Set aside funds now for bird flu, WHO expert says

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The world’s governments should set aside 5 percent of their spending on influenza vaccines to help get ready for the next big flu epidemic, a World Health Organization expert proposed on Monday.

The money could be used to research quicker ways to make influenza vaccine - notably one that would work against avian flu, which threatens to kill hundreds of millions around the world if it mutates enough, said Dr. Klaus Stohr, WHO’s top influenza expert.

More research is also needed on who may have some natural immunity to avian flu and if so whether study of such people can help fight the virus, experts told a meeting sponsored by the Institute of Medicine in Washington.

The H5N1 flu has killed 49 people in Asia since late 2003 and killed or forced the destruction of tens of millions of chickens and other birds.

Every year so-called seasonal flu kills 500,000 people and it occasionally evolves into a form that kills many, many more - up to 40 million in 1918, for example.

Yet the world relies on old-fashioned methods for making influenza vaccines that require the use of specially grown chicken eggs and months of culturing. Each year the vaccine cocktail must be changed to follow the mutations of the flu virus and each year people must be re-vaccinated.

This same painstaking method is being used to make a new vaccine against H5N1 flu. WHO estimates it would take a year to produce enough vaccine to protect substantial numbers of people against avian flu, by which time it could have swept the globe, Stohr said.

What is needed, several experts told the conference, is a vaccine that works against multiple strains, can be produced quickly in lab dishes instead of in eggs and that produces immunity for years.

JUST-IN-CASE VACCINES

The United States is testing the first H5N1 vaccine in people now; Germany, France, Canada, Japan and other countries will soon follow, Stohr said. But production of a vaccine against H5N1 or some other potential new influenza strain must wait for the epidemic to emerge first - because it just might be different enough to evade current vaccines.

“Stockpiling vaccine is not possible,” Stohr said.

Stohr estimated that 300 million doses of seasonal influenza vaccine are produced every year around the world, at an average cost of $7.50 a dose. Public health authorities in 40 countries will spend $28.3 billion over the next 10 years on vaccinating people against influenza, he predicted.

Setting aside 5 percent of the spending would make $1.4 billion available to create a better influenza vaccine - one that could be formulated quickly and that could work against various strains of influenza, Stohr said.

Such a vaccine could be stockpiled, and production could be stepped up quickly if needed. “That would certainly address most pandemic and epidemic scenarios,” he told the meeting.

Countries are also stockpiling Tamiflu, an antiviral drug that can both prevent and treat influenza strains that include avian flu. The United States has banked 2.3 million doses of the drug, made by Swiss drug giant Roche under the generic name oseltamivir.

But infectious disease expert Michael Osterholm of the University of Minnesota said drug makers also face production limitations.

“If you look at all the orders, it is going to be years before all these orders are filled,” he told the meeting. “Even though we think we have them now, we don’t.”

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