Global public health security is both a collective aspiration and a mutual responsibility that demands cooperative action at all levels. The expansion of the current H5N1 avian influenza enzootic and its incursion into human health presents a real and significant threat of an influenza pandemic. The world has for the first time an unprecedented opportunity for pandemic preparation. Current global efforts to tackle the H5N1 pandemic threat are centred around the framework of the International Health Regulations (2005) that requires countries to openly share disease intelligence including clinical samples, viruses and epidemiological information. Present international initiatives also seek to establish more equitable allocation and sharing mechanisms for developing countries, of therapeutic resources, public health interventions and other broad-based support in the event of a pandemic. To be sustainable, country preparatory efforts need to be integrated within wider national emergency preparedness frameworks and emphasise the strengthening of basic capacities in disease surveillance, outbreak response and health systems that can respond to a range of public health emergencies. Such capacity building represents permanent investments in health that will have enduring benefits beyond a pandemic. Preparations must also go beyond the health sector; greater promotion of intersectoral cooperation and an adoption of a whole-of-society approach to preparation is recommended. Broad collaboration is vital in addressing the complex challenge posed by influenza to our collective security.
Animals ; Birds ; Communicable Disease Control ; methods ; Global Health ; Health Planning ; Humans ; Influenza A Virus, H5N1 Subtype ; isolation & purification ; Influenza in Birds ; epidemiology ; virology ; Public Health

Objective To assess the relationship between body mass index (BMI) and ischaemic heart disease (IHD) mortality,especially in populations with low mean BMI levels.Methods We examined the data from a population-based,prospective cohort study of 220 000 Chinese men aged 40-79,who were enrolled in 1990-1991,and followed up ever since to 1/1/2006.Relative risks of the deaths from IHD by the baseline BMI were calculated,after controlling age,smoking,and the other potential confounding factors.Results The mean baseline BMI was 21.7 kg/m~2,and 2763 IHD deaths were recorded during the 15-year follow-up (6.8% of all deaths) program.Among men without prior vascular diseases at baseline,there was a J-shaped association between BMI and IHD mortality.When baseline BMI was above 20 kg/m~2,there was a strongly positive association of BMI with IHD risk,with each 5 kg/m~2 higher in BMI associated with 21%(95%CI:9%-35%,P=0.0004) higher IHD mortality.Below this BMI range,the association appeared to be reverse,with the risk ratios as 1.00,1.11,and 1.14,respectively,for men with BMI 20-21.9,18-19.9,and ＜ 18 kg/m~2.The excess IHD risk observed at low BMI levels persisted after restricting analysis to never smokers or excluding the first 3 years of follow-up.Conclusion Lower BMI was associated with lower IHD risk among people in the so-called 'normal range' of BMI values (20-25 kg/m~2).However,below that range,the association might well be reversed.