The threat of a pandemic stems from the H5N1 bird flu virus, which surfaced in 2003, is enternched in parts of Asia and Africa, and has killed hundreds of people while causing billions of dollars in losses. This is nothing compared to the massive outbreak among humans that would follow the emergence of a new strain of influenza to which almost no one would have natural immunity, experts say.
Similar events have already unfolded: The Spanish Flu of 1918, which may have killed some 50 million people, is thought to have begun when another strain of bird flu crossed over into the human population.
"Because such a pandemic would spread very quickly, substantial efforts need to be put into place to develop effective strategies and contingency plans that could be enacted at short notice," says the bank.
In June 2006, the agency anticipated costs of 3.1 percent of global GDP or about two trillion dollars. Its more calamitous assessment, completed in recent weeks, comes ahead of international talks to be held in Egypt next week.
Poorer nations face the greatest risk.
"Generally speaking, developing countries would be hardest hit, because higher population densities and poverty accentuate the economic impacts," bank economists Andrew Burns, Dominique van der Mensbrugghe, and Hans Timmer write in the latest estimate.
In their current estimation, a "mild" pandemic, like the Hong Kong Flu of 1968, could kill some 1.4 million people and cut global GDP by 0.7 percent in the first year. A "moderate" pandemic, similar to the Asian Flu of 1957, could claim 14.2 million lives and cut global economic output by 2 percent in the first year. The "severe" worst case, in which 71 million or more could die, would slash global GDP by 4.8 percent.
Some of the loss would result from deaths and infections, which could affect 35 percent of the population and would prompt absences from work. However, says the bank, "people's efforts to avoid infection are five times more important than mortality and more than twice as important as illness."
Most of the cost would arise because people would change their behavior in hopes of avoiding infection, it says.
The bank assumes that fears of contracting disease in the close confines of an airplane would push down air travel by 20 percent during the first year of a severe pandemic, with similar declines in tourism, mass transport, and restaurants.
"The assumed 20 percent declines are well below the peak decline of 75 percent in air travel to Hong Kong during the SARS epidemic and an average decline of 50-60 percent during the four-month period the outbreak was active," the report says.
Since it is virtually impossible to say when and to what extent a pandemic will sweep the globe, the bank cautions that its latest scenarios are "purely illustrative."
"They provide a sense of the overall magnitude of potential costs. Actual costs, both in terms of human lives and economic losses, may be very different," it says.
Participants in the Oct. 24-26 Sixth International Ministerial Conference on Avian and Pandemic Influenza will be confronted with the bank's estimates and asked to commit some $500 million, the annual amount the United Nations says is needed to fend off and prepare for a potentially ruinous outbreak.
International donors have pledged $2.7 billion -- and delivered $1.5 billion -- to buttress affected and at-risk countries' own spending on the fight against bird flu in the five years since the highly pathogenic disease broke out in Southeast Asia and spread across Asia, Europe and Africa, according to a joint World Bank-UN report prepared for next week's talks.
Vaccines have been developed, poultry has been slaughtered from Hong Kong to Britain, public awareness has been raised, and health personnel are being trained to distinguish bird flu among humans from other ailments with similar symptoms.
As a result, so far this year the world has seen "fewer outbreaks in poultry, fewer newly infected countries, fewer human cases, and fewer deaths compared to the same period in 2006 and 2007," says the "Fourth Global Progress Report on Responses to Avian Influenza and Pandemic Readiness."
More than 50 of the 61 countries that have suffered outbreaks of H5N1 have succeeded in eliminating the disease but "the virus remains enternched in several countries and the threat of further outbreaks...in poultry (and sporadic cases in humans) persists," the report says.
However, it warns: "Even with such efforts, an eventual human pandemic at some unknown point in the future is virtually inevitable."
Since December 2007, according to the bank, new outbreaks have been confirmed in Bangladesh, Benin, China, Egypt, Germany, India, Indonesia, Iran, Israel, Myanmar (also known as Burma), Poland, Russia, Turkey, Ukraine, and Vietnam. The disease has affected chickens, turkeys, geese, and ducks.
Other animal viruses that have afflicted and killed humans include SARS, HIV, Ebola, and West Nile.
Seasonal flu epidemics result in 250,000-500,000 deaths a year, mostly among the elderly, according to the World Health Organization.
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