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Unformatted text preview: www.sciencemag.org SCIENCE VOL 303 12 MARCH 2004 1605 CREDIT:P.VIROT/WHO G ENEVA Klaus Sthr does not seem to be enjoying himselfeven though its his birthday. Looking pale and almost gaunt at 8:30 on a Friday morning, Sthr sighs as he sits down for the first of several daily meetings. The topic, as it is every day lately: the avian influenza outbreak thats sweeping through Asia. Swiftly, Sthr and a dozen colleagues at the World Health Organization (WHO) Headquarters here run through todays action points. Can WHO provide guidance for the treatment of human patients? Thats difficult, Sthr says. Clinical infor- mation about the more than two dozen patients so far is limited; many have died and have been buried be- fore samples could be tak- en. Its very frustrating, Sthr says. Next: Whats the latest with develop- ment of a vaccine? How many antiviral tablets are currently available for those culling chickens? Can somebody rapidly produce a chronology of the outbreak, which a New York Times reporter has re- quested? Although far removed from the Asian poultry farms where the H5N1 virus is raging, WHO has become the worlds nerve center for the battle against avian influenza and, for that matter, any other newly emerging disease. Since 2000, WHOs de- partment of Communicable Disease Sur- veillance and Response (CSR) has coordi- nated a global network of labs and other or- ganizations dedicated to stopping infec- tions. Together, they act as a planetary fire brigade, constantly on the lookout for out- breaks and ready to fight them before they spiral out of control. Thats a far cry from the situation of 10 years ago: Typically, a multitude of agencies would join the fray when a disease broke out, usually without much coordination. Its also a big transition for WHO, says Sthrs colleague Mike Ryan, who manages the global outbreak response. Traditionally seen as a bunch of shiny-arsed administrators in Geneva focused on science but aloof from the chaos on the ground, the agency has now taken a more hands-on approach, says Ryan. But in the age of globalization, when each new pathogen is just a plane ride away, the shift to a global system was inevitable, experts say. And they add that last years se- vere acute respiratory syndrome (SARS) outbreak demonstrated that WHO can han- dle the job. Theyve earned a lot of new re- spect with that, says C. J. Peters of the Uni- versity of Texas Medical Branch in Gal- veston. I hope they can keep it, because well need them more and more. The idea for a global disease watchdog arose during the 1990s. Until then, the ap- proach was a bit haphazard. Rich countries organized their own control efforts when a disease erupted unexpectedly; poorer nations often called in foreign agencies such as the Pasteur Institute or the U.S. Centers for Dis- ease Control and Prevention. (CDCs field- work on new and scary microbes is leg- endary.) But many other parties flocked toendary....
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