Are we prepared for a viral pandemic?

Tadataka Yamada
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The outbreak of the H7N9 bird flu in China should be viewed as a major global concern. So far, there have been 127 reported cases, out of which 26 people have died.

The transmission of H7N9 takes place from birds to humans. So far there has been no evidence of human-to-human transmission, which will require a few more mutations of the virus. The problem with this virus is that there are no symptoms in the birds and it is difficult to know when a particular community of birds gets sick, making it hard to predict when and where the next case will be.

Another worry is that the case mortality rate is extremely high – around 20%, which is much higher than previous flu epidemics. This strain of bird flu also seems to be more easily transmitted from birds to humans, according to the World Health Organization. All these factors make it essential for us to take notice and actively work towards preventing a pandemic.

The Center for Disease Control in China has learned a lot from past epidemics – SARS and H1N1 – and is managing the best they can. But, given the above uncertainties, it is not an easy job. While the world is better prepared for an epidemic/pandemic than it was when SARS broke out, there is still potential for the virus to have a huge impact on the region in question.

A critical element of commerce today is travel, and any industry which relies on transport will be affected by a pandemic, if it occurs. Travel becomes severely constrained, impacting the airline and tourism industries, logistics and the supply chain. Of course, immediately impacted are also industries connected to agriculture, livestock, food supply and restaurants due to contamination of poultry farms. These industries need to be aware and take precautions to mitigate the risks associated with a pandemic.

Affected countries and those with the potential to get affected also need to have prevention measures in place to avoid severe adverse impact. Public health systems of some countries have been dormant after the 1940s and 1950s in the aftermath of eradicating polio, and have been lulled into complacency. The population needs to relearn the basic fundamentals of public health to escape the risk of an outbreak.

I suspect that there will be a substantial imperative to make a H7N9 vaccine. However, there are several barriers to the successful creation and distribution of vaccines. First, it takes a while to make the vaccine since every strain of influenza is different – we can’t immediately have a supply of millions of doses of vaccines. Second, not all countries have the manufacturing capacity for vaccines and have to rely on those countries that do.

Some countries are better prepared. Japan has invested over US$ 1 billion to develop manufacturing capabilities of influenza vaccines domestically, making the country stronger against a potential risk. But in general, each nation acts in its self-interest and there exists an unhappy and unfair distribution of vaccines. Rich countries have better negotiation power and are able to stockpile vaccines, whereas poorer countries, which sometimes need them more, have to wait until the domestic needs of the rich are met and then are supplied with what remains.

When there’s a limited supply of vaccines, who gets it? And what is fair? It’s uncertain when there are economics of production involved. But what is clear is that it’s not fair that the poor, who may be at greatest risk, have the least access to the much needed potentially life-saving vaccines.

Author: Tadataka Yamada is Chief Medical and Scientific Officer, Executive Vice-President and Board Member, of Takeda Pharmaceuticals International. He is also a Member of the Global Agenda Council on Personalized and Precision Medicine.

Image: A man covers his face among his chickens REUTERS/William Hong

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