You can’t swing a sick chicken these days without hitting a pundit pontificating about bird flu. After nearly two years of sporadic news coverage, the media woke up to the threat in late September when George W. Bush spoke about the potential pandemic; now, the topic is regular fodder on the nightly news, the weekend shows, the daily papers, and the popular newsweeklies.
Everyone is having their say and, unremarkably, everyone seems to view it through their own lenses. Thomas Friedman recently opined on the Don Imus show that bird flu demonstrates the "flat-world" hypothesis of his latest best-selling book. Apocalyptic evangelicals cite it as a sign of the impending End Days. George Bush wants to invoke his administration’s handling of it, post-Katrina, as an example of their competence. Democrats say that Bush’s approach to the problem represents the exact opposite, as Senator Edward Kennedy argued in a Boston Globe op-ed last Sunday.
In fact, the danger of an influenza pandemic is real and serious. It is almost certain that the current H5N1 strain, which has thus far killed more than 60 people, all in Southeast Asia, will spread to poultry in most or all of the world. So far, almost all cases in humans have resulted from contact with live infected birds. And the virus could remain in its current form, which does not seem to spread easily from human to human (as a common cold would). In that case, it will have a massive economic effect, but relatively few fatalities. Or, it may well mutate, as past viruses have, to a person-to-person disease, in which case millions, or tens of millions, will perish.
Even if we luck out with this version of the disease, we are only buying time. The consensus is that the big one is coming; we just don’t know when and how bad it’s going to be.
It is unsurprising that the US and the world in general have been slow to take the threat seriously. Governments are not so different from mainstream media — only so many things occupy the high-priority bin at any given time, and bird flu hadn’t made it there until just recently. Yes, it should have; the warning signs have been flashing for at least eight years, if not longer. But it has not until just recently.
What is disconcerting — in addition to the basic problem of infrastructure readiness laid bare by the Gulf Coast hurricanes — is that the US is facing the threat with a perspective no less slanted than those of Friedman or the apocalyptic preachers.
In the case of Bush and the rest of the administration, that slant is primarily capitalistic and secondarily militaristic. These are, in fact, the only two types of solutions the Bushies seem to know. Name any problem of the past five years, and the administration’s proposal has been either to provide financial incentives to big business — remember that they have touted corporate and high-income tax cuts as the proper response to both recession and growth — or to roll out the armed forces.
Bush’s recent proposal to use the US military to impose quarantines has drawn considerable attention and justified criticism. But that is merely a sideline. The primary bird-flu strategy involves giving as many concessions as necessary to prompt the pharmaceutical industry to make the drugs we’ll need. There are arguments to be made for that approach, but stronger arguments against it — including, most noticeably, that it has failed miserably before.
Bush has said that his thinking about bird flu was shaped by a book on the 1918 pandemic. There is surely much to learn from that horrific episode, which killed somewhere between 20 and 80 million people worldwide, depending on whose estimates you use.
But while the current version of the virus is similar to that one — making it fully appropriate for scientists to study it for clues to a potential medical solution — the world it comes into is a vastly different place. Of course the world’s response in 1918 was inadequate: understanding of viral disease was in its infancy, infrastructure for global cooperative efforts was practically nonexistent, and the world was distracted by the largest war it had ever known.
In fact, more-relevant lessons can be learned from virus-pandemic scares of the last half-century, when knowledge, resources, and infrastructure were at hand. Unfortunately, those lessons are cautionary since, in every case, presidents have handled the threat poorly. Bush appears well on his way to sustaining that track record.
In 1957, Dwight D. Eisenhower refused to order mass production of vaccines, relying instead on the market, and 80,000 Americans died. Another 34,000 died in the 1968 outbreak, when again Lyndon B. Johnson failed to prompt pharmaceutical companies to produce sufficient vaccine quantities. The swine-flu scare of 1976 led Gerald Ford to hand over the farm to the drug manufacturers and the casualty-insurance industry, forking over large sums of money, granting indemnification against claims, and allowing proprietary-secret concerns to trump government oversight. The result was an expensive fiasco, particularly when the flu strain proved relatively mild. Finally Ronald Reagan dismantled Jimmy Carter’s attempts to create ongoing vaccine-development programs, and, of course, failed to marshal the power of the US government to stem the HIV/AIDS epidemic.
There is a common theme here: reliance on free-market forces, which proved woefully unsuitable.
Bush is not reading about these historical episodes, nor is he learning their lessons. Quite the opposite. Bush and his team have made explicitly clear that the plan is to take every pro-business measure they have ever supported, and apply them to the vaccine industry.
This strategy dates back at least a year, to the policy of former Health and Human Services secretary Tommy Thompson, but it has been re-emphasized repeatedly in the past two weeks by HHS secretary Michael Leavitt, the country’s de facto avian-flu czar.
After a bird flu meeting between Bush and pharmaceutical executives on October 7, Leavitt spoke to the press about the need to pass medical-liability reform, to indemnify drug makers from litigation, and to "create a streamlined regulatory process" for those companies.
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Issue Date: October 21 - 27, 2005
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