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Home Front: Tech
Asia in the Lurch as West Buys Out Avian-Flu Drug Stocks
2005-08-28
A race to corner limited stocks of 'Tamiflu', the only known drug capable of stopping an epidemic of the deadly avian flu, has brought into the open a divide between the developed and developing world that, left unchecked, could have disastrous consequences for all.

The disparity has been fuelled by the speed with which the developed world, led by the United States, has used its financial muscle to acquire global stocks of the drug that health authorities say is the most potent anti-flu medicine currently available.

In addition to securing sufficient doses of Tamiflu to care for over two million people, the U.S. is reportedly making a bid to buy even more stocks from the Swiss pharma giant Roche, which produces the drug. Other developed nations like Britain, France and Norway are also reported to have ordered the anti-flu drug to cover between 20 to 40 percent of their respective populations.

Public health experts in the developing world, particularly in South-east Asia, which is the epicentre of the H5N1 strain of the deadly bird flu virus are riled by the development especially since neither the U.S. nor Europe have suffered from bird flu in the way that Vietnam, Thailand, Cambodia and Indonesia have. "The U.S. and Western countries are gobbling up the drug and denying access to developing countries that need it most," Philippines' health secretary Francisco Duque told reporters here Thursday. "The poor countries once again have been excluded from the arena".

The Philippines, which has watched from the margins as the lethal avian flu swept through its regional neighbours since January 2004, still has to gain access to Tamiflu. "We have nary a stock of this drug," said Duque. "We need to stockpile the drug but we are low down on the pecking order". Duque was echoing sentiments expressed earlier this week Lee Jong-wook, head of the World Health Organisation (WHO). Wealthy countries, he said, should not display an attitude that only the health of their citizens matter and secure stocks of the only available remedy while excluding others, he told media here.
Any American politican who didn't put America first on this one will be stoned.
He warned that such a policy would be counterproductive since virus does not respect national boundaries. He said WHO had a limited stockpile of the drug that could treat about 125,000 patients and that the Geneva-based health body had plans to increase its global stockpile of Tamiflu to about one million doses.

Thailand, often recognised as a leader in public health issues in the region, has secured Tamiflu doses to treat barely 22,000 patients.

Duque and Lee were in Bangkok to participate in a week-long international health conference that focused on health prevention measures. Discussions during the conference, which ended Thursday, focused on bird flu, given the increasing concern over the threat of a global flu pandemic breaking out in the immediate future.

Since avian flu began spreading across South-east Asia, nearly 60 people have died after having come into contact with infected poultry. Of that, Vietnam had 40 fatalities, Thailand 12, Cambodia four and Indonesia three. The total number of bird flu cases reported to WHO from these countries is 112, reflecting the high, 50 percent fatality rate of this strain of the flu.

The fear of bird flu mutating into a virulent virus which can be passed from human to human is at the heart of the worry that has given rise to doomsday scenarios of the global pandemic. That is because humans lack a natural response to fight the deadly H5N1 strain of the virus.
Yet, at the moment, infectious disease researchers say there is little evidence of such mutation. "This is reassuring," a researcher from the Centre for Disease Control and Prevention in the U.S. told IPS. "There has been a subtle evolution of the virus but that is something we expect".

Of the two previous global pandemics caused by flu, the one in 1918 which resulted in the deaths of 50 million people across the world, was linked to a flu strain that jumped from birds to humans.

Yet public health experts feel that preparations being mounted to confront another pandemic are dramatically different from anything the world has seen so far. The push to stockpile the anti-bird flu drug is "really epidemic prevention" said William Aldis, WHO representative in Thailand. "This is a radical and new idea".

"The main purpose of stockpiling is to supply sufficient quantities of the drug to the location to burn out the virus," he said during a press conference. "We are capable of burning out the virus at its source".

And for South-east Asia to carry out such an operation, the region needs to have between three to five million doses of Tamiflu, Kumnuan Ungchusak, director of the epidemiology division at Thailand's department of disease control, told IPS. "If the outbreak starts, this region will be the hardest hit," he added. "It will spread fast because of modern transportation, unlike previous pandemics that took one to two months to spread".
Posted by:Anonymoose

#12  People need to get over being afraid to hurt other people's feelings.

A close friend was sick as a dog last winter and I offered to get some pet food and other things she needed and bring them by, and pick up a bag of hand-made products to deliver to a shop where we both sell.

She met me at the door - carrying the bag for me to deliver - wearing latex gloves. I was wearing not only latex gloves but a mask. Never went in the door, just made the exchange, asked how she was doing, and left. Peeled off gloves & mask and used hand sanitizer when I got to my car.

Didn't get the serious crud she had. NO feelings were hurt on either side. And I know people who thought we were nuts.

By the way, if you do use latex gloves, don't try to reuse them. Peel off one, ball it up in the other still-gloved hand, and peel the second one off so that it's turned inside out with the first glove inside. Discard into the trash and don't pick up again. Then wash your hands (or use Purell) anyway.

I've got a box of gloves already; need to pick up a box of masks soon. It's not like they go bad or anything.
Posted by: Barbara Skolaut   2005-08-28 22:54  

#11  And another thing that you probably won't be told soon enough is children, especially young children, are THE primary vector for initial transmission of flu. So pull your kids out of school as soon as the first case occurs in your city/area.
Posted by: phil_b   2005-08-28 18:37  

#10  One other thing, get a supply of face masks (they will be unobtainable within hours of the first USofA case). IMHO considerably more effective than Tamiflu. Note that face masks work by stopping you touching mucous membranes. Consider protective goggles for this reason.
Posted by: phil_b   2005-08-28 18:30  

#9  Animal experiments show Tamiflu only works as a prophylactic. That is, it only protects (and then only partially) when taken before infection occurs. A 'dose of Tamiflu is either a 5 or 10 day course. The pandemic will last, and people will be at risk, for 12 months or longer. Hence, 2 million doses will protect less than 50,000 people for the duration of the pandemic. A drop in the proverbial ocean.
Posted by: phil_b   2005-08-28 18:24  

#8  Other common sense precautions include frequent laundering of linen and clothing using oxygen bleach, not re-using dirty dishes by diswashing more frequently

In other words if it looks like a Frat house avoid it.
Posted by: Peter Finch   2005-08-28 16:32  

#7  Noted and saved, Anonymoose. I'll go shopping this week. And thanks!
Posted by: trailing wife   2005-08-28 15:42  

#6  There are a few OTC preventatives available, and these should be remembered and used when the flu period hits. (Also remember that flu hits in two major waves, so don't let your guard down after the first one has passed through your area.)

First and most important, during the outbreak, use hand sanitizer with alcohol six times a day, using soap if there is obvious contamination. This will reduce your odds of catching flu by 80%.

Second, slowly dissolve 3 or more Cold-Eeze lozenges in your mouth each day, refraining from food or drink for an hour afterwards. The proprietary metallic zinc available only in that brand of lozenge, not in supplements, inhibits virus reproduction in your mucous membranes. Tastes bad but it is worth it in this case.

Third, drink large quantities of ordinary store-bought cranberry juice. Large amounts only of cranberry juice may prevent cell transfer of these viruses, though only proven so far to work in two other types. It also contains large amounts of vitamin C, which may have a prophalaxis effect against the disease. (Note: small amounts of juice have little or no effect.)

An obvious solution: avoid people with the disease, even loved ones. Insist that *they* hand sanitize even more frequently, to reduce contamination in your shared environment.

A very strong decontaminant can be obtained at health food stores. GSE Grapefruit seed extract, sold as a "calcium supplement", is extremely toxic to microorganisms, but is non-toxic to people. A few drops will sterilize a quart of water (metallic calcium ions). If you are in a closed air system with people who have the disease, add a tablespoon to the water of a room vaporizer/humidifier. It will speed disinfection of surfaces in the room and the air considerably.

Other common sense precautions include frequent laundering of linen and clothing using oxygen bleach, not re-using dirty dishes by diswashing more frequently, and if you do get surgical masks, they should be worn by those with the disease, if at all possible. Disposable latex gloves are very inexpensive and should be worn before cleaning and disposing of vomit and diarrhea messes. Remember to dispose of them or to decontaminate the outside of the gloves after handling contaminant.
Posted by: Anonymoose   2005-08-28 14:55  

#5  IIRC under WTO rules, countries are permitted to compulsory license drugs and start local manufacture if there is a national emergency.

There is certainly the technical skill in Asia for this. The Indian pharmaceutical industry has been reverse engineering stuff for decades.
Singapore has a lot of biomedical capability.

The WHO buys a lot of its anti-retroviral drugs from Indian manufacturers.

SE Asia could also import from Brazil, who also have a quite capable drug industry.
Posted by: john   2005-08-28 14:49  

#4  Let's be realistic. For political, social and economic reasons, most of the world cannot and will not have access to any sort of protection against the next flu pandemic.

As I noted with the Marburg outbreak in Angola. When your life expectancy is 40, does it really matter what you die from?
Posted by: Chuck Simmins   2005-08-28 14:19  

#3  In addition to securing sufficient doses of Tamiflu to care for over two million people, the U.S. is reportedly making a bid to buy even more stocks from the Swiss pharma giant Roche, which produces the drug

we only have two million doses and the whiners are saying we're basically hoarding?? FOAD assholes. We should have 100 times that. We've been supporting your f*&ked up medical drug industry at subsidized cost for decades and now you whine about protecting ourselves? Perhaps if your countries (yes, you, China and Viet Nam) spent a lot less on weapons, you might support a medical drug development program rather than depending on patent theft
Posted by: Frank G   2005-08-28 10:31  

#2  Don't the new flu strains each year come out of Asia?

So why aren't they ahead of the crowd instead of sucking hind teat?

Couldn't have anything to do with them thinking they're supposed to be given everything by the West they hate so much, could it?

It's not just the "West"; betcha Japan has stocked up too.
Posted by: Barbara Skolaut   2005-08-28 10:28  

#1  The disparity has been fuelled by the speed with which the developed world, led by the United States, has used its financial muscle to acquire global stocks of the drug that health authorities say is the most potent anti-flu medicine currently available.

That's a feature not a bug. Its having the smarts to be ahead of the crowd, whether that's acquring the vaccine or developing a free and open captialist society far earlier to make it all possible. Its getting out of Pompeii when the mountain starts to smoke rather than waiting around till its too late. Those who left earlier were around to repopulate. Those who stayed weren't. Darwin had some observations on this.
Posted by: Snese Uninesh2330   2005-08-28 08:33  

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