accomplished in the near term or, following additional research or resolution, in the future. What can be said and was echoed throughout the discussions—if the question is: “Are we ready for a pandemic influenza?,” the answer is “no.”

Addressing Unmet Needs

Close Gaps in Global Surveillance3

Many countries lack infectious disease surveillance capabilities. Disturbingly, some of the most glaring gaps in surveillance occur in Asia, where H5N1 avian influenza has infected and killed scores of people since 1997. Developed countries’ interests would be well served by funding improved influenza surveillance in such flu “hot spots.” In addition to increasing surveillance capacity, replacing the current economic disincentives to early reporting of disease with incentives for surveillance, timely disease detection, and access to vaccines and antivirals will greatly increase the chance of catching and containing an emerging pandemic strain before or soon after it emerges.

U.S. data on severe illness and death from influenza are also inadequate. Improved data would more effectively inform priorities for prevention and treatment investments and strategies made at the local, state, regional, and national levels (e.g., immunization and preparedness planning). Importantly, improved real-time surveillance and disease reporting could provide an early warning for an emerging pandemic outbreak.

Integrate Animal and Public Health Communities4

Influenza surveillance, research, and pandemic response planning should reflect the zoonotic nature of the disease. Improved communication and the development of professional relationships among veterinary and medical researchers and agriculture and public health officials would encourage a greater appreciation in both communities for the implications of animal diseases in human populations, and for human practices that promote or prevent zoonoses. Current lack of integrated funding for influenza surveillance within the animal and human populations collectively now


Buranathai (2004); Cox (2004); Gellin (2004); Gostin (2004a); Meltzer (2004); Stöhr (2004); Webster (2004a).


Cardona (2004); Nguyen (2004); Sibartie (2004); Stöhr (2004); Swayne (2004); Webster (2004a).

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