Health officialsaround the world are preparing for a surge in the number of H1N1 flu cases,also known as swine flu. But while richnations may have the resources to produce or acquire adequate doses of vaccine,developing countries could fall far short.
In June, the WorldHealth Organization announced that an H1N1 global pandemic was underway. The action was taken not because of theseverity of the illness, but the extent to which to new virus had traveledaround the world.
Dr. Ruth Karron,director of the Center for Immunization Research and the Johns Hopkins VaccineInitiative, says the disease should be taken "very seriously."
"I don't think thatanybody can absolutely predict at this point what the final impact of this newvirus is going to be?. Because we knowthat this virus is a really highly infectious virus," she says.
Health officialsdon't know at this time how ill those infected will become.
"So far a lot ofthis illness that it's caused is mild?. If the virus starts causing worse illness, then I think the fact thatit's so infectious and readily transmitted is really a problem," she says.
Also she says H1N1flu has the potential of being more severe in poor countries simply becausethere is more underlying disease there overall.
In the UnitedStates, health officials are debating whether 600 million doses of vaccine willbeneeded to deal with the pandemic.
"The assumption hasbeen for this new vaccine we would need to give two doses. So, if there are 300 million people in theUnited States, and everybody needs two doses, that's how you get to the numberof 600 million," she says.
Some have posed thequestion that if the United States and European nations are looking to produceor procure huge amounts of H1N1 vaccine, should they also help poor nations doso?
"I think wealthiernations are looking at protecting their population and then they're alsoconsidering the needs of other countries. I know that some of the pharmaceutical companies have pledged some dosesto a WHO (World Health Organization) stockpile of vaccine. How many doses and in what time frame I thinkis probably the difficult question," she says.
Poor countries mayhave to wait until the pharmaceutical companies fulfill their obligations tothe wealthy nations. Karron says sheexpects the goal will be to make the vaccine available as soon as possible toafford the best protection.
In the earlieryears of the HIV/AIDS pandemic, many accused the pharmaceutical companies ofnot doing enough to help poor countries. Legal battles erupted over the availability of ARVs, or anti-retroviraldrugs.
Dr. Karron saysconditions are different in this case.
When we weretalking around ARVs, we were not talking about scarcity?. That if you provided anti-retroviral drugs inresource-poor settings, it wasn't an issue that somebody in a wealthy countrymight not get the ARV that they needed. Here we're dealing with ?scarcity," she says.
Nevertheless, shesays the debate over how much to help poor countries will heat up if thepandemic grows more severe. And it'spossible pharmaceutical companies could again face criticism.
Karron says thelast major flu pandemic occurred in 1968, but she says much has improved inresponding to illnesses.
"We can track viralspread in real time. We can understandthe genetic composition of the viruses that are spreading in real time. We can make vaccine more rapidly andanti-virals. And we have more optionsfor the kinds of vaccines that we make," she says.
She says becauseall these tools are now available, there is a responsibility to use them tocombat the H1N1 pandemic.
Dr. Karron hasconducted research for or consulted with pharmaceutical companies that produceflu vaccines.
In late August, the World Health Organizationhad confirmed over 209,000 cases of the so-called swine flu, with nearly 2200deaths.