Gaps Remain in Global Preparedness for Swine Flu Pandemic

While widely implemented strategies seem to have prepared the world better than ever before for the influenza A virus H1N1 (swine flu) outbreak, there still exist important gaps between countries regarding the logistics of drug and vaccine distribution. These are the latest findings of Datamonitor (London, United Kingdom), a leading business information and market analysis company.

Many governments around the world, encouraged by the World Health Organization (WHO, Geneva, Switzerland) have developed pandemic preparedness plans. These strategies, which encompass a wide range of measures including the stockpiling of antiviral drugs, surveillance, measures to prevent the spread of infection, and the development of pandemic vaccines are now being put to the test as a result of the current outbreak of H1N1. To date, the outbreak has proved to be relatively mild, with Mexico the only country to report significant mortality; as a result, the limits of global public health systems have not yet been truly tested. Such a test will come if the virus spreads more widely, or returns in a more severe form in the coming winter.

Currently, the most widely applied countermeasure for H1N1 is the rapid distribution of government and WHO stockpiles of influenza antivirals such as Tamiflu (oseltamivir) and Relenza (zanamivir). However, governments should consider the possibility that the pandemic influenza virus could become resistant to these drugs, and should not rely on antivirals alone, as they may become ineffective in later waves of the pandemic. A further strategy to counter the threat of an H1N1 pandemic is the development of a vaccine. The United States government has provided significant funding to vaccine manufacturers over the last decade to provide incentives for the extension of influenza vaccine manufacturing capacity in the U.S. and the development of new, pandemic-relevant technologies and products. Thanks to this increased investment and scientific advances in the vaccine sector, manufacturers have developed and advanced strategies such as adjuvants and novel manufacturing systems. These have the potential to overcome the current bottlenecks of long vaccine production times and manufacturing capacity shortages for pandemic influenza supplies.

Since, from the current point of view, the current H1N1 outbreak is likely to remain relatively mild over the summer months of 2009 in the northern hemisphere, relevant governments and healthcare authorities will have an opportunity to reassess and improve their pandemic strategies over the coming months. This interim period should be used to reevaluate and optimize the pandemic response, to replenish stockpiles, and to develop and manufacture a vaccine before a more virulent version of the influenza A virus H1N1 can return towards fall and winter of 2009-2010.

"These issues will require significant coordination between medical, industry, political, financial and regulatory stakeholders across the globe in order to be addressed successfully," said Datamonitor infectious diseases senior analyst Hedwig Kresse. "A timely reassessment and implementation of antipandemic measures is our best hope to significantly reduce the impact of a pandemic, and avoid the millions of deaths observed in previous global influenza outbreaks."

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