works against such integration. Better coordination between public and private funders of research and disease surveillance will be necessary.

Explore Compensation for Preemptive Culling of Animals5

As is the case with surveillance, encouraging farmers (or even entire countries) to curtail or prevent a human pandemic by sacrificing their poultry or livestock is in the interests of global public health. A variety of options should be explored to support this outcome in a variety of settings, from individual farmers in low-resource settings to industrial poultry and livestock producers in wealthy countries.

Promote the Use of Rapid, Inexpensive Influenza Diagnostics6

Cheap, simple diagnostic tests would improve influenza surveillance in animals and humans. Polymerase chain reaction (PCR) testing is the best current option, but the international veterinary community has yet to adopt PCR. As a result, the first farm to be culled in the recent H7N7 outbreak in The Netherlands was delayed 4 days as officials waited for virus isolation results. Increased use and improved diagnostics for influenza will also promote more prudent and effective use of both vaccines and antiviral drugs.

Increase Demand for Annual Influenza Immunization and Antiviral Therapy and Prophylaxis7

Demand for influenza vaccine drives supply. After last year’s severe flu season and this year’s unanticipated vaccine shortages, the public may respond well to a pro-immunization campaign, perhaps one that introduces the hazards of pandemic influenza. It will be important to include in that message the distinction between the protective effect of an antiviral influenza vaccine and additional vaccination that would be necessary to respond to a pandemic strain. A similar argument can be made for increasing interpandemic demand for antiviral drugs, which to date have low demand. More interpandemic use of antivirals means the greater production and greater supply of them for use in an outbreak situation. Moreover, increasing physician experience with and public awareness of antiviral medications should support their effective use in responding to a pandemic.

5  

Buranathai (2004); Meltzer (2004); Soebandrio (2004); Webster (2004a).

6  

Koch (2004); Nguyen (2004); Swayne (2004); Webster (2004a); see Perdue in Chapter 5.

7  

Brown (2004); Fedson (2004a); Gellin (2004); Hosbach (2004); Nowak (2004).



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