Table of Contents:

Foreword

Introduction

I. Storm Gathering

1. 1918

2. Master of Metamorphosis

3. H5N1

4. Playing Chicken

5. Worse Than 1918?

6. When, Not If

II. When Animal Viruses Attack

1. The Third Age

2. Man Made

3. Livestock Revolution

4. Tracing the Flight Path

5. One Flu Over the Chicken's Nest

6. Coming Home to Roost

7. Guarding the Henhouse

III. Pandemic Preparedness

1. Cooping Up Bird Flu

2. Race Against Time

3. Tamiflu

IV. Surviving the Pandemic

1. Don't Wing It

2. Our Health in Our Hands

3. Be Prepared

V. Preventing Future Pandemics

1. Tinderbox

2. Reining in the Pale Horse

Topics

References 1-3,199

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State agriculture and industry officials stage photo opps

With between 30,000 and 50,000 birds commonly found in each unit on intensive poultry farms, mass culling means significant financial loss.2158 There are facilities in Thailand reported to each have more than ten million chickens.2159

According to the Thai Broiler Association, Thailand was the world’s fourth-largest poultry exporter before bird flu hit,2160 producing more than a million tons of meat every year and generating four billion in U.S. dollars in revenue.2161 At the center of the meltdown of Thailand’s poultry industry is 61-year-old multibillionaire Dhanin Chearavanont, profiled in Time magazine’s “The Families That Own Asia,”2162 who brought the U.S.-style industrial chicken farming pioneered by Tyson to Thailand2163 more than 20 years ago, transforming a small family business into a multinational corporate empire.2164 Chearavanont was the Thai tycoon caught making an illegal $250,000 donation to the U.S. Democratic National Committee in 1996. Not to be partisan, he stands accused of slipping former George H. W. Bush a quarter-million dollars as well.2165

In November 2003, chickens started dying across Thailand. Senator Malinee Sukavejworakit, a medical doctor and representative of one of the worst affected provinces, became concerned. The government assured her that it was just chicken cholera—a disease with no human health implications—and therefore nothing to worry about. The third week of January, she got a call from a physician colleague about a local butcher dying with classic bird flu symptoms. The senator visited him in the hospital. “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 said. “They smelled rancid.” She visited the devastated farm. “[W]hatever this is,” the farmer told her, “it isn’t cholera.” When the Public Health Department refused to release the butcher’s test results, she decided to go public.2166

As chief advisor for the Senate Committee on Public Health, Sukavejworakit convened a meeting and held a press conference the next day. For her efforts to expose the truth, the Deputy Agriculture Minister accused her of being “irresponsible to the motherland.” The Prime Minister himself 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.”2167

Chearavanont wasn’t suffering, though. Throughout the crisis, while birds were dying, corporate processing plants were working overtime. “Before November we were processing about 90,000 chickens a day,” trade unionists explained to the Bangkok Post after the scandal broke. “But from November to January, we had to kill about 130,000 daily. It’s our job to cut the birds up. It was obvious they were ill: their organs were swollen. We didn’t know what the disease was, but we understood that the management was rushing to process the chickens before getting any veterinary inspection. We stopped eating [chicken] in October.”2168

Later it was divulged that the nation’s veterinary scientists had been detecting and reporting H5N1 for months to Thailand’s Livestock Department, but as one senator alleges, “All the academics and experts had to shut up due to political interference.”2169 The Bangkok press found evidence that the government had been colluding with Big Poultry2170 to hide the epidemic to give exporters time to process and sell diseased inventory.2171 An editor at the Bangkok Post later explained to a group of journalists why the press didn’t pick up on the cover-up sooner. “Our tendency is just to report what people are saying and rely too much on the government,” she said. “As it turned out, the government was suppressing the truth.”2172

The international community was not surprised. “The bottom line is, economic considerations are what dictate the responses of the governments trying to ensure the consequences of avian outbreak is minimized,” said WHO’s representative in Thailand. “That’s understandable, but it’s more important that sufficient measures are taken to prevent humans from catching the disease.”2173 A six-year-old boy was the first to die of H5N1 in Thailand. “The government knew,” his father said, “so why didn’t they tell the public so that we could protect ourselves?”2174

This scenario was repeated throughout the region. An outbreak in Japan was concealed by poultry company officials—two of whom later committed suicide2175 —and only came to light thanks to an anonymous tip. The Japan Times editorialized that the factory farm—one of the largest in the area—was apparently “concerned more about profit than safety.”2176 After Indonesia’s national director of animal health disclosed to the Washington Post that pressure from the poultry industry forced the government to hide its outbreak for more than a year, she was fired. When UN officials complained about the dismissal, the Agriculture Minister replied, “The thing is, we don’t want to publicize too much about bird flu because of the effect on our farms. Prices have dropped very drastically.”2177 He withheld information, he explained, because “we did not want to cause unnecessary losses through a hasty decision.”2178

The deputy director of Focus on the Global South, a nonprofit advocacy organization, summed up the Thailand scandal:
The government handling of the bird flu is a saga of cover-ups, incompetence, lies and extremely questionable decisions: the long delay before admitting the existence of the bird flu both in animals and in humans, the selective measures taken to stop the spread of the epidemic and most spectacularly, the massive public relations campaigns to convince Thai citizens that eating chicken was nothing less than a patriotic act.2179
The director is referring to numerous PR stunts across the region. The Thai government gathered celebrities2180 for free “chicken eating festivals,”2181 and Kentucky Fried Chicken in Thailand gave away 50,000 pieces of chicken.2182 In China, the executive vice minister of health—a vegetarian—ate chicken for the first time in 30 years to proclaim its safety. China’s main propaganda unit acknowledged that the staged meals suggested an official shift “from traditional propaganda to Western-style political communications skills to handle crises.”2183 The strategy was perhaps made most famous by the British Minister of Agriculture who was shown on television feeding a hamburger to his four-year-old daughter while reassuring the public with the blanket statement that eating beef was “perfectly safe,” a few short years before young people started dying from mad cow disease.2184

Not all such media events had the desired effect. At a cull ceremony at a pig farm in Indonesia, the Minister of Agriculture showed up in a special white outfit complete with gloves and mask, surprising the staffers, reporters, and hundreds of locals who wore no protective gear at all. “Don’t blame me if you get bird flu because you don’t wear a mask. This is very dangerous, you know, as the virus can be transmitted through the air,” he warned reporters through his mask.2185

The official state cover-ups surrounding bird flu remind many of the SARS debacle in China. All occurrences of infectious disease outbreaks were considered official state secrets; physicians or journalists caught disclosing SARS-related information to their friends were arrested under the official State Secrets Law.2186 By the time China finally admitted there was a problem—months after the first discovered case—there were already hundreds of people infected.2187 In general, said a WHO spokesperson, “Economics and agriculture are weighing too heavily in decisions taken by governments, and more concern should be given to the risk to human health.”2188

This is one of the reasons that the prospect of ring-fencing an influenza pandemic in time is so remote. “If they would have acknowledged this [SARS] early, and we could have seen the virus as it occurred in south China, we probably could have isolated it before it got out of hand,” explained one infectious disease expert. “But they completely hid it. They hide everything. You can’t even find out how many people die from earthquakes.”2189 The foundation of the theoretical models is openness and cooperation for rapid detection of outbreaks of influenza. “Would they admit to it if it was here?” one Asian diplomat asked. “That’s the big question, since they deny everything left, right and center.”2190

Reluctance to share data seems a universal phenomenon. In an article in the journal Science titled, “Flu Researchers Slam U.S. Agency for Hoarding Data,” international scientists claim that getting data from the CDC is somewhere between “extremely difficult and impossible.”2191 “The CDC is not the CIA,” the director of the Federation of American Scientists’ project on government secrecy said. “Withholding data is not just bad public policy, it is bad science.”2192

During a 2004 outbreak of low-grade bird flu in Delaware and Maryland, state authorities refused to release the identity of the affected poultry operations. “The stigma attached to having an infectious disease is real,” explained one North Carolina State University veterinarian in Poultry International,2193 “and often leads people to keep this information from others.” A spokesperson for the group Common Cause in Delaware, however, disagreed with the policy. “When you’re talking about a worldwide problem, you really can’t keep things secret even if you think it’s good public policy. People want to know, and they want their government agencies to be honest, open and transparent.”2194

Even when governments try to do the right thing, the populace may not go along. When H5N1 hit turkeys in Turkey, the order, “Bring your poultry to the town square this evening for slaughter,” blared from town hall speakers. “Failure to comply could mean up to six months in jail.”2195 When authorities went to forcibly round up ducks and chickens in the region they were reportedly met by hostile farmers armed with pitchforks and axes.2196

Part of the problem may be that existing international law on infectious disease control is archaic, formed a half-century ago before mass global travel. The World Health Organization, for example, can only issue “soft law” recommendations, rather than binding obligations. This outmoded system of international relations in general dates back to the 17th-century Peace of Westphalia ending the Thirty Years War. The Westphalian system is built upon the principle of absolute national sovereignty.2197 “Many governments see it [disease prevention] as an internal business,” said the WHO’s Director-General. “There is a basic gut feeling that this is my problem, I will deal with it in my way. Now, in a globalized world, any disease is one airplane away. It is not a provincial or national issue, it’s a global issue.”2198

The World Trade Organization has more powers than the World Health Organization.2199 Analogous to FEMA during the Katrina crisis, the WHO also lacks the authority to investigate outbreaks without an invitation.2200 For SARS, though, the WHO did issue the first travel advisory in its 55-year history.2201 The ensuing political backlash over lost trade and tourism may explain some of the deference to member nations in somewhat downplaying the immediacy of the current pandemic threat.2202 Finally, some argue, the WHO is under-funded, with an annual core budget of $400 million. By comparison, the annual budget of New York City’s health department exceeds $1.2 billion.2203 In the understated fashion typical to international law journals, one review concluded, “The soft law process on infectious disease control has not been working well.”2204