Wednesday, October 19, 2005 FULL SHOW | HEADLINES
2005-10-19

Mike Davis on The Monster at Our Door: The Global Threat of Avian Flu

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We spend the hour with Mike Davis author of the new book, "The Monster At Our Door: The Global Threat of Avian Flu." Davis says, "2005 is the year in which avian flu, now has acquired a critical mass amongst birds that it won’t be eradicated and it’s unclear whether it can be contained. Most likely, avian flu will fly to every corner of the world. It will probably reach Alaska and Northern Canada, for instance, in the near future. Avian flu–the threat of pandemic avian flu–has become, like HIV AIDS, a fundamental test of human solidarity." [includes rush transcript]

On Tuesday, European foreign ministers declared that the European Union was not prepared to deal with the global threat of avian flu. This follows statements made by U.S Secretary of Health and Human Services Michael Leavitt who said on Monday, that no country was prepared to combat a pandemic of avian flu. The deadly disease has been making headlines recently and Monday’s discovery of the disease in a bird found on a Greek Island marked the first time that the virus had migrated across the EU’s borders. It was also the third country in a week to identify its first case–the others are Turkey and Romania. Avian flu has killed more than 60 people in Asia since 2003.

Also yesterday, Roche, the Swiss pharmaceutical company that makes the anti-viral drug Tamiflu, said it would consider granting other firms licenses to make the drug. Tamiflu is the most effective anti-viral drug currently available for avian flu. This announcement from Roche, came after organizations, including the United Nations, mounted pressure on the company to do away with commercial barriers to producing the drug.

We spend the hour discussing avian flu with Mike Davis, author of "The Monster At Our Door: The Global Threat of Avian Flu."

  • Mike Davis, professor of history at the University of California, Irvine. He is a renowned urban theorist, social historian and author of six books including "City of Quartz." His latest book, which has just come out is, "The Monster At Our Door: The Global Threat of Avian Flu."

Transcript

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: We go now to Mike Davis, a professor of history at the University of California, Irvine, renown urban theorist, social historian and author of six books, including City of Quartz. His latest book, which has just come out, is called The Monster at Our Door: The Global Threat of Avian Flu. I spent an hour yesterday interviewing Mike Davis in San Diego. He began by talking about the central thesis of his book.

MIKE DAVIS: The principal concern in my book is that most of the world, the poor countries of the world, have absolutely no protection against the threat that most public health authorities consider to be an inevitable threat of an avian influenza pandemic. They don’t have access to anti-virals. They don’t have access to vaccine. Indeed, they don’t — many of them don’t even have the means of surveillance to detect the flu or monitor its progress once the flu pandemic were to reach the southern hemisphere, the poorest countries in South Asia or southern Africa. And right now probably the most worrying thing that’s happening in the world is not that birds with avian flu have reached the doorstep of Europe, but the very same birds will imminently carry avian flu probably to East Africa and the Nile Valley and almost certainly into South Asia. And I think what we need to be most worried about is the combustion of avian flu, with its potential to become a human pandemic, with urban poverty.

AMY GOODMAN: Mike Davis, can we take a step back and explain what avian flu is?

MIKE DAVIS: Of course, because a lot of people would ask and ask with good reason, 'Why should we be so worried about a disease which has infected under 200 people, killed less than 100, when we live in a world where millions of people die every year of malaria, tuberculosis, H.I.V.?' And the answer, of course, is the experience of humanity in 24 weeks in 1918, when between 40 and 100 million people died of a pandemic influenza. This is the greatest mortality event in human history. There have been two subsequent pandemics in 1957 and 1968. Neither were anywhere as deadly as 1918. And then, suddenly in 1997 this new flu emerged in Hong Kong, and scientists discovered to their horror that rather than being incubated in a pig or a human being who had been co-infected with several strains of the flu, it had jumped directly from birds to humans with a wild and extraordinary virulence that’s now — probably half the people who we know have had this flu, die of it. And the concern is that if this flu were to acquire the few mutations that it would need to become transmissible in the same ways an ordinary flu or winter cold, and if it preserved any portion of its current virulence, it could be a catastrophe on a global scale comparable to 1918.

AMY GOODMAN: How does a bird get it?

MIKE DAVIS: Well, it’s endemic in birds. If you were to go to any lake in Canada or Alaska at the end of summer when birds are getting to migrate and you tested the water, it would be full of flu. Flu is an endemic and usually benign infection of the gastrointestinal tracts of geese and birds and ducks and other migratory birds, and it’s existed amongst birds for millions of years. And apparently what happens, although rarely, is the flu undergoes mutations or re-assorts with the genes of an already — flu that’s already existing amongst humans or other mammals and then infects human beings.

What’s extraordinary now is that this particular subtype, H5N1, which is a kind of license number for its surface proteins, jumped from wild birds to poultry to humans and then jumped back again. And scientists were horrified to see — and many of them had never seen this before — that flu was actually killing wild birds, who are normally its a benign host. And right now it’s become a bird pandemic, not yet a human pandemic, but even if this flu posed no threat to human beings whatsoever, it would still be a global ecological cataclysm. And it’s spreading around the world now with migrating birds and has become basically ineradicable amongst birds and probably also amongst poultry.

AMY GOODMAN: Right now, I have just heard about the situation, for example, in Thailand where the head of a school of public health, when Thailand goes to get Tamiflu to deal with avian flu, that the U.S. government has bought up all the Tamiflu in the world from Roche. Is this true — the manufacturer that makes it — and what is the significance of this?

MIKE DAVIS: Well, the U.S. is currently trying to buy large quantities of it, but this is to make up for the delinquency of the Bush administration, which has failed to build adequate stockpiles of Tamiflu. Tamiflu is a anti-viral developed at a hospital, an American hospital and basically public sector or nonprofit sector in medicine, then was developed into a pharmaceutical by a small company in California and now is controlled and monopolized by Roche, the giant French-based pharmaceutical corporation. It manufactures Tamiflu at a single factory in Switzerland. So this anti-viral, which has now become probably the most sought after drug in the world, is an utter monopoly of a single corporation, confined right now to one plant in Switzerland.

A few months ago an a meeting of the World Health Organization, when Thailand and South Africa raised the question, the urgent need to be able to produce Tamiflu generically in their own countries and for the third world, the United States and France blocked the debate. They actually shut down the debate. And essentially, what’s happened is that two deals have been cut. The Bush administration has got Roche to agree to open a plant next year to manufacture Tamiflu in the United States, although Americans should be aware we won’t have anywhere near an adequate stockpile of this anti-viral until 2007, that we’re essentially naked until then.

At the same time, the World Health Organization has abandoned support or criticism of Roche’s monopoly, in turn for the donation by Roche of three million courses of Tamiflu to the W.H.O., which proposes to use this to douse an outbreak if that is possible, which most researchers doubt. So in a way the health of the whole world right now is held hostage to the corporate property rights of Roche, supported by the United States and other governments like France.

AMY GOODMAN: Why does it endanger Americans if the U.S. government buys up all the Tamiflu and people in, for example, Vietnam or Thailand don’t have it?

MIKE DAVIS: Well, several things. First of all, the U.S. is only trying to buy up Tamiflu. We’re at the back of the queue. The Clinton administration and the Bush administration have been told repeatedly since 1997 by the leading flu researchers and by their own public health officials to build an adequate stockpile. The Bush administration initially put other priorities higher, things like abstinence education and then, after 9/11, throwing billions of dollars at the largely hypothetical threat of bio-terror weapons like anthrax and Ebola fever. So, the U.S. now is trying to buy up a huge amount of this, but it won’t really have it for two years. So until 2007 there’s only enough Tamiflu in the United States to be fought over by the troops that the President proposes to put in the streets and by critical military personnel. There’s no Tamiflu for the ordinary population.

At the same time, because of this limited production of Tamiflu and because the rich countries have bought up most of it, and now orders extend over a period of years, and because it is expensive, manufactured by Roche, selling for $40 to $60 a course, there’s essentially no Tamiflu for the third world. The W.H.O., as I say, is receiving a donation, and it’s not clear when that would arrive, which would apply at the beginning of an outbreak somewhere in the third world. But if that fails, as many researchers fear this strategy would, then the rest of the world is essentially helpless. It doesn’t have Tamiflu. It has no access to potential flu vaccines, unless heroic decisions are taken and taken quickly.

And what this means is that right now with flu in Europe, you can put the chickens indoors, you can cull the poultry, but inevitably avian flu will begin to appear in countries that have no flu surveillance. And if it achieves a critical mass, if it becomes pandemic in a poor country, it will spread to the rest of the world at the speed of a traveling jet airplane. We already have the experience of SARS in 2003, when a single sick person, a Chinese doctor, infected all the other guests on a floor of a hotel in Hong Kong, many of them aircrew, and within a matter of weeks SARS managed to travel to Singapore, Hanoi and Toronto. And you can be sure that avian flu will have the same kind of travel plan that SARS did.

AMY GOODMAN: Professor Mike Davis teaches at University of California, Irvine. He is the author of The Monster at Our Door: The Global Threat of Avian Flu. We’ll be back with him in a minute.

[break]

AMY GOODMAN: We return to Professor Mike Davis, Professor of History at University of California, Irvine, author of many books, his latest, Monster at Our Door: The Global Threat of Avian Flu. I talked to him yesterday about the global threat.

AMY GOODMAN: We’re talking to Professor Mike Davis who has written the book, The Monster at Our Door: The Global Threat of Avian Flu. In a recent news conference President Bush held, he said there could be another avian flu epidemic in this country. And he said the military might be needed to enforce quarantines and other emergency measures. Your response, Professor Davis?

MIKE DAVIS: Well, boots on the ground seems to be the administration’s one-stop solution to any problem, mainly because they lack the means or they have dismantled the capacities to act in other ways, as we saw with FEMA during Hurricane Katrina. Some people, very rightly, raised the question, 'Well, is America going to become one single huge squalid Superdome under martial law if there were an avian flu epidemic?' And indeed, this whole idea of militarizing response to a pandemic, of relying on the Pentagon and Homeland Security, rather than the Department of Health and Human Services, does raise this whole specter that is essentially a coup d’etát in the name of fighting pandemic.

But there’s another question that I’m frankly more concerned with. This is this very limited stock of the antiviral Tamiflu. And right now there’s fierce debate going on exactly who should get Tamiflu. But the agreement is that the first priority should be immediate responders, critical medical personnel. However, the Pentagon has never signed on to this principle. And last year in a memo circulated through the Pentagon, the Pentagon asserted that it had first priority both to anti-virals and to potential flu vaccines. So if you militarize the response to a pandemic, if you federalize the National Guard, put the 82nd Airborne in the streets to enforce quarantines, obviously the Pentagon is going to insist that the priority for anti-virals go to the troops in the street. And this sets up a zero sum conflict with the critical medical personnel. The danger here is that you will take the anti-virals from the people who we should assure have first priority at it, and that poses further dangers of a collapse of the public health response to a potential pandemic.

AMY GOODMAN: Professor Davis, you talk about the "virulence of poverty." Can you explain?

MIKE DAVIS: Well, in the current models in how pandemic flu might spread, most of the research has been on influenza in rural regions and at rural densities. The missing link in all of this is the fact that there are now, according to the United Nations, a billion people living in slums in the mega-cities of the third world. This is, of course, an exponentially larger slum population than existed in 1918. Of course, a large portion of the population of poor, urban people live in appalling conditions of public sanitation. They live with medical and public health infrastructures that have been in many cases devastated by debt and by structural adjustment in the 1980s.

So this actually offers the absolute optimum situation not only for the rapid spread of an avian flu epidemic or other potential epidemics, pandemics, but also it preserves its virulence. If a virulent virus can easily jump from one host to another and has a large enough supply of hosts, there’s no reason for its virulence to be attenuated. In 1918 the influenza pandemic of that time had had to cross a number of fire breaks and gradually lost its virulence, eventually becoming one of the flus that we now get every year. And some researchers fear that because of concentrated urban poverty across the world, combined with rapid air travel, you’re treating conditions that would preserve the virulence, that is, the killing power, of pandemic flu. So, in this aspect it might even be worse than 1918.

AMY GOODMAN: Can you explain how a human being gets it, how it’s transferred from one human being to another, and actually what happens in the body when you get avian flu?

MIKE DAVIS: Well, avian flu is just like ordinary influenza, except that it has the ability to penetrate deep into the lung tissue, the ability to cause viral pneumonia, the ability to reproduce at an incredibly higher rate than normal flus. The 1918 flu, which was recently resurrected in a breathtaking but dangerous experiment by the Centers for Disease Control — They literally sent this on. It’s the 1918 flu. And they discovered to its horror that in four days in mice it was producing 39,000 times more flu particles than an ordinary flu.

So the point is that an avian flu, a pandemic flu, would spread in the same way as a normal flu, which is approximately the same way as a cold. And the problem here is that you can be spreading viruses 24 hours or more before you’re sick, before you show any symptoms. Also with flu, very often they are asymptomatic cases, people who have the virus but never get sick. This has also been the case, apparently, with the current circulating avian flu. This makes quarantines almost impossible. SARS was much easier to defeat because with SARS you weren’t contagious until you had the symptoms. So it was obvious who was contagious. This would not be the case with the avian influenza, pandemic influenza.

You would get it as a normal flu. Some people would not experience symptoms probably any worse than the seasonal flu. Other people, in much larger numbers than normal, would develop secondary infections, bacterial pneumonia, something which we’re much better prepared to treat with antibiotics today than we were in 1918. But a minority of people, but potential large minority, would get a devastating viral pneumonia. This is what has killed many of the people in Southeast Asia. And this is just a catastrophic illness and perhaps fewer than half the people who got viral pneumonia would be able to be saved. So even in a rich country like the United States, but a country with devastated public health infrastructures with shortages of hospital beds and intensive care facilities would be overwhelmed with the huge number of cases of pneumonia, both bacterial and viral pneumonia. And even more important than possessing stocks of anti-virals or potential flu vaccine really is the basic health of our local hospital system and our public health responders.

AMY GOODMAN: You have a chapter in your book, The Monster at Our Door, called "Plague and Profit," and you start by talking about a multibillionaire based in Thailand.

MIKE DAVIS: Yes. I mean, what’s important to grasp is that this isn’t just the return of an old monster, but it is a new disease threat that we’ve partially attended the birth of. That is, the ecology of influenza, like other diseases, has changed dramatically in the last 10 or 15 years because of economic globalization, because of the breakdown of biological barriers between animal and human populations, because of air travel, because of urbanization, but in this case, above all, because of something called the "livestock revolution." And that’s been the generalization around the world of the American model of poultry production, the Tyson model. Tyson is the giant poultry producer, one of the most exploitative corporations in the United States with just an appalling record of working conditions. Tyson kills several billion chickens a year. It’s created huge conurbations of chickens, unprecedented concentrations of chickens.

Now this model has spread to East Asia. China has become the biggest consumer of poultry in the world, and the leading company involved in China is a Thai-based firm called C.P., which has used the Tyson model, a vertical integration of concentrating poultry in enormous warehouses. And it was directly involved in the Thai government’s cover-up of the initial outbreak of avian flu in Thailand last year. That is, the government gave the corporate poultry producers in Thailand time to clear their inventories to slaughter sick chickens to send them to Europe before it notified or was forced to notify the rest of the world that avian flu existed. It also failed to notify the peasant backyard poultry producers whose children then began to die from the avian flu. So the outbreak of avian flu — and H5N1 is only one of several subtypes that have managed to jump to human beings. There are other cases in Holland two years ago and even in British Columbia last year. All this indicates that human intervention, the industrialization of poultry, above all, has sped up the evolution of influenza. It’s changed the nature of disease by changing its ecology.

AMY GOODMAN: Can you get avian flu from eating a dead avian flu-infected bird?

MIKE DAVIS: You could get avian flu from the preparation of a dead bird and if you ate it raw. There’s no evidence at this point that you can get it from cooked chicken. But people have got avian flu from things like drinking raw duck’s blood, which is a traditional delicacy in Vietnam, or sucking the mucous out of the nose of their fighting cock, as happened in one instance in Malaysia. The easiest way for avian flu probably to be spread from poultry is through excrement, through poultry manure. This makes killing flocks very difficult, because the killing crews can actually spread the influenza simply through particles of excrement on their boots or clothing. In other words, amongst birds, influenza is a gastrointestinal disease, where in humans it’s almost always a disease of the upper respiratory tract, the lungs, although there is a disturbing case that appeared recently in Vietnam where avian flu actually affected the brain. It took on aspects of meningitis, showed frightening power to infect cells that influenza normally doesn’t infect.

AMY GOODMAN: Now with the level of the birds that are killed in this country to eat poultry, the poultry industry, could the excrement wash into rivers?

MIKE DAVIS: It’s possible. I mean, the people in the greatest danger, of course, poultry workers themselves. The corporate poultry industries have undertaken an international offensive, claiming that the fault resides entirely with the backyard producers, the tens of millions of small farmers across the world who have free-range chickens in constant contact with ducks and wild birds and children playing amongst them. And although this is part of the ecology of avian flu, the thing that has changed the way that flu emerges, that has amplified, I think, the danger and the speed with which it evolves, are these huge industrialized concentrations. Having said all of that, avian flu at this point is still relatively difficult to get. Some people pick it up. Other people can have intense contact with infected birds, don’t seem to get it. Nobody understands exactly why. Pandemic flu would mean a genetic modification or even just the mutation of a few shifts of a few amino acids that would give it the ability to spread as a normal seasonal flu, able to infect, for instance, up to one-third of Americans in a single season.

AMY GOODMAN: Professor Davis, the Swiss drug maker Roche has said it will consider allowing companies, as you said, in countries the right to make the anti-viral drug Tamiflu, if they’re ready to do that, if they can deal with it. What about that? Why doesn’t every company make Tamiflu right now?

MIKE DAVIS: Well, the problem is that it will take a long time to actually start up production lines for Tamiflu. And even in third world countries, the handful that immediately have the ability to produce Tamiflu, for instance, India, South Africa and Brazil and, of course, Cuba, have the means to start a production of Tamiflu. Perhaps a few other countries. But it remains very expensive to produce. And it can’t be produced in quantities really to cover the general population. Its use would apply, we hope, to first line medical personnel. There’s always a danger that, in fact, the rich would end up with the Tamiflu. And there are examples for the W.H.O. has actually donated quantities of Tamiflu and had it confiscated by the local military. But right now and for the next several years at the very least, where the real attention has to go, and I totally support the generic manufacture of Tamiflu and breaking Roche’s monopoly, but where the greatest priority must be is on the detection and monitoring of influenza in countries that presently don’t have that ability and directing resources to the grassroots in poor countries to give them just even the most basic means to deal with large numbers of cases of pneumonia and to know what they’re fighting.

The United States and other rich countries have been just scandalously selfish and neglectful in refusing to fund the modest request of Vietnam or the U.N.'s Food and Agricultural Organization, just asking basically for a few tens of millions of dollars to reinforce surveillance efforts and to compensate poor peasant farmers for the killing of their flocks. But we've refused to do this. And this is just another one of these, you know, pennywise, pound foolish measures. The Bush administration, where it’s proposing to spend billions on buying anti-virals for Americans, but it won’t give the aid to Vietnam, a country to which we have the greatest moral debt, which is actually on the front line of avian flu and still the country that I would think that the W.H.O. and the other international organizations must worry about, in terms of the possible center for the emergence of a pandemic variety.

AMY GOODMAN: Professor Mike Davis, he is author of The Monster at Our Door: The Global Threat of Avian Flu. We’ll be back with him in a minute.

[break]

AMY GOODMAN: We return to a final excerpt of our interview with Mike Davis, reached him yesterday in San Diego, author of The Monster at Our Door: The Global Threat of Avian Flu. I asked him how we know Tamiflu works.

MIKE DAVIS: Well, some questions have been raised whether Tamiflu works, and this is largely based on the fact that it’s effective only if given within the first 24-36 hours of symptoms. Laboratory studies have shown that Tamiflu has been effective against H5N1 and has also shown that it even works on the 1918 flu. But the current avian flu is evolving and changing very rapidly. Whole numbers, dozens of different strains, have existed at one time or another. And now there’s laboratory evidence of the emergence of resistant strains. And this is only to be expected.

Right now, Tamiflu is the major frontline weapon of choice. There’s another anti-viral which works on the same principles as Tamiflu called Relenza, which might even be better, but it’s a flu, and it’s very difficult to store and use. But we can expect that Tamiflu will work forever. Right now, it is a sensible investment to build strategic stockpiles of it, but somehow the illusion has been created that Tamiflu is really the difference of life and death in case of a pandemic. And the far more important variable here is local public health, is hospital surge capacity, the ability to cope with large numbers of cases of pneumonia.

And here’s where the United States really joins the third world, rather than Europe, because we have lost that capacity. And in city after city simulations or the experience with just even normal seasonable heights and influenza or other respiratory diseases has shown that that capacity doesn’t exist. We don’t have the hospital beds. We don’t have the intensive care facilities. And in large part this is the byproduct, not only of federal and state neglect, but the H.M.O. revolution which works on the principle of increasing bottom lines by reducing the number of hospitals, reducing the number of hospital beds, leaving Americans incredibly vulnerable in the face of any kind of epidemic or pandemic disease.

AMY GOODMAN: Mike Davis, let’s pursue this point, that the idea that the best way to fortify national security would be overall better health care system. What would that look like from health insurance to the entire hospital clinic structure in this country?

MIKE DAVIS: Well, I mean, we should begin with the 40 or 50 million Americans who lack health coverage, per se. And my believe is, of course, that there is no fix for this problem within the current market economy and depending on the private provision of medicine, particularly when you read in today’s paper about how yesterday’s most powerful unionized workers in America, the auto workers, are now forced to suffer swinging cutbacks in medical coverage. The whole system of workplace-provided, contractually provided medicine and healthcare in America has broken down. We must have some kind of national health system.

Secondly, we must have adequate, proactive preventative public health, a priority that’s consistently neglected despite the fact that administrations, including the Bush administration, has actually thrown billions of dollars in infectious disease but in the wrong places — hypothetical or imaginary diseases — and a lot of the money going to big corporate contractors or large labs, big pharma, and not enough of it percolating down to where it’s absolutely essential at the local level.

And thirdly we must increase the surge capacity of medicine at the local levels. We need more hospital beds, more intensive care facilities. This is the only wealthy country I know of where during a pregnancy a woman is sent home within 24 hours of delivering a baby. And we will pay a terrible price for this in the event of a pandemic or an epidemic. What will happen in many American cities, will look more like what’s happening in the third world than, for instance, to our neighbor north of us, Canada, which probably has right now the best planning, the most adequate preparation to deal with avian influenza or, for that matter, almost any pandemic.

AMY GOODMAN: Mike Davis, the issue that we’re talking about, avian flu and how it ties into healthcare in this country and the first responders, we all know about what happened with Hurricane Katrina, with Michael Brown, Bush’s Brownie, who he called "Brownie, you’re doing a heck of a job," head of FEMA. But many are pointing out now that that goes well beyond FEMA, that we’re talking about the scientific agencies of this country, the medical agencies of this country losing their most talented people, like, for example, the Centers for Disease Control, people leaving more and more and getting more hacks and political appointees in there. Can you talk about how this affects the avian flu?

MIKE DAVIS: Well, the person who has the most immediate frontline managerial responsibility for preparing for an avian flu epidemic, pandemic and combating it is Stewart Simonson. He’s the Assistant Secretary of Health and Human Services for Infectious Disease Preparedness, for Emergency Medical Preparedness. And he has quite extensive background in running railroads. He worked with — as an administrator for Amtrak. He’s a protege and appointee of the former Secretary of Health and Human Services, Tommy Thompson. And I don’t — not to be unfair to the Assistant Secretary, whether he’s the same kind of incompetent that Mr. Brown was in FEMA, but he’s obviously someone without any real background in dealing with public health system or with infectious disease, a position that should go to someone of the most eminent stature and with years, if not decades, of experience.

So the problem that’s haunted the response to Katrina, of political appointees, of hacks, of broken morale, of lavish plans that in the field break down and don’t work at all, of huge promises by the administration to protect the safety and health of Americans which evaporate in the first emergency. Katrina was a trial run for what would happen with pandemic influenza. And the danger is that we would have 40 or 50 New Orleans-type situations in the United States. And, indeed a simulated influenza pandemic, a simulation that was run in Chicago not too long ago, showed the public health system breaking down almost immediately in response. The national pandemic strategy, which The New York Times recently was leaked a draft of the final version of it, has apparently harrowing images of panic, rioting, breakdown on a local level.

The Secretary of Health and Human Services, Mike Leavitt, and the President can promise us that things are getting better all the time. But the evidence is that Americans are in great and absolutely unnecessary peril from the government’s lack of preparation, a failure to build strong policy and, most of all, the running down of America’s health system over the last generation.

AMY GOODMAN: Mike Davis is our guest. His new book is The Monster at Our Door. You wrote a piece, "25 Questions about the Murder of New Orleans." Tell us what those questions are.

MIKE DAVIS: Well, all I was doing — I was in New Orleans for a week and then in southwest Louisiana during Hurricane Rita. This was simply a piece I wrote with a local friend of mine, Anthony Fontenot, just relaying questions that local people were raising about what happened, about why certain levees fell, why so little attention has been given to probably the biggest hit-and-run accident in American history: A privately owned, corporate barge which was hurled through the industrial canal’s flood wall and was probably responsible for the death of several hundred people. Questions about government incompetence, negligence at almost every level from the city administration up to the White House itself, including the Pentagon. Very interesting questions can be raised about the role of Secretary of Defense Rumsfeld.

But, of course, all of these questions echo in any debate about avian flu or any other kind of national emergency. And what’s so shocking is that the real response to this, apart from the President’s empty promises that he made in Jackson Square a month or so ago, the real response to this is always to use more military. Smart disaster preparation, everywhere in the world, is disaster preparation that builds from the grassroots. The buttresses, the ability of local medical responders and emergency responders to act, that mobilizes the population in an active role to take care of themselves and their neighbors and their neighborhoods, not this system where we’re told, you know, 'Store toilet paper and bottled water and wait to be dug out of the rubble.'

And as far as I know, the only American locality which really has a different model of how to deal with disaster is San Francisco, because in San Francisco, the city’s actually identified on a block-to-block basis. People with medical skills, people with important skills like firemen or even construction workers or engineers, to mobilize those people as a vast army of first responders and to ensure that if San Francisco were to crumble in an earthquake or be faced with avian influenza, there would be somebody who would know when to turn off the gas in an old woman’s house or know where the house-bound person in a wheelchair was that needs aid. The government’s formula is basically to militarize disaster response and to turn every situation into some version of its occupation of Iraq.

AMY GOODMAN: Professor Davis, do you think global warming fits into this picture? Or how does it fit into the picture, from the hurricanes to just the general climate in this country and around the world, and has any links that might be interesting to highlight with an outbreak of avian flu?

MIKE DAVIS: Well, I’m not sure that we could associate avian flu directly with global warming or global environment change, but there’s, of course, a huge scientific literature warning us that climate change, global warming will first of all extend the geographical boundaries, so tropical diseases into the subtropics, even into temperate countries. You see the return of malaria, the spread of dengue fever. Environmental change will bring about new and unexpected contacts between species which have had little contact or have been separated by biological barriers. Global change, global warming has huge implications for infectious disease. Sea level rise will be implicated in the spread of things like cholera.

And as Laurie Garrett and others have been pointing out for years, the combination of economic globalization and a changing world environment demand that preventative medicine and world-scale public health infrastructure must be the number one priority. But, of course, what’s happened along with economic globalization is in so many countries been actually the dismantling of the ability to respond to epidemic diseases. The immigration of doctors and nurses. The closure of local public health clinics. This is one of the things, of course, responsible for the human holocaust of H.I.V.-AIDS in Africa.

So one of the most effective steps you could take immediately in fighting disease and increasing the health of the world would simply to end the debt payments, the tribute paid from poor countries to rich. But it is a global problem. And one of the great illusions that now exists around avian flu is that you can build a national fortress. You can build fortress Britain or fortress America, stockpile anti-virals, work on your own vaccine and not worry about the public health of the rest of the world. This is a total illusion. We may be two humanities, in terms of income and power, but biologically we remain one humanity. And avian flu will be a great equalizer.

AMY GOODMAN: And finally this update on our top story today. That, Mike Davis, The Monster at Our Door: The Global Threat of Avian Flu.

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