Transnational Threats in Asia: Diseases
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Transnational Threats in Asia: DiseasesSophal Ear, Ph.D.
Assistant ProfessorNaval Postgraduate School
24 June 2010
Disclaimer: Material contained herein is made available for the purpose of peer review and discussion anddoes not necessarily reflect the views of the Department of the Navy or the Department of Defense.
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Myriad Problems
Poor to non-existentsurveillance
Poor diagnostic
laboratory capability Disincentive to report
(bad publicity, bad for
business) Viral sovereignty (in
Indonesias case)
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Page 213:
In 2006, Indonesia claimed viral
sovereignty over samples of
H5N1 collected within its bordersand announced that it would not
share them until the WHO and
developed countries established
an equitable means of sharing the
benefits (e.g., vaccine) that couldderive from such viruses.
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Page 3:
in the poorest countries per capita expenditure on all
aspects of health care [is] 3%
expenditure in high-income
countries staff in over 90%
not familiar with quality
assurance principles more
than 60% of laboratory
equipment is outdated or
not functioning
August 2001: the more
things change
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TimelineContextHuman Pandemic Flu Timeline
Spanish (H1N1) HK flu H3N2 HPAI H5N1 H7N2 H7N3 H10N7
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Downside of Globalization:
Global Reach of Diseases
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Quality of Health Care, 2002
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H5N1: Highly Pathogenic Avian Influenza
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Avian influenza
situation in China
8 June 2010 -- 22-year-old pregnant woman died
on 3 June exposed to sick and dead poultry.
Of the 39 cases confirmed to date in China, 26
have been fatal: mortality rate of 66%!
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Indonesia Case Study
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After FOUR
decades, the
Naval Area
MedicalResearch Unit-
2 (Namru-2) is
kicked-out ofIndonesia
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And all because of one woman?
Maybe not.
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Issues Raised in Indonesia
0%
10%
20%
30%
40%
50%
60%
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Cambodia Case Study
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Lucky guy, thanks to Namru-2...
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Issues Raised in Cambodia
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Low Staff
Compensation
Donor Dependence
Pathologies
Poor staff
management/HR
Patronage networks
detrimental to workenvironments
No compensation for
culling
Differing host and
donor priorities
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Goal: reduce pandemic potential that could
strike donor countries themselves
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TimelineMoments
Start: SARS (2002), A Wake-up Call; Enter HPAI (2004)
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http://www.youtube.com/watch?v=YeL3pM8L8DA
16 minute video
Available in two parts on
YouTube under the title:
Cambodia: THE BIRD FLU
"PANDEMIC" HOAX!
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But lets end where we started, with
Indonesia and Cambodia
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Dateline: 11 April 2010
Namru-2 Jakarta is shuttingdown. I have been verysad. Not only because Iam losing my job, but
more than that, Indonesiawill loss [sic] anestablished laboratoryresearch coz [sic] ofpolitical reasons
--Senior Indonesian scientist
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The end or the beginning?
25 June 2010: Director ofNamru-2 Phnom Penh steps
down
Former Namru-2 Jakarta
Commanding Officer will
head Namru-2 Phnom Penh
Lessons learned from
Indonesia should be applied
to Cambodia
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