Washington, D.C., May 3, 2009 (PAHO/WHO) — Guaranteeing access for developing countries to vaccines, including a possible vaccine for the new influenza A(H1N1) virus, is a major concern of the Pan American Health Organization (PAHO), the regional office for the Americas of the World Health Organization (WHO), a PAHO vaccine expert said during a media briefing today.
"Equitable distribution of vaccine to developing countries is an absolute top priority for PAHO," said Dr. Jon K. Andrus, PAHO's lead senior technical advisor in immunizations. "As it stands, several manufacturers have preproduction contracts with some countries, which could impose some barriers to vaccine access for the poorest of the poor. We need to keep advocacy and dialogue going to prevent a humanitarian crisis in case of possible vaccine shortages, particularly if this current outbreak were to become more severe."
PAHO and WHO are actively working with technical collaborating centers and vaccine manufacturers to produce candidate vaccine virus strains for an eventual vaccine. Andrus, a member of the PAHO/WHO influenza A(H1N1) Vaccine Task Force, said the supply of vaccine is expected to be "perhaps 1 to 2 billion doses," which falls far short of the world's more than 6 billion population. For this reason, he said that vaccination strategies will need to target high-risk individuals.
"The data coming out of Mexico determining risk factors for morbidity and mortality will be critical, not only for Mexico but for the rest of the world."
Andrus also noted that PAHO and WHO are working to ensure that member countries have equitable access to the antiviral drug oseltamivir, which is currently effective against the new influenza A(H1N1) virus. WHO and PAHO both have stockpiles of the drug.
PAHO has mobilized 27 experts in epidemiology, logistics, infection control, communication, and virology to Mexico, where they are working side-by-side with Mexican health officials.
"As the Secretary of Health said from Mexico, and as WHO has said from Geneva, everyone has done everything possible to work collaboratively and to respond in a timely fashion," said Andrus. "The task now is to move forward in this same spirit of collaboration."
Andrus said that currently available data suggest that the new influenza A(H1N1) outbreak is "mild to moderate in terms of severity." Of the 160 cases in the United States, for example, there have been 1 death and 5 hospitalizations.
"However, that is not to say that things cannot change very quickly and very dramatically. What we know about influenza and RNA viruses in general is that they are predictable in their unpredictability. The rapid and fairly aggressive response by PAHO and WHO has been appropriate, given this completely novel strain of new flu virus. We need to be vigilant but calm, so as not to create panic and loss of public confidence."
Among new countries reporting cases of the new influenza A(H1N1) virus are two Latin American countries: Colombia (1 confirmed case), and Costa Rica (1 confirmed case). In collaboration with the U.S. Centers for Disease Control and Prevention (CDC), PAHO is helping to ensure the distribution of rapid virus testing kits to its member countries in Latin America and the Caribbean to help them do preliminary testing of cases.
Andrus said PAHO is urging countries in South America to continue vaccination with the seasonal influenza vaccine, since the region is just entering its colder-weather period and the traditional influenza season. The composition of the current Southern Hemisphere seasonal vaccine includes a different strain of H1N1 influenza virus (Brisbane-like), but data so far show it offers no cross-protection for the new A/H1N1 strain.
Best estimates suggest a vaccine against the new influenza A(H1N1) strain will be available in 4-6 months, before the Northern Hemisphere's traditional flu season gets well under way. In the meantime, people should follow public health advice such as covering coughs and sneezes with a tissue, washing their hands frequently, and postponing travel if sick. Those who travel and return sick should seek medical advice. PAHO and WHO recommend that countries not impose restrictions on normal travel nor close borders. Andrus noted that there is no risk of becoming infected by the new influenza virus by eating cooked pork.
Andrus noted that PAHO and its member countries in North, Central and South America and the Caribbean have successfully confronted other major epidemics by working closely together. These include polio, which was eradicated from the Western Hemisphere before any other WHO region; an epidemic of cholera in the 1990s, which was successfully controlled through joint pan-American public health action; and measles and rubella, which are close to eradication in the PAHO region.
"When you work in disease eradication, every day is an emergency," said Andrus. "Every day that passes means more children are being paralyzed. This is unacceptable, so every day has to be an emergency if the job is going to get done. In the Americas, countries have been highly successful with achieving these disease elimination efforts."
Confirmed case counts, frequently asked questions, public health recommendations, and other information on the new influenza A(H1N1) outbreaks are available at www.paho.org.