Avian Flu, Human Fear

'Kill the chicken to scare the monkey' goes an old Chinese proverb. It is a piece of ancient wisdom worth recalling especially in the times we live in where chicken are indeed being killed by the millions to scare the human monkey.

One is referring of course to the pandemonium over the avian flu 'pandemic' that is gripping many parts of the world, including India in recent times.

According to the 'believers' avian flu, an influenza with a high mortality rate – which is transmitted from birds to human beings will become catastrophic when it starts spreading between human beings 'at some stage'. The WHO for example has been warning the world repeatedly of a pandemic that could kill 'millions' within a period of months if not weeks with the total death toll being put by some as high as 150 million.

According to the 'skeptics', like this writer, the way to understand the avian flu phenomenon is as follows:

a) The flu is indeed as dangerous as it is portrayed to be and many millions are going to die of it. Given the fact we have no known vaccine or effective antidote (except the very dubious 'Tamiflu' currently being stockpiled by many governments) and given the sheer speed with which such a pandemic will go around the globe there is really little anyone can do to prevent it or even stem its tide. In this scenario avian flu falls in the same category as the unpreventable possibility (don't ask about probabilities) of an asteroid hitting Planet Earth or another tsunami even larger than the last one hitting us – and killing millions. Or,

b) The flu is not as dangerous as it is portrayed to be and falls into the same category as many infectious diseases in the globe with a high mortality rate like Ebola or meningitis or Legionnaire's Disease all of them deadly but in a localized way. In which case all the current panic over the disease is completely unwarranted and smacks of either extreme paranoia or a planned diversion of global attention away from other things that are actually killing many people around the world every day – including the US war on Iraq, malaria, TB and HIV.

To put the entire avian flu scare in perspective it is important to remember that the idea of a 'killer' global pandemic in recent years has been hitting the headlines off and on ever since the panic over SARS in early 2003 and over anthrax in 2001 soon after the September 11 event. To go back even further in modern history there have been several such global alarms over influenza pandemics ever since the so-called Spanish Flu of 1918 that is supposed to have left over 40 million people dead around the world in a matter of a few months.

The first documented infection of humans with an avian influenza virus, that normally infects only birds and pigs, occurred in Hong Kong in 1997, when the H5N1 strain caused severe respiratory disease in 18 humans, of whom 6 died. Medical researchers believe that the virus had jumped directly from birds to humans.

The current fear about avian flu is because of the possibility that humans, if concurrently infected with human and avian influenza strains, could serve as the "mixing vessel" for the emergence of a novel subtype that could be easily transmitted from person to person. Such an event would mark the start of an influenza pandemic against which we have little or no immunity.

There is no evidence so far however that human-to-human transmission of avian flu has occurred anywhere. The total number of avian flu cases recorded since 2003 up to mid-March 2006 has been 176 out of which there have been 97 deaths.

Given all this information anyone should be deeply afraid indeed and initiate measures to prevent such a global pandemic from ever happening. The real question however is as to what these measures should consist of, what other health issues pose competing threats to the world and hence what the international priorities should be.

Instead of going to the root of the problem which often lies in poverty, lack of health infrastructure, ignorance and pressures of the market economy on everyone from pig and poultry farmers to pharmaceutical companies international agencies and governments are dubiously headed in the direction of treating avian flu on par with the threat of global terrorism. So the microbe is the new 'terrorist' to be hunted down by medical 'commandoes' or its 'facilitators' carpet bombed out of existence with medication.

Falling expenditure on public health

If there is a chance at all of tackling a global pandemic it can only be at the grassroots level by promoting the concept of Health for All and by making it a reality by investing the required resources in the right places.

For the simple truth about any public health system is that it can only be as strong as the poorest patient in the country. What pandemics often do is to make everyone on the planet realize, quite harshly, that they are born equal and can also die equally.

If new diseases today originate in the crowded, poor and desperate parts of Asia and Africa the response cannot be to shut them out from the rest of the world. However instead of attracting more investment, with the juggernaut of privatization rolling across the globe, public health systems, particularly in the developing countries, are on the verge of collapse everywhere.

As all epidemics start at the local level it is essential that resources be urgently diverted to setting up basic public health infrastructure and creating the necessary human resources. There is no indication at all that either the WHO or its member governments are very serious about this at all.

Global Migration

The movement of labour across national boundaries has been the Achilles Heel of the entire theory of globalization that claims that lowering tariffs and opening up markets will automatically bring all round prosperity. What this theory ignores is the real history of our world with its long periods of colonialism, imperialism and ever-present racism that deems some sections of the world as being more equal than others.

With unemployment rising in developed nations due to the dismantling of their social welfare systems by neo-liberal politicians there have been consistent attempts over the past decade or more to find any excuse possible to keep migrant labour out.

While crude racism is used often it is not really the ideal weapon because of its obviously illogical and indefensible nature. In recent years, the cover conjured up to harass migrants has been the possibility that they might be 'terrorists' – which automatically means anyone with dark skin, a beard and a strange sounding name or even any one of the above will do!

When the bogey of terrorism loses credibility and dies out I am afraid the new pretext to keep out developing country migrants from going to developed nations is going to be 'disease'. After all a microbe cannot catch a flight or a boat or walk over land all by itself – it also needs a carrier and who is more qualified to carry the burden of strange and new diseases than the humble migrant worker?

There might also come a day, like it did unfortunately in the days of the Nazis, when the carriers and microbes will be deemed to be one and the same and dealt with accordingly. All of which brings me to my next point.

Human Rights

At the height of the paranoia about SARS I remember the way the purpose of public health suddenly became reason enough to take away all basic rights of individuals even merely suspected of being ' microbe carriers'.

While international law on human rights recognises that governments may infringe on civil and political rights for public health purposes governments cannot assume they can do anything they want with the rights of individuals.

However, at the time of the SARS outbreak, given its suspected origins in China there was widespread discrimination across the south-east Asia region and even in other parts of the world against mainland Chinese citizens traveling anywhere. Within China itself, once the authorities decided to make a big show of how concerned they were about the outbreak, hundreds if not thousands were quarantined, arrested arbitrarily and had their individual rights suspended indefinitely. In Singapore , officials went to the extent of requiring suspected SARS carriers to wear electronic tags that could trace their movements, which were already restricted under threat of punishment.

Given the severe erosion of human rights that the world is witnessing due to the US-led ' 'War on Terror' the last thing the world needs now is one more excuse to confine, arrest, isolate people and suspend all their human rights under the pretext of their being a 'threat to law, order and the American Way of Life'. Unfortunately the way the WHO has approached the entire issue of possible global pandemics smacks of a heavy cowboy influence coming from the Head of State of the world's loneliest Superpower!


Lastly, it needs to be mentioned, that quite ominously, in the context of the revival of Western colonial adventures a la Iraq or Afghanistan in recent years, the new paranoia over avian flu provides one more excuse to rich and powerful nations to erode national sovereignty of poorer countries and 'intervene' – this time under the guise of safeguarding global health! (It is only a matter of time before El Baradei of the IAEA is given the task of identifying 'rogue nations' that don't report their local epidemics to the world)

Even well meaning public health activists in some developed countries seriously talk of 'intervention' in developing countries that cannot 'manage' their local epidemics properly. In other words, Western colonialists who spread the plague, small pox, and other diseases far and wide through their conquests around the world for centuries will now come back and occupy Asian, African or Latin American nations because well – 'they are potential TB carriers you know!'

While this warning may still be a bit early there is no doubt in my mind at all that given the portents at some point of time in the future a WHO report about X or Y country 'hiding an epidemic' could trigger off global sanctions and possibly war. There is still time to avert the possibility of health becoming the next weapon of choice in the arsenal of Imperialism.