In the event the bird flu virus started to mutate and transmit from human to human, initial estimates of costs to fight a pandemic 'will be multiplied by several orders of magnitude,' says a World Bank official.

The figure includes $1 billion the World Bank forecasts will be needed to combat the virus in poultry in Asian countries already afflicted or at high risk of contracting the disease, as well as the cost of drawing up pandemic flu plans in countries that don't yet have one.

At the close of a three-day global coordination meeting on the issue, the World Health Organization said it would cost another $500 million over three years to develop and produce a pandemic vaccine and to research new antiviral medications.

The estimates do not include the cost of stockpiling the anti-flu drug Tamiflu, WHO said, because the agency's ongoing negotiations with Roche, the drug's maker, over the price, supply and distribution of the pills means it is impossible to accurately predict the expense. WHO plans to buy millions of courses of the drug to ensure that poor countries can get some.

First Approximation

Delegates from the United States said they were hoping that by the time the major players gather again in Beijing for a funding conference Jan. 17 and 18, more precise cost estimates will be available.

"I think we saw a first approximation today," said Dennis Carroll, a senior infectious diseases adviser at the US Agency for International Development.

The cost will likely be higher than estimated at the Geneva meeting, said Kent Hill, also of USAID.

"There was some caution about putting out numbers and I think everybody knows it's going to cost a little more than what's been presented," he said.

Delegates said one of the most striking aspects of the meeting, which drew more than 600 participants from more than 100 countries, was the universal acknowledgment the H5N1 virus poses a serious threat and the remarkable unanimity on how to tackle the problem.

"There's consensus. There's clarity. There's cash," said David Nabarro, the UN coordinator for bird and human flu. "We should be able to deal with the bird flu epidemic much quicker and ... if the pandemic comes, it will be smaller as a result."

Figures Will Change

Experts agree a global flu pandemic is inevitable. What is not known is when this will occur, how bad it will be or whether the H5N1 virus will be the culprit. The strain, which has resulted in the deaths of more than 150 million birds and at least 64 people over the last two years, is considered a likely candidate for the next pandemic.

The H5N1 virus could transform into a human one by mutating spontaneously or by mixing with a human flu strain and creating a hybrid. Such a change could make the virus weaker or more deadly, but experts are preparing for the worst. They say it is important to stamp out the disease in poultry quickly because the more virus there is in circulation, the more opportunities there are for mutations.

"Let me stress that these are indicative figures; if tomorrow one of these [at-risk] countries or a new country is affected, these figures will change," Fadia Saadah of the World Bank said of the estimates. In the event the bird flu virus started to mutate and transmit from human to human, "all of these figures will be multiplied by several orders of magnitude," she said.

The World Health Organization, UN Food and Agriculture Organization and the World Organization for Animal Health said they need a total of $35 million in donations immediately to finance their part of the fight over the next six months.