Published 14 October 2009, doi:10.1136/bmj.b4216
Cite this as: BMJ 2009;339:b4216

News

WHO will start delivering H1N1 vaccine to 100 poorer nations in November

¹ Geneva

About 100 low and middle income nations will start receiving the first deliveries of H1N1 flu vaccines donated by drug companies and governments as early as November, World Health Organization officials announced on 12 October. Healthcare workers have been designated the highest priority target group.

Marie-Paule Kieny, director of WHO’s vaccine research initiative, told reporters, "The director general of WHO will approve, most likely today, a list of countries who will be the beneficiaries of these donations."

The countries on the WHO list currently don’t have access to pandemic vaccine, said Dr Kieny. She said the agency is finalising guidelines for introducing the vaccine

"The principle for the deployment of the vaccine will be vulnerability: countries that are most vulnerable should receive the vaccine first. Then the second factor is readiness of a country to introduce a vaccine," she said.

Assessing vulnerability will take into account each country’s ratio of H1N1 deaths per million people in the population, she said.

WHO’s target is to achieve a coverage of 2% of the population in all eligible countries as soon as possible—during the next four to five months if all goes well—followed by other vulnerable groups, such as pregnant women.

This initial 2% will be sufficient, Dr Kieny said, to cover all health workers who have been given the highest priority by WHO’s strategic advisory group of experts.

When and if more vaccine becomes available, WHO will strive to make doses available to cover up to 10% of the population of these countries, or about 300 million of the estimated population of three billion, she said.

In September WHO revised downwards its figures for the availability of H1N1 vaccines for the first 12 months from 4.9 billion doses (the May estimate) to three billion.

However, new estimates are expected after a revised production survey is conducted with vaccine manufacturers.

On the availability of vaccines worldwide, Dr Kieny said, things were looking better than a few weeks ago.

"We have good news, although it seems the yields of the latest vaccines provided by manufacturers to the WHO . . . are not as good as the seasonal [vaccines]. There has been a marked increase in the yields, and we are coming to a situation where the availability of vaccines will be higher than was feared a few weeks ago," she said.

GlaxoSmithKline has pledged 50 million doses of vaccine to WHO, and Sanofi has pledged a further 100 million doses. Discussions are taking place with another manufacturer, Medimmune, which has a product licence in the United States for a vaccine delivered by nasal drops.

WHO is also in talks with nine rich countries that have pledged to provide the agency with 10% of the vaccines they are purchasing for their own domestic use to see how many doses they will provide and when they will be delivered.

About 50 million doses are expected from the nine countries, bringing the total number of vaccines donated to 200 million, leaving a shortfall of 100 million.

WHO’s director general, Margaret Chan, and the United Nations’ secretary general, Ban Ki-moon, are still calling for more support from the public and private sectors, Dr Kieny said.

WHO has also received donations of vaccine vial monitoring equipment, to ensure that vaccines have been kept at the right temperature, from a company called Temptime and syringes from Becton Dickinson.

Cite this as: BMJ 2009;339:b4216

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