Asian Countries Gear Up to Tackle Bird-Flu Threat

Across Asia, governments are slowly gearing up to battle a potential bird-flu outbreak among humans, and their preparedness -- more so than any measures in the West -- could prove critical to preventing a global pandemic.

While dozens of Western countries have been stockpiling antiviral drugs for months now, many countries in Asia have only just begun to seriously wrestle with the threat, even though most experts agree that any pandemic will likely begin in Asia.

In the U.S., the Bush administration is preparing to ask Congress to spend somewhere between $6 billion and $10 billion on vaccines and antiviral medicines, according to officials in Congress and the administration. But some experts say much of that could prove useless should an outbreak originate in Asia.

"If we don't stop the fire and put it out, the Tamiflu stocks anybody has -- that Roche could produce in an emergency -- would be futile," said Peter Cordingley, a spokesman for the World Health Organization in Manila.

The United Nations health agency, based in Geneva, estimates that it would have three weeks to swoop into the site of a nascent Asian outbreak and distribute hundreds, maybe thousands, of packets of Tamiflu, produced by Roche Holding AG of Switzerland, to try to slow or stem the spread of the disease.

Still, that plan relies on the ability of local health officials across the region to spot the disease and report it quickly -- a huge challenge given problems with health care and a reluctance to disclose information in many countries. The Philippine government, for instance, has no stockpile; China has covered up disease outbreaks in the past; and many countries in the region have scarcely begun planning beyond the first stage of a pandemic.

"What if the bodies are building up at the back of the hospital?" asked Mr. Cordingley. "How do you get the food from the market to the town?"

The deadly strain of avian influenza, known as H5N1, has killed some 60 people in Vietnam, Thailand, Cambodia and Indonesia since late 2003. While the vast majority of those cases were likely the result of direct contact with infected poultry, scientists have been warning for years that the virus could mutate into a form that passes easily among humans, unleashing a global pandemic that would kill millions.

In Indonesia, where dozens of suspected bird-flu cases in humans and six confirmed deaths from the disease have caught the government off guard, Australia announced it was donating funding for at least 400,000 tablets of Tamiflu to the country. At 10 tablets per person, Health Minister Siti Fadilah Supari said that "currently we have enough supply of medicine" to treat 40,000 people. Indonesian health officials have been reluctant to kill large swaths of infected flocks, despite the WHO's urging to do just that, because the government says it doesn't have enough money to compensate farmers for their birds.

William L. Aldis, the WHO's chief representative in Thailand, said the Thai government is working on what he called a "radical" plan to stockpile a number of bird-flu drugs in preparation for a possible pandemic that would be offered to neighboring countries if an outbreak occurred.

"In that way, even a small, poor country like Laos or Cambodia would have the benefit of a massive supply of drugs to stamp out the epidemic at the source," he said.

In China, the Ministry of Health released a bird-flu preparedness plan last week, and southern Guangdong province -- where severe acute respiratory syndrome, or SARS, first broke out a few years ago -- has already stockpiled 10,000 packets of antiviral drugs, according to a health official, who referred to the pharmaceuticals as "miracle drugs."

The province's health department has also begun organizing supplies of Chinese herbal medicines as a backup. "If the flu did hit Guangdong, the miracle drugs are surely not enough, so we have to rely on traditional medicines too," he said.

Singapore has stockpiled enough Tamiflu for the city-state's health-care workers. And in neighboring Malaysia, a national avian-flu committee has been set up to take measures such as stocking up on antiviral medication, vaccinations and protective gear to tackle a possible outbreak, which the country's health minister estimated would cost 500 million ringgit ($133 million).

The Malaysian government has also directed inspections be stepped up at border checkpoints to stop the smuggling of chickens from neighboring countries to prevent the spread of the disease.

In Japan, the Ministry of Health, Labor and Welfare has a plan to stockpile enough doses of Tamiflu for as many as five million people over the next five years, according to health officials in Tokyo, who also said the health ministry has dispatched quarantine experts to Vietnam and Indonesia.

The Japanese government has been quick to cull flocks of birds that may have been exposed to the virus. In June, for instance, an outbreak of bird flu on 31 farms northeast of Tokyo prompted officials to cull some 1.6 million birds. Health inspectors throughout the country regularly test chicken farms for the disease.