What are the problems with focusing on avian flu as the APHA’s primary action issue? To summarize a longer essay that many have already received:

·         Avian flu has infected only about 250 people worldwide, and it is by no means sure that this H5N1 bird flu will cause the next pandemic.

·         The last pandemic in 1918 killed 40-100 million people, but the deaths were much higher among the poor, both in the United States and worldwide. The same disparities in underlying health, health care and public health infrastructure exist today. Without an attack on these disparities, no effort to limit the harm from a flu epidemic will be very useful.

·         Even in the United States, social distancing and the means to guarantee that people can remain out of school and work while maintaining nutrition and access to medical care is the most important epidemic control measure. Our lack of a social safety net, health insurance, public health and medical care cuts make this unfeasible.

·         The main prevention needed is support of poor nations where bird epidemics take hold, with compensation to farmers, assurances of equal access to vaccines, and assistance with research, all of which is vastly underfunded.

·         The U.S. government’s main plan for epidemic control is militarily enforced quarantines, which is of medically limited use, but useful to continue the militarization of public health and many other aspects of our society.

·         During the last epidemic during WWI, the priority given to war over U.S. or world health was largely responsible for the spread and the severity of the illness.  The current war in Iraq and likely future wars against Iran and China make this scenario likely again.

The way for APHA to fight epidemics of flu or any other health problem is to continue the fight for universal coverage, expand the public health infrastructure, fight racism and health disparities, and oppose war and the militarization of our public life.  We should demand more of our organization on these fronts and not permit these emphases to be lost. 

Ellen Isaacs