# 589
As the bird flu virus continues to fester and presumably mutate in Indonesia, negotiations are ongoing to obtain samples so that a vaccine might be produced. Indonesia continues to hang tough, demanding access to an affordable vaccine before allowing samples to leave their country.
Today, the press is reporting that the WHO (World Health Organization) is attempting to placate the Indonesians with somewhat vague assurances that access to a vaccine would be made available to developing nations.
Poor countries square off with WHO over bird flu vaccine access
JAKARTA, Indonesia (AP) -- The World Health Organization might guarantee that poor nations get access to bird flu vaccines in the event of a pandemic, the top WHO flu official said Monday, hoping to end a dispute triggered by Indonesia's decision to stop sharing virus samples.
Not clear at this time is exactly how the WHO will guarantee access to a vaccine that not only doesn't exist, but one that can't be produced in anything near enough quantity during the first year of a pandemic.
Another rub is, we honestly have no idea how effective any vaccine we produce might be against the H5N1 virus. It's never been tested. Presumably it will confer some immunity, but we won't know until we actually produce and administer it how much that will be.
There is talk of a `virtual stockpile', where a percentage of all vaccine manufactured in developed countries would be set aside for non-vaccine producing nations. Again, quoting from the above article.
Dr. David Heymann, WHO's top flu official, said one short-term solution might be "stockpiles of pandemic vaccine in which industry would set aside a percentage of pandemic vaccine for developing country needs, with a guarantee of purchase from WHO."
Admittedly, this sounds good, particularly if you live in a non-vaccine producing nation. At least until you run the numbers.
While no one really knows how many doses of vaccine we could produce in a year, since the amount of antigen needed to confer immunity is still an open question, the accepted number is roughly 500 million doses.
That's enough for 1 person in 13, globally. And that's a year or more into a pandemic.
The presumption is that vaccine producing nations would willingly give up a significant portion of their inadequate vaccine supply during a time when millions of their own citizens are at risk of dying.
No one seems to be talking percentages. Assuming that a deal can be brokered, how much vaccine would really be available for developing nations?
Well, if we remove the populations of vaccine producing nations (roughly 750 million people) from the global total, we have roughly 5.7 Billion people living in non-vaccine producing countries.
If 10% of the total global vaccine production were diverted to a virtual stockpile, and distributed to this population, there would be 50 million doses for 5.7 billion people. Enough for 1 person in 114.
Less than 1%.
If 20% were diverted, we'd be up to almost 2% coverage. And if half of all production were diverted, we'd have enough for nearly 5%.
The rub, of course, is for every 10% diverted from vaccine producing nations, 6% of their combined population will be denied a vaccine. Most countries would be hard pressed to make that decision.
If fairness and equality are the standard, then nearly 90% of the world's vaccine production would have to be diverted to non-vaccine producing nations. In that way, each nation would have enough vaccine to inoculate between 8% and 9% of their population.
Of course, that's not going to happen.
The only way any of this can ever be resolved is by increasing our global manufacturing capacity, a project that the WHO say's will require 10 years and $10 billion dollars. Last week the WHO announced that they had $18 million dollars to begin this project.
We put a man on the moon in far less time. The cost of that project (in 2006 dollars) has been estimated at $135 billion dollars.
You'd think, if we were serious about solving this problem, we'd be building vaccine manufacturing plants and transferring technology like there's no tomorrow.
Afterall, with a potential pandemic on the horizon, for millions of people there may not be.
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