Government urged to stock flu antiviral

Stockpiling the active ingredient of the influenza antiviral Tamiflu should be one of the actions taken by the government in view of the looming influenza pandemic, a medicines expert has said.

Oseltamivir - Tamiflu's active ingredient - has a longer shelf life and costs a fraction of the price of Tamiflu, a prescription medicine used to reduce the symptoms of the flu which can also be used as a prophylactic.

The medicines expert explained that this could be stockpiled and reconstituted by pharmacists when an influenza pandemic starts.

Asked whether pharmacists were able to conduct the reconstitution process, the expert said this already happened in the case of some medicines. Another of the drug's positive attributes is the fact that it can be given to children. According to its manufacturer, Roche, pre-clinical tests have shown that Tamiflu would be effective against the H5N1 influenza virus (avian flu), which is considered the most likely source of a pandemic strain and has already killed at least 42 people in Asia.

"The government needs to stockpile enough to at least give it to the key people who would keep the country going - like medical personnel and those responsible for maintaining law and order," he said.

The expert said that when reconstituted the medicine would have a shelf-life of about two weeks but the powder formulation has a longer shelf life.

According to sources, Tamiflu is not currently available in Malta but since it holds a centralised European licence it could be marketed here without the need to apply for a marketing registration.

The medicines expert said oseltamivir could be imported without a licence.

He said it would be ideal to also stock some Amantadine (another antiviral) in case there were people who could not take oseltamivir.

He underlined the importance of having a stock of antibiotics and buying the vaccine against avian influenza when this becomes available.

Influenza experts have been warning about the possibility of a flu pandemic for quite some time and the consensus is now shifting from an "if" to a "when" this will happen. Fears lie in the fact that the avian flu virus will genetically mutate in a way that it becomes easily transmitted between humans.

The World Health Organisation is comparing the current scenario to that which led to the 1918 Spanish Flu pandemic that killed millions and estimating that up to eight million people could die and 30 million hospitalised by a pandemic.

On Tuesday, the British government announced that £200 million worth of Roche's Tamiflu would be delivered over the next two years, amid fears that at least 50,000 people could die in Britain when the pandemic strikes. Antivirals can be used during an influenza pandemic as a temporary solution and should reduce the severity of the disease and also the mortality rate.

Contacted by The Times, Malta College of Family Doctors president Pierre Mallia said the college had as yet not formulated an official position on the issue.

However, he said, as a general practitioner he was worried that people did not take the influenza vaccine. He said a number of people did not do so claiming that when they did take it they still got sick. But this stemmed from a misconception that if one took the vaccine it would serve as prevention against the common cold, whereas the vaccine actually helped in the prevention of influenza.

Dr Mallia said that when a chunk of the population got vaccinated this would lead to "herd immunity", which meant that a number of people would be immune to the flu strain. This could also help others who did not take the jab not to contract influenza.

"People have to realise the importance of getting vaccinated. Influenza is potentially a very serious illness which could kill," he warned. Every year there are a number of fatalities because of influenza, especially among elderly people.

Dr Mallia said that although the WHO strongly suspected that a pandemic was on its way, this did not mean that Malta would be affected, which made it more important for people to get vaccinated if the country was to avoid the pandemic.