With generous support from the Rockefeller Foundation, we organized a meeting on this topic in Bellagio, Italy, from 24-28 July 2006. An international group of experts in public health, animal health, virology, medicine, public policy, economics, ethics, law, and human rights from a dozen countries met to consider questions of social justice and the threat of avian and human pandemic influenza.
Following the July meeting, the group drafted a Statement of Principles that members believe should guide ongoing efforts to respond to the threat of an influenza pandemic. A major concern of the group was how the world's disadvantaged are particularly affected by such policies and responses. As an example, consider backyard poultry farmers who are forced to cull their flocks when a local outbreak of AI is reported. Are they adequately compensated? Or consider when epidemiologists are sent to a remote village to investigate a suspected human cluster. Are the needs and rights of the local villagers protected in the midst of (what are certainly necessary) the measures taken?
The Bellagio Group also developed a set of checklists to help incorporating the broader principles into concrete planning and response efforts. Such checklists are not new. The World Health Organization's Checklist for Influenza Pandemic Preparedness Planning outlines the steps governments should take at various stages of planning (preparedness, surveillance, investigation, containment, etc.). The U.S. Centers for Disease Control & Prevention have circulated checklists to guide state and local governments, businesses, and community organizations in their planning efforts. The checklists developed by the Bellagio Group are focused specifically on protecting the needs and rights of individuals, particularly of individuals from disdadvantaged groups. Ethical issues such as these, while not ignored, perhaps have not been emphasized as much as they ought to. Perhaps these checklists can contribute to broader planning efforts.