PREPARATIONS NEEDED

“This is the largest infectious disease outbreak amongst animals we have ever experienced, unprecedented in the history of influenza,” Asia-Pacific Advisory Committee on Influenza (APACI) chairman Dr Lance Jennings said in an interview, explaining the relationship between bird flu outbreaks and a human influenza epidemic. “As long as this virus circulates amongst poultry populations globally and exposes humans, we will see ongoing human infections occurring.”

Dr Jennings also said that the closeness between humans and animals in South-east Asia has facilitated the conditions that allow the merger of viruses, and that it is of particular importance that people, especially in the Asia-Pacific region, realise the seriousness of influenza. As for when a possible global pandemic will happen, Jennings’ words echoed Nabarro: “We can safely say that we will have a human influenza pandemic. We don’t know when and we don’t know how severe it is. ” Jennings also points out that there are a number of other human influenza viruses circulating that could become the next human pandemic virus, and that no one can predict whether the H5N1 virus will indeed turn out to be this. (APACI) met in Beijing a few months ago.)

Vaccines are the primary medical intervention for protecting people against pandemic influenza, but a human vaccine against H5N1 is not yet available at the moment. Vaccination is also a tricky issue and WHO does not yet have an official position on pre-pandemic vaccination.

First, vaccines work well when they match the circulating strain of flu. But the H5N1 strain has not evolved into a form that passes easily between humans. So there are questions on the effectiveness of the vaccines in research. Second, following this appoach everybody in the world should be vaccinated -- and this is obviously not practical. Even if there are enough financial resources, policymakers have to weigh the risk of immunising against a pandemic that may not happen. A similar lesson is provided by the 1976 swine flu scare in the United States. That year, millions of Americans were vaccinated against swine flu after an outbreak at a U.S. army base, but this never occurred -- and the vaccine was blamed for a rise in cases of a rare neurological illness.

Despite these shortcomings, vaccines remain the final solution to the problem. WHO gathered 120 public health experts and launched a plan in October 2006 to increase global flu vaccine capacity, which is expected to rise to 780 million doses by 2009. Even if the goal is met, the production capacity is still far short of what would be needed to fight a global pandemic. The plan could cost three to 10 billion U.S. dollars over the next decade. Preparations for a possible pandemic could lead to a huge waste of money and production facilities. Who will pay for the bills? For sure, the most vulnerable developing countries cannot afford this huge cost.