The World Must Work Together to Tackle the Growing Avian Influenza Crisis

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The recent eruption of avian influenza cases takes us back to a crucial meeting held in New York City twenty years ago organized by the Wildlife Conservation Society (WCS) and hosted at Rockefeller University. This symposium focused on the transmission of diseases among human, domestic animal, and wildlife communities.

The resulting framework, the Manhattan Principles, recognized the interconnections between human, domestic animal, and wildlife health—the first clear articulation of what we call One Health. They likewise highlighted the risks that infectious diseases pose to people, food security, and economies.

There have been sporadic reports of avian influenza for more than two centuries, but 25 years ago an influenza virus named A/goose/Guangdong/1/1996(H5N1) was first detected in domestic geese raised commercially in rice paddies and farms across southern China. Thus emerged High Pathogenic Avian Influenza (HPAI), a virus with a frightening reach, the response to which raises questions of global health equity today.

Over a short time, given high mutation rates and a propensity to exchange genetic material, strains from this virus spread widely in poultry production facilities, followed by recurring spillover events from poultry into wild birds across Asia, Europe, and Africa. Still, until the beginning of this decade, infections could not subsist in wild birds, leading to seasonal outbreaks that burned out over time.

Unexpectedly in 2020, HPAI outbreaks in wild birds and poultry production facilities exploded, and a new clade named 2.3.4.4b became globally dominant. This virus established itself in Europe and North America before spreading to Africa, South America, and the Antarctic, leaving a devastating swath of millions of dead birds and tens of thousands of dead mammals. Helping drive the spread was the virus’s new ability to persist in wild birds.

We find ourselves now in an avian influenza panzootic—a global outbreak affecting an unprecedented number of animals, including humans. We tally the growing death toll. We marvel at the increasing breadth of mammal and avian species affected at interfaces where they meet. We observe related outbreaks in far-flung corners, like the recent die-off of more than 20,000 elephant seal pups in Argentina or at European mink farms.

Some dead pups in the front line with an adult male carcass contrasting in size, and another adult individual (apparently a male too) in the background. The beach is empty of living seals, that should be thriving at this time of the year. Photo credit: ©Maxi Jonas.

While the hundreds of wild bird species and the more than 60 mammal species infected by H5N1 are staggering in themselves, the spillover into ruminants (grass-eating mammals with multi-chambered stomachs) caught most of us veterinarians and scientists wholly off-guard, as the virus found its way first to a small number of goats. Since then—and far more consequentially—it spilled over into the 85-million-strong US national cattle herd.

Beyond the surprising species involvement, the actual spillover interfaces have stunned us. We’ve seen multiple host species, including dairy cows across numerous states, wild birds, chickens, domestic cats, and unfortunately at least one individual working on a dairy farm, all potentially harboring and sharing the virus.

These events capture the central idea in the Manhattan Principles: that the health of livestock, wildlife, and humans are interdependent. Particularly worrying, the circulation and spillovers of HPAI into cattle and between mammals provide the virus with endless opportunities to evolve novel traits that can facilitate infections of other mammals or, in a worst-case scenario, person-to-person transmission.

Sampling efforts suggest that more than 95 percent of the Southern elephant seal (Mirounga leonina) pups born along 300 km of the Patagonia coastline of Argentina died at the end of 2023. It was the first report of massive elephant seal mortality in the area from any cause in the last half century. Photo credit: Valeria Falabella ©WCS.

Confronting this challenge requires independent coordination and close collaboration between animal and human health disciplines in sectors across the globe—both north and south. No single entity or agency can or should tackle this crisis. It demands rapid, comprehensive, transparent sampling, analysis, and reporting to the scientific community.

Shockingly, more than six weeks after the first detection in US dairy cows, critical data is only slowly and incompletely being shared by responsible agencies. As a result, we do not know the extent of infections in cattle and other farm-associated species. We suspect but don’t know if infections are more widespread in farmers and farm workers.

Currently, the 194 member states of the World Health Organization (WHO) are negotiating an international accord on pandemic prevention, preparedness, and response in Geneva. These discussions and negotiations have proven difficult and are at loggerheads between developed and developing country blocs regarding the timely sharing of information about emerging pathogens and access to vaccines developed in response.

If much of the data and viral samples being used to understand the extent and nature of the spread comes from the developing world, it is only fair that it is guaranteed access to treatments and vaccines should the virus emerge in a form that threatens a global pandemic akin to Covid-19.

International agreements and regulations firmly establish health as a human right and cornerstone of societal well-being. However, when facing a potential crisis, there is still an urgent need for independent oversight, enhanced collaboration, and proactive measures to effectively implement a holistic approach to health that mitigates the risks posed by potential future pandemics and safeguards the health and well-being of all.

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