Swine Flu

Every few decades, a flu pandemic spreads westward from Asia. The last one, in 1968, was relatively mild - and we have yet to see the full damage caused by the swine flu outbreak. But the next pandemic is inevitable - and it's likely to come from China.


“WATCH, we are going to have an international crisis, a generated crisis, to test the mettle of this guy,” Joe Biden warned during the 2008 presidential campaign. The vice president of the United States was all but declaring that a terrorist attack would mark President Barack Obama’s first six months in office.

Biden was wrong of course. Bioterrorism aside, Al Qaeda does not appear to be behind the latest outbreak of swine flu that has infected people in 20 countries as far flung as France, Canada, New Zealand and South Korea. The WHO has declared a “public-health emergency of international concern” and may well be compelled to raise that alert to a full-blown pandemic in coming days. If that happens, it would be the first pandemic of flu in 40 years, and the resulting crisis may yet be one of the toughest Obama is likely to face as president.

Every quarter century or so, a flu pandemic spreads from influenza’s heartland – Asia. In 1889-90, a virus swept westward from Asia to Russia, killing an estimated 250,000 people in Europe alone. In 1918, following four years of human misery caused by World War I, the “Spanish flu” wiped out 40 million people within a year, surpassing even the Black Death of the Middle Ages in mortality.

The last two pandemics, in 1957 and 1968, were relatively mild. Statistically speaking, therefore, we’re due for another scourge, which could well be catastrophic. No one knows when, where and just how the next pandemic will unfold. What’s certain is that it will. And it will have its share of surprises.

As with mass graves, the one rule about flu epidemics is to expect the unexpected. Who could have guessed, for example, that North America would be the epicenter of the current swine flu. Americans who blame Mexico – or indeed, Muslim terrorists – for it should note their own nation was the focal point of the 1918 Spanish flu pandemic. That infection did not come from Asia. Its first eruption was at a military barracks in Kansas during the spring; by September the virus had swept Boston, coastal France and Freetown, the capital of Sierra Leone. In Philadelphia, some 7,500 people died in two weeks, many within 24 hours. The city ran out of coffins and streetcars served as hearses. Those who narrowly escaped death spent weeks in delirium.

Still, when Westerners think of the flu, they tend to think of Asia. After all, that’s where poor people live in close, often intimate proximity to farm animals. But the proximity itself isn’t the problem. Neither is poverty necessarily to blame. The problem is poor farming practices – and the real scandal is that international financial institutions such as the Asian Development Bank and the World Bank do nothing to put an end to them.

When flu first crossed the species barrier from birds to humans in 1997 in China, the world was fed media images of domesticated pigs and ducks cramped into cages strategically located over ponds full of farmed fish. The caged animals are fed; the fish live off their feces. Think about that the next time you eat Chinese-exported carp or order “Chilean” sea bass at your local green restaurant.

This isn't some clever way to recycle but a grotesque form of animal husbandry. And although it’s hardly limited to China, the world’s most populous nation is by far its biggest and most dangerous practitioner. In its ruthless pursuit of double-digit economic growth over the past two decades, China has neglected its rural areas so sorely that the poor often have no choice but to exploit animals to eke a living.

And with what devastating consequences for public health. At the University of Hong Kong, scientists have performed blood tests on birds, animals and farmers in Hong Kong’s semi-rural New Territories and in the Chinese mainland province of Jiangsu and the Pearl River Delta. Their finding: Particularly in the latter two places, farmers have antibodies that suggest they have been exposed to every single strain of flu found in animals.

As these viruses circulate among Chinese farmers, they will sooner or later pick up human flu genes, adapt and mutate. Once a new virus becomes capable of airborne transmission from one human to another, the results will be as devastating as the Spanish flu, which killed one in 60 of the entire world’s population. SO WHERE does Obama – and the United States – fit into all these dire scenarios? Is there anything that the world’s most powerful human being can do to protect us from the vagaries of nature -- albeit nature that humans have tinkered with?

Although it's surely too late to reverse the damage done to the health of China’s farmers and to its ecosystems, Obama can certainly insist that China’s rulers pay more attention to rural development. Indeed, there has never been a better time. As the world grapples with the worst economic meltdown since the Great Depression, it hardly makes sense for China to continue to rely on an urban-centered export economy that’s not only unlikely to recover anytime soon but is one of the key reasons why we’re all in this mess today.

But that's another story.