Nancy Cox

When Time magazine named “The Time 100: The People Who Shape our World,” the list was predictably dominated by household names: George W. Bush, Bill Gates, Pope Benedict, Oprah Winfrey. Listed among these globally recognized figures is Dr. Nancy Cox. Including a 31-year veteran of the federal civil service among the world’s most prominent figures might seem like a bit of a stretch—until you realize what she does. Dr. Cox is leading the U.S. and global effort to prepare for the possible outbreak of an avian flu pandemic. In other words, the lives of literally millions of people could be riding on her work. Not so much of a stretch any more, is it?

In 2003, a deadly strain of an avian flu was found in Southeast Asia. This virus subsequently moved into Russia, then Eastern Europe, and most recently, into parts of Africa and Western Europe. Roughly 200 people have been infected, the majority of whom have died. Currently, the virus has only been transmitted by extremely close contact with sick birds, but it is constantly mutating, and should it change in a way that would enable it to be transmitted easily from human to human, it could trigger a global pandemic. To understand the serious nature of this threat, consider that the Spanish flu of 1918, the most severe pandemic of the 20th century, killed up to 40 million people worldwide and more than 500,000 people in the United States.

When the stakes are this high, nothing less than the best will suffice when it comes to the team leading the response. By any reasonable measure, Dr. Cox and her team are the best.

Dr. Cox is Chief of the Influenza Branch of the Centers for Disease Control and Prevention (CDC) and is also the Director of the World Health Organization (WHO) Collaborating Center for Influenza. She is a world renowned leader in her field and has made countless contributions to global influenza knowledge, prevention and control. Her colleagues describe her as a “visionary” and a “unique contributor to science and public health.”

Dr. Cox and her team at CDC have already made important strides toward reducing the impact of any pandemic influenza. First, they have dramatically improved influenza surveillance. Cox’s team has developed the gold-standard algorithm for determining if a human is infected with a novel avian strain. Dr. Cox has participated in a number of outbreak investigations to better understand risk factors for avian influenza.

The team has improved research and vaccine development. Dr. Cox’s group has developed pandemic vaccine candidates for multiple avian influenza strains. Her team has reconstructed the 1918 influenza virus to understand the lethality of this virus and how to best control it. Their write-up of this research recently won Paper of the Year from one of the world’s leading medical journals.

Dr. Cox and her team have enhanced vaccination and infection control efforts. They have provided technical assistance and training to state and international partners for the identification of avian viruses. They have developed strategic plans about who should receive vaccines first.

Her accomplishments are hardly limited to her work on the avian flu. Dr. Keiji Fukuda of the World Health Organization says that her work on vaccines has already saved thousands of lives. In addition, her group recently determined that seasonal influenza viruses had become resistant to one class of antiviral drugs used to treat and prevent influenza infections. Within two weeks, her team had published a paper revising the policy for the use of anti-virals and notified all relevant local, state and international health professionals.

Hopefully, an influenza pandemic will never strike the United States, prompting an occasion for Dr. Nancy Cox to become a household name. But if such a crisis were to occur, the American people can feel better knowing that Dr. Cox and her team are on the case.