Are we prepared for a pandemic?

Sceptics abound, convinced that talk of a pandemic must be scare-mongering, or scientists crying wolf. Surely with support care, drugs and vaccines, at least the rich world can easily stand up to a flu virus? After all, this is 2005, not 1918, when a flu pandemic killed up to 50 million people worldwide. But while the science and medicine of flu have advanced substantially, our ability to mount an effective public-health response has made remarkably little progress over the decades...

Over the past 300 years, ten influenza pandemics have occurred among humans. ... According to recent analysis, [the 1918-19 pandemic] killed 50 to 100 million people globally. ... Today, with a population of 6.5 billion [...], even a "mild" pandemic could kill many millions. The reality of a coming pandemic, however, cannot be avoided. Only its impact can be lessened. Some important preparatory efforts are under way, but much more needs to be done by institutions at many levels of society.

The world is obviously unprepared or inadequately prepared for the potential of a pandemic. ... Pandemics have been with us from the beginning of time and they will be with us in the centuries in the future. We haven't seen one for some 30 years and consequently we forget, but we cannot forget because ultimately they happen.

The probabilities of some sort of pandemic striking in the next decade are extraordinarily high. ...if we make an investment now in creating the infrastructure for vaccine production, strengthening the distribution system and the relationship between federal, state and local governments, those investments won't be wasted even if we're lucky and this particular strain of avian flu doesn't mutate, because we'll then be in a position to deal with whatever pandemic comes down the road.

But the real story isn’t how bad H1N1 was. The real story is that we are lucky it wasn’t worse because we were almost completely unprepared for it. ... Hopefully this outbreak will serve as a wakeup call to get us to invest in better capabilities, because more epidemics will come in the decades ahead and there is no guarantee we will be lucky next time. The 1918 flu killed more than 50 million people.