Saturday, January 29, 2005

Dismaying and predictable

The Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota has an interesting, dismaying and utterly predictable report on the WHO executive board meeting January 24. Citing an AP report (I was not able to find it) the board foundered on a resolution that would have allowed countries to ignore drug patents in the event of an influenza pandemic.

The patent override was suggested by the delegate from Thailand, which is in the midst of trying to halt a spreading epidemic of influenza A(H5N1) ("bird flu") and is a neighbor to Vietnam, where an epidemic amongst poultry already rages and human cases and deaths are being reported almost daily. The Thai delegate wished to add the patent provision to a resolution on ways to improve disease surveillance and augment research and stockpiling of vaccines, when and if one becomes available for H5N1.

The cost of a 6 week course of antivirals is about $120, beyond the reach of the nations now struggling to contain the disease (see previous post on the ethical and public health issues involved in distributing antivirals). The opponents of the resolution were delegates from the US and France, where major pharmaceutical interests are involved in vaccines and antivirals.

As I said, as dismaying as it is predictable (or as predictable as it is dismaying, take your pick).

Reuters Alertnet now reports that Hong Kong residents and mainland Chinese tourists are buying up available pharmacy supplies of Tamiflu. While a prescription drug, it is easily obtainable over the counter, with no questions asked. There is concern that indiscriminate use might lead to the development of resistance to what is now considered the drug of choice of H5N1.
"I'm worried the Hong Kong government won't respond quickly enough or take tough enough measures to prevent a mass outbreak," said one foreign resident who rushed to buy supplies for his family after word of the latest deaths.

"Doctors and hospitals could be completely overwhelmed ... it might be hard to get medical aid," he said.


Public fears mounted after media reports that Chinese exports of geese and ducks to Hong Kong had dropped sharply in recently weeks. China said it was due to stronger demand on the mainland, but many Hong Kong residents were not convinced.

The deadly SARS virus first emerged in southern China in late 2002 and quickly spread to Hong Kong and then around the world. Chinese authorities initially suppressed news of its spread.
The bottom line was summed up nicely by WHO's Dr. Dr. Anarfi Asamoa-Baah:
As a global community we are still ill-prepared—and as long as one of us is not prepared, none of us is prepared.

[See links in left sidebar for previous posts on bird flu]