, and we have tested and robust mechanisms like the Global Outbreak Alert and Response Network.

As I said, an influenza pandemic is an extreme expression of the need for global solidarity. We are all in this together. And we will all get through this, together.

Thank you.

http://www.who.int/dg/speeches/2009/62nd_assembly_address_20090518/en/index.html