Developing nations could face flu drug shortages

GENEVA, Tuesday

Developing countries may struggle to gain access to the antiviral drugs they need to combat a fast-spreading outbreak of swine flu.

"It is going to become a problem," said Sangeeta Shashikant of the Third World Network, which campaigns for better drug access for the poor.

She said "advance purchase agreements" and other deals securing medicines for wealthy governments could drain the global supply chain of effective medicines.

The antiviral drugs Tamiflu made by Swiss drugmaker Roche Holding AG and Relenza, made by GlaxoSmithKline, have been shown to be effective against the swine flu strain that has infected people in Mexico, the United States, Canada, Spain and Britain. Up to 149 people have died in Mexico.

But there are not likely to be enough doses to treat the whole world in a pandemic, and production is limited.

"Many countries have stockpiled antivirals, although how to deliver them within a maximum of 48 hours remains a huge challenge," the London School of Hygiene and Tropical Medicine said in a statement.

"Preparedness levels in middle income and lower income countries remain low. Therefore it is likely that this flu outbreak will also be a test for global solidarity."

UN Secretary-General Ban Ki-moon used the same expression in his appeal for assistance for states vulnerable to the health crisis who may need drugs, diagnostic tools and other help.

"If we are indeed facing a pandemic, we need to demonstrate global solidarity," he said in a statement.

"Poorer nations are especially vulnerable. They have been hit hard by other crises this year: food, energy, the global economy, climate change. We must ensure that they are not also hit disproportionately hard by a potential health crisis."

Avoid needless deaths

Mike Palmedo, research coordinator at American University's programme on information justice and intellectual property, said the international community should ensure drugs reach those who need them in order to avoid needless deaths.

"I suspect that in the event of an epidemic, many countries would find their supplies inadequate," he said, suggesting that increased generic production could help ease shortfalls.

"Whatever the amount of drugs currently available, more generic competition would drive prices down further, making access available to more countries."

India's Cipla began to manufacture generic oseltamivir, or Tamiflu, in 2006, and Ranbaxy and Hetero also make the drug in India. Shanghai Pharmaceuticals and HEC make it in China, according to Palmedo.

Roche said the World Health Organisation had not yet asked it to deploy 3 million treatment courses being held as a "fire blanket" to use wherever a pandemic breaks out. The WHO also has an additional 2 million packs that Roche donated in the past for use in countries which are not so well prepared for a pandemic.

Shares in Roche and Glaxo rose 4 and 5 percent in European trading on Monday on expectations those companies would benefit as governments and corporations ordered their drugs.

Efforts to create a swine flu vaccine could also create strains for poorer states, Shashikant said. "You need production for developing countries and access to technology," she said.

Indonesia created diplomatic uproar at the height of the world's bird flu pandemic fears three years ago when it refused to share virus samples without a guarantee that poor states would later be able to afford the vaccines developed.

Developing a vaccine against the variety of swine flu circulating will take several months.

Despite its shorthand name, the disease is spread person-to-person and has never been seen in pigs. It has components of classic avian, human and swine flu viruses. (Reuters)