IHS Global Insight Perspective | |
Significance | The A/H1N1 influenza (swine flu) pandemic appears to be dying down. However, the Council of Europe Parliamentary Assembly Healthcare Committee has raised questions about whether the virus did indeed pose a pandemic threat, as classified by the World Health Organization (WHO). |
Implications | This could raise questions about how the WHO declares pandemics in the future, and the role played by the pharmaceutical industry in terms of influencing this decision. |
Outlook | A/H1N1 flu emerged as a top public health priority in 2009, and the debate about the pandemic can be expected to continue to rage in 2010, given the financial resources that governments have poured into the pharmaceutical industry for the provision of A/H1N1 flu vaccines. |
Swine Flu: A Snapshot
Mortality Data for Swine Flu | |
Region | Number of Deaths |
Africa | 130 |
America | 6,670 |
Eastern Mediterranean | 693 |
Europe | 2,422 |
South-East Asia | 1,056 |
Western Pacific | 1,249 |
Total | 12,220 |
Source: WHO Pandemic (A/H1N1) 2009, update 81 | |
According to the World Health Organization (WHO), 12,220 fatalities have been reported from the A/H1N1 influenza (swine flu) virus since it first emerged in Mexico in 2009. North, Central, and South America, and the Caribbean accounted for almost 55% of reported deaths in 2009, followed by Europe, which accounted for almost 20% of reported deaths. The Western Pacific and South East Asia region reported a similar burden of the virus, but the number of deaths in the African and Eastern Mediterranean region was notably lower.
The WHO declared an A/H1N1 flu pandemic in July 2009, after 30,000 confirmed cases were reported in 74 countries. This was followed by claims that the pandemic threat would grip the Western Hemisphere by the winter. This threat created a global panic, as governments looked for solutions to control the disease. Even though anti-viral drugs such as Tamiflu (oseltamivir; Roche, Switzerland) and U.K. pharma GlaxoSmithKline's (GSK's) Relenza (zanamivir) were already available on the market for the treatment of flu and the prevention of flu-related complications, there were no available treatments for protection against A/H1N1 flu. Pharmaceutical companies were quick to respond to this urgent market need by expediting their research and development activities to produce A/H1N1 flu vaccines. Governments were keen to secure orders of these vaccines for their respective populations, even before the vaccines were ready—an indication of the urgency of the public health threat that the virus was though to pose.
Did Swine Flu Really Pose a Pandemic Threat?
Towards the end of 2009, there was a sharp decline in the number of cases being reported, and the feared second wave of the pandemic failed to materialise in Western countries. The were a few exceptions to this, most notably in Ukraine, where the number of suspected cases reported by the ministry of health stood at 250,000; however, the number of deaths reported stood at 70 (see Ukraine: 4 November 2009: Ukrainian Generic Production of Tamiflu Set to Commence). As a clearer picture of A/H1N1 flu incidences emerged towards the end of 2009, so did calls for an enquiry into the role that pharmaceutical companies have played in terms of the WHO's decision to declare an A/H1N1 flu pandemic. More specifically, the Council of Europe Parliamentary Assembly (PACE) has proposed a resolution titled "Faked Pandemics—a threat for health", demanding an enquiry into the role played by pharmaceutical companies in terms of influencing the WHO to declare a pandemic, which in turn forced many governments to commit significant resources in order to obtain vaccines, Pharmalot reported. The resolution is being spearheaded by Dr Wolfgang Wodarg, chairman of the PACE Health Committee, with the backing of 13 members of the Health Committee. PACE will discuss this resolution in an emergency debate scheduled for some time in January.
Outlook and Implications
If the enquiry does go ahead, it could possibly pose a threat to the credibility of the WHO's status as an international health authority. Meanwhile, the WHO continues to warn that even though the pandemic threat has waned, it is possible that it could resurge in the future. However, governments appear to be less willing to react to the possibility of a third wave of A/H1N1 flu. Amid fears that A/H1N1 flu cases would peak during the winter months, many western governments had committed significant resources to buying vaccines from companies such as GSK, AstraZeneca (U.K.), Sanofi-Aventis (France), and Novartis (Switzerland), and these companies in turn forecasted windfall sales from their respective vaccines. However, towards the end of 2009, the demand for these vaccines dwindled, in response to low uptake rates and clinical studies showing that a single dose of the vaccine would provide the required level of protection, as opposed to the recommended two doses. European countries such as Spain, Germany, Netherlands, France, Greece, Ireland, and Switzerland are all looking to part with millions of doses of vaccines that they now do not need. In light of the level of government resources that have been spent on acquiring these vaccines and the revenues that pharmaceutical companies are expected to generate from A/H1N1 flu vaccine sales, it is possible that calls for a full enquiry could be conducted into the A/H1N1 flu pandemic, as governments will be keen to establish whether or not they were justified in committing such high levels of spending on the vaccines.