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HEALTH: H1N1 Pandemic Is Over, But Vigilance Needed – WHO

Marwaan Macan-Markar

BANGKOK, Sep 7 2010 (IPS) - The World Health Organisation (WHO) is urging countries in Asia to remain vigilant about the spread of the H1N1 influenza virus, which the international body declared was no longer a pandemic a month ago.

“In the current post-pandemic period, we expect to see localised outbreaks of different magnitude, and some continuing ‘hot spots’ will continue to show high levels of H1N1 transmission,” said Margaret Chan, the director general of the WHO, on the opening day of a regional health conference in the Thai capital.

“The pandemic virus has not gone away,” she warned. “The virus is likely to continue to cause serious illness in a younger age group. Protecting high-risk groups and maintaining vigilance are recommended actions.”

Outbreaks of the deadly virus, which had killed over 18,130 people by May this year, have continued to be reported in India, New Zealand and Australia. At the height of this virus’s pandemic period, the WHO had reported cases in 214 countries and overseas territories.

Chan’s statement at the meeting of health ministers and public health officials from 11 countries in South and South-east Asia stemmed from the global health body’s assessment based on epidemiological data from around the world indicating that “the new H1N1 virus had largely run its course.”

The 28th Health Ministers Meeting and the 63rd Session of the Regional Committee for South-East Asia runs from Sep. 7-10.

The WHO’s downgrading of the deadly new virus was announced on Aug. 10, when Chan said: “Based on experience with past pandemics, we expect the H1N1 virus to take on the behaviour of a seasonal influenza virus and continue to circulate for some years to come.

“Globally, the levels and patterns of H1N1 transmission now being seen differ significantly from what was observed during the pandemic,” she had added. “Out-of-season outbreaks are no longer being reported in either the northern or southern hemisphere.”

It is a picture that contrasts sharply with the reality that emerged when reports of this lethal virus, which was also called ‘swine flu’, spread in March and April last year. Alarm bells were sounded in the wake of outbreaks of the new influenza virus that began in Mexico and rapidly spread through North America.

Growing concern by public health officials about the new virus, against which people had no natural immunity, was confirmed in June 2009, when the U.N. body declared that the world was facing a pandemic. The Geneva-based WHO estimated at the time that nearly two billion people – a third of the world’s population – could be infected with the new virus.

Parallels were also made with the last flu epidemic, the 1968 ‘Hong Kong’ flu, which killed about one million people, and the 1918 ‘Spanish’ flu pandemic. The latter killed over 50 million people globally, having begun as a mild outbreak in the spring of that year and then evolved into a more virulent second wave during the winter.

The fatalities from the ordinary flu, on the other hand, are much less. It reportedly kills 250,000 to 500,000 people every year.

In response to this global health challenge, the WHO triggered a race to mass-produce vaccines for the lethal virus. At one point, it projected a need of close to 220 million doses annually, “with a surge capacity that could reach 420 million vaccine doses” a year.

In July 2009, GlaxoSmithKline Plc, the British pharmaceutical giant, had been inundated with orders for 440 million doses from nearly 20 governments, according to media reports.

But while the pharmaceutical giants, who are mostly based in Europe, Britain, North America and Japan, were in the spotlight to produce – and profit – from this surge in demand for the new vaccines, the new pandemic also paved the way for flu vaccine production to emerge from Asia.

India, China, Thailand and Indonesia responded to the public health challenge to boost the global vaccine supply.

Yet the WHO admits that the world’s vaccine production centres are still unable to meet the spike in demand stemming from the outbreak of pandemics such as H1N1. “Current vaccine production methods are too slow,” said Gregory Hartl, a WHO spokesman. “It takes four to six months to produce a flu vaccine.

“Till then we will be constrained in having the same time line,” he added during a telephone interview from Geneva. “The H1N1 vaccine is probably the most closely scrutinised vaccine in history. The safety profile of this vaccine is as good as, if not better than, the safety profile of the seasonal flu vaccine.”

Such a clean bill of health about the H1N1 vaccine has done little to prevent criticism of the WHO, following revelations that a member of the WHO’s Strategic Advisory Group of Experts on Immunisation, which helps shape the WHO’s vaccine policy, had ties to a vaccine research programme of a pharmaceutical giant.

This scandal was revealed by ‘Information’, a Danish daily newspaper, in December 2009. The publication alleged that a Finnish member of the WHO’s panel of experts had been paid the equivalent of 7.8 million U.S. dollars for a vaccine research programme from a drug manufacturer.

The WHO’s Chan has rejected the allegations that the U.N. body’s decision to declare H1N1 a pandemic was influenced by pharmaceutical giants.