Poor countries worry about flu vaccine shortage

As the A/H1N1 swine flu virus spreads rapidly worldwide, developing countries are left behind in the race to get scarce vaccines. Some are making moves to produce their own vaccines even if these are patented by the rich countries' companies.

Martin Khor

DEVELOPING countries are increasingly concerned they will not have access to vaccines for the A/H1N1 flu virus (popularly known as swine flu virus) because of the great demand for them and the limited amounts that can be quickly made.

The vaccine is made using parts of the virus itself, and only hundreds of millions of doses can be made in a year. However, governments in developed countries have already booked almost all the doses that can be produced. For example, Britain has ordered 60 million doses, or one dose for each person in the country.

According to the World Health Organisation, a fully licensed vaccine may not be ready until the end of this year. By that time the pandemic will be worse than now.

It is reported that some governments are already preparing to start vaccination even before the vaccine is fully cleared for safety. The first human trials in the world have already started in Australia.

As swine flu continues to spread rapidly across the world, there is an 'ugly scandal brewing over the vaccine', according to an Associated Press (AP) news report.

It quotes experts as predicting that during a global epidemic, governments are under tremendous pressure to protect their own citizens first before allowing companies to export doses of vaccine out of the country.

According to Michael Osterholm, director of the University of Minnesota's Center for Infectious Diseases Research: 'If there is severe disease, countries will want to hang onto the vaccine for their own citizens.'

It is estimated that 70% of the world's flu vaccines are made in Europe, and the AP report indicates that there is already a scramble even among the developed countries to get their hands on the scarce vaccines. There is hardly any production reported in developing countries, which will therefore be worst affected by shortages.

Two articles in the British papers in July show the looming problem. First was a report that security guards are guarding supplies of Tamiflu, which is a drug that can treat symptoms of flu, because of fears that worried citizens would break into the warehouses that stock them.

Second was a report of citizens protesting that a drug company was making billions of dollars of profits from selling flu-related drugs at high prices, thus cashing in on the increased demand.

The latest estimates are that almost 1,800 people have died worldwide from he virus, and over 180,000 have been infected. A scare recently swept the United Kingdom when a cabinet minister warned that there could be 100,000 new cases of swine flu a day by the end of August in the country.

While the disease is spreading very rapidly, fortunately swine flu is relatively mild, and medical treatment is not needed in many cases. However, health experts fear that the virus could mutate and become more dangerous.

Developing countries are being left out in the battle to get the vaccines, which are too expensive for most of these countries to pre-book. The companies making the vaccines have also probably applied for patents that block others from making them.

Thus, even if a developing country has the technology to make the vaccines, it could be prevented from doing so by intellectual property.

On 24 July, the presidents of Argentina and Brazil called for developing countries to be allowed to set aside patents so that the countries can produce more swine flu vaccines.

'It would be very advantageous to propitiate a kind of lifting or suspension of the patents law because the WHO has recognised that we're dealing with an epidemic,' said Argentine President Cristina Fernandez, speaking at the summit of Mercosur, the regional trade grouping.

She said that failing to act could mean 'condemning millions of people to death' while suspending the patents law could save millions of lives. She said that laboratories cannot keep up with the world demand for vaccines.

Fernandez said Argentina and Brazil both have highly developed pharmaceutical industries and should be able to produce vaccines. 'It's beyond question that we're confronting a situation in which the needs of millions of people cannot be subordinated to economic interests.'

Brazilian President Luiz Inacio Lula da Silva proposed that leaders discuss setting aside patents to help contain the epidemic, according to Brazil's state news agency, Agencia Brasil.

It added that the Brazilian health minister is negotiating with all vaccine producers to boost the vaccine's availability. 'Brazil is willing to defend the health security of its population,' said the minister.

Thailand is also known to have the capacity to produce vaccines for the flu virus.

The developing countries are well within their rights to produce or import generic versions of vaccines, even if these vaccines are patented. The intellectual property agreement in the World Trade Organisation allows governments to issue compulsory licences for this purpose.

Countries that have made use of such licences to produce medicines to treat HIV/AIDS and other diseases include Malaysia, Indonesia, Thailand, Brazil and Ghana.

It would not be the first time if countries decide to issue licences to companies to produce or obtain generic versions of the flu vaccines.

Martin Khor is Executive Director of the South Centre, an intergovernmental organisation with 50 member states from the developing world, and former Director of the Third World Network.

*Third World Resurgence No. 227, July 2009, pp 20-21