27.08.2009

Prevention and Profit in Times of Swine Flu

Since the beginning of the AIDS epidemic in the early 80s, debates about the right measures and justified resources in order to deal with an imminent health threat, haven’t been as heated as they are today with the global new strain of influenza H1N1.

Are the authorities in the affected countries in Latin America downplaying the real dangers in order not to endanger the tourist industries and to divert attention from the neglected and failing health systems, as our project partners in Chiapas, Mexico are reporting? Or is the WHO and the “world community” overdramatizing the situation to strengthen their own leadership role and to demonstrate their ability to act , while the huge gap in the global health situation is widening in the current economic crisis?

Without doubt, seeing the obvious less virulent behaviour of the virus, the WHO ’s “Chronicle of an Announced Epidemic” is increasingly seen with scepticism, and concerns are already raised that a “catastrophe failed to come” could even do more harm than good in public trust in administrative disaster preparations.

Even if some health politicians/administrators now see the H1N1 Influenza as a welcome test run for existing disaster planning, a certain amount of mistrust against the profiteers of such scenarios remains necessary and the ever valid question : qui bono? Who is profiting? needs to be raised.

A reality check is much needed: In all debates about the global management of health threats it becomes clear that Blood is still thicker than water, and global solidarity is just a token word when it comes to the established world order. Nowhere is this as blatantly visible as in the “hard facts” of production and distribution of medicines and vaccines. Here a real “global responsibility” for the supposed global challenge would be matched with a truly collective effort towards the means of solving the crisis.

In reality, while the development of a vaccine has been spurred successfully in the last months and the first vaccine charges are expected in early September, the political conditions for a global accessibility to these vaccines are still insufficient. The vaccine production that exists within transitional economies and developing countries is mostly limited to standard immunisations and in their capacity only slowly expandable, while the more modern methods, developed in the last years and using easy multipliable cell lines rather than eggs, are heavily patent protected and cannot be copied easily.

In combination with the expected “profitable” price of the new vaccines, this means that the people in the economical deprived areas of the world will not have an equitable access to this production – beyond some charitable acts, like the 150 Mio vaccine doses promised to WHO from the producers – given an expected maximum of 900 Mio doses annually this would be just 16% for two thirds of the world’s population.

This would indeed be a good chance to give flesh to the “global Solidarity”, that is so often talked about. Interestingly, recently the countries of the ConoSur, Argentine, Brazil, Chile, Paraguay and Uruguay, suggested declaring the new vaccine against the pandemic influenza a “global public good” and to waive all patents – this would indeed be a new and rather revolutionary development and – coupled with a comprehensive technology transfer from North to South – could increase the accessibility of the new vaccine substantially.

If such a step was taken – this could be an important piece on a new strategy for “Health for All”, a goal the WHO reaffirmed only last year in its Annual Report 2008. And it is this goal both the WHO and the other actors in global health politics must be matched against.

Andreas Wulf, MD Medico international Germany