ARE WE PREPARED?
With all the news lately about new H5N1 cases and an imminent pandemic, a growing number of people are asking the same question: Are we prepared to handle a H5N1 pandemic?
We are not prepared to handle a flu pandemic. No country in the world today is prepared, according to the WHO. Here are some statistics and facts you should know.
- One-fifth of the world's countries have pandemic-response plans.
- 30 countries are planning to stockpile large amounts of Tamiflu, but the manufacturer Roche cannot make the drug fast enough to fill orders promptly.
- Twelve drug companies worldwide make flu vaccines. 95% of their output, or 260 million doses, are used in the world's wealthiest countries.
- Current trends indicate that many developing countries will not have access to vaccines and antiviral drugs during a pandemic.
In an interview with Brian Ross on ABC's Primetime, US Secretary of Health and Human Services Michael Leavitt had this to say about our preparedness:
Ross: Is this country prepared today for this epidemic?
Leavitt: Not as prepared as we need to be. We're better prepared today than we were yesterday. We'll be better prepared tomorrow than we are today. But no one in the world is prepared enough yet.
Influenza experts have spoken out about the dangers of avian influenza since 2001. Robert Webster, a leading flu researcher, has continually called for an increase in the production of neuraminidase inhibitors, such as oseltamivir and zanamivir. Webster also calls for governments to begin stockpiling these drugs in large quantities. "If a pandemic happened today, hospital facilities would be overwhelmed and understaffed because many medical personnel would be immobilized. Reserves of existing vaccines, M2 inhibitors, and NA inhibitors would be quickly depleted, leaving most people vulnerable to infection," Webster states.
However, many countries, including the US, ignored these warnings for many years. Here in the US, the government was focused on researching and developing vaccines for unlikely biological threats like smallpox, anthrax, and Ebola fever, rather than developing a vaccine for the diseases that posed a greater and more realistic threat.
The threat of a pandemic has prompted many governments to begin stockpiling Tamiflu. The United States currently has 2 million doses stockpiled, with plans to have a total of 20 million doses of Tamiflu. But is this enough? Health experts have criticized the US for its lack of preparedness. Roche, maker of the drug, suggests that countries order enough Tamiflu for a quarter of their population. This would mean 74 million doses for the US, but the CDC and many others would like to see the US have more than 100 million doses stockpiled. However, Roche has come under intense scrutiny, because it can only produce 8 million courses a year, not nearly enough to satisfy countries orders promptly. In addition, poorer countries in Africa and Asia are unlikely to receive any antiviral drugs at all.
Several steps can be taken to lessen the risks of a pandemic occurring. Vaccinating people who work closely with infected birds with regular flu vaccines would help prevent the co-infection of humans with avian and human flu viruses, decreasing the chances of genetic reassortment. Constant surveillance of poultry markets, aquatic bird reservoirs, and domestic poultry would also help to decrease the risk. The WHO continues to encourage countries to develop pandemic-preparedness plans, as well as stockpiling antiviral drugs in preparation for a pandemic.