# 530
The idea of a `virtual' global vaccine stockpile is apparently being floated by the WHO (World Health Organization) as a way to share limited vaccine production with developing nations. They admit, it is only a stopgap measure, and won't solve the problem.
First the article describing the idea, then a discussion.
WHO: Global pandemic vaccine stockpile would help ensure poor nations not left out
Posted 3/2/2007 9:43 AM ET
JAKARTA, Indonesia (AP) — Building a global stockpile of vaccine to fight a pandemic would help ensure that poor countries do not lose out to wealthy nations if a flu virus starts killing people around the world, the World Health Organization said Friday, as it works to end a standoff with Indonesia over the issue.
Only up to 500 million doses of vaccine can currently be produced worldwide, far short of the amount needed to protect the world's population in a major pandemic. Indonesia and other developing countries in Asia fear they would not have access to the limited supply of bird flu vaccine, even though they provided the viruses to make it.
A so-called virtual stockpile, in which countries would pledge to donate a portion of their vaccine, is one short-term strategy that could guarantee at least some vaccine would be equitably distributed within poor countries in the event of a pandemic, David Heymann, WHO's top flu official, said Friday.
A long-term goal would be for poor nations to receive enough technology and training to produce vaccines themselves, he said.
"What we need to do and want to do is develop mechanisms that will permit countries to have access to vaccines if they need it," Heymann said, adding that Brazil and India are involved in projects to produce vaccines with help from experts.
This issue is directly connected to my last blog entry, where Indonesia has refused to share virtual sequences until assurances could be made that an affordable vaccine would be made available to them during a pandemic.
Regardless of anyone's intentions, sensibilities, or priorities, the cold hard facts are that no large quantity of vaccine will likely be available to anyone for at least six months into a pandemic. And it will take 12 months of production beyond that, to produce 500 million doses with current technology.
No matter how you divide it up, 500 million doses will only cover a little over 7% of the world's population. And many of those doses wouldn't roll off the production line until a year or more after a pandemic begins.
There are 11 significant vaccine producing countries in the world, that together, produce 95% of all vaccines. They are: Australia, Canada, France, Germany, Italy, Japan, the Netherlands, the United Kingdom and the United States of America.
All are western nations, and their combined populations exceed 750 million people, or just over 11% of the world's total. In other words, at full production, under the best possible circumstances, it would take 18 months to produce enough vaccine for their own use, and that would come after a six-month ramp up period.
And that assumes that the virus doesn't mutate enough to require a second vaccine a year into a pandemic.
There are hopes that new DNA cellular replication vaccine techniques may speed up production, but for now, those are just hopes and several years away.
Now, I suppose if you wanted to be absolutely fair and spread the limited vaccine evenly across the globe's population, you'd say that as the vaccine producing countries only comprise a little over 10% of the world's population, they should donate 90% of their production to developing nations.
But that isn't likely to happen.
An effective vaccine (assuming we have one) will be more valuable than gold during a pandemic. Vaccine stockpiles will be viewed as a matter of national security. I don't doubt that some percentage might be donated to a global `virtual' stockpile, but I have trouble believing that many nations will donate much.
Every dose donated to another country increases the death toll in their own country. And the political price for that would be heavy. Imagine trying to sell the idea to your own citizens that the reason they can't have an inoculation is because you've sent half, or a third, or even a fifth of your production to a developing nation?
It it fair?
Should Americans or French or English peoples have access (limited though it may be) to a vaccine while people in Thailand or Laos or Nigeria will likely not?
One could argue, I suppose, that tax dollars from western nations, and decades of ongoing purchasing of vaccines by the public, have funded the development of these lifesaving vaccines and, therefore, the citizens who helped pay for them should get first shot (so to speak). It may not be nice, but it has a bit of truth to it.
Developing nations could have, over the past few decades, devoted more time and money towards setting up their own vaccine plants. They didn't. They had other priorities.
Of course, we could have encouraged them to do so, but apparently that didn't happen either. After all, when there is no pandemic threat, there is an advantage to having the global vaccine concession.
But on an ethical, or humane level, it isn't remotely fair that the have's will have and the traditional have-nots will go without. Particularly when we could have avoided this problem with a little foresight.
This `virtual' stockpile may come into existence. It may end up supplying a limited amount of vaccine to needy countries. But even so, it won't begin to address the problem. It will be little more than symbolic at best.
The only real solution is to quickly promote greater production of vaccines worldwide, share the technology, and help build plants. Even if it cuts into some western vaccine manufacturer's bottom line. The cold reality is, right now, there simply isn't enough global manufacturing capacity to handle a pandemic.
We either fix that, or we suffer the consequences.
It's a cold equation, I know. But mathematics cares not about human suffering or loss of life. It only cares about the bottom line.
It is up to us to care about those things.
And then do something about it.
