May 23, 2007 (CIDRAP News) – As expected, the World Health Organization (WHO) approved a resolution on the sharing of influenza viruses and access to pandemic vaccines just before adjourning its annual meeting of member countries today.
The resolution calls on the WHO to establish "an international stockpile of vaccines for H5N1 or other influenza viruses of pandemic potential, and to formulate mechanisms and guidelines aimed at ensuring fair and equitable distribution of pandemic-influenza vaccines at affordable prices in the event of a pandemic," the WHO said in a news release.
The resolution also calls for creation of an interdisciplinary working group to draw up new "terms of reference" (TORs) for the sharing of flu viruses by WHO collaborating centers and reference laboratories, the agency said.
"The new TORs will take into account the origin of influenza viruses going into the WHO Global Influenza Surveillance Network and will make their use more transparent," the WHO said. "Once finalized, these TORs will be submitted to a special Intergovernmental Meeting of WHO Member States and regional economic organizations."
The resolution is a response to Indonesia's recent withholding of H5N1 influenza virus samples to protest the high cost of commercial vaccines derived from such samples. Breaking with a long tradition of free international sharing of flu virus specimens, Indonesia stopped sending samples to the WHO last December. Last week the country said it had resumed supplying viruses, but the WHO has said it has received only three samples so far.
Countries are expected to continue sharing viruses while the new WHO rules are hammered out, news reports have said. But Dr. David Heymann, the WHO's head of communicable disease control, said today that the new agreement is voluntary, according to the Associated Press (AP).
"If countries wish to make exceptions, they will make exceptions," Heymann told the AP. "We will have an opportunity to see over the next few weeks, as we begin to request the viruses, if there are any conditions on [using] the viruses as they are sent in."
Indonesia and other developing countries had proposed that the WHO supply H5N1 virus samples to vaccine manufacturers only with the consent of the source country. But the adopted resolution, which emerged from a WHO committee yesterday, says that vaccine makers should have full access to viruses from the WHO during a public health emergency, the AP reported yesterday.
WHO Director-General Margaret Chan, in closing remarks, reminded the delegates of their responsibilities under the revised International Health Regulations (IHR), according to the WHO release. The revised regulations, which take effect in June, are designed to stop the international spread of infectious diseases.
"When collective security is at stake, public opinion can carry great weight," Chan said. "After very considerable discussion, you have adopted a resolution on the sharing of influenza viruses and access to pandemic vaccines and other benefits. I want to underscore the importance of this decision. My responsibilities in implementing the IHR depend on this sharing."
In a statement today, US Health and Human Services Secretary Mike Leavitt said he was pleased that the WHO resolution makes clear that member states must continue to share flu viruses with the agency's flu surveillance network.
"Withholding influenza viruses from the Global Influenza Surveillance Network greatly threatens global public health and is inconsistent with the spirit of the legal obligations we have all agreed to undertake through our adherence to the International Health Regulations," Leavitt said.
As the 10-day WHO meeting ended, Heymann warned that current global vaccine production capacity remains far from adequate to protect the world's population in the event of a pandemic.
According to a Reuters report, Heymann said vaccine makers can produce enough vaccine for only 1.5 billion of the world's 6.2 billion people. It will be "a five-year maximum before we believe we will have enough vaccine to begin to talk about equitable sharing," he said.
In a report last October, the WHO estimated world flu vaccine production capacity at 350 million doses of trivalent (three-strain) vaccine, which could possibly be pushed to 500 million trivalent doses in an emergency. That would be the equivalent of 1.5 billion doses of single-strain vaccine.
In other action, the World Health Assembly of WHO members approved a record budget of $4.2 billion for 2008-09, up from $3.3 billion for 2006-07, the agency said. "The new budget highlights the continued trend of increased investment in global public health," the statement said.
The members also approved resolutions dealing with the prevention and treatment of malaria and tuberculosis and the eradication of polio, among other actions.
May 23 WHO news release
May 23 United Nations news release
Oct 23, 2006, CIDRAP News story "WHO seeks urgent push for pandemic flu vaccines"