# 1998
Fourteen months ago the idea was floated of creating a `virtual stockpile' of bird flu vaccine to ensure that developing countries get their `fair share' in a pandemic. Vaccine developing nations would pledge a certain amount of their vaccine to this stockpile for dispersal to developing nations.
In May of 2007, at the WHO assembly, the idea was adopted. And in June of last year, GlaxoSmithKline promised to donate 50 million doses.
Now, after full year, no vaccine has been donated or stockpiled.
Here is an excellent report from CIDRAP news on the project and its goals, followed by some comments of my own. This is just an excerpt, follow the link to read the entire article.
Launch of WHO H5N1 vaccine stockpile still awaited
Robert Roos
News Editor
May 16, 2008 (CIDRAP News) – A year after the World Health Organization (WHO) called for the development of an international stockpile of vaccines against H5N1 influenza, the stockpile has not yet materialized, the WHO said in a report released today.
At the World Health Assembly in May 2007, WHO member countries called on the WHO leadership to set up an international vaccine stockpile against H5N1 and other influenza viruses of pandemic potential. And in June, the pharmaceutical company GlaxoSmithKline (GSK) pledged to donate 50 million doses of vaccine to the stockpile over 3 years.
In today's report, the WHO says development of a stockpile is under way, but no doses have been acquired yet.
"At this time, a physical WHO stockpile of H5N1 vaccine does not exist, and its development will depend on several factors, including discussions with manufacturers on the terms and conditions of their donation, as well as on technical issues such as obtaining further information on the stability of vaccines," says the report, which is based on a scientific meeting held in Geneva in October 2007.
The 26-page report assesses the development of H5N1 vaccines to date and discusses their possible uses, including how the planned WHO stockpile would be used. The document is titled "Options for the Use of Human H5N1 Influenza Vaccines and the WHO H5N1 Vaccine Stockpile."
In 3 more years, the report says, the stockpile could contain 50 million doses, or enough to vaccinate 25 million people with two doses each, which is likely to be needed to generate a good immune response.
(Cont. )
According to this release, it will take 3 more years to acquire 50 million doses (enough to inoculate 25 million people). Since Glaxo has already pledged 50 million doses, one has to assume that no other firm offers of vaccine donations have been made.
At the risk of being a party-pooper, 14 months ago I predicted as much. In Cold and (Flu) Equations I wrote:
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.
While our ability to manufacture vaccine has reportedly improved over the past year, and further advances are expected over the next few years, our global production capability right now is probably close to 1.5 billion doses of (monovalent) vaccine.
Enough to inoculate 750 million people.
That in a world of 6.7 Billion.
So, after a startup delay of probably 6 months, and a production run of a year, we currently have the capability to produce enough vaccine for 11% of the world's population.
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.
And fate would have it, their combined populations exceed 680 million, very close to the amount of vaccine they could produce in a year.
Once a pandemic begins, and their people begin dying from the virus, it will be politically very difficult for any vaccine producing nation to allow vaccine to leave their borders until every one of their citizens has been inoculated.
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 must increase production.
We're seeing some of that now.
India, Taiwan, Indonesia, Brazil, South Korea, and others are gearing up to produce vaccine. In most cases their capacity will be small, but every vaccine plant online and operational during a pandemic is lifesaving.
But it is just a start. We need much more.
Even with these new vaccine production facilities, nearly 6 Billion people are likely to go without during the first year of the next pandemic.
Putting the humanitarian concerns aside (something we as a species seem increasingly able to do), the global economic impact of a pandemic will be directly tied to how many people are sickened or die.
With nearly 90% of the world unprotected, the cascade effects are likely to severely affect all of us.
Even the vaccinated.
It is to everyone's advantage that we solve this problem. And not 3, 5, or 10 years from now.
