Apr 4 2005
The World Health Organisation (WHO) is recommending that governments throughout the world need to set aside 5 per cent of what they spend on influenza vaccines to help get ready for the next big flu epidemic.
Every year flu kills 500,000 people and it occasionally evolves into a form that kills many, more - up to 40 million in 1918, for example.
Each year the vaccine cocktail must be changed to follow the mutations of the flu virus and each year people must be re-vaccinated.
Old-fashioned methods for making influenza vaccines that require the use of specially-grown chicken eggs and months of culturing are still being relied on.
This method is painstaking and is presently being used to make a new vaccine against H5N1 flu which has already killed 49 people in Asia since late 2003 and killed or forced the destruction of tens of millions of chickens and other birds.
Klaus Stohr, WHO's top influenza expert, says the money could be used to research quicker ways to make influenza vaccines, and notably one that would work against avian flu, which threatens to kill hundreds of millions around the world if it mutates enough.
Dr Stohr estimates it will take a year to produce enough vaccine to protect substantial numbers of people against avian flu, by which time it could have swept the globe. More research is also needed into why some people have natural immunity to avian flu and whether the study of such people can help fight the virus, experts told a meeting sponsored by the Institute of Medicine in Washington in the US.
Several experts feel that what is needed is a vaccine that works against multiple strains, able to be produced quickly in lab dishes instead of in eggs and that gives immunity for years.
Dr Stohr says the United States is testing the first H5N1 vaccine in people now; Germany, France, Canada, Japan and other countries will soon follow suit.
But producing a vaccine against H5N1 or some other potential new influenza strain must wait for the epidemic to emerge first because it just might be different enough to evade current vaccines and stockpiling vaccine is not possible. It is estimated that 300 million doses of seasonal influenza vaccine are produced every year around the world, at an average cost of $US7.50 a dose and public health authorities in 40 countries will spend $US28.3 billion over the next 10 years on vaccinating people against influenza.
Setting aside 5 per cent of the spending would make $US1.4 billion available to create a better influenza vaccine, one that could be formulated quickly and that could work against various strains of influenza, says Dr Stohr.
Such a vaccine could be stockpiled, and production could be stepped up quickly if needed, which would address most pandemic and epidemic scenarios. Tamiflu, an antiviral drug, is being stockpiled in some countries, Tamiflu can both prevent and treat influenza strains including avian flu.
The US has banked 2.3 million doses of the drug, made by Swiss drug giant Roche under the generic name oseltamivir.
Michael Osterholm, an infectious disease expert from the University of Minnesota said drug makers face production limitations and it will be years before all orders are filled.