Donald G. Ainslie: I think all I would like to say here is that part of the issue that I see is that a lot of the developing countries' companies located there, the bottom line has been drawn and everything. Everything is now is outsourced and offshore. The reality is that I think the bigger risk is for the developing countries because what is going to happen, they are going to shut the boarders, close the boarders. You have prescription drugs; in the U.S. for example, more than 50 percent come from outside the U.S. You talk about the adjust time economy. Back in the 60's, a jolly green giant had a can of corn that from the time it was harvested from the time that it was on the shelves was twelve months. Today it is within weeks. Within the U.S. for example during Katrina there are concerns about bodies floating in the water. They thought they were going to have a large body count. So the FEMA director asked all the truckers with refrigerated trucks to come down there and load the bodies. What they found there though is that the fact that they were there, the produce was not being delivered to the grocery stores. My point here is I think that is an issue. I think we are going to find that we are going to have a bigger problem than those developing countries because the boarders are going to be shut down. Everything that we have off shored and outsourced is there. I don't think we are doing enough to invest in getting ourselves ready and certainly I don't believe we are doing enough to educate and get other parts of the world ready.
David Nabarro: There are different elements of work in which countries have to be engaged right now: The first thing is that they have got to be doing what they can to deal with the current episodic of highly pathogenic avian influenza. The reason why this is a big worry is that this is the most unpleasant avian influenza virus that has ever been known. It kills birds within hours, and if it gets into a chicken farm, it will kill three quarters of the birds within a day. Now this Avian Influenza virus is not only very profound in South East Asia, but it has also moved in to west Asia, Eastern Europe, Africa, and Western Europe. The movement was very dramatic in the early part of 2006. This virus is already mutating at quite a speed and it can cause disease in humans thus far. Only a few over 240 humans have been infected that we know. More than half have died. Each time a human gets infected, the selective pressure for further mutation to the point where the virus could be transmitted in a sustained way from human to human increases. So the first job is to stamp out the Avian Influenza virus at source. Indonesia has moved very rapidly in the last two or three weeks to take forward its operations, and I was there just ten days ago. I am very impressed with the new moves that have taken place in that country. Avian Influenza is in more than 260 out of the 440 districts in Indonesia, more than thirty out of the thirty-three provinces. In order to get on top of it, it needs significant amount of cash: probably between 100 and 150 million dollars per a year. Extra investment is needed to help the Indonesians deal with this. There are other countries in the region that also continue to need significant amounts of money. We have had a reasonable amount of external assistance pledged for this. The U.S. is one of the leading countries in providing that assistance. But this is not a problem that is going to go away tomorrow. It is going to take years to deal with Avian Influenza, years to transform poultry production systems so that they are safe. And we are going to need to have significant investment at the country level in countries that are affected by the problem over the next ten years. I think I need all of your help to try and make the case that in order to prevent the likely emergence of the next Influenza pandemic coming from this particular very unpleasant bird flu virus, we need to maintain international investment. It is much greater than it is at the moment. Please don't imagine that simply by closing borders here that we are going to be able to keep America safe. Safe America depends on a safe world.
Elisabeth Rosenthal: Can I ask a question? There was a big pledging conference in Beijing earlier this year to try and address some of this problem. How much of that money actually came through in the end.
David Nabarro: We got a pledge of 1.9 billion dollars, which was 1 billion dollars of grant money and .9 billion of loan money. That money has virtually all been committed, which means it legally has to be spent. The disbursement rate is pretty good for what normally happens in these kinds of things. The reality is that we are going to need to see considerably more international investment in this in order to get the right level of response to avian influenza and pandemic preparedness. At the World Bank IMF meetings in Singapore just last month, the World Bank estimate for the potential cost of the next influenza pandemic is between 1 and 2 trillion dollars. So to be investing say 2 or 3 billion dollars even a year in preparedness is not unreasonable. When you consider the scale of the threat of an influenza pandemic, compared with the threat of some other sources of risk that we are engaged in, the amounts of money we are talking about here are relatively small, even when talked about naked they sound like an awful lot.