Friday, April 27, 2007

Desperate Measure

FDA Approves Sanofi’s Version of the Vaccine

And we succumb...

The US government agency in charge of facilitating the development of a vaccine against bird flu approved on April 24 a vaccine developed by Sanofi Pasteur, Inc. (Full story on Fluradar.)
This despite the vaccine’s rather “limited” protection against the H5N1 virus; the vaccine protected less than half of adults it was given to compared with the 90 percent protection for young, healthy adults of typical flu shots.

Sanofi executives describes this the “’first key step’ in protecting people at increased risk of exposure to bird flu during the early stages of a pandemic.” While the FDA announced that this is the ad hoc drug that will prevent perpetuation of severe cases until the time a more effective vaccine can be formulated.

(Studies are looking at the use of immune boosters, called adjuvants, to try to improve the effectiveness of the H5N1 vaccine, and cell-based vaccines, which are faster to produce than are current egg-based vaccines.)

Tests have been conducted, and there were no reports of drastic side-effects. I feel though that it is no assurance of a lack of health risks from this vaccine. Nevertheless, this vaccine seems to be the best bet the world has got against the looming threat of a bird flu pandemic. In February, FDA advisers said that the Sanofi vaccine would be “better than nothing.”

FDA also announced that the drug is not yet available to the public. The US government will purchase and stockpile (enough for 20 million citizens), distributing the vaccine to its people only if and when outbreaks occur inside its borders. No mention of sharing outside its borders.
In this context, where does the pledge of extending assistance to bird-flu stricken countries come in?

It is but natural for the US to protect and propel its own interest first. But to keep this particular resource to itself when other countries are stricken by bird flu?

Clearly, the US benefited from the strain sample-sharing by affected countries. Clearly, also, the affected countries are not yet benefiting.

I do not question US policy-making, but I stress that there is a need to generate an awareness of and a concern about bird flu in developed nations, and lend a helping hand—if not for the sake of the people in affected developing countries but for everyone’s sake. Because, once bird flu strikes, it could spark more than a localized outbreak but a raging series of infections gone out of control.

Now is always an excellent time to address pressing issues. Not tomorrow; only when there is surplus. After all, these third world countries must be tired of purchasing (and begging for) leftovers from the world’s superpowers.

Local Planning, Far-Reaching Results

It really helps when government people go into the community and use the meetings and gatherings that already exist, rather than convening special city government town halls to communicate information…

The more we meet with our neighbors in settings and forums that they convene in, the more the message gets communicated that we want to work with groups that are functioning in effective and healthy ways."

Arrietta Chakos, Assistant City Manager of Berkeley, California, said this. She participated in the Working Group on Community Engagement in Health Emergency Planning, the panel that produced the University of Pittsburgh Medical Center report.

Some states have already reached out to local communities and even tapped grass-roots groups. Community health departments in Seattle, Washington, and Berkely, California have partnered with local leaders and other concerned citizens to increase awareness of bird flu and the importance of preparing for a pandemic.

They are able to create networks to further this humanitarian cause by capitalizing on communities’ intense interest to be politically involved.

Certain academic communities also seem keen on being safe than sorry. Recently, Harvard planners performed an “on-real time” drill to actualize the management plan that it has prepared. Its Incident, Crisis and Management Support Teams implemented the Central Administration’s recommendations on pandemic planning, incorporating them into the University’s emergency response system.

The number of events, conferences, and workshops with actual emergency drill-exercises on pandemic preparedness is also growing, which addresses somewhat the need to promote an awareness of bird flu in the communities.

An online bird flu news source reports that a Bird Flu School Planning Summit is being scheduled on May 21 in New Jersey ( I have come across reports of non-governmental organisations being formed specifically to stand against bird flu: our warriors against mutable flu viruses and their feathered steeds.

Glad to find that certain local groups and scattered individuals here and abroad realise that the risk is far too great to be ignored.

Greener Pastures: Tapping the Communities

I came across an article in a news source citing how the US government could improve its efforts to prepare for the bird flu pandemic threat. (Full story in, April 18 issue.)

‘Tis quite striking, really. Two independent reports pointed out that the nation’s pandemic plans are missing an important opportunity—by not tapping communities and grassroot groups—to improve preparedness.

The US is now in the same spotlight as the UK government was when The Royal Society and the Academy of Medical Science submitted their evaluation of my country’s readiness to face the bird flu threat. How interesting to see—and compare notes--how the US will respond—or whether it will—to critical but constructive observations.

Remarkably, the reports agreed on the same thing: Get the people involved!—and recommended that this be done immediately.

One of the reports quoted Jason Corburn, assistant professor in the urban planning program at Columbia University, New York City:
"Engaging community members and their knowledge about how they move through the world, and what they know about their disease management and exposure risks in their community, can contribute to better science and policy."

And also noted risk communication expert Peter Sandman of Princeton, N.J.:
“Tapping communities' self-knowledge, rather than dictating to them, ought to be an essential component of pandemic planning.”

Everyone will be affected should there be a pandemic, after all. Indeed, why not tap the power of communities determined, unified, and prepared, which can move mountains, to, at least, increase the awareness of bird flu?

Although the powers-that-be have supposed taken great strides to prepare for this global health threat, most people remain skeptical and very critical (particularly myself) of results, motives, and effectivity. Do you not wonder why, despite these supposedly Herculean efforts, the message of “bird flu is a serious global health threat and that we should be prepared because it could devastate the world should it develop into a strain capable of human-to-human transmission” does not get across to those who matter most and who can do the most—the public?

Mass media tools are not being maximized to channel important information. We in Flublogia are doing our best to inform, educate, motivate, and scare up action, but, the reality is, what we can do and accomplish are very limited.

The vast majority remains ignorant—and worse, the most likely next-victims of this pandemic threat do not even have access to or would not even know of the medium we are using. On a positive note, the reports are very timely. They reinforce the need to strengthen pandemic preparedness plans and give communities the chance to take up the cause.

Empowerment. In the fight against bird flu, no one should be empty-handed

Monday, April 16, 2007

FINAL VERDICT on the Bernard Matthews Case, part two

The BM case calls into question the UK’s own ability to meet the threat of a bird flu pandemic, should the strains now devastating poultry stocks around the world mutate into that bigger monster that infects humans and then other humans.

So does the UK have a grand enough design against bird flu and efficient enough pandemic preparedness in place? Medical experts from the Royal Academy and Academy of Medical Sciences doubt that we are.

Not even government efforts to stockpile Tamiflu are enough to put apprehensions to rest in this matter, I’m afraid—especially not when the UK government merely shrugged at the experts’ observation and warnings, treating these as hardly more than presentiments of doom.

Complex, baffling—the government does not even seem to want to avail itself of eminent scientific advice when making critical decisions about bird flu. At best, I suspect complicity, but with what, who, and why should there be? At worst, I suspect laxness, a shortsightedness that must not be overlooked for lives are at stake.

In any case, transparency is paramount. Without it, government efforts may well just be in vain. FSA should be more transparent of its “standards” and “methods”—so that people will be reassured that its decision in favor of BM was done all right and proper.

The price we pay for this lack of transparency may well carry over to other matters. This incident does not preclude cover-ups or downplay of future outbreaks—done so as not to alarm the public, of course—when the truth is too inconvenient to be let out.

Monday, April 9, 2007

FINAL VERDICT on the Bernard Matthews Case, part one

Bernard Matthews walks away with murder, "exonerated" by the Food Standards Agency (FSA), and leaves labor leaders and bird flu smiling. Visit FluRadar for the full story.

UK’s FSA clears BM, Europe’s biggest Turkey producer, of any legal liability, and lets it off the hook. How short-sighted can the UK get?

"I hope that the Food Standards Agency has not been influenced by short-term concerns about employment at the plant… If consumers lose confidence in the regulatory regime, the damage to the whole poultry farming industry would potentially be devastating." said Liberal Democrat environment spokesman Chris Huhne, quoted by the Guardian Unlimited.

BM’s trial by publicity was off to a great start, fed by British hurt pride and stiff-upper lip idea of cleaning up one’s own mess. The meat scraps, improperly disposed polythene bags, and biosecurity lapses in BM’s turkey plants in Holton, Suffolk and Hungary were swept under the rugs instead—spoiling what could have been an ironic consequence of outraged fuss, much of good intentions, and public confidence over the British officials’ grasp of the big picture.

The bird flu virus, having clearly dropped in on the UK across Europe and the English Channel through BM’s breaches of standards in food hygiene and carefree animal-by-product regulations, suddenly spits at the BM signature, made legible by the H5N1 strain in the dead Turkeys in Hungary and livestock in England, in both countries owned by BM, smudging it, mortifying it—and us who wanted to talk straight but ended up with a “turkey (animal, giant poultry farmer, or government—take your pick)” instead of the truth.
Authorities have earlier revealed that the H5N1 strain found in Hungary were practically identical with the strain that killed 2,600 turkeys and caused the culling of 160,000 more birds in Suffolk. BM regularly transports turkeys and turkey products between the UK and its plant in Hungary.
Investigators from the Department of Environment, Food and Rural Affairs also reported gross deficiencies in the disposal of animal by-products in the farm—gulls were feeding on waste left in uncovered bins and buildings with holes big enough for rats (another possible route of infection).
BM was “warned” several times but, each time, problems were “sorted out,” reports said. Yet on April 2, the FSA decided not to prosecute, a move that Huhne described as “astonishing.” According to the FSA, there were “insufficient grounds” to boost charges against BM.
Though shaken at the verdict, many who have followed this case closely realize that FSA itself now stands on shaky ground. Speculation is rife that FSA prioritized industry interests over human lives should its actions have weakened the country’s defenses against further onslaught of the bird flu virus.
The FSA was increasingly concerned about BM’s labor cutbacks following the outbreak. It turns out that the meat firm had accomplished a series of employment lay-offs to cushion the drop in sales. FSA juggled with the issues, prioritized smiling worker faces over labor union discontent, and left the public doubting the Agency’s ability and commitment to handle a serious public health threat.

That the bird flu virus was contained—this time-- was only through Faith’s good humor, sparing British Isles locals and tourists alike of bird flu transformed into the dreaded flu pandemic by negligence and hospitable climes.

Still, all it not cut out and dried, and I’m quite willing to see all sides of the issue. Maybe, the FSA was not readily swayed by economic forces that needed immediate gratification, made more pressing by the demands of other processed-poultry manufacturers also affected by the bird flu outbreak. Maybe, it looked at the bigger picture and far ahead for long-term consequences.

Still, I wonder if the FSA truly realized that, with its decision in the BM case, it risked far more than the loss of jobs at one meat processing plant?

Saturday, March 31, 2007

II. The (Un)Expected

On the grill: WHO’s sincerity—how faithful will it be to its reassurances of transparency on the results of sample sharing for vaccine production?

Said WHO, “[it] is not involved in financial negotiations, either in selling viruses or buying vaccine.”

Dr. Heymann, WHO assistant director-general for communicable diseases, adds:Countries will negotiate bilaterally with vaccine manufacturers. We will certainly facilitate if countries are asking for support…”

So, how strong is this reassurance, given that vaccine manufacturers would consider profit its major reason for being? How humanitarian can we expect them to become?

In the end, with few bargaining chips, Indonesia had no other alternative than to give in to the constant vexation from other self-serving entities. Indonesia has been in a no-win situation from the very onset of these preposterous negotiations. If not WHO, some other super power would have pushed and prodded until the third world country gave in.

At the bottom line, the issue is moot and academic; fairly wanting “proper consideration and timing.” I can only regret: Equity of benefits for both developed and developing nations is but only a figment of some philanthropist's imagination.

Pity. Had Indonesia stood firmer, it could have made sure of priority access to vaccines and even free vaccines from manufacturers. It could have gone farther by stipulating that vaccines be made available for all third world countries at very affordable prices.

Had it demanded more, maybe when all hell breaks lose, the unexpected may not come at too steep a price for all.

Friday, March 30, 2007

I. The (Un)Expected

Indonesia finally blinks, buckling under pressure from the global community.

After three months of negotiations with the World Health Organization (WHO), Indonesia finally surrenders to the global health body its precious H5N1 samples for vaccine development and production. Earlier, this Southeast Asian country from where 74 people have died of bird flu, had dug in its heels and refused to release samples, citing the fear that large pharmaceutical companies would use the virus to make vaccines that would be unaffordable to developing countries.

But Indonesia changed its mind. Whatever happened to Indonesia’s brave attempt to stand up for its fellow-third world countries until WHO addresses this pressing concern?

After all, WHO did not give any concrete assurance of how it would ensure that cash-strapped countries would benefit equally with cash-rich nations when time for handing out the fruits of sample-sharing.

Muted for reasons unclear, Indonesia held out, gave in: Did its cry for fairness register? Unless WHO presents clearly how the H5N1 study results will be shared, Indonesia’s efforts may very well all go to waste. And sad but true—even if the power struggle between super power and third world had ended in stalemate, Indonesia, with its impoverished majority, may likely be incapable of taking advantage of the vaccines once effective ones are developed.

“Previously, WHO used a mechanism that was not fair for developing countries,” Siti Fadilah Supari, the health minister, said at a March 27 press conference in Jakarta. “This mechanism was not fair and transparent in terms of the expectations of developing countries. We think that mechanism was more dangerous than the threat of pandemic H5N1 itself.” See full story on FluRadar

Not fair? Not transparent? Has this mechanism, this system been changed that Indonesia finally gave in? Is the “danger” no longer present? The danger is still there, and the glaring disparity still gnaws on the inadequate resources of developing countries. This imbalance will persist if the international community continues to feed it.

Consider WHO’s statement:

“H5N1 vaccines are a different issue,” said Dr. David Heymann, WHO assistant director-general for communicable diseases. “We will now modify our best practices to ensure that they are transparent to the developing countries which are providing samples and which have requested to share in the benefits resulting from those viruses.”

Can an assurance to modify an age-old system grant Indonesia the medical stockpile it needs when the next pandemic comes?

Heymann’s assurance of transparency comes out only as convenient, a pat on the back, a mere consolation, a feeble effort for WHO at best. From WHO, we need concrete action plans on how third world countries will gain more of the fruits of their sample-sharing and other bird-flu related endeavors.

Location: United Kingdom

An average citizen tired of the many grimy coatings bird flu news is being slathered with.

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