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The avian flu is migrating steadily westward and health experts are concerned about the lack of an integrated strategy to combat it. Millions of birds have died or been killed after outbreaks of the H5N1 strain of avian flu appeared in Southeast Asia in 2003. The virus has now traveled well into Europe (NYT): Confirmed cases have been diagnosed in Greece, Bulgaria, Italy, and Germany, while Slovenia, Croatia, Austria, and Denmark have also detected likely cases among birds. Meanwhile, experts say the first case of bird flu in Africa—detected on a farm in Kaduna in northern Nigeria (AllAfrica.com)—will soon lead to further outbreaks (BBC). The World Health Organization (WHO) provides a timeline of global H5N1 outbreaks (PDF) and the BBC offers a comprehensive map of countries dealing with bird flu.

To date, the latest spread has not led to human-to-human infections. But a new report released by the Australia-based Lowy Institute for International Policy estimates that a worst-case scenario bird flu outbreak could kill more than 140 million people worldwide and cost $4.4 trillion in lost global economic output (Reuters). For the time being, the H5N1 virus is hard for humans to contract, but scientists—like these four bird flu experts interviewed by cfr.org—warn the disease is steadily mutating (Independent). Nearly ninety people have died from bird flu since 2003, close to a 50 percent mortality rate. As a call to action, both Foreign Affairs and Nature magazines devoted special issues and websites on what could be the world’s “next pandemic.”

So how can governments plan against a global avian flu pandemic? Options are limited, experts say. According to a WHO report (PDF) on recommendations for preventing a flu outbreak, the main preparedness plans adopted by countries concentrate on fast-action response plans, vaccine development, and stockpiling antiviral drugs—all costly activities that only wealthy countries can afford. And even if medicines are stockpiled, developing vaccines for a newly mutated virus could take four to six months (NPR).

In November, over 600 experts met in Geneva for a meeting convened by the WHO, the UN Food and Agriculture Organization (FAO), the World Organization for Animal Health (OIE), and the World Bank. Their ten conclusions and twelve recommendations (PDF) included minimizing the threat of infection, developing “early warning” surveillance systems, regional preparedness plans, and technology-sharing for developing medical treatments. In a similar vein, President Bush’s National Strategy for Pandemic Influenza, released in October, requests $7.1 billion in emergency funding mainly for vaccines and drugs. A new Congressional Research Service report outlines U.S. and international responses to the spread of H5N1, while a conference hosted by CFR on the Global Threat of Pandemic Influenza tackles these issues in a series of panels and cfr.org’s resource page offers additional links with important information.