WHO: Influenza A(H1N1) – update 38

The WHO continues to issue regular updates posted on the WHO main page, as well as other advisories linked from that page. Here is the current update:

Influenza A(H1N1) – update 38

25 May 2009 — As of 06:00 GMT, 25 May 2009, 46 countries have officially reported 12 515 cases of influenza A(H1N1) infection, including 91 deaths. Map of the spread of Influenza A(H1N1): number of laboratory confirmed cases and deaths [png 247kb]

Strategic Advisory Group of Experts (SAGE) on Influenza A (H1N1) vaccines

WHO released “Recommendations of the Strategic Advisory Group of Experts (SAGE) on Influenza A (H1N1) vaccines, 19 May 2009. Below is full text of a portion of the document”

“After considering the following issues:

1. the need for any recommendation to balance both risks and benefits,

2. the current uncertainty about the severity of influenza A (H1N1) illness,

3. the readiness of vaccine seed strains and reagents for large‐scale vaccine production,

4. the current status of production of seasonal vaccine for the Northern hemisphere, and the risks associated with a premature cessation of seasonal vaccine production, The Working Group considered it premature to recommend that commercialscale production of influenza A (H1N1) vaccine should start immediately.


WHO: High-Level Consultation on new influenza A (H1N1)

WHO released “Summary report of a High-Level Consultation: new influenza A (H1N1) Geneva, 18 May 2009.” Below is full text of a portion of the document:


The overriding objective is to mitigate the adverse impact of the new influenza A (H1N1) on the health of people and populations.

Facilitating a global response

27. Member States agree to work with the Secretariat to assure ongoing, rapid dissemination of epidemiological information and technical guidance based on scientific evidence concerning the current situation. Monitoring and tracking the global spread and impact of the new influenza A (H1N1) virus is being strengthened. This will support better understanding of the virus’s epidemiology, its virological characteristics, diagnosis, clinical management, outbreak control and strategies, etc.

28. Through its convening power, the Secretariat will continue to facilitate a multilateral and multisectoral response and maximize collaboration between partners.

29. In addition it is providing ongoing technical assistance to countries for epidemic preparedness and response, with a focus on the most vulnerable countries.

Ensuring equity in access to medicines and vaccines

30. Given the potential impact of pandemic influenza on populations in low-income countries, where other medical conditions are widespread, concern remains about access to antiviral medicines and vaccines.

31. The Secretariat has dispatched antiviral medicines from its emergency stockpile to 72 countries so as to accelerate their availability where they are most needed.

32. WHO collaborating centres are developing seed stocks of virus for vaccine production. Close links are being maintained with the pharmaceutical industry and potential financiers to ensure an adequate global manufacturing capacity, and funding for production and distribution of new influenza A (H1N1) vaccine and other relevant medicines.

Building public health capacity

33. Building institutional and technical capacity in low-income countries, especially in laboratory services, is needed if the world is to mount an effective response. Securing finance for building this capacity – as a key element of health systems strengthening – will be essential.

Moving from Phase 5 to Phase 6

34. The current process is based purely on geographical spread and not on severity of disease. Several Member States spoke in favour of giving the Director-General greater flexibility in the progression between different phases.


HHS directs US$1 billion toward vaccine development for A (H1N1)

HHS Secretary Kathleen Sebelius announced that “the department will take important steps necessary to prepare for potential commercial-scale production of a candidate vaccine for the novel Influenza A ( H1N1),” and that HHS “is directing approximately $1 billion in existing funds that will be used for clinical studies that will take place over the summer and for commercial-scale production of two potential vaccine ingredients for the pre-pandemic influenza stockpile.” Secretary Sebelius said, “Preparation and planning are critical to keep Americans safe in the face of a potential pandemic. Our goal throughout this new H1N1 outbreak has been to stay one step ahead of the virus. An important part of this effort has been our work to develop a potential vaccine because vaccines can help prevent and control influenza virus outbreaks. The actions we are taking today will help us be prepared if a vaccine is needed.”

HHS said the funds will be used to place new orders on existing contracts with companies that hold U.S. licenses for flu vaccines. With these orders, they will produce a bulk supply of vaccine antigen and adjuvant. HHS noted that having both antigen and adjuvant on hand provides maximum flexibility in a future immunization program, “if a program is recommended. For example, if needed these ingredients could be used in vaccine to help protect health providers and other members of the critical workforce, as recommended by the National Strategy for Pandemic Influenza.”

The funds will also support manufacturers which will also “prepare pilot lots of potential vaccine for use in clinical studies to determine the proper dose for a vaccine, determine if adjuvants are appropriate and ensure a vaccine is safe and effective. The U.S. government will share as much information as possible from the results of these clinical studies with the World Health Organization and the global community so that other countries can benefit from the U.S. efforts to determine dosage, safety and effectiveness.”


Global measles elimination goals

Global measles elimination was discussed by WHO’s Executive Board last week. The report developed for the meeting “summarizes the progress and challenges towards achieving the regional measles elimination goals and reducing global measles deaths by 90% between 2000-10. The report also highlights the programme of work initiated by WHO to examine issues relating to the feasibility of a global measles elimination goal including reviewing the biological aspects and cost-effectiveness of such a goal.”


IFFIm raises US$2 billion dollars+ on capital markets to support GAVI vaccines programmes

GAVI said the International Finance Facility for Immunisation (IFFIm) “has raised more than US$ 2 billion dollars on the international capital markets so far to support life-saving immunisation programmes through the GAVI Alliance.” IFFIm board chairman Alan Gillespie, at a meeting on innovative financing in Geneva, noted that “…there is a strong demand among individual and institutional investors for ethical investments….this is just the beginning and we believe we can raise another US$ 2 billion. The demand is there.” IFFIm is backed by the United Kingdom, France, Italy, Spain, Sweden, Norway and South Africa, which have pledged to contribute US$5.3 billion to IFFIm over 20 years. IFFIm “converts these long-term government pledges into immediately available cash by issuing bonds on the capital markets” which carry a triple-A rating from the three major rating agencies…making it an attractive and ethical investment opportunity to both individual and institutional investors alike. The World Bank acts as financial adviser and Treasury Manager to IFFIm.