In-Flew-Enza: Pandemic Influenza and Its Security Implications - Innovation in Global Health Governance - page 130

necessary to analyse the nature of the pandemic as well as the context in which it
unfolds. after a discussion of the potential characteristics of the pandemic influenza
and the international context, this chapter addresses its economic, sociopolitical, and
military and strategic implications. It ends with some policy recommendations on
how to mitigate the security risks of the pandemic.
How Nasty Is the Bug?
Most infectious disease experts agree that the world now stands at the edge of
an influenza pandemic (Knobler et al. 2005). while there is no hard science to
support that position, an examination of the timeline of influenza over the past
100 years suggests a disproportionate increase in the number of reports of novel
sub-types in humans and in the number of animal and bird species involved (webby
and webster 2003). 2 In part, this is because influenza is an RNA virus, which is
prone to mutation. According to the World Health Organization ([WHO] 2005), all
prerequisites for the start of a pandemic have been met save one: efficient human-
to-human transmission.
while scientists cannot determine exactly which viruses might cause pandemics,
recent outbreaks of avian influenza in asia make the H5n1 virus the most likely
candidate to spark the next influenza pandemic (Lee Jong-wook 2005). Unlike most
avian influenza viruses, which emerge briefly and are relatively localised, H5N1 is
spreading widely among birds in asia and has unusual staying power (wHo 2005).
a report published in 2005 by the Institute of Medicine of the national academies
(IoM) in the United States called the H5N1 avian influenza in Asia 'unprecedented
in its scale, in its geographical distribution, and in the economic losses it has caused'
(Knobler et al. 2005, 12). It may be just a matter of time before H5n1 adapts to
humans, since the virus behind the 1918 Spanish influenza was derived completely
from an avian source (taubenberger et al. 2005).
although the timing of the next pandemic cannot be predicted, efforts have been
made to estimate its demographic consequences. the upcoming pandemic will likely
resemble the mild influenza pandemics in 1957 and 1968 (both strains were the
result of reassortment, meaning an exchange of genetic material between human and
avian viruses), which killed 3 million people worldwide. according to research by
the centers for Disease control and Prevention (cDc), hybrid viruses that combine
seasonal human influenza virus and the H5N1 virus fail to spread efficiently, at least
in ferrets (Kaiser 2006). It is expected that the longer H5n1 lives in wild birds, the
more likely it will become mild (orent 2005). Modelled on the pandemic of 1968,
the best-case scenarios predict that 2 million to 7 million people would die and tens
of millions would require medical attention (wHo 2004).
chances are that the next pandemic may not be as mild as the one in 1968.
research on the newly recovered 1918 virus suggests that it completed an avian-
to-human transfer without gene reassortment, while the number of mutations to
get from the avian variant to the human one was relatively small (taubenberger