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Monday, September 12, 2005

A Global Katrina?

In 1969, Hurricane Camille slammed into the Gulf Coast and left in its destructive wake 255 people dead, 15,000 homeless and over a billion dollars in damage. In 1969, another disaster struck the U.S.—a relatively mild Hong Kong flu pandemic claimed the lives of 34,000 U.S. citizens

In the aftermath of Katrina, the losses of Camille look tame. Similarly, the next pandemic to strike America—and the world—has the potential to dwarf the 1969 pandemic. It has been that estimated a “medium-level epidemic” could kill up to 207,000 Americans and cost $166 billion. An H5N1 avian influenza (the type most feared if it becomes transmittable from human to human), could claim 16 American million lives and impose unimaginable economics costs.

In the August edition of Foreign Affairs Laurie Garrett, a senior fellow for Global Health at the Council on Foreign Affairs, and Michael Osterholm, the Director of the Center for Infectious Disease Research and Policy, had articles warning of the pending dangers of the coming pandemic.

Both experts were careful to note that the next pandemic is difficult to predict. It could be next month, next year or in ten years. But what both said is that the “reality of a coming pandemic cannot be avoided. Only its impact can be lessened.” The warning is eerily similar in its premonitory description to article in National Geographic last October documenting what would happen in the event of a major hurricane slamming into New Orleans.

While the lessons of Katrina are still fresh in our mind, our political leaders must not just focus on figuring what went wrong with our lack of preparation and poor response to Katrina, they must also turn their attention to improving our preparations to deal with the coming pandemic.

We don’t know exactly when it will hit, but—like a major hitting the Gulf Coast—we now it is coming and we know are not doing enough to prepare. Our public health experts are now telling us that our first line of defense against a pandemic—flu antivirals—is pitifully small.

What is tragic is that these antivirals, if aggressively administered at the site of an outbreak, have a good chance—like a strong levy system—of controlling the flu. To date though, the Food and Drug Administration has only been granted an additional $80 million to stockpile antivirals. It is the equivalent of making a small pile of sandbags in advance of a Category 5 hurricane.

Even more shortsighted than this is our failure to create the necessary infrastructure to develop a good vaccine and then quickly distribute it to a global population in the event of pandemic. It is estimated that at peak capacity only about 14 percent of the world’s population would be vaccinated within a year of an outbreak. One potential solution is to bolster the modest $400 million budget of the World Health Organization to address this dangerous shortcoming.

It is now clear that a deadly and destructive global pandemic is somewhere on the horizon. And like a hurricane, it can’t be stopped in its entirety but it can be limited. To do so, however, we must begin fortifying the equivalent of our levee system by creating an adequate supply of flu antivirals, as well as strengthening our emergency response systems by improving out vaccine production and distribution system.

Unfortunately, because of Katrina we now understand the cost of being unprepared. The time to head off this global crisis—a crisis that could quite possibly kill hundreds of millions world and cripple the global economy—is now. The responsibility is ours. The question is: will we learn the right lesson in time?

Jack Uldrich is the former head of the Minnesota Planning Agency and the author of Soldier, Statesman, Peacemaker: Leadership Lessons from George C. Marshall.