Published 29 September 2009, doi:10.1136/bmj.b3988
Cite this as: BMJ 2009;339:b3988

News

UN seeks $1.5bn and donations of vaccines to help poor nations fight swine flu

¹ Geneva

United Nations health officials have called for rich nations to pledge more money and donate vaccines against H1N1 flu to help developing countries fight the pandemic. It is expected that the impact will be more severe in these countries than in richer countries.

The call comes as revised estimates from the World Health Organization indicate that drug companies would produce only about three billion doses of vaccines a year, down from the 4.9 billion doses predicted in May.

"These countries have the weakest capacity and resources to withstand an escalation of H1N1 and the most vulnerable populations," concludes a United Nations task force report.

It adds, "Countries where health services are overburdened by diseases, such as HIV/AIDS, tuberculosis and malaria, will have great difficulty managing the surge of cases seen when pandemic influenza spreads."

The report says that a contingency fund of $1.48bn (£0.9bn; 1bn) is needed for 85 resource strapped developing countries to provide urgent interventions.

This includes $1.1bn for essential drugs and vaccines ($600m for vaccines and $525m for antivirals) and $240m to strengthen countries’ readiness, including training in pandemic surveillance and laboratory support.

The goal is to provide developing nations that depend entirely on donations with enough vaccine to cover 5% to 10% of the population, says the report, compiled by WHO and UN health experts.

Marie-Paule Kieny, director of WHO’s initiative on vaccine research, told reporters that the goal was to have immediate access to 300 million doses of vaccine to cover 10% of the target population of three billion people.

Dr Keiny said that WHO has so far been offered 150 million doses from two manufacturers and that nine governments—Australia, Brazil, France, Italy, New Zealand, Norway, Switzerland, the United Kingdom, and the United States—have offered to donate 10% of their own supply, likely to be 50 million more doses.

The remaining 100 million doses of vaccine are expected to be secured through more donations and through funds raised by UN agencies, she said.

Meanwhile David Nabarro, the UN’s coordinator for avian and pandemic influenza, said in a teleconference from New York, "It is most likely that there will be other countries donating 10% of their H1N1 stocks."

Dr Keiny said that WHO expects to receive the first donations of vaccines by the end of October and to start the first delivery during November.

But she emphasised that WHO would need to have an assessment of each country’s readiness to distribute the vaccine and noted that this would include "having a plan, having identified the target groups." She added, "We will review this with the government before we send the vaccines."

Healthcare workers would be the first priority group to receive the H1N1 vaccine, Dr Keiny said. After that it would be up to national governments to consider people with underlying health conditions, such as those with asthma, a cardiac condition, or immunodeficiency and pregnant women.

Dr Keiny said that early data indicate that for adults and adolescents "one dose is sufficient" but noted that for young children in certain groups "it is probable that two doses will be needed."

Cite this as: BMJ 2009;339:b3988

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