No Swiss Neutrality On Pandemic Flu

#235

The patron saint of Switzerland, and the father of their isolationism and neutrality policy, is ironically enough, Nicholas of Flüe. His advice of nearly 500 years ago, essentially: “Don't get involved in other people's affairs", has kept this tiny European nation out of numerous wars and conflicts over the past 5 centuries, and had allowed the Swiss to become one of the most economically advanced and stable countries in the world.

By avoiding taking sides in military conflicts, the Swiss have evaded the rigors of invasion and occupation, and are able to devote far more of their resources to defining, and improving, their social and economic structure. As a result, the Swiss are among the healthiest people in the world, with a life expectancy higher than the United States. Their people suffer minimal unemployment, and their standard of living is among the best in the world. The Swiss economy is robust, and their debt is modest.

To many observers, the Swiss remain the very model of efficiency and level headedness.

It is therefore somehow appropriate that the Swiss, building on the advice of one type of Flüe, are perhaps the best prepared to deal with another Flu. One of the pandemic variety.

Swiss authorities have announced that they have purchased 8 million doses of a pre-pandemic vaccine from GlaxoSmithKline, enough to inoculate every citizen of their country. Delivery is set for early in 2007.

A pre-pandemic vaccine is, of course, not a panacea for a pandemic. When the H5N1 bird flu virus mutates into a pandemic avian flu, vaccines based on the older strains will likely prove less than fully effective. But the Swiss maintain, and may well be correct, that a pre-pandemic vaccination will provide a modicum of protection, even if it isn’t a perfect match to the virus. Recipients of this vaccine, they suggest, may well still contract the mutated form of the virus, but are less likely to die from it.

And researchers cite evidence that a pre-pandemic vaccine will help build antibodies that a second pandemic specific vaccine, one that won’t be available until many months into a pandemic, would reinforce.

Additionally, they have ordered 2 million doses of Tamiflu, and are looking at adding Relenza, another anti-viral, to their arsenal. When a pandemic strain specific vaccine becomes available, they expect to be first in line to purchase it.

The Swiss authorities obviously take the threat of a pandemic very seriously.

Details as to exactly when the Swiss will begin wholesale vaccination of their population against a pandemic have not been released, but one can assume that they will do so early on. A vaccine, even a poorly matched one, needs several weeks to confer immunity, and so to be of any real use, it must be given before a pandemic begins.

The decision as to exactly when to give the vaccine is not an easy one. The immunity wears off over a period of time. If you inoculate the people too soon, the vaccine could lose effectiveness and be wasted. Wait too long, and a pandemic could sweep through the populace before the vaccine could take effect. And the shelf life of a vaccine, generally considered on the order of 12-18 months, further complicates matters.

Thus far, the Swiss are the only nation with the ability to vaccinate their entire citizenry. They are fortunate in that they only have 8 million people to inoculate, and that geographically; they are all in a relatively small area. Both factors will make this task easier.

Given the limited window of opportunity, and the cost of this vaccine (reportedly $150 million dollars), the Swiss must fear we are reasonably close to a pandemic outbreak.

Other nations, including the United States and the UK are also negotiating with vaccine manufacturers, but neither is in a position, either economically or logistically to prophylactically inoculate their entire population. At best, emergency workers and others deemed essential, might receive a pre-pandemic vaccine.

While the debate over the efficacy of a pre-pandemic vaccine rages on, the desire to do something, even if it is of limited value, is very strong. The specter of a pandemic is the stuff that nightmares are made of. The damage one could do is incalculable.

To anyone who maintains that the Avian pandemic threat is simply hype, I would simply point out that the Swiss are not known for taking reckless and reactionary stances. For the Swiss Authorities to spend the money, and risk exposing their citizens to the (admittedly small) danger of side effects is a testament to their level of concern.

Despite half a millennium of neutrality, the Swiss apparently have found a war they consider worth fighting, a threat to their nation they cannot ignore.

And that should serve as a lesson to all of us.