World 'unprepared' for pandemic

The world would not be prepared to handle an influenza pandemic if it broke out now, international experts said yesterday during the Second European Influenza Conference, which is being held in Malta.

The World Health Organisation's scientist in charge of influenza control, Klaus Stöhr, said that from a global perspective the world was not well prepared for a pandemic, although some countries had done a lot of preparatory work. He said there was no vaccine available if the pandemic had to happen now.

Despite the general lack of preparedness, William Dab, from the Conservatoire National des Arts et Métiers in Paris, said the key elements to deal with the pandemic were in hand.

The conference, which will come to an end tomorrow, was one of these helpful elements, Dr Dab said. Around 800 influenza experts from around the globe, mainly from the Europe region, are currently discussing various issues related to influenza, with a main focus on the pandemic threat. The biannual conference is organised by the European Scientific Working Group on Influenza (ESWI).

ESWI chairman Ab Osterhaus said the meeting broke the mould of scientific conferences since for the first time, scientists, government representatives and opinion leaders in healthcare gathered to discuss a joint approach to reducing the impact of influenza.

"We are dealing not only with epidemic influenza. The H5N1 influenza virus is causing problems in south-east Asia, has extended to Siberia and there is a threat of outbreaks of avian influenza in Europe," he said.

Dr Stöhr explained that influenza pandemics took place every two to three decades, and in the past have caused considerable public health problems, with millions of people around the world dying in a short time. It is estimated that between 30 and 50 million people died during influenza pandemics during the last century.

"We believe that such a pandemic is overdue. There is a virus of great pandemic potential circulating in Asia," he said, referring to the H5N1(bird flu) virus which has led to the culling of millions of poultry and led to the deaths of around 63 people in Asia.

Bram Palache, ESWI's liaison member for industry, said the major problem if a pandemic had to start now would be the limited production of both antivirals and the vaccine for the strain of virus causing the pandemic. He said it was imperative to take decisions now to increase the production capacity of pharmaceutical companies.

This was reiterated by Dr Stöhr, who said that although data indicated that a good vaccine could be made, it was not available if the pandemic had to strike now. He also said that experts needed to rack their brains to find a way of formulating a vaccine that was suitable for as many people as possible.

Speaking during the first media briefing organised as part of the conference, Dr Stöhr said vaccine production was low because the seasonal influenza vaccine was under utilised. WHO recommended that all those over 60 as well as anyone suffering from chronic diseases should be given the seasonal vaccine.

The WHO official said although good drugs to treat the pandemic flu virus were available, they could not be produced fast enough and were also expensive.

In fact, he said, if a pandemic had to break out now, there would only be enough antivirals to treat two per cent of the world's population. If the pharmaceutical companies had to continue producing antivirals at the rate they were now for the next 10 years, there would only be enough for 20 per cent of the world's population at a cost of $14 billion.

He said experts were "reasonably sure" that the antivirals would work against the virus strain causing the pandemic.

Asked whether it was possible for Malta to avoid the pandemic by effectively closing its borders, Dr Stöhr said that the preparedness plan of the United Kingdom - another island - stated that if it reduced its air traffic by 90 per cent during the pandemic, they would only delay the arrival of the virus by one and two weeks.

He added that although in theory closing borders may work, reality could be different. Closing borders could be good for some countries which were self sufficient, like Australia and New Zealand, if it was exercised for a short time.

Only those countries that were well prepared for the pandemic could respond well once it happened. However, he added, only around 50 of the world's countries had a preparedness plan, ranging from one-page to 450-page documents. Moreover, he said, only around five countries had translated their preparedness plans into regulatory documents.