Health Leaders Gather at WHA, WHO Encouraged To Rethink Pandemic Alert System

Tuesday, May 19, 2009
http://globalhealth.kff.org/Daily-Reports/2009/May/19/51909-Swine-Flu-Update.aspx

Health leaders gathered at the World Health Assembly (WHA) to discuss the spread of the H1N1 (swine influenza) virus and prepare for a possible pandemic, Reuters/Washington Post reports. Other health topics were tabled to focus on H1N1, "while drug-resistant tuberculosis was initially slated to be postponed and then re-added at the last moment," according to Reuters/Washington Post. "For the first time in humanity, we are seeing, or we may be seeing, pandemic influenza evolving in front of our eyes," WHO Director-General Margaret Chan told the WHA meeting in Geneva (MacInnis, Reuters/Washington Post, 5/18).

The WHO on Tuesday confirmed that 40 countries have officially reported 9,830 cases of H1N1, including 79 deaths. A full list of country cases and deaths is available here (WHO Influenza A(H1N1) - update 33, 5/19).

Because of the rapid spread of H1N1 infections, the WHO last month raised its alert level to 5 "and declare[d] a pandemic is 'imminent,' a designation that reflects views on the way the new virus is spreading and not the seriousness of its effects," writes Reuters/Washington Post (Reuters/Washington Post, 5/18). WHO rules indicate that signs of "the disease is spreading in a sustained way in a second region of the world would prompt a declaration that a full pandemic is under way," Reuters/Wall Street Journal writes (Reuters/Wall Street Journal, 5/19).

Some representatives from member countries said the WHO's pandemic alert system exacerbates public misunderstanding about the threat of the flu and should be reworked (Reuters/Washington Post, 5/18). "Mexico, which has suffered the most deaths and virtually shut down its economy for several days in response to the outbreak, urged WHO to reconsider its pandemic scale," AP/Google.com writes. "People don't understand what 4, 5 or 6 means," Mexico's Health Minister Jose Angel Cordova said. "They think that when you go to a higher level things are worse" (Jordans, AP/Google.com, 5/18).

The Los Angeles Times reports, "Governments in many countries, including China, Japan and Britain, fear that raising the alert level will put more pressure on their health systems, impede international travel and cause panic even though the new strain of virus appears to be no more lethal than seasonal flu" (Maugh, Los Angeles Times, 5/19).

HHS Secretary Kathleen Sebelius, who on Monday addressed the WHA, said that she needed more time to look at the proposal before taking a position on the matter, according to AP/Google.com, which also wrote that "in a speech to the assembly [Sebelius] noted that each day 26,000 children will die from poverty and preventable diseases" (AP/Google.com, 5/18). Oman, Egypt and the United Arab Emirates have voiced support for changing the WHO's alert system. Switzerland's health leaders encouraged the WHO to tie the decision to move to Phase 6, the top alert level, to the decision for vaccine makers to shift from the seasonal flu vaccine to swine flu vaccine production (Nebehay/MacInnis, Reuters, 5/18). Although no changes were immediately taken to change the pandemic alert system, Chan said the request would be considered (Reuters/Washington Post, 5/18).

Poor Countries Remain Unprepared For H1N1

Health officials from Nigeria, Thailand and Tonga on Monday at the WHA asked members of developed nations to help them to become better prepared for a possible H1N1 pandemic, Reuters reports. "Somehow, somebody decided to start this epidemic in very rich countries ... This helped all of us," said Tonga's Health Minister Viliami Tangi, during his address, adding that without adequate medical supplies and staff, drugs, and vaccine production capabilities, poor countries were unprepared for a possible swine flu outbreak.

"We on the African continent are very worried," Nigeria's WHA delegate said at a high-level meeting. "We are far from being ready. The continent is in dire need of support."

"An influenza pandemic is an extreme expression of the need for solidarity before a shared threat," Chan said, addressing the WHA. "I strongly urge you to look closely at anything and everything we can do, collectively, to prevent developing countries from, once again, bearing the brunt of a global contagion" (MacInnis, Reuters, 5/18).

Bloomberg reports that Chan has asked Roche – the makers of Tamiflu – for more supplies of the antiviral, which has been shown to reduce the spread and severity of the H1N1 flu, to be made available to developing countries. WHO is also training doctors and laboratory technicians to test populations in developing countries for the H1N1 virus or send the specimens to other countries, Chan said (Gale, Bloomberg, 5/18).

Scientists in South Korea To Send H1N1 Vaccine Candidate Strain to CDC

Researchers from South Korea's Chungnam National University say they have created a candidate strain of the H1N1 virus that may be able to be used for a future H1N1 vaccine – 11 days after receiving the H1N1 virus strain from the CDC, the Brunei Times reports (Brunei Times, 5/19). According to CNN.com, Seo Sang-heui, who led the researchers, says that he plans to send eight vials containing the candidate strain – a genetically modified version of the live H1N1 virus – to the CDC for additional testing. The findings have yet to be proven by the CDC or WHO (CNN.com, 5/18).

H1N1 Death Rate 'A Little Bit Higher' Than Seasonal Flu

The CDC's interim deputy director for science and public health program Anne Schuchat on Monday said that the swine flu is slightly more deadly than the seasonal flu, HealthDay News/Atlanta Journal-Constitution reports. Unlike the seasonal flu, however, Schuchat said the majority of swine flu cases are occurring in young people.

"The hospitalizations that we are tracking have this disproportionate occurrence among younger persons," she said. "That's very unusual to have so many people under 20 requiring hospitalization in some of those intensive-care units" (HealthDay News/Atlanta Journal-Constitution, 5/18).

The Kaiser Daily Global Health Policy Report is published by the Kaiser Family Foundation. © 2009 Henry J. Kaiser Family Foundation. All rights reserved.