Demands For Physical Emergency Measures For Food Supply, Public Health

May 2, 2009 (LPAC) — Barely days into the outbreak, the new A/H1N1 virus is the occasion for calls from many sectors for physical economic emergency measures (mobile health vans; mass production of livestock flu test kits, etc.) to deal with this and potential new threats, not only for health as such, but the food supply. This goes against all the tenets and practices of globalization, which caused the present-day pandemic threat to begin with.

Confirmed cases of A/H1N1, as of 19:00 GMT today, are in 13 countries, with 365 cases of infection in Mexico and the United States. The following countries have reported laboratory confirmed cases with no deaths — Austria (1), Canada (34), China, Hong Kong, Special Administrative Region (1), Denmark (1), Germany (3), Israel (2), Netherlands (1), New Zealand (3), Spain (13), Switzerland (1) and the United Kingdom (8), Hong Kong, China and Denmark being the new countries.

- Threat of Re-Combination -

Senior virologists are stressing that the threat of re-combination of the virus is high and dangerous, as it arrives and spreads in Asia where H5N1 is endemic. "The prospects for change [in the virus] are considerable and worrying," as it spreads and can mix, or re-assort and turn into something more lethal, warns Emeritus Professor Kennedy Shortridge, at the Univ. of Hong Kong, who was active in the initial emergency period of H5N1 avian flu in 1997, and in subsequent flare-ups. He was one of the first to study the "mixing bowl" role that pigs can play, to receive, host, and transmit viruses.

The Paris-based O.I.E., World Animal Health Organization, is issuing warnings for bio-security for livestock, given the many unknowns about the new A/H1N1 flu strain and transmission from humans to animals. E.g., Penn State University's alert this week: "Unlike most swine flu strains, it can be transmitted from person to person, but it's unclear whether it can pass form people back to pigs. Until we know more, our best advice to producers is to be vigilant and step up your biosecurity."

Given the danger of co-infection, epidemiologists are calling for rush-production of testing and surveillance equipment, wide access to micro-array capability, and accessible genomic level bio-information.

- 200 Million Migrants -

There are millions of vulnerable migrants. Taken altogether, their number worldwide would constitute the fifth most populous country on the planet. The U.N. International Organization for Migration (IOM) estimates that there are more than 200 million migrants worldwide, roughly 20 to 30 million of whom are undocumented, comprising around 10% to 15% of the world's immigrant peoples. Plus there are 26 million internally displaced persons (IDPs). One third of the world's migrant workers live in Europe, with slightly fewer than that living in Asia and North America.

IOM Senior Migration Health Policy Adviser Jacqueline Weekers said this week, "The rapid spread of the H1N1 virus is testimony to the critical relation between human mobility and health.... It is in the public health interest of every community to ensure all people have access to clear information, treatment, and care. Efforts should also be made to allay fears of irregular migrants who fall sick, that they may be deported or face other repercussions if they seek medical assistance. All barriers to access need to be removed in such a situation."

- Ramping Up Vaccine Production -

According to Dr. Marie-Paule Kieny, Director of the WHO Initiative for Vaccine Research, who gave the daily WHO update today, the decision to mobilize to produce the new pandemic A/H1N1 vaccine globally is close. Manufacturers and the WHO are in accord. On April 29, Dr. Margaret Chan, WHO Director, met with vaccine manufacturers in a very long virtual meeting. Several dozen potential manufacturers, from developed and developing countries were involved as well as other scientists. The CDC will provide the seed virus in two forms — the usual form for growth and reassortment in eggs, and the reverse genetics approach (which carries patent rights). Big players and little players are to be involved. She specifically mentioned participation by Brazil, Hungary, and China. By mid-May, the virus will be ready to transfer to manufacturers.

As in all questions of infrastructure, kept down during the past 40 years of globalization, there are great constraints in vaccine production capacity, and also in producing anti-viral medications. After the 2004 episode of botched production of vaccine for the flu season, at the facility in Liverpool, England, and the renewed outbreak of avian flu, new vaccine capacity was spurred by government and commercial action. "Pandemic production capacity has increased by 300% over the last two years," according to the WHO and the New York City-based firm, Oliver Wyman, in a statement February, 2009 about their survey of some 44 vaccine firms worldwide. But capacity is still way below what is needed to deploy, and to stockpile.