# 687
An interesting article in the TimesOnline tonight, where the UK is seriously considering spending billions of dollars on vaccines and Tamiflu.
First the article, then a bit of discussion.
Ministers say they need to double bird-flu drug stock
Mark Henderson, Science Editor
Plans to double Britain’s emergency stockpile of flu drugs have been made by health ministers after they accepted that too few drugs have been ordered to contain a devastating pandemic, The Times has learnt.
The Department of Health has asked the Treasury for £150 million to buy at least 15 million extra doses of Tamiflu, the antiviral drug that is the main line of defence against the virus, under a review of its pandemic preparations.
It is also considering ordering vaccines against H5N1 avian flu to cover everyone, at a cost of up to £1 billion.
The revised proposals come after statements by scientists that the existing stockpile of 14.6 million doses of Tamiflu will not allow preventive therapy, the most effective way of saving lives.
A flu pandemic could infect up to half the population and kill up to 750,000 people, according to Government estimates, but giving antivirals to everyone in infected households could reduce both figures by 40 to 50 per cent.
There are currently enough drugs for a quarter of the population, but the latest draft of the Government’s pandemic plan asks hospitals to prepare for a 50 per cent infection rate.
Proposals to “at least double” the stockpile have now been agreed by Patricia Hewitt, the Health Secretary, a senior Government adviser told The Times.
The Treasury has yet to clear the order, but is understood to be sympathetic.
With 30 million doses available, Tamiflu could be given to everybody living in the same home as an infected patient, assuming an attack rate of about 25 per cent. Enough drugs would be available also to treat every clinical case for attack rates of up to 50 per cent.
(Cont.)
In terms of their Tamiflu Stockpile, the UK is far ahead of most countries, including the United States. They already have 15 million 10-pill courses, for a population of 60 million. That's enough, at the standard course, to treat 25% of their people.
The United States currently has enough to dispense to somewhat less than 10% of their citizens, and of course, many nations have very little at all. Complicating matters, there is doubt that a 10-pill course will prove adequate for treating the H5N1 virus.
While unstated, I'd suspect that the recent revelations that Tamiflu may need to be administered at double the dose for double the duration may also be driving this move to acquire more antivirals.
The idea of providing prophylactic Tamiflu to members of a household with an infected member has merit, and could save lives, but will burn through their supply rapidly.
This article is the first hint we've seen that they are considering a 50% attack rate. The `conventional wisdom' has been that 30% would fall ill, although that is an assumption based on a limited data set from previous pandemics during the last century.
No one really knows what the attack rate of the next pandemic will be. A 50% attack rate, with a novel virus, would not seem outlandish. It might even be low.
With the pound sterling at roughly U.S. $2.00, the UK is looking at an expenditure of 2.3 billion dollars for both Tamiflu and a vaccine. An extraordinary commitment, and on a per capita basis, far greater than the U.S. has considered. To match that, the U.S. would need to spend over 11 billion dollars.
While the U.S. has committed billions of dollars for vaccine research, the amount we are actually spending to acquire vaccines is in the hundreds of millions, not billions.
Vaccines, and Tamiflu, have a limited shelf life. If a pandemic were not to occur in the next few years, much of that investment could be lost. For the UK to consider spending this kind of money, their level of concern must be very high.
Whether they actually make this investment is yet to be determined.
The fact that they are considering it, speaks volumes.
