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Rutgers Model United Nations 2008 Delegation: France Committee: World Health Organization Topic: Pandemic Preparedness Delegate: Aaron Himelman and Ishan Thakore EAST BRUNSWICK HIGH SCHOOL 2 From 2003-2008, there were 387 reported cases of avian flu worldwide, with scores more awaiting transfer from poultry and livestock (“Cumulative Number” 1). However, avian flu is only one of sixteen recognized pandemics by the Epidemic and Pandemic Alert and Response (EPR) branch of the World Health Organization (WHO), with each occurring in more frequent numbers (“WHO Global Influenza Preparedness Plan” 5). In today's modern age, pandemics spread faster to more diverse populations, via air travel and increased mass transit. Pandemics like Ebola, a virus, have devastated African nations like the Democratic Republic of the Congo, with every 2 out of 3 cases resulting in deaths, and no confirmation of the actual source. (“Ebola Outbreak Chronology” 1). France is deeply concerned with the pandemic issue, and is committed to encouraging further preparedness. In order to combat such a global issue, France wishes to take an international framework approach, with global standards that can meet individual state needs. A pandemic develops when a nation is unable to contain a disease or illness before it spreads to a wide area, like with avian flu in Southeast Asia (“Alert and Response Operations” 1). Pandemics also spread rapidly; the SARS epidemic spread to forty countries within ten days, and had a mortality rate of up to 18.2% (Apostolopoulos 174). With the BBC estimating 150 million deaths from an influenza outbreak, other epidemics have the possibility of worldwide devastation (Garoon 1). Factors such as political indifference, inadequate health infrastructure and limited resources all contribute to pandemics, explaining the resurgence of diseases like polio and plague in Sudan and Asia (Apostolopoulos 169). Moreover, fear caused by infectious contaminations can “underscore the crucial role of rapidly mobilized health information systems” 3 (Apostolopoulos 169), preventing the WHO or other national health groups from acting. For instance, China prohibited the WHO from entering the country during the initial outbreak of SARS, and even prevented access to patients when the WHO did inspect the region (Apostolopoulos 170). Furthermore, prioritizing vaccinations or medication in developing countries contributes to the spread of disease, as not enough of the population is vaccinated. For example, 69.9% of Africans infected with HIV do not receive proper drugs or treatment, continuing the spread of the HIV virus (Hunter 45). In terms of developed nations, pandemics have the capability to ravage economies and businesses, by infecting workers and even preventing tourism. SARS infected 438 people in Canada, killing 43, and costing the economy $419 million, according to the Tourism Commission (Osterholm 2). Even international flights between Hong Kong and the United States dipped 69%, resulting in millions of lost profit (Osterholm 2). All of these events occurred only within a relatively short time frame, highlighting the impact a yearlong epidemic would have (2). Other epidemics have had similar effects in Africa, such as HIV/AIDS. 1.5 million died in 2007 from the virus in Africa alone (“Worldwide HIV” 1), causing food output to decrease by almost twenty percent in Zimbabwe, as well as worker layoffs (“The Impact” 1). The WHO is imperative to curbing this global issue, before it reaches catastrophic levels. As an active participant of health development, France is well experienced on the issue of pandemic preparedness. France currently has a three part plan designed to “protect the French mainland and overseas population as well as protect citizens abroad” (“National Plan” 4). Using the basic outline from the WHO Influenza Pandemic Report of 2005, France details what should be done in each of the six phases outlined in the 4 WHO report (“National Plan”4). These six phases are a part of the WHO’s system of identifying the level of an influenza pandemic, with level six entailing a worldwide pandemic (“WHO Global Influenza Preparedness Plan” 6). One of the most important strategies in France’s plan is delaying the peak of pandemic activity, allowing for enough vaccines and anti-viral drugs to be produced in order to minimize the deadly effects (“National Plan” 4). France also hopes to stretch the peak of pandemic contamination out so that enough resources, such as hospital care, are never overburdened for the public use (“National Plan”5). Moreover, France has begun to develop pre-pandemic vaccines against the growing threat of avian flu, although pandemic vaccines can only be efficiently created when the strength of the actual outbreak is known (“National Plan”11). In preparation against the avian flu, France has conducted mock drills to train its public officials how to act (Sector 1). During a recent 2006 drill, the drug company SanofiPasteur was also on standby, ready to produce the Tamiflu vaccine (Sector 2). France’s current policies have been successful so far, with no significant epidemic cases since 2006, according to the WHO (“EPR:France” 1). Furthermore, France continues to cooperate fully with the WHO, with 31 collaborating centers designed to assist the WHO (“EPR:France” 1). After reinforcing partnerships with CIRAD, Institut Pasteur, and the IRD, France has committed a total of €39.5 to this cause (Chippaux 1). France also continually strengthens the activities of these independent scientific organizations in its developing African and Asian allies, donating a total of €12.5 million to the Pasteur Institutes in these continents (Chippaux 1). In order to become effectively prepared when a pandemic of great magnitude occurs, France believes that the cooperation of the international community is 5 needed, yielding when necessary to the authority of the WHO. Currently only thirty-six UN member states have developed pandemic preparedness plans (Garoon 1). However, France believes that each individual nation must develop a concrete national action plan to prevent a breakout and effectively react to one based on its own specific needs. These plans, with actions relating to the six pandemic stages, should be held up to the requirements of the WHO Influenza Pandemic Report of 2005, and should be completed by the year 2012. In specifically dealing with the issue of prioritizing vaccinations in the case of a pandemic, France believes that those most at risk of developing complications are in need of the first vaccinations. According to the Institut Pasteur, two main objectives are to “combat morbidity” and to “fight mortality,” (Chippaux 1) meaning that measures must first be taken to limit the spread of the illness, while those most likely to die have the ethical right to be vaccinated first (Chippaux 1). As a result, priority is encouraged to be given to those most in need of a vaccination. These include medical and public health workers that are dealing with the pandemic, in addition to those aged sixty-five and over, pregnant women, and infants aged six to twenty-three months (“HHS Pandemic Influenza Plan” 62). France would look to both stall the spread of the pandemic and lengthen out its peak, creating a circumstance in which not everyone is in need of supplies at the same time. By noting this, France recognizes that the vaccines must be first sent into the area of the pandemic outbreak, donating the majority of its resources into ‘the hot zone’ to ensure that the pandemic does not reach its own borders. However, France recognizes that not every nation is economically equipped to handle a pandemic, and thus 6 recommends that 0.7% of the country’s GDP be donated to the WHO’s efforts in case of a pandemic. The fact of the matter is that viruses and bacteria recognize no political boundaries, and that the rich cannot avoid from the problem, as clearly evidenced in history through the Black Plague. Even before a pandemic breaks out, however, each nation must be prepared to react and must allow for transparency. Moreover, newer pandemics like avian flu and SARS demand the need for more stringent sanitary and import regulations. As a precaution, chickens and livestock grown in Southeast Asia should pass more stringent tests by customs officials in those countries. Also, the WHO recommends that countries perform mock drills involving the distribution of Tamiflu, personal protective gear and vaccinations in the case of an outbreak. Such a drill, like the one conducted in France, was also effectively performed as Panstop 2007 in the South Pacific (“Rapid Containment…” 1). Furthermore, pandemic treatment and handling in the case of an outbreak should be eventually handled by the WHO, serving as an unbiased third-party to help resolve the issue. Being an international organization, the WHO can pool together resources from member nations to help treat a region, rather than that one country attempting to solve the crisis individually. Such an issue occurred in China during the SARS pandemic, in which WHO intervention “might have been able to prevent its spread to the rest of the world," according to Executive Director of Communicable Diseases, David L. Heymann (Bork 1). Such international cooperation is needed to forgo a crisis, allowing a more experienced organization to handle the situation. The issue of pandemic preparedness has become a major global concern, prompting the need for international cooperation. Regardless of political ties or 7 geographical boundaries, a pandemic can strike at any time, resulting in casualties and devastating effects. However, with the proper planning and the assistance of the WHO, a global crisis can be quickly and effectively handled, or safely averted. France is fully committed to working with other nations to solve this most pressing issue. 8 Works Consulted Apostolopoulos, Yorghos, ed. Population Mobility and Infectious Disease. New York: Springer, 2007. Bork, Ellen. “China's SARS Problem, and Ours.” The Daily Standard. 4 March 2004. Online. Internet. <http://www.weeklystandard.com/Content/Public/Articles20 /000/000/002/504jlpnl.asp> October 28 2008. 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