What is a pandemic, and how serious is it likely to be?

According to the WHO, an influenza pandemic occurs when a new strain of the influenza A virus appears (antigenic shift) against which the human population has no immunity, resulting in several simultaneous epidemics worldwide with enormous numbers of deaths and illness.

According to experts and the WHO, the next influenza pandemic is imminent. Two of the three widely-accepted criteria for an influenza pandemic have already been met by the most recent strain of the H5N1 avian influenza virus inAsia; firstly, a new influenza virus strain has emerged, and secondly, the virus has spread to humans. The last barrier will be the effective transmission of the virus from human to human. Such an outbreak would be facilitated by widespread air travel, urbanisation and overcrowded living conditions in cities.

The WHO estimates that between two and seven million people worldwide will die from the next pandemic.

Preparation

Is the world prepared for the next pandemic?

Experts agree there is still a great deal to be done and they encourage countries to have pandemic plans in place; one component of such a plan is the stockpiling of antivirals ahead of time.

Pandemic influenza and seasonal influenza

What is the difference between a pandemic strain of influenza and a seasonal influenza?

A pandemic strain of influenza is always of the A variety and is a completely new strain to which there will be no immunity whereas a seasonal strain of influenza is one that has previously been circulating, which may have changed slightly (antigenic drift) and to which a level of immunity exists.

Pandemic Supplies

What is Roche doing to make sure enough antiviral is available for a pandemic outbreak?

Roche took the decision to increase production capacity of its antiviral at its own risk as early as February 2004, in advance of receiving any firm orders from governments for pandemic supplies.

Pandemic preparations

Are we ready for a pandemic?

The WHO has recommended that governments put in place a pandemic preparedness plan to deal with an influenza pandemic which includes the stockpiling of antivirals.

Roche is working as a socially responsible company with governments on pandemic planning. We have agreed quantities and delivery schedules with more than 75 countries worldwide for stockpiling of an antiviral.

In August 2005 Roche donated a rapid response stockpile of 3 million courses of antivirals to be used to contain or slow the spread of a pandemic at its site of origin. This was in addition to 125,000 courses of therapy donated by Roche in 2004 which was used by the WHO in affected countries inAsia. In January 2006 Roche announced the donation of a further 2 million treatment courses, of antivirals to the WHO for the establishment of regional stockpiles for use in the management of the current avian influenza strain or in the event of a pandemic.

Do national governments have pandemic plans in place?

The WHO has urged all countries to develop pandemic preparedness plans, and has developed a checklist to assist governments in their preparations, but only around 40 have plans to date.

The London School of Hygiene and Tropical Medicine, (LSHTM),UK, conducted in 2006 two major reviews into publicly available national plans, addressingEuropeand the Asia-Pacific region respectively. The findings assessed the level of preparedness of each individual plan and the regions as a whole, highlighting the gaps to be filled to ensure adequate preparedness.

What were the key findings of the LSHTM’s European report?

The European report found thatEuropeis moderately well prepared for pandemic influenza, but considerable gaps exist amongst the individual preparedness plans. The authors called for European nations to work together and on the European Union to act to improve the situation, ensuring that policies are consistent, planning is robust and that resources are distributed appropriately.

What were the key findings of the LSHTM’s Asia-Pacific report?

The Asia-Pacific report found that the Asia-Pacific region, although likely to be the origin and initial centre of the pandemic, is subject to significant challenges. The region’s plans were found to belong to two very distinct groupings according the quality and applicability of the plans. Australia,New ZealandandHong Kongwere found to have relatively good plans. HoweverChina,ThailandandVietnam’s plans were insufficiently operational and had significant gaps that need to be addressed.

What have been the developments since the LSHTM research was published?

Since the LSHTM publications, a number of governments have been in contact with the LSHTM to update the researchers on developments and new plans, since the reviews of plans were based on those publicly available at the time of research only. The LSHTM is addressing the possibility of updates on the situation and the lead author (Dr Coker) has conducted a number of professional and media briefings to comment on the findings, recent developments and implications.