Editor’s Note: Jaime M. Yassif, Ph.D., is vice president of Global Biological Policy and Programs at the Nuclear Threat Initiative, a nonprofit global security organization focused on reducing nuclear and biological threats that endanger humanity. The views expressed in this commentary are her own. Read more opinion at CNN.
The headlines are worrying: “Highly pathogenic bird flu found in dairy cattle in Texas and Kansas.” “Bird flu detected in dairy worker.” “First human case of bird flu in Texas raises alarms.” Could this be how the next pandemic begins? Well, so far, U.S. officials say they believe there is minimal risk to the public from the latest version of bird flu.
But as evidence mounts of possible mammal-to-mammal spread, just weeks after the new avian flu was discovered in cows, many of us in the biosecurity and pandemic preparedness community believe that leaders in capitals across the world world must work to prevent this. new threat to public health in case the H5N1 flu virus can spread among humans.
There have also been documented cases of transmission to humans: Earlier this month, the US Centers for Disease Control and Prevention announced that a second person in the US had tested positive for bird flu. The first human H5N1 case in the US occurred in 2022, involving a poultry worker in Colorado, and the more recent case involved a dairy worker who had direct contact with infected cattle in Texas. Both human cases had mild symptoms, were treated and made a full recovery, but previous cases of bird flu in other parts of the world were much more serious, with many fatalities. What we don’t know – and what scientists are concerned about – is whether the virus will evolve in a way that makes it easier to spread through the human population.
A first case of the H5N1 virus in cattle was reported in March and although direct cow-to-cow transmission has yet to be confirmed, the occurrence of cases in cattle in at least six states suggests that cows may transmit the flu virus directly among themselves when transported to different farms, rather than being infected by sick birds.
While we face uncertainty about what will happen next, many scientists say increased government action is warranted because of the risk that bird flu could turn into a pandemic. Many researchers believe that Covid-19 may have begun in a similar way: spreading from animals to humans by first acquiring the ability to spread among mammals that have come into contact with humans, and then evolving to spread directly between humans to be transferred.
The US and other governments around the world must take H5N1 seriously and demonstrate that we have learned the lessons of the Covid-19 pandemic that has upended our lives for years. They must take immediate steps to avoid this risk, rather than taking a wait-and-see approach.
In the short term, governments must act now to use the capabilities they have to protect against the uncontrolled spread of the H5N1 avian flu virus as it spreads among humans. This includes funding research into vaccines likely to be effective against the virus, stepping up surveillance of livestock and people and broader emergency response planning.
It was encouraging to hear that the U.S. Department of Health and Human Services has ramped up surveillance systems and supported testing of potential vaccine candidates that could be more effective against this form of avian flu than the existing, limited supplies of H5N1 vaccines that have been available for years developed. past.
Going forward, it will be critical for the human and animal health sectors – including the CDC and the U.S. Department of Agriculture – to collaborate on biosurveillance, including by developing a shared approach to monitoring humans – and animal populations and by exchanging data, to monitor how the virus is developing.
In addition, if the U.S. government is successful in identifying an effective vaccine against the novel bird flu, it will be important to put plans in place to produce the vaccine quickly so that it is ready for use when needed. Furthermore, the US and other governments should consider how to update and act on their existing influenza pandemic response plans in the event that H5N1 begins to spread among humans.
To be prepared for a potential bird flu outbreak, governments around the world must take these steps now, even in the face of uncertainty. If they wait for a confirmed outbreak among humans, it will be extremely difficult to prevent the uncontrolled spread of the virus.
It is also time to reassess the long term and ensure that countries around the world have the capacity to detect and respond to future epidemics and pandemics. According to the Global Health Security Index, there are significant gaps in countries’ pandemic preparedness capabilities.
During the Covid pandemic, we have witnessed first-hand that capacity matters when it comes to saving lives. According to a study published last year by experts from the Brown University Pandemic Center, the Gates Foundation and NTI, almost all countries that had strong pandemic preparedness at the start of Covid had lower death rates than less prepared countries.
A wide range of capabilities have been shown to be effective, including disease detection systems, medical countermeasure distribution systems, and public health infrastructure to deploy non-pharmaceutical interventions.
Playing the long game means investing now to ensure countries have the capacity they need to respond to the worst of the H5N1 pandemic or be prepared for the next one. Given the impact of Covid, it is deeply disappointing that national governments are not investing the necessary resources to build life-saving pandemic preparedness. This just doesn’t make sense.
In the United States, federal funding for pandemic influenza is far below what we need to effectively address this threat. Government experts have called for $1.15 billion in influenza pandemic funding by 2025, but the Biden administration has requested only $335 million. Making matters worse, Congress has made major cuts to pandemic preparedness funding as part of the ongoing appropriations process.
This is also a problem internationally. Most countries – even those with sufficient resources – have not made financial investments in strengthening pandemic preparedness. The 2021 Global Health Security Index – which measures national-level pandemic preparedness capacity and was jointly developed by NTI, the Johns Hopkins Center for Health Security and Economist Impact – shows that 155 out of 195 countries have run out of money over the past three years allocated to improve capacity (apart from public health emergencies) to address epidemic threats.
The White House just announced a new Global Health Security Strategy, which includes a commitment to work with 50 countries to build pandemic preparedness. This is a big step in the right direction, but the US government and its partners will need to ensure they have the financial resources and political will to deliver on this promise.
Playing the long game also means supporting the World Bank’s Pandemic Fund, which is designed to invest in the long-term pandemic preparedness of low- and middle-income countries. The fund has received $1.9 billion in committed resources from national governments, philanthropic organizations and other groups, but it provides grants to support valuable capacity-building efforts and will soon run out of funds. Experts estimate that it will cost about $10 billion a year for at least five years to provide the financing that will allow countries to build the infectious disease detection and response capacity that will be needed to protect against pandemics. We must do better.
Covid highlighted the risks of pandemics, and unfortunately we have witnessed the deadly consequences in many parts of the world. Governments must now act quickly and decisively to tackle the growing public health threat posed by H5N1 influenza, while investing in long-term capacity building to ensure the world is better prepared for the next pandemic.
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