Study Finds Limited Benefit From Tamiflu

British researchers said there is little evidence Tamiflu stops complications in healthy people who catch the flu, though public health officials contend the drug reduces swine flu hospitalizations and deaths.
Researchers at the Cochrane Review, an international nonprofit that reviews health information, looked at previously published papers on Tamiflu as used for seasonal flu. They found insufficient data to prove whether the antiviral reduces complications like pneumonia in otherwise healthy people but concluded the drug shortens flu symptoms by about a day. The papers were published online Tuesday in the British journal, BMJ.
The researchers said the benefits of Tamiflu were small and that authorities should consider its side effects before using the drug in healthy people. While the reviewed studies only looked at Tamiflu use for seasonal flu, the experts said their conclusions raised questions about the widespread use of the drug in people with any flu-like illness, including swine flu.
Fiona Godlee, BMJ's editor, said the papers cast doubt not only on how safe and effective Tamiflu is, but on the drug regulatory system that approved it. "Governments around the world have spent billions of pounds (dollars) on a drug that the scientific community now finds itself unable to judge," she said in a statement.
But the World Health Organization disagreed. They said data from countries around the world show that when given early, Tamiflu can reduce the severity of swine flu symptoms, though the agency recommends the drug be saved for people at risk of complications, like pregnant women, the elderly, children, and those with underlying medical problems.
"This will not change our (Tamiflu) guidelines," said Charles Penn, a WHO antivirals expert. Penn said that while past studies show Tamiflu only has a modest benefit, when patients with severe illness or at risk of complications are treated early, there are fewer hospitalizations and deaths.
And Roche, the maker of Tamiflu, defended the drug, saying in a statement that they "firmly believe in the robustness of the data."
Both the British researchers and WHO said there is little evidence to support the widespread use of Tamiflu in otherwise healthy people -- precisely the policy Britain has adopted to fight swine flu.
In addition to recommending Tamiflu be saved for at-risk groups, WHO recommends Tamiflu only be used on a doctor's recommendation.
In Britain, however, Tamiflu is regularly dispensed to healthy people who catch the flu. The drug is given out via a national swine flu hotline by call center workers with no medical training.

Roche’s Tamiflu Not Proven to Cut Flu Complications

Roche Holding AG’s antiviral drug Tamiflu may not prevent complications from influenza in healthy adults, according to a review by an independent research group that reversed its previous findings that the medicine warded off pneumonia and other deadly conditions linked to the disease.
The pill has been the mainstay of treatment for pandemic swine flu, which has killed nearly 9,000 people since it emerged in April, according to the World Health Organization. Roche, based in Basel, Switzerland, defended the benefits of the drug, which it expects to generate 2.7 billion francs ($2.64 billion) in sales this year.
An analysis of 20 studies by the Cochrane Collaboration showed Tamiflu offered mild benefits for healthy adults and found no clear evidence it prevented lower respiratory tract infections or complications of influenza, according to the group. The review, published in the British Medical Journal and broadcast yesterday on the U.K.’s Channel 4 News, showed the drug eased and shortened symptoms if taken quickly.
The report, an update of a 2005 analysis by Cochrane, excluded eight studies funded by Roche that haven’t been published and whose full data wasn’t given to the researchers. The exclusion reversed the nonprofit group’s earlier finding that Tamiflu protects against complications.
Insufficient Evidence
“We now conclude there is insufficient evidence to describe the effects of Tamiflu on complications of influenza or the drug’s toxicity,” Tom Jefferson, the lead researcher from the Cochrane Collaboration in Rome, said in a telephone interview. “We have multibillion-dollar public health policies in place that rely on evidence not available for independent analysis.”
The group, which reviews medical evidence, excluded the eight studies, involving 2,500 patients, because it couldn’t get satisfactory access to the data involving the healthy adults in the study, he said.
The report raises questions about how drugs are reviewed, approved and distributed, Fiona Godlee, the British journal’s editor in chief, wrote in an editorial. The studies originally used to establish the benefits of Tamiflu were written by Roche employees and paid consultants, under-reported serious side effects and failed to clearly identify all the authors, she wrote. In at least one case, a study was attributed to a researcher who disavowed any involvement to the journal, Godlee wrote.
‘Taken on Trust’
Governments relied on the studies to justify the widespread use of Tamiflu, known chemically as oseltamivir, she said. The reviewers were unable to find any independent studies of the drug in healthy adults, she said.
“This case exposes how much of the evidence on drug safety and effectiveness is taken on trust,” Godlee wrote. “Governments around the world have spent billions of pounds on a drug that the scientific community has found itself unable to judge.” She called for more independent research, greater access to raw data used to license and sell drugs and stricter regulations on the conduct, review and publication of medical research.
Roche defended the drug’s benefits and its research, saying confidentiality agreements with patients enrolled in the trials kept the company from giving the investigators unreserved access to the findings.
“We fully stand behind the robustness of the data and the integrity of that data, particularly the efficacy and safety of Tamiflu, the conduct of our studies and publication policies,” David Reddy, head of the company’s global pandemic task force, said on a conference call with reporters. “We believe this drug is playing a pivotal role in the management of the current pandemic.”
Data From Pandemic
Two published trials show Tamiflu reduces complications in patients with seasonal influenza, while an observational study suggests it may lower death rates, Reddy said. Data emerging from the swine flu pandemic shows giving the drug within two days of symptoms appearing is the only effective way to help patients, he said.
More than 8,768 people worldwide have died from swine flu since it was first identified in Mexico and the U.S. in April, according to the Geneva-based WHO. More than 68 million people have taken Tamiflu since it was approved a decade ago. Influenza kills as many as 500,000 people worldwide each year.
The WHO recommends giving Tamiflu to infected people with a high risk of developing complications, including pregnant women and people with underlying medical conditions. The researchers said there is little evidence now available to show that otherwise healthy people should be routinely given Tamiflu.
In the U.K., patients can get a Tamiflu prescription by calling a national hotline or filling out an online questionnaire about their symptoms.
“The evidence shows that if taken within 24 hours, Tamiflu reduces symptoms of influenza by about a day,” Jefferson said. “It may reduce transmission. But we could not verify the claims that Tamiflu reduces complications. Once you took out the eight unpublished studies, the data relating to healthy adults that weren’t published, what remained showed no effect.”

Drug-resistant swine flu strain spread between patients at a Welsh hospital

THE first European cases of a strain of swine flu which cannot be treated with the drug Tamiflu have been diagnosed in Wales.
The five patients at the University Hospital of Wales, in Cardiff, could also be the first confirmed cases of person-to- person transmission of Tamiflu-resistant swine flu in the world.
Two of the patients have been treated and discharged, one is in critical care and the remaining two are on a ward receiving treatment.
It is thought that they contracted the virus, which must be treated with an alternative antiviral medicine, while they were in hospital.
Public health officials last night took steps to reassure the public that Tamiflu, which is also known as oseltamivir, is safe.
The Government stockpiled millions of doses of the drug, which can cut the duration and severity of flu infections, before the emergence of the swine flu pandemic in April.
The drug has been used as a first line treatment in those people who become infected and have underlying health problems, putting them at greater risk of complications.
Dr Roland Salmon, director of the National Public Health Service for Wales’ (NPHS) communicable disease surveillance centre, said: “The emergence of influenza A viruses that are resistant to Tamiflu is not unexpected in patients with serious underlying conditions and suppressed immune systems, who still test positive for the virus despite treatment.
“In this case, the resistant strain of swine flu does not appear to be any more severe than the swine flu virus that has been circulating since April.
“For the vast majority of people, Tamiflu has proved effective in reducing the severity of illness.
“Vaccination remains the most effective tool we have in preventing swine flu so I urge people identified as being at risk to look out for their invitation to be vaccinated by their GP surgery.”
The NPHS last night said that all the patients at UHW who have been diagnosed with Tamiflu-resistant swine flu have been treated with an alternative antiviral. They have either been isolated or are being cared for in a designated area for influenza cases. All other patients on the unit have also been tested for swine flu.
The NPHS said that Cardiff and Vale University Health Board has ensured that all appropriate infection control measures are in place on the unit.
Patients and staff at the unit have been offered swine flu vaccines and those patients due to come onto the unit for treatment will be contacted over the weekend and advised to have the swine flu jab before they are admitted.
Household contacts of the patients with swine flu are also being followed up to ensure early and appropriate treatment is offered should they develop flu-like symptoms.
Dr Tony Jewell, Wales’ chief medical officer, said: “We know that people with suppressed immune systems are more susceptible to the swine flu virus, which is why they are a priority group under the first phase of the vaccination programme in Wales which is progressing at pace.
“We have stringent processes in place for monitoring for antiviral resistance in the UK so that we can spot resistance early and the causes can be investigated and the cases managed.
“Identifying these cases shows that our systems are working so patients should be reassured.
“Treatment with Tamiflu is still appropriate for swine flu and people should continue to take Tamiflu when they are prescribed it.
“It’s also important that good hygiene practices are followed to further prevent the spread of the virus.”
The emergence of Tamiflu- resistance swine flu is not unheard of – the World Health Organisation said 28 resistant viruses have been detected and characterised.
The emergence of Tamiflu- resistant swine flu at UHW came a day after the swine flu-related death toll rose to 21 in Wales and it was confirmed that children under five will be offered the swine flu jab.

Don’t give up on swine flu jab

THE five Welsh patients with a Tamiflu-resistant strain of swine flu have increased the need for those at risk to be vaccinated, health officials have said.
Over the weekend, three of the five remained in Cardiff’s University Hospital of Wales. The five are thought to be first confirmed person-to-person cases of a Tamiflu-resistant strain in the world.
Concerns exist that those in need of vaccination will now pass up the offer because they believe the virus is untreatable, but hospital officials warned the opposite was true and that vaccination was more important than ever.
Dr Roland Salmon, director of the National Public Health Service for Wales’ (NPHS) communicable disease surveillance centre, said that the emergence of a Tamiflu-resistant strain was not unexpected where patients had serious underlying conditions and suppressed immune systems.
He said: “I wouldn’t like people to go away with the idea that this is completely untreatable.
“This is a very special set of circumstances, and it remains to be seen whether this would actually happen out in the community, where most of the people you would meet would have perfectly normal immune systems.
“One of the things this does say to us is, if anything, it makes vaccination more important and particularly vaccination of those people who have been top of the priority list, which is those with underlying health conditions of the type which have given rise to the problem here.
“The one medicine, an important medicine that we’ve got a lot of, Tamiflu, these patients have developed resistance to.
“But there is another perfectly good treatment, Relenza or Zanamirvir, still available and to which this virus is not only sensitive but, for various biological reasons, we expect to remain sensitive.”
Two of the five Cardiff patients were treated and discharged while one is spending the weekend in critical care and the other two are on a ward being treated.
It is thought that they contracted the virus in hospital, but health officials have stressed there is no risk to anyone else.
Tests have been carried out to establish what happened and officials have issued reassurances to the public that Tamiflu, also known as oseltamivir, is safe.
The Government stockpiled millions of doses of the drug, which can cut the duration and severity of flu infections, before swine flu first emerged in April.
The drug has been used as a first line treatment in those people who become infected and have underlying health problems, putting them at greater risk of complications.
Despite the latest alert, statistics show that cases of swine flu are falling
Dr Salmon said: “The number of people contacting their GP with flu symptoms has stalled and started to decline slightly over Wales as a whole.
“Nevertheless, flu is still circulating and we therefore continue to emphasise the importance of being aware of the symptoms of swine flu and of the steps that can be taken to prevent its spread.
“The vaccine against swine flu has been tested and approved. It is now being offered to people at most risk of complications from the virus as well as front line health and social care workers.
“Vaccination is the most effective tool we have in preventing swine flu, so I urge people identified as being at risk to look out for their invitation to be vaccinated by their GP surgery.”
In the UK, 214 people with swine flu have died – 21 in Wales. Most had underlying health conditions.

Swine flu jab to be offered to healthy under-fives

Healthy children aged between six months and five years old will be vaccinated against swine flu from next month, the Department of Health has confirmed.
The expansion of the government's inoculation programme comes as the latest pandemic bulletin reported a sharp rise in the number of children being admitted to hospital and a further surge in patient deaths.
The overall estimate of swine flu cases, however, showed a second successive weekly fall. Health officials estimate there were 55,000 new cases this week in England compared with 64,000 last week. There was also a dip in cases in Scotland. The decline could still be a temporary consequence of warm weather or half-term: pupils have been one of the main transmission routes.
The number of people who have died from swine flu in the UK has risen to 215, with 18 deaths in England alone last week. The figures since the start of the outbreak in May now stand at 142 fatalities in England, 21 in Wales, 39 in Scotland and 13 in Northern Ireland. Among the latest confirmed deaths was that of a five-year-old schoolgirl from Slough, Berkshire.
The number of people needing hospital care for the virus is 783, down slightly from 785 in the previous week. Of those in hospital, 180 were in intensive care - up from 173 the previous week. 
The decision to include young children in the next phase of the inoculation programme comes as evidence accumulates demonstrating their vulnerability to the H1N1 virus. Around 21% of all H1N1 deaths in the UK have been among the under-14s. More than 80% of the under-fives who ended up in hospital had no previous health problems.
The existing vaccine priority groups include those with pre-existing medical conditions, their carers and pregnant women. Youngsters with asthma or diabetes, for example, are already being vaccinated. The additional categories will raise the target numbers for priority vaccine groups from 14 million to approaching 20 million. GPs are expected to begin offering the vaccine to healthy young children before Christmas even if they have not inoculated all their patients in other priority groups. 
The chief medical officer, Sir Liam Donaldson, said: "Protecting those most at risk from the disease will reduce the levels of serious illness, and deaths. That's why we will shortly offer the vaccine to young children. 
"Vaccination remains a personal choice, but I urge everyone who is offered the vaccine to accept it and protect themselves. While the risks of serious complications from flu may be small, the impact on those affected can be devastating."
Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health, said: "[We] strongly recommend that parents should get their children vaccinated if they are offered the vaccine. We would like to emphasise the importance of children's doctors and nurses being vaccinated too, not least to prevent passing the infection on to their patients who may be vulnerable children with serious diseases."
Andrew Lansley, the Conservative health spokesman who has urged the government to vaccinate healthy children, said: "This is in line with emerging evidence that they are one of the groups with the highest rates of hospitalisation, which is putting a real strain on the NHS."
Around 715,000 people are estimated to have caught the infection. Nearly two-thirds of those who have died in the UK have been under the age of 44.
The Medicines and Healthcare Regulatory Agency (MHRA) yesterday released further details of reported adverse reactions to vaccines and anti-viral drugs prescribed for swine flu. It said that no safety concerns had emerged. Eight deaths had been reported among patients who took Tamiflu but: "These cases have been fully evaluated and in none of these is there evidence to confirm that Tamiflu was directly responsible for the fatal event. Underlying medical conditions and/or concurrent infection provide a more plausible alternative explanation for the events."

GSK may shift some Relenza manufacturing to mainland

British drugmaker GlaxoSmithKline (GSK) Plc is planning to move part of its flu drug Relenza manufacture to China to better support the local market.
"I hope that we will be able to shift some Relenza manufacture to China to make our products more accessible in the country," said Chief Executive Andrew Witty.
The drug, which received the State Food and Drug Administration (SFDA) approval in September for domestic sales, is used to fight the flu virus along with Roche's Tamiflu.
Welcoming the Chinese government's speedy approval for Relenza in the country, Witty said GSK is the only firm that produces both vaccines and drugs to tackle H1N1 flu.
GSK has adopted a three-pronged strategy to tackle the epidemic, said Witty. Apart from producing the vaccine, the company is also making anti-viral face-masks, and anti-viral medicines such as Relenza.
The company plans to ship nearly 450-500 million doses of its anti-H1N1 flu vaccine and sell 60 million packs of Relenza globally from this quarter to next year.
The CEO said GSK's joint venture with a Shenzhen-based pharmaceutical firm would "help bring more of GSK's technologies to China".
GSK inked a deal with Shenzhen Neptunus Interlong Bio-tech in early June to develop flu vaccines for the Chinese market and invested $35.3 million for a 40 percent stake in the new venture.
"The joint venture with Neptunus, which focuses on flu vaccines will hopefully in the future create greater domestic capability," he said.
GSK also signed a deal with Yunnan Walvax Biotech in October to co-launch a company that focuses on vaccines for kids, with an initial investment of 451 million yuan from the two companies.
Witty said the company is now putting more emphasis on its vaccine and consumer goods businesses and focusing on emerging markets like China, Brazil and Russia.
"We have a leadership position in vaccine and consumer products. What I want to do is to build these two businesses so that the three main arms of pharmaceuticals, vaccines and consumer goods, can complement each other. That way we would be able to mitigate our risks and deliver consistent and sustainable growth," he said.
Emerging markets like China offer immense potential for growth due to the rapid development of the healthcare sector, he said.
"It's an easy decision to prioritize here as I've spent most part of career in emerging markets like Asia and Africa," said Witty.
The company is enhancing its investment in China by increasing the amount of R&D investment and employing more people to work with hospitals, apart from forging partnerships with local companies, he said.
"In reality, for GSK, the center of gravity is moving to the east."
GSK has so far invested $400 million and has around 4,000 employees in China.

Drug-resistant swine flu found

SCOTLAND could be facing a drug-resistant strain of swine flu after two patients failed to respond to treatment.
One patient in the Lothians and another believed to be from Fife failed to respond to Tamiflu, one of the only treatments for the H1N1 virus.
Doctors around the world have seen a handful of cases where the virus has mutated to develop resistance to the drug.
NHS Lothian confirmed it has seen one patient with Tamiflu-resistant swine flu.
A spokesman for the Scottish Government said: "We are aware of Tamiflu resistance in two Scottish H1N1 patients.
"We have asked Health Protection Scotland to monitor the situation closely."

H1N1 Flu Update

They will reopen the phone bank at Kalamazoo County Health and Human Services this morning to continue taking reservations for this Friday’s Flu clinic. Apparently there were so many calls at one point yesterday morning that it tied up every line the County owns, jamming up the County’s Phone System for two hours.
County Health Director Linda Buzas says its better that they have to wait on hold, than have to wait on line outside. He says with ten operators on duty, she can’t promise you won’t spend some time on hold, but it won’t be as bad as it was yesterday morning. She says they are taking about 200 reservations an hour…so they could run out of vaccine sometime today.
The number if you want to try is 373-5283, but remember you must be a member of a high risk group to qualify.
The State is reporting 6 more swine flu deaths in Michigan, bringing the total to 12 in the past week and 28 since September first.
Two of them were in Kalamazoo, the death of a person in their 20s back in October and the death of 10 year old Kamren Blakely Last Wednesday.
It also includes the death of 29 year old Erica Lynn Mitchell of Otsego last Wednesday at Bronson hospital. She is reported as an Allegan county death. But the death rate is still typical of a seasonal flu outbreak…its just coming earlier this year.
State health officials are urging people with asthma to get the seasonal and swine flu shots as soon as possible. Chief Medical Executive Greg Holzman of the Michigan Community Health Department said on Monday that a third of those hospitalized nationally this year with H1N1 symptoms had asthma.
Holzman says that four Michigan residents with asthma were among the 34 H1N1 patients who've died in the state since April. He says those with asthma should see a doctor promptly if they get flu-like symptoms so they can receive Tamiflu. State health officials say that since September first, 28 Michigan residents have died and 801 have been hospitalized with H1N1-like symptoms.

Will Tamiflu Shortage Drive U.S. To India's Version?

With demand for the swine flu vaccine outpacing supply, the Centers for Disease Control and Prevention says it is open to considering importing a generic flu drug from India. There's just one problem: Tamiflu, the brand-name drug, is still under U.S. patent.
Flu-related hospitalizations and deaths are still on the rise in the United States. But there's a shortage of Tamiflu, the anti-viral medication that can protect against complications caused by the illness.
To deal with the shortage, the CDC has ordered more Tamiflu from Roche, its Swiss manufacturer — but it is not expected to arrive until January. 
Antiflu, a generic version of Tamiflu, is made by the Indian company Cipla — despite the fact that Tamiflu's patent is protected under U.S. law until 2016. The Cipla version costs 20 to 30 percent less than the brand-name drug.
Dr. Yusuf Hamied, chairman of Cipla, says he is eager to provide the U.S. market with his generic version of the drug. 
"We would keep our factories open night and day, because this is an emergency," he told NPR's Steve Inskeep.
"We would certainly cooperate in whatever way possible." 
The U.S. government has already released its last 200,000-some doses of the oral liquid version of Tamiflu for children. The highest hospitalization rate for swine flu is in children age 4 and under.
A recent poll from the Harvard School of Public Health found that only about a third of adults who have tried to get a swine flu vaccine have been able to get it.
Hamied says Antiflu is an exact clone of Tamiflu. It has been approved by the World Health Organization and is already for sale in India. 
In 2001, Cipla tried to import its generic version of the antibiotic Cipro — which was stockpiled after the anthrax attacks in 2001. 
"The drug was covered under patent," Hamied said. 
"And I think what happened — the American government stockpiled Ciprofloxacin and probably made a deal with Bayer [the manufacturer] at a much lower price than what was the prevailing market price at the time." 
Hamied said his new plan to export Cipla's version of Tamiflu to the United States faces similar problems.
To import Antiflu before 2016, the U.S. government would have to override patent law, which it would likely only do in a real emergency. And Cipla's drug does not yet have Food and Drug Administration approval.
India is the largest and fastest-growing producer of generic medicines; Hamied's company has a long history of producing generic drugs to sell at cheap prices in the developing world. 
The most famous of these is Cipla's generic anti-retroviral drug. It is considered to be lifesaving for HIV-positive people in Africa, because it is available for a fraction of the cost of brand-name anti-retrovirals. 
In developed countries, anti-retrovirals cost around $6,000 per patient per year; the Indian generic version is available in the developing world for $800.
All of this has not made Cipla — or Hamied — popular among pharmaceutical companies. 
In the interview, Inskeep mentioned that the head of the pharmaceutical giant GlaxoSmithKline has called Hamied a "pirate" and described the quality of Indian generic drugs as "iffy". 
"You know what I replied to that, Steven?" Hamied said. "I said, 'We do not break any laws. We live by the laws of the land.' And then I sometimes add that even Robin Hood was regarded as a pirate."

The great flu snafu

How is the world ever going to agree on a strategy for fighting climate change when it can't even co-ordinate its response to swine flu? One might assume that a virus that's been involved in the deaths of 5,700 people is an easier threat to contain than the noxious gases oozing in to the atmosphere.
A total of 78,000 new cases of the H1N1 virus were reported in England last week. Among them was my three-year-old son. Our local doctor prescribed a half dose of Tamiflu. Unlike paracetamol and ibuprofen, Tamiflu doesn't come in strawberry or orange flavour so we mixed it into a bowl of ice cream. Within half an hour, he vomited. Later in the day we tried accompanying the medication with a heaped teaspoon of honey with the same result. Rather belatedly, we were told that many children under five can't tolerate Tamiflu. 
Instead, every four hours for six days we gave him a cocktail of over-the-counter paracetamol and ibuprofen while suffering through the sobbing desperation (of parents and child) that comes when you 're forced to plunge your child into a cool bath. If we were in Australia, this whole drama might have been avoided because our whole family would have been vaccinated by now. Australia was among the first countries to introduce the mass vaccination program. 
The World Health Organisation and most health authorities around the globe are urging people to get vaccinated. The problem is that there's not enough of the stuff to go around and drug companies aren't exactly accelerating the costly manufacture of speedy supplies. In the UK, the vaccine has been rationed and is doled out only to those deemed "at risk". Once our son was diagnosed with the illness, my husband and I thought that our family might fall in to that category. We were wrong. 
Australia has enough doses of vaccine to cover the entire population. Of the 137 British swine flu related deaths since April, one in three were not in the priority group for vaccination. The government has ordered enough doses to cover the entire population but if everyone showed up at an NHS hospital demanding to be immunised, they'd be overwhelmed. At best, Britain hopes to inoculate 15 per cent of the country this year. You need to have lived in Britain or have watched the Little Britain TV series to understand why this is so. The computer says no.
Terrorism suspects at the Guantanamo Bay detention facility in Cuba are being vaccinated, but my 22 month old lives in the UK so she's not eligible and neither is my five-year-old even though children under the age of 15 now account for a fifth of all swine flu hospital admissions in Britain. According to the National Health Service, young children are not "at risk". Who exactly is most at risk is still up for debate. There is some evidence today in the Journal of the American Medical Association that among the highest risk factors is obesity. Will the World Health Organisation now advise that people who are overweight jump the vaccine queue? 
The UK's chief medical officer Sir Liam Donaldson said that the situation was "eerily similar" to Australia where similar numbers were in intensive care units during their flu season .. so how do you explain the different tact in vaccination programs?
Perhaps there's a political edge to this. In July, the US President, Barack Obama promised to have 160 million doses of H1N1 vaccine ready for distribution by the end of October.
Instead, only 28 million doses are now available to protect a population 10 times that size. Barack Obama has declared a national emergency but isn't swine flu, like climate change, an international emergency like climate change?
Like so much that goes wrong in government policy, this one has the stamp of a failed public private partnership. Entrusting the private sector to take care of public health doesn't look like a good idea because economics can get in the way of common sense. Britain's GlaxoSmithKline, the world's second biggest pharmaceutical company, has reported much higher than expected profits. The chief executive announced that since the discovery of swine flu, sales of influenza products had contributed "significantly" to the results. Demand for their vaccine is outstripping supply and in economics that's an enviable position for a company to be in.
But vaccines are not a profitable business. Big Pharma is not known for its charitable endeavours and certainly wouldn't change its manufacturing regime if it had an adverse impact on earnings. There is a way to speed up the production of flu-vaccines by switching to cell-based methods. This is an expensive alternative and would need to involve political interference because it's also time consuming and not particularly profitable.
Ninety-odd years after the H1N1 pandemic that killed tens of millions around the world, most approved flu-vaccine producers still "grow" the vaccine in eggs. The US Center for Disease Control and Prevention calls that method "outdated". In other parts of the medical establishment it's been referred to as "antiquated". When you need vaccine quickly, this process can't deliver. On the other hand, cell-based vaccine production is quick and could have ensured mass coverage by now
For all the talk of pandemics and national emergencies, neither governments nor the World Health Organisation seem able or inclined to speed up the vaccine production process. So six months after the first deaths from swine flu in the UK, the advice is the same: put your hands over your mouth when you cough, throw your tissues in the bin and wash your hands. Oh, and pray that the vaccination program catches up to you before the virus does.