What’s Next in the Sino-Viral War?

It’s been nearly two years since the last cases of SARS were reported in China. Since then, a new affliction has risen to take its place at the pinnacle of killer pandemics — avian flu. Also known as H5N1, the influenza virus is endemic to waterfowl and has shown a disturbing propensity during the past nine years to infect chickens and human beings. Avian flu is the Ebola of the poultry world, a hemorrhagic fever that induces profuse bleeding from every orifice of its winged victims. It can turn a chicken coop into a mass of goop and feathers in just two days. When the virus jumps to humans, it is far less grotesque in its presentation but almost as lethal, with a fatality rate as high as 33 percent. Since 2003, the geographic range of reported avian flu infection among chickens has increased steadily to include Cambodia, Indonesia, Romania, Russia, Thailand, Turkey, and Vietnam. Even more alarming, the number of human infections and fatalities has correspondingly increased; as of late January, there had been 83 deaths due to avian flu, almost all of them traced to close human contact with diseased birds. So far, only seven of those confirmed deaths have been in China, although there are rumors that the toll is actually more than 100.

Global pandemic prevention relies on the cooperation and openness of the nations at risk of infection. Naturally, international health authorities are concerned about full disclosure, especially given that China is home to 14 billion poultry and 1.3 billion people — 20 percent of the world’s fowl and folk. At the time of the 2003 SARS epidemic, the government was still publicly denying the existence of avian flu within its mainland borders. That was a ludicrous claim, seeing as how thousands of chickens were turned away from the Hong Kong border every year for testing positive for the presence of the virus. But as a result of the international exposure and ensuing embarrassment of the SARS coverup, China has made important strides. Among other measures, Beijing has launched the largest mass inoculation in history, as it attempts to vaccinate billions of birds against the flu. China has also been much more cooperative with the World Health Organization and foreign scientists in sharing data and information about outbreaks, even hosting an international conference on bird flu in Beijing in late January.

However, despite this tentative openness, there is still a troubling lack of transparency. Last July, the government halted the work of a lab in Shantou that had published a paper in the journal Nature linking the spread of avian flu from poultry in southern China to migratory birds in the western province of Qinghai. At least six Chinese journalists who sought to cover the Qinghai outbreak were detained and forbidden to continue their reporting. Not only is information still restricted, there are also logistical hurdles to overcome in the fight against avian flu. More than a dozen Chinese companies have been fined for distributing unauthorized vaccines. And although the inoculation program is ambitious, its efficacy will depend a great deal on implementation in a country where chickens are raised in close quarters with humans in a million villages. Vaccinators often don’t wear gloves and goggles when handling the birds, and they dispose of needles carelessly, possibly spreading the virus.

Last fall, Chinese Premier Wen Jiabao toured an avian flu vaccine factory. "Just as we conquered the SARS epidemic in 2003," he declared, "we will surely conquer bird flu as well." A lofty goal, but can the means match the end? Not likely. China’s problem is with the system itself. The apparatus that allowed for the suppression of information about SARS cannot really be overhauled as long as information about infectious disease outbreaks is still considered a state secret, and publicly revealing it a form of treason, punishable by a lengthy reeducation sentence, or even death. Then the casualty list would not only consist of those infected; it would include victims of the government, too.