GENEVA, SWITZERLAND--With all the fear about an avian flu pandemic, you might think that stocking vaccines to protect humans from the virus ravaging poultry worldwide--H5N1--would be a no-brainer. It's not. There are so many doubts about whether H5N1 vaccines will do any good if a pandemic strikes that many countries don't have plans to stockpile them. But today, member states gave the World Health Organization (WHO) the green light to explore whether the world should invest much more in amassing H5N1 vaccines. In a related development, WHO announced that it will help six developing nations build their own flu vaccine factories.
The question of whether to stash the antiviral drug oseltamivir was easy, because most scientists feel confident that it will work during a pandemic, no matter which flu strain causes it (ScienceNOW, 3 August 2005). It's less clear-cut with vaccines. They would be based on currently circulating H5N1 virus strains, but by the time H5N1 becomes a pandemic, it may have changed so much that the vaccine would offer almost no protection. A pandemic could also come from a completely different strain, say H7N7, which would make a H5N1 vaccine worthless. So far, just a few rich countries, such as the U.S. and Switzerland, have begun building a H5N1 vaccine stockpile.
But WHO has argued for a while that the stockpiling idea deserves much more serious attention. And a meeting of over 30 member countries here today ended in a consensus recommendation that WHO begin finding answers to the many questions.
The proposal dovetails with WHO's efforts to give the developing world its own vaccine production capacity. Currently, almost all flu vaccine factories are in western countries. Developing nations have expressed fear that they may not get their hands on vaccine if a pandemic strikes, and Indonesia withheld flu samples from the international community for a while in part to get the issue on the agenda (Science, 6 April, p. 37).
Yesterday, WHO announced that as part of a global action plan to address the gap, six countries--Brazil, Mexico, India, Thailand, Vietnam, and Indonesia--will get starting grants worth a total of $18 million as well as technical help to acquire flu vaccine manufacturing technology themselves. Having these countries produce a H5N1 stockpile could keep their new vaccine factories in business, says Keiji Fukuda, a flu expert at the agency, especially because until now, demand for seasonal flu vaccine in the developing world has been very low.
Viroj Tangcharoensathien, director of the International Health Policy Program at Thailand's ministry of health, says his country is happy with the grant. Within 5 years, Thailand could produce 20 million doses of flu vaccine annually. The new facility will primarily produce seasonal flu vaccine, he says, which can save lives in Thailand just as it does in the west. But producing H5N1 vaccine in Thailand is an option as well, he adds--but not without a lot more study.