Most public health experts and risk managers agree that the world is overdue for an influenza pandemic. Yet many European companies and government agencies are still ill-prepared for an event that could kill millions of people, sicken many more, and cause hundreds of billions of dollars in economic losses.

A presentation at this year’s World Conference on Disaster Managementin Toronto laid bare the large gaps in preparation and planning for a pandemic in Europe.Richard Coker, head of the Communicable Diseases Policy Research Group at the London School of Hygiene and Tropical Medicine, surveyed the information available to the public and companies in the 27 member states of the EU as well as Norway, Switzerland, and Turkey.

He began by setting out the scope of the challenge. The range of forecast outcomes in a pandemic vary greatly, which makes planning a major challenge. A flu outbreak in the EU could sicken about 150 million people, one-third of its total population. About 3.7 million people could die. The economic costs are estimated at $270 billion. Coker says these are rough forecasts, because in a crisis “we would have complex feedback loops that make it very difficult to predict effects."

Yet few companies in Europe are prepared for an influenza crisis. The H5N1 strain of the virus has been travelling westward from China for years, and has recently appeared in Europe. It affects mainly poultry and wild birds. The World Health Organization has only reported 310 cases of human H5N1, including 189 deaths, since the disease was first identified in Hong Kong a decade ago. However, scientists fear the disease, with a lethality rate of 60 percent, could mutate and begin to rapidly infect humans.

Coker cited surveys which found that 44 percent of companies lack a plan specifically designed for an influenza pandemic. Another showed that 54 per cent lack an employee communications plan.His research team analyzed information, mainly from national government agencies in the EU and a few consultancies to map the guidance given to local companies. Coker says he did not attempt to evaluate the quality of the advice, but just counted whether it included key items. Only a handful of countries such as Ireland, France, and the United Kingdom have relatively well-designed national plans.

Yet most of the information given to companies is still inadequate, says Coker. He says governments give insufficient attention to legal issues and internal communications. Indeed, he says, politicians are rejecting expert advice in critical areas, such as policies toward EU nationals living or traveling overseas. Recent debates in the European parliament indicate that politicians may urge governments to repatriate European citizens from high-risk regions in a crisis, a proposal that would accelerate the spread of the influenza virus. “That would not be a good idea,” says Coker.

He found that few corporate plans are coherent with regional, national, or global plans. There is little advice for companies on stockpiling antivirals, or how to prioritize their distribution. Neither does the advice companies receive from governments address in any depth corporate legal responsibility in a crisis. For instance, could companies be compelled to cooperate with government authorities and could they be held liable for actions they undertook under government direction? Furthermore, says Coker, “there is very little recovery planning and no attention to business recovery."

The larger EU countries seem to be better-served than smaller, less developed EU countries in Eastern Europe or Turkey. And most of the companies at risk are small- and medium-sized enterprises (SMEs). Multinational companies, especially those in financial services and the oil industry, have drawn up sound and detailed plans, says Coker.

Unfortunately, most European private sector employees work for SMEs that lack the management depth or budgets needed to prepare for a major health crisis.