WHO's 'war room' prepares for bird flu pandemic

GENEVA, (Reuters) Known as the 'war room' or the 'bunker', it is the world's nerve-centre for tracking deadly diseases from Ebola haemorrhagic fever to bird flu.

Each day, officials at the World Health Organisation (WHO) use its sophisticated communications systems to monitor suspected disease outbreaks and contact experts in the field.

The screen-filled room will become a global command centre if the H5N1 bird flu virus, which has killed more than 60 people in Asia since 2003, mutates into a form which spreads easily among humans, sparking an influenza pandemic which could kill millions in months.

"This room is the eyes and ears of the global epidemic response. The technology in the room takes us to another level," said Dr. Mike Ryan, WHO's director of epidemic and pandemic alert and response.

The Strategic Health Operations Centre (SHOC) is a $5 million state-of-the-art facility in a former cinema at the WHO's Geneva headquarters. Shortly after opening a year ago, it was used to help coordinate medical teams during Asia's tsunami.

Funded by donors led by the United States, it has screens for video-conferencing and displaying Web sites and satellite feeds. Round-the-clock, computers transmit audio, video and data from some 66 offices connected to the hub so far.

"Pandemic flu will run us ragged here," Ryan said.

"The world will look to the WHO for immediate information, for risk assessment, for the world's weather system when it comes to where the flu is and where it is going," he said.

Ryan said the war room gave the WHO a single point of coordination to try to contain outbreaks of diseases like cholera, dengue fever, Ebola, SARS, malaria and bird flu.

The United Nations agency's public profile has risen since bird flu and SARS, or Severe Acute Respiratory Syndrome, emerged in Asia in the past few years and then jumped continents.

The SARS crisis, which began in 2002, prompted calls for the WHO to play a more active role after China was criticised for being slow to alert others to an outbreak which spread across 30 countries, infecting nearly 8,500 people and killing around 800.

Ryan said the WHO's 192 member states now recognised that openness was the best way to deal with outbreaks.

"It has been a progression, but the paradigm has shifted."

When Lee Jong-Wook took over as WHO director-general in July 2003, he ordered the agency's small existing operations centre revamped so that it could tackle public health emergencies.

"We lacked an operational focus for this kind of rapid response activity, both in terms of information management and field deployment," said Ryan, an Irish doctor and public health expert who joined the WHO in 1996.

"It does have a war room, or bunker feeling ... There is no natural light. Sometimes you are here at 3 a.m. and you don't know whether it is night or day - we become a little mad," he said with a grin as he showed reporters around the bunker.

U.N. Secretary-General Kofi Annan last month toured the war room, where he was briefed by officials.

"This is our nerve-centre. We have voice, video, Internet and satellite tracking so that we can be on the ground virtually alongside our member states," Lee told Annan.

The WHO's Global Alert and Outbreak Response Network has deployed 500 experts to 50 outbreaks in 40 countries since 2001, according to Margaret Chan, assistant director-general for communicable diseases.

"When you're facing a major outbreak, no single institution or country can handle it. This is a cost-effective system to provide rapid response on the ground," said Chan, former head of Hong Kong's health department and WHO's top pandemic expert.

As part of its arsenal, the WHO uses an Internet-based early-warning system developed by Canada's health ministry which scours 30,000 news sources, picking up rumours of outbreaks. "The median time from finding out an event and verifying it is 24-48 hours. We've become very fleet of foot," Ryan said.

The WHO currently ranks bird flu at phase three on a scale of six, meaning there is no or very limited human-to-human transmission. Phase six is the start of a pandemic.

Ryan said that if several people without an obvious link to infected poultry developed the disease in the same village, it could be the sign of a cluster of infections.

This would flag increased human-to-human transmission and trigger phase 4, when the centre would urgently trace victims' contacts and step up containment measures.

"There may be a window of opportunity ... We may have the opportunity to apply control measures, including use of antivirals, but we have to be very fleet of foot," Ryan said.

"Certainly in Vietnam there were some tense moments when we were wondering whether we were seeing the beginning," he added.

He was referring to preliminary confidential scientific reports in May suggesting there may have been more widespread infection in the general population. This proved to be a false alarm in June, but WHO officials refer to it as the "dry run".

Ryan said a pandemic would place a "huge demand" on the WHO.

"Are we ready for a pandemic? No, we are not," he declared.

But the WHO is investing another $2 million to beef up a global IT infrastructure to be used in crises, officials said.

"If a pandemic were declared tomorrow, we would have to look at the resilience of our Web site because we are going to get millions of hits in the first minutes," Ryan said.

The current network, linking headquarters to regional and country offices in 66 countries, has big gaps in Asia.

"We need to increase the number of countries connected, particularly those countries at risk of avian flu. We need to accelerate their connectivity so we have protected bandwidth," Ryan said.

"The last thing I want to be doing is competing for a telephone line to China or Vietnam in the middle of a crisis."