Uncertainty Surrounds Bird Flu Preparedness Efforts

Laurie Garrett, who runs the Global Health Program at the Council on Foreign Relations, notes that people are trying to do the right thing but nobody knows what the right thing is. Governments are spending billions of dollars to buy medicines and vaccines to prepare for a possible human bird flu pandemic, but too little planning has gone into how to use the accumulating arsenal of medical weapons. The World Health Organization and some countries have focused on limited purchases aimed at people likely to be exposed in an epidemic, but there is huge uncertainty about how best to prepare.

Key Takeaways:

• The use of anti-viral medicines, such as Tamiflu, to control flu epidemics is not well understood, with only a few small studies available.
• There is a risk that the virus could quickly become resistant to the available drugs, making it even more dangerous.
• The stockpiling of anti-viral medicines is not only about having a large quantity of drugs, but also about having an actual plan to use them effectively.
• The World Health Organization notes that there is not "a huge amount of literature or experience" in using anti-viral drugs to control flu epidemics.
• Many countries have ordered millions of doses of Tamiflu, but have not indicated whether they are for treatment or prevention.
• A vaccine that could prevent people from getting infected with bird flu would be ideal, but one does not exist.
• Sanofi Pasteur is producing a vaccine developed at the U.S. National Institutes of Health that targets a H5N1 animal strain of bird flu from 2003, but no one knows how well it will work if and when the animal virus mutates into a strain that can be spread by humans.
• The production of a dose of vaccine takes four to six months, and it may not be effective against a pandemic strain of the virus.
• The lack of leadership and planning has led to a reliance on "a quick technological fix."

Statistics:

• There have been about 120 known human cases of bird flu worldwide, all in Asia, half of them fatal.
• The World Health Organization has stockpiled a small but significant supply of Tamiflu, much of it donated by Roche, for a targeted public health campaign.
• Roche is giving countries a discount on pills bought for flu preparedness, with the active ingredient of Tamiflu costing about £25 for a five-day treatment.
• $3.9 billion has been earmarked for bird flu preparedness in the United States, with 80 percent of the funds going for massive purchases of Tamiflu.

Sources:

• Garrett, L. (No date). People are trying to do the right thing, but nobody knows what the right thing is. (As quoted by Rosenthal)
• Rosenthal, E. (No date). World Health Organization officials say that the country's stockpiling of anti-viral medicines is not only about having a large quantity of drugs, but also about having an actual plan to use them effectively.
• World Health Organization (No date). We have no way to be sure that the vaccine will work against a pandemic strain of the virus.
• Sanofi Pasteur (No date). The production of a dose of vaccine takes four to six months.
• Garrett, L. (No date). We're building a whole public health strategy based on these drugs, extrapolating a huge amount from a few small studies.
• Roche (No date). Roche is giving countries a discount on pills bought for flu preparedness.