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SPEECH/04/405












David BYRNE

European Commissioner for Health and Consumer Protection



Combating emerging zoonoses: challenges and prospects at community level



















Conference on Infectious Disease: European Response to Public Health Risks from Emerging Zoonotic Diseases
The Hague, 17 September 2004

Introduction

I am pleased that the Presidency, with the support of the Commission, has organised a well researched programme for the Conference.

Avian Influenza in Holland

These proceedings are taking place against the backdrop of the devastating outbreak of Avian Influenza here in Holland last year. While the animal welfare issues and economic losses were enormous, the human implications were brought home very starkly in a European context for the first time.

Resolute action at the time by the Commission, and the Dutch, Belgian and German authorities, brought what was a serious situation back from the brink of being a tragic human catastrophe of huge proportions. Yet, we had one very regrettable death and over eighty human cases of avian influenza. And, we had clear evidence of human-to-human transmissions of the virus.

This crisis was a major wake-up call to European governments and policy makers.

We must learn the lessons of this episode, as well as from SARS and the current outbreak of avian influenza in Asia.

I have said very clearly that we need to develop an integrated zoonoses strategy embracing both human and animal dimensions. The realisation of this strategy must become a top political priority in the period ahead.

Putting in place a coherent, planned approach makes a huge amount of sense from an economic and human health point of view. We only have to consider the human tragedy costs, and political fall-out of playing catch-up with, for example, BSE.

I would like to outline to you a few personal reflections and policy proposals arising from my own direct involvement in the European and Asian outbreaks of the so-called bird-flu.

Transparency

Firstly, the issue of transparency. Unless farmers, producers, public and private authorities and everyone else involved are 100% open and transparent at all stages, then a bad situation can only get worse.

Look at China on SARS and Thailand on avian influenza as two classical examples of an absence of transparency and the ensuing consequences.

Precautionary measures

Secondly, the key need to have all aspects of risk analysis working at a premium - assessment, management and communication. Obviously, a correct diagnosis of the problem is essential at the outset. However, pending a formal, clinical confirmation, it may already be necessary to take immediate precautionary measures to halt the spread of the pathogen in question. Speed is of the essence.

EU Zoonoses Strategy needed

The taking and implementation of sound risk management measures is a pre-requisite to bring the disease under control and to stamp it out as quickly as possible. To achieve optimal performance, all key actors must be working to a well-rehearsed, pre-determined plan.

In the absence of a thorough EU-wide zoonoses strategy, I remain to be convinced of individual Member States’ capacities to deal optimally with zoonotic threats.

Preparation is, as we have learned, half the battle. An overall zoonoses strategy should address issues such as co-ordination, surveillance, response, investigation, reaction, culling, vaccines; the list goes on and on.

Communication

The third aspect of my personal reflection relates to communication with the public. This is a key area but also a potentially troublesome one. For example, the only solution to stamping out a zoonotic outbreak may be to cull millions of animals, including citizens’ pet animals. How do you explain this to a public which thinks that a vaccine or a pill is the cure for everything? This takes skill and courage, and an amount of political risk. But it must be done.

All stakeholders need to be involved in the communications exercise – from the political establishment right through to the person on the street.

Communication must be based on honesty and transparency. Even if the message may be unpalatable, it must be delivered openly and consistently. All aspects of communication must be clearly spelled out in the EU-wide Zoonoses Strategy and in national contingency plans.

Vets and Doctors

The fourth dimension of my reflection that I wish to share with you concerns the need for much greater co-ordination between the veterinary and medical professions in the context of zoonoses control.

The rationale for the creation of my Directorate-General was to bring together the public health veterinary and food safety experts under a unified system. There has to be greater inter-action between our doctors and vets to facilitate joined-up policy making. To bolster our public health function, I need to obtain the agreement of the Luxembourg authorities to have even a small public health presence in Brussels. In such conditions, pragmatic solutions have to be found. I hope, in the interests of the common EU good, we can find a mutually satisfactory solution so that we can develop a coherent EU approach to these issues.

Also, very often in our Member States, the vets and doctors are separated into Agriculture and Health Ministries.

At national level this needs to be recognised and adequate mechanisms put in place to ensure synthesis of approach between the two professions at Government level. Again this is something that the EU Zoonoses Strategy must address.

Pandemics

All of that said, it is one thing to speak of how to address an outbreak of a particular zoonoses, however big.

It is quite another matter to address a pandemic brought about by the convergence of human and animal influenzas, for example.

Here, we could be talking of the most devastating consequences. With the experience of three flu pandemics in the last century (1918, 1957, 1968), we could be on the eve of a 21st century calamity.

While we have witnessed the deaths of millions of animals in Europe over the past couple of years, are we prepared for the deaths of 10 or 20 million of our fellow citizens arising from the mutation of a human and animal virus that we cannot control?

I do not want to be seen as a prophet of doom. But I am obliged to ring the alarm bell as the European Commissioner for Health.

Plan against Pandemics

Political action in a most concerted way is needed to plan thoroughly and adequately. This is essential in the Union and I have already launched the process with the Commission’s ideas on pandemic influenza preparedness planning.

Our document stresses the benefits of improved interaction between human and veterinary influenza surveillance systems. We see the need to support a Community reference laboratory network in this area. We propose a mechanism to establish Outbreak Assistance Teams to be set up in collaboration with the Member States and to compare and co-ordinate national influenza plans.

The plan also calls for urgent work on vaccines and anti-virals for influenza that will involve industry and engage the Member States. The present situation is not satisfactory and gives rise to concerns about readiness for the next pandemic. Here again, more has been done on the veterinary side that can be usefully emulated in the human health sector. In this regard, our citizens will find it difficult to understand that we have a higher level of vaccine preparedness for animals than for people.

Collaboration on zoonoses does not stop at the animal health and public health realms, of course. Other sectors should weigh in, particularly those dealing with emergency plans and with research. Our influenza preparedness plan makes that clear.

We need also to recognise that we are not alone. We must be fully plugged in to international strategies through the WHO, FAO, OIE and others.

On our own doorstep, we need to ensure that our emerging Neighbourhood Policy – with countries in North Africa through the Middle East to the Urals – takes full account of pandemic planning.

And, in this sphere, we need to communicate with our citizens. The risks must be explained in a pragmatic and reasonable way. Strategies for vaccination must be implemented thoroughly against human influenza strains. But we should encourage awareness that a pandemic may not be controllable by vaccination alone.

Based on the Commission’s ideas, I want to develop, with the Member States, an agreed planning strategy to deal with health threats, including pandemics.

This strategy must embrace :

  • a triggering mechanism for various actions
  • a communication strategy for coherent messages and information dissemination
  • a command and control structure for EU co-ordination
  • a threat mitigation and consequence management capability
  • an internal consultation mechanism

Work on this strategy needs to be accelerated.

Intensive Agriculture

Let me say a final word on animal rearing practices. In the agricultural sector, greater account needs to be taken of the implications of intensive animal husbandry practices. Public health policy needs to have a much greater role to ensure human health protection.

Policies need to encourage a shift way from intensive rearing and to ensure the adequacy of risk management measures at farm and production unit level. These are issues that we also need to pursue at international level.

Conclusion

All in all, the issues brought into focus by this Conference are timely and hugely relevant. Inadequate pandemic planning could lead to major human and economic losses in Europe.

Sustaining and improving our very way of life into the future depends on the protections we put in place today.

Thank you.


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