“Unrealistic” to share North American antiviral supply

As the WHO was orchestrating a massive international effort to share influenza antiviral treatment in the developing world, Canada and the US decided not to create a common North American stockpile.

Figure. Infected wild birds are migrating across Asia, Russia, Siberia and Kazakhstan. Photo by: Art Explosion

Oseltamivir (Tamiflu) could help to reduce illness and death in the event of an avian flu pandemic, but supply will be far short of demand if a pandemic hits in the next few months.

It is “unrealistic” with limited supplies “to start talking about sharing,” said Dr. Karen Becker, a senior health adviser with the US Emergency Preparedness Department, during a dialogue on US–Canada Joint Preparations for an Avian Influenza Pandemic held Aug. 23.

So far, the US has enough oseltamivir to treat 2.3 million people, while Canada has supplies for 1.6 million citizens.

The incentive to have sufficient supplies is huge. If a pandemic hits, medical costs, outpatient visits, drug purchases and time off work are “conservatively estimated at $10 to $24 billion,” says Dr. Arlene King, the Canadian Public Health Agency's director of immunization and respiratory infectious diseases.

Roche Holdings, the world's only manufacturer of oseltamivir, has agreed to donate 3 million treatment courses to a WHO stockpile for use at the initial site of an emerging pandemic.

Philippine's Health Secretary Dr. Francisco Duque told reporters that WHO and its member states should “bond together and exact pressure to make sure that not just one drug manufacturer is going to produce the antiviral.” He said that Roche's monopoly on drug production is “bordering on the immoral.”

Developing countries are allowed to manufacture generic copies of patented drugs in the event of a medical emergency. However, after initial speculation in Thailand in March this year, no further talk of generic development has emerged.

Some countries are also researching ways to produce a vaccine against avian influenza. Because the final genetic make-up of a pandemic virus is unknown, it cannot be produced beforehand. However, the US is producing “enough eggs to ramp up vaccine production quickly,” says Becker. The US is also investing in “cell culture vaccines” that could produce vaccines “more rapidly and in higher quantities.

Dead seagulls in northern Finland have raised fears that avian flu may have already entered Europe. Officials fear further spread to Europe, the Middle East and Africa as tens of millions of birds nesting in Siberia migrate to warmer climates.