Via CIDRAP, Robert Roos writes: Fineberg: 5 years after H1N1, world still not ready for pandemic. Excerpt:
Five years after the 2009 H1N1 influenza virus emerged, the world's ability to cope with a flu pandemic is a bit better than it was in April 2009, but there's still a long way to go, says Harvey Fineberg, MD, PhD, who chaired the international committee that was assigned by the World Health Organization (WHO) to evaluate the global response to the pandemic.
"We said in our core conclusion that the world is not well prepared," Fineberg said in an interview. "It is better [now], but it's not adequate."
The 2009 H1N1 virus (pH1N1) emerged in Mexico and spread to California in late March of 2009. The virus rapidly traveled around the world, triggering the WHO's pandemic declaration on Jun 11 (2009). In the United States the epidemic peaked in October and November of that year.
Fineberg is also president of the Institute of Medicine, part of the US National Academy of Sciences. The WHO-appointed review panel issued its report in May 2011.
Estimates of H1N1 death toll
Just how many people died of H1N1 illness during the pandemic remains unknown, but estimates range from 105,700 to 395,600, Fineberg said in a commentary published last week in the New England Journal of Medicine.
Those numbers are similar to what happens in a "relatively mild" non-pandemic flu season, but because children and young adults were hit disproportionately hard and elderly people were less affected, the effect in terms of years of life lost was greater than in a normal flu season, he noted.
In his commentary and the interview, Fineberg recalled the pandemic review committee's findings and reflected on developments in pandemic preparedness since the report came out.
"There are some areas where we are definitely better off today than 5 years ago," he said. "One is the agreement on sharing of viruses and vaccines."
He referred to the WHO's pandemic flu preparedness framework, which provides for access to flu vaccines in developing countries and the sharing of flu viruses for disease surveillance. The pact, which answers one of the recommendations of the review committee, was hammered out under WHO leadership and signed in 2011.
"That's a step forward," he said. "It does pre-position certain [vaccine] manufacturers who agree to dedicate a certain portion of their production to a redistribution pool that WHO will oversee." The agreement adds "a measure of fairness" to the distribution of vaccine supplies, he added.
In addition, the WHO has incorporated some of the review committee's other recommendations in its work plans, which is encouraging, Fineberg said.
But another recommendation of the review panel—establishment of a contingency fund that the WHO could tap in a public health emergency—has not been fulfilled, Fineberg said.
"There are no steps to my knowledge on that," he said.