Is A Human Pandemic Next? — page 2

The Politics of Disease
If there was one clear lesson from last year's SARS outbreak, it was this: when it comes to fighting viciously contagious diseases, nothing is more important than decisive government intervention and unvarnished candor about the dangers at hand. Yet in their early handling of bird flu, governments across Asia have, with depressing frequency, displayed a dangerous tendency to resort to denial and secrecy.

No country, perhaps, has handled the current crisis more ineptly than Indonesia—and the results have been devastating, as Indonesian farmer Ah Tong can attest. As early as mid-October, says Ah Tong, his chickens began to die in tens every day. At first he wasn't too alarmed. After all, officials insisted that the birds were merely suffering from Newcastle disease, a viral infection that's deadly to chickens but which poses no threat to humans. So Ah Tong's vet treated his 180,000 chickens with a vaccine for Newcastle disease. But it didn't seem to work, however, and by late November, about 100 chickens were dying each day. The vet then sent a blood sample from a dead chicken to the veterinary research bureau of the Bogor Institute of Agriculture, near Jakarta. "They found it was not Newcastle disease that killed my chickens, but AI—avian influenza," says Ah Tong. "But the government still insisted it was Newcastle disease."

In the end, Ah Tong lost about 150,000 of his chickens in one gruesome month. "About 90% of the chickens in all farms around here were hit at the time," he says, making a total of about 3 million chickens in just his area. "It feels funny now, watching the officials on TV telling you to be cautious of AI, when all you have are empty chicken pens. Where were they when we were battling the disease, when our chickens were dying by the thousands?"

	The government is to blame. If we'd been told earlier about the bird flu, we wouldn't have let our son go near the birds. —CHAMNAN BOONMANUJ,  father of a six-year-old Thai boy who died of avian flu

Marthen Malole, who heads the virology laboratory of the Bogor Institute of Agriculture's faculty of animal husbandry, says he suspected an outbreak of avian flu as early as August 2003. "I told the Agriculture Ministry people in October, but they were very angry at me. I don't know why. I just wanted them to take immediate action." Indonesian officials finally admitted on Jan. 25 that the country was in the grip of a major outbreak of bird flu. Even then, however, Agriculture Minister Budi Tri Akoso said the government would leave it up to farmers whether or not to cull chickens in infected areas, citing the high expense. After heavy pressure from the WHO, Jakarta finally reversed its stance and on Jan. 29 President Megawati Sukarnoputri promised to begin a comprehensive cull. Again, though, there were damaging displays of official indecision. Tata Trisatyaputri, Indonesia's director for the development of animal husbandry, told the press on Jan. 30 that there would be cullings only in areas with new infections: "In other regions we will do vaccinations. A mass cull will cause restlessness among the people, and the people are already restless."

In Thailand, it wasn't just the bureaucrats who were reluctant to face reality. Politicians also publicly vilified would-be whistle-blowers. Senator Malinee Sukavejworakit, a medical doctor who represents one of the worst-affected provinces, had been concerned about the large numbers of chickens dying as far back as November. Despite her growing suspicions, she initially accepted government assurances that the situation was under control, and that the deaths were due to chicken cholera or a diarrhea epidemic. Then she received a phone call on Jan. 17 from a doctor friend in her province asking her to visit a patient of his. "He suspected it was a case of bird flu," she says. "He had sent a specimen to the Public Health Department for testing but hadn't heard back. He felt that if he pushed it with the government he would be told to stay quiet. So he told me." When Malinee went to see the patient, a 49-year-old butcher, he displayed classic symptoms of h5n1 infection: weight loss, rapid pulse, high temperature, and muscle pain. "He told me he'd been butchering chickens on a farm and he'd come across a whole lot of birds with insides like he'd never seen," she says. "They smelled rancid."

Malinee then went to visit the farm and the farmer told her "whatever this is, it isn't cholera." She convened a meeting of the Senate Committee on Public Health, for which she is chief adviser, and revealed her findings. The same day she held a press conference, asking the government to release the results of tests on the hospitalized butcher and to explain what was killing chickens in such terrifying numbers. For Malinee's efforts, Deputy Agriculture Minister Newin Chidchob accused her of being "irresponsible to the motherland" and endangering its economy. This attitude of aggressive denial went right to the top: a few days earlier, Prime Minister Thaksin Shinawatra dismissed the idea of a bird-flu epidemic as "fantasy and imagination," warning that such "exaggeration will damage the country's poultry exports and leave chicken farmers and workers in the field to suffer."

Those farmers are certainly suffering now. Bird flu has been detected in nearly half of Thailand's 76 provinces, and nearly 11 million birds have been culled across the country. In addition to young Kaptan, the disease is also confirmed to have killed another six-year-old boy. Twelve other people are suspected to have been infected, and seven of them have died.

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	Playing Chicken [January 26, 2004] Thaksin Shinawatra's government comes clean on the extent of avian flu in Thailand On High Alert [January 19, 2004] From Japan to Vietnam, Asian countries are culling millions of chickens infected with a strain of bird flu that can also prove deadly to humans. Can they prevent a pandemic? The Cycle of Death [April 7, 2003] SARS is only the latest in a string of epidemics to emerge from southern China Hong Kong's Fowl Problem [February 15, 2002] Hong Kong's latest bird flu scare points to a lack of Chinese cooperation More Related Items | Search all issues of TIME Magazine