The threat that an outbreak of avian flu (fugleinfluenza) deadly to humans could become the next flu pandemic has produced a potentially tragic case of haves and have-nots, writes the World Bank press review Wednesday.
Richer countries facing little immediate avian-flu danger are stockpiling vast amounts of the drug needed to fight the current outbreak and possibly forestall the pandemic. Asian nations at the epicenter of the threat are seriously short of the drug.
It is a familiar problem in global health care. Life-saving drugs for infectious diseases that also pose world-wide threats – AIDS, tuberculosis, influenza – rarely reach poorer countries where they are often needed most.
The flu drug, known as Tamiflu, has shown strong results in lab tests. Tamiflu also has the backing of the World Health Organization, and was successfully used to quell a bird-flu outbreak that infected Dutch farmers in 2003.
A worried WHO has urged countries to prepare for the threat of a pandemic partly by stocking up on Tamiflu. The last flu pandemic killed as many as four million people in 1968, and the next one is overdue, according to the WHO.
Scientists believe that if Tamiflu is quickly supplied at the site of an initial pandemic outbreak, it could help to contain the bug for as long as six months or even eliminate it. Those six months are exactly what researchers would need to develop a vaccine based on the pandemic strain that emerges.
The WHO recommends that countries in the area hit by avian flu stockpile enough Tamiflu to cover 25 percent of their populations. But Asian nations have lagged behind others in ordering the drug because of its relatively high cost, about 3,90 US dollar, or 3 euros, a capsule. Vietnam, the country hit hardest by avian flu and home to 84 million people, has only 2.000 treatments.
Vietnamese officials said Tuesday that they had detected the countrys second case of a human infected with avian flu in a week. Neighboring Cambodia, whose population is 14 million, has 300 Tamiflu treatments, most of it donated. Officials there say they need at least 15.000 treatment doses.
Norway, Canada, Australia, New Zealand, Finland and France have together ordered tens of millions of doses. The US has so far requested 2,3 million treatments and could order more. The UK has ordered 385 million dollar worth of the drug to cover a quarter of its 60 million citizens.
The WHO has an emergency “mobile stockpile” of 120.000 Tamiflu doses. But Ira Longini, a public-health professor at Emory University in Atlanta, estimates that one million courses of Tamiflu would be more appropriate.
The drug, to be effective, must be given within 48 hours after a patient starts to feel ill. Since flu symptoms resemble those of other ailments, including the common cold, many infected patients do not seek medical assistance until it is too late.
Some studies also suggest that certain strains of the flu virus are resistant to Tamiflu. Ensuring that Tamiflu gets to the front lines of an outbreak is so crucial to containing it, some public-health officials recommend that richer nations donate part of their Tamiflu stockpile to the countries most affected by avian flu.
Kilde: www.worldbank.org
