SWINE 'FLU (Influenza A H1N1) is rapidly spreading. A vaccine to prevent infection is urgently needed but it will be next year before there are sufficient supplies to protect everyone in Britain. Eventually half the population may be infected.
Fortunately, for most people the infection is unpleasant but not serious. The number of people developing complications or dying does not seem to be higher than normal seasonal flu. But 'flu viruses are unpredictable because they can quickly change. It could become more serious as a result.
Flu pandemics - affecting much of the world - occur every few decades. Scientists have been warning of a new one for several years. The outbreak of bird flu in 2005 could have been the beginning, but that virus was not particularly infectious to humans.
The pharmaceutical industry has had plenty of time to get ready, so how prepared is it to meet the demand for billions of doses? Flu vaccines cannot be developed in advance, because of the way the virus changes. Neither can a production line simply be switched on, as the vaccines involve growing a modified form of the virus, which takes at least 12 weeks and may take months.
Safety trials should be carried out, in case of side effects. But there needs to be factories ready to start production as soon as the development work has been done.
Around 300 million doses of seasonal flu vaccine are produced globally each year. If manufacturers were to switch to producing a single pandemic strain vaccine, they might triple the number of doses to around 900 million.
The World Health Organisation said up to 4.9 billion doses could be produced in 12 months. But if more than one shot per person is needed (two are likely) and production yields are lower than for seasonal flu vaccine, far fewer people would have access to protection.
US manufacturer, Baxter International, said on 23 July that it has taken orders from five countries, including Britain, Ireland and New Zealand, for a total of 80 million doses of vaccine and will not take any more. It will manufacture these in new factories in the Czech Republic and Austria.
Baxter could take $30-$40 million in revenue from these contracts, according to the Chicago Tribune. That's 50 cents a dose - about 30p. In the second quarter of this year, Baxter made $587 million profit - 8% up on last year. Dividend payments rose 13%.
Another company benefitting from the flu scare is GlaxoSmithKline (GSK). Sales of the company's Relenza inhaler, an alternative to Tamiflu used by pregnant women among others, are expected to top £600 million. This figure could be boosted by up to £2 billion once deliveries of its vaccine begin in September.
"We are not trying to generate some crazy level of profit," said GSK chief executive Andrew Witty. "Equally our shareholders wouldn't want us to do it for anything other than a return."
GSK and other pharmaceutical companies won't build and maintain expensive factories that might not be needed for many years, just to be ready for a pandemic when it arrives. That's why the pressure to bring out a swine flu vaccine quickly threatens normal production of seasonal 'flu vaccines. The same production facilities may be needed.
The US government has just awarded a $35 million contract to Protein Sciences Corporation. This company is developing a new and quicker way to make vaccines, using insect cells in which to grow viruses, rather than the conventional hen's eggs. Only the day before the contract was made, the company was on the verge of bankruptcy!
Developing and producing vaccines should not be left to the whim of corporations run for profit. A publicly owned and democratically controlled pharmaceutical industry would put the necessary resources into pandemic preparation, even if these were not needed for many years.
It would also ensure that there was capacity to manufacture enough doses for everyone at risk, including those living in countries where most people have no adequate health services. The speed with which this virus spread from Mexico shows that an international plan to fight such infectious diseases is needed.
Since 9/11 the US has spent over $864 billion on war in Afghanistan and Iraq. It would probably cost under $10 billion to produce sufficient flu vaccine for the whole world. There is no doubt which expenditure would make us all safer.
Jon Dale, CWI
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