Does France top the leader board of countries armed to deal with avian ’flu?

[26 April 2007 - 17h40]
[mis à jour le 30 April 2007 à 10h45]

When it happens, the next H5N1 virus ’flu pandemic, could cause tens of millions of deaths across the world. The figures seem to vary between 50,700 and 693,00 in the United States and 101,400 and 1.38 million in the countries of the European Union.

According to a study published in the journal Nature , these spectacular differences depend to a very great extent on the degree of preparation in the countries concerned. In the absence of a vaccine – and the vaccine can only be developed once the mutant strain has been clearly identified – the only reliable option is antiviral drugs. And this means oseltamivir (Tamiflu), the principal drug recommended by the WHO or, alternatively, zanamivir.

As part of its pandemic preparation plans, the WHO has recommended building up logistical stocks of Tamiflu. This would mean that ideally each country would be ready to respond to the developing situation. But there are glaring disparities in this respect. Only France, it seems, is currently in a position to provide its citizens with optimum protection. Protection that would guarantee treatment of all clinical cases of the virus and of those who have come into contact with sufferers at work, at home and of course at hospitals and healthcare centres.

During an update session held today in Basel, Switzerland, senior managers from the Roche group – which manufactures Tamiflu – announced that the stock level held in Europe was on average 20%. “But with extremes varying from 3% to over 54%”, pointed out Eugène Tierney, head of Roche’s virology and transplantation divisions. France tops the list whereas Greece, for example, would be in a position to treat only about 5% of its citizens. Between these two extremes are countries such as Germany (18%), the United Kingdom and the United States (approximately 25%) and Austria (30%).

The experts are all in agreement about one thing – the pandemic will happen. The question is knowing when… And it will cost dear in terms of both human lives and economically. Between 2 and 4 trillion (2 and 4 million millions) of dollars! Ways of protecting the population exist and considerable efforts have been expended to increase industrial production platforms, including of generic versions of oseltamivir. Some countries are even encouraging companies to build up safety stocks for their employees.

Moreover, further stocks have been set aside to satisfy demand from the less advantaged countries of Africa and Asia. In the region of 3 million doses have placed by the manufacturer at airports in Europe and North America. And 2 million doses are available to the WHO. All of which has only been made possible by a substantial effort to develop production capacity. At Roche they are now producing as many as 400,000 treatment units per year. However, the Basel-based manufacturer has decided to reduce this figure to below 200,000 due to lack of demand. Because, as William Burns the company’s CEO of pharmaceuticals explains, “it’s not possible to continue building up stocks for which no customers exist”.

Source : Ferguson N. , Nature 2006 442 : 448-452 ; OMS ; Roche 26 April 2007, from our special correspondent in Basel.

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