From correspondents in Hong Kong
September 25, 2005

WORLD health chiefs are keen that Western governments do not respond to the disease in the secretive, and costly, way many in Asia did.

Since large outbreaks emerged in 2003, authoritarian regimes and elected governments alike have tried to dampen speculation and prevent media coverage on the extent of the deadly H5N1 virus within their borders, arguably aiding its spread.

"In an epidemic, when you have a well informed public you have a far greater chance that there will not be any panic and that they will do things to keep themselves healthy and slow the spread," said the World Health Organisation's Bob Dietz.

A senior university microbiologist who works closely with the Hong Kong government on its flu prevention strategy was more forthright: "Cover-ups have cost lives," he said.

Desmond O'Toole, professor of biology at Hong Kong's City University said governments were duty bound to act quickly.

"They should be testing straight away and acting fast -- delays are a no " O'Toole said.

It is probably no coincidence that the three countries worst affected by bird flu -- Vietnam, China and Thailand -- are the three that have been least transparent about its spread.

In January 2004, Vietnam's Tuoi Tre daily published a report sent by the agriculture ministry to Prime Minister Phan Van Khai, revealing bird flu had been detected on a large poultry farm in the north six months earlier.

At the time, however, Vietnam was preparing to host the 22nd Southeast Asian Games and believed everything should remain under wraps.

"So we did not announce it for political and economic reasons," a ministry official told Time magazine later.

Some 42 human deaths and the culling of millions of poultry birds later, the central authorities are cooperating.

"We don't have any indication that there is not a good reporting system," said Hans Troedsson, the World Health Organisation's (WHO) representative in Hanoi.

Information can yet still be a problem, due to the inability of the central government to control a vast country of 82 million people and hundreds of million poultry in backyards everywhere.

Astrid Tripodi, avian influenza coordinator for the UN's Food and Agriculture Organisation in Hanoi said: "If the provinces do not pass on the information, the higher officials cannot know what is happening."

Most scientists look to China as a possible incubator for contagious human strain of the virus, a disease that has been known amongst poultry birds for decades.

Although Beijing has appeared more forthcoming with infectious diseases since its failed attempt to cover up the Severe Acute Respiratory Syndrome (SARS) epidemic in 2002, health organisations continue to clamor for more transparency.

The government has set new regulations on reporting outbreaks. Though they still give the government final say in publicising diseases, they are widely seen as a move towards greater transparency.

China was quick to report the spread of the bird flu among wild birds in western China's Qinghai province in May, but it just as quickly forbade journalists from travelling to the region and failed to provide timely information on human testing for the virus.

Thailand, one of Southeast Asia's top poultry producers, was slow to admit to an initial outbreak in 2003.

The government has described its own handling of the first human case as a "screw up", but the government's many critics saw it as a cover-up.

Thailand announced in January 2004 that a seven-year-old boy had contracted bird flu, after repeatedly denying the disease had reached the kingdom. The boy later died, making him among the first of the nation's 12 bird flu fatalities.

Since then, 11 more Thais have died and the government response has improved markedly, including "Chicken Day" awareness campaigns to teach the public how to safely cook poultry and to avoid handling sick birds.

The Hong Kong researcher said what appeared to be a cover-up in some countries may actually have been a cloak for a lack of any real information.

"There are some places that don't have the capability to monitor the situation," he said. "It may not be that they are covering anything up, they just may not know."

Indonesia, where the region's latest outbreak is centered, is a case in point. The archipelago of 17,500 islands has poor communications and its disease reporting mechanisms are weak.

"Informing more than 200 million people is not easy. It takes time and costs a lot of money," Indonesian Health Ministry spokesman Sumardi said. "That's why it is not only the responsibility of the government but also that of members of the public and the media to educate the people."

Cambodia, where four people have died of bird flu since 2003, also lacks monitoring infrastructure and often relies on international bodies like the WHO to keep tabs on the situation.

By contrast, developed economies with open governments and solid health institutions have remained largely free of infection.

Though Hong Kong's initial response in 1997 was criticised as slow, the Chinese territory has never been accused of keeping bird flu under wraps and has suffered no deaths since that outbreak.