By Jim Fisher-Thompson
Washington File Staff Writer

Washington - U.S. government officials and experts praised China before a high-level congressional commission February 24 for that country's efforts to combat the deadly H5N1 virus that has infected hundreds of millions of birds and could cause a pandemic if it becomes contagious among humans.

Erika Elvander, an official with the Office of Global Health Affairs in the Department of Health and Human Services (HHS), told the Congressional-Executive Commission on China (CECC) that the Asian giant has begun "to open up internationally" about the effect of infectious diseases like HIV/AIDS and avian influenza, more commonly called bird flu.

The virus first was identified in 1997 during an outbreak among fowl in Hong Kong.  Since 2003, it has infected 170 people who had close contact with poultry, 92 of whom have died of the disease.  Scientists fear the virus could mutate into a form that could be transmitted easily between humans - an even more pressing concern now that H5N1 has been detected in birds in 30 nations in East Asia and Central Asia, Eastern Europe, the Middle East and Africa.

According to Elvander, China especially is vulnerable because it is home to more than 15 billion domestic fowl - one-fifth of the world's poultry - with 60 percent of its population - 800 million people - living in close contact with the birds.  This situation maximizes the potential for human infection from birds and for human-to-human infection.

INCREASED INVESTIGATION AND REPORTING OF CASES

Elvander told the commission that lessons learned from previous infectious outbreaks in Asia have "encouraged China to recognize the need to investigate openly and report at least suspect human cases of H5N1."

"China has learned that openness about public health issues of global concern would not necessarily bring shame, but might actually bring financial resources … to improve China's public health surveillance and disease reporting networks so that epidemics may be prevented and contained, not left to fester quietly," she said.

The United States plans to be a partner in that effort, the HHS official said.  "While no specific [financial] amount is targeted at China as of yet, those decisions are being made as I speak."

Elvander said that in 2004 "HHS alone funded more than $34 million worth of bio-medical research and basic public health activities with China, and we foresee that figure increasing, not decreasing."

HHS also plans to expand its public health staff currently working in Beijing from seven members to 10 members, according to Elvander.   "It is our belief that by working with China as a partner to confront issues of public health importance such as avian influenza, we will be able to create an environment that … promotes scientific and bio-medical transparency and sharing of data," she said.

Dr. John Clifford, deputy administrator for veterinary services with the U.S. Department of Agriculture (USDA), commended China for "reporting detections" of bird flu to the international health community.

But he told the commission, "We also feel that [Chinese] officials need to be much more transparent and forthcoming with information on surveillance testing, disease control and eradication measures and related information."

According to Clifford, USDA has received $18 million "to advance collaboration with international organizations to help countries in southeast Asia take steps to enhance their veterinary infrastructure and adopt other practical, effective programs against Asian H5N1."  These funds are part of the Bush administration's recent pledge of $334 million to support the global campaign against bird flu. (See related article.)

FLU PANDEMIC PREPARATIONS

According to Bates Gill, an Asian specialist with the Center for Strategic and International Studies (CSIS), China "deserves some praise … [because its] central government leadership exhibits a strong political commitment to tackling the avian flu outbreak."

Gill told the commission Chinese authorities were making "good preparations for a possible flu pandemic."  He explained that the Ministry of Health formulated a plan in September 2005 that includes:

• Organizing and coordinating epidemic contingency measures;

• Ensuring health authorities "above the county level" will collect, register and deliver flu virus samples for testing; and

• Providing for a national system "to manage the surveillance information."

With this "strengthened emergency" planning, Gill said, "China is demonstrating a greater awareness of the need for a prompt and effective response … [to] potential avian flu outbreaks."

Gill also credited China with working more closely with the United States on bird flu prevention.  During a visit to Washington in October 2005, he said, Chinese Minister of Health Gao Qiang signed a partnership agreement with HHS that strengthens bilateral collaboration "on emerging infectious disease including avian flu, HIV/AIDS, and West Nile virus."

Gill said the U.S. government pledged to help the Chinese upgrade their testing laboratories, train "biomedical research, prevention and control personnel," conduct disease surveillance and cooperate on the development of a potential bird flu vaccine.

China also has demonstrated "greater openness and commitment" on the international front as well, Gill said.  In January, the Chinese government hosted an international conference on bird flu in Beijing where $1.9 billion was pledged to fight the spread of the virus, with the Chinese government promising $10 million toward the effort.

"This meeting was another positive example of China's effort to become a more responsible global ‘player’ on international health issues," Gill said.

For more information on U.S. policy, see Bird Flu (Avian Influenza) and The United States and China.

The texts of remarks by Elvander, Clifford and Gill are available on the CECC Web site.