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The WHO World Health Assembly is meeting in Geneva, Switzerland 18-22 May 2009

Geneva, Switzerland (GenevaLunch) - Widespread uncertainty concerning the A/H1N1 virus and its so far relatively mild symptoms are complicating the decision-making process about vaccine production. The debate has been a major focal point at the World Health Assembly, the annual meeting of the World Health Organization (WHO) in Geneva, 18-22 May.

Manufacturers need four to six months to ramp up production of the vaccine and are waiting for clear signals from the WHO to go ahead. The organization has said that it does not want a vaccine for A/H1N1 to interfere with existing production of vaccines for seasonal flu, which kills an estimated 500,000 people world-wide yearly. WHO’s director, Margaret Chan, and UN Secretary-General Ban Ki-moon stressed in addressing the Assembly that funding would be forthcoming for poorer countries, to allow them to purchase needed stocks of vaccine.

Drugs manufacturers, in Geneva to meet with WHO Director Chan, told the WHO Strategic Advisory Group of Experts (Sage) that once full-scale vaccine production was reached, up to 4.9 billion doses could be manufactured in 12 months, if the manufacturing process is similar to seasonal flu vaccine production and if they are able to use minimum-dose formulations, according to recommendations published 19 May. The Sage group also reported that recently deployed seasonal flu vaccines from 2007 and 2008 have not conferred immunity against the A/H1N1virus on vaccinated groups who have been tested. It concludes that these vaccines are “unlikely to provide public
health benefits in terms of protection against influenza A (H1N1). ”

While the effects of the virus are currently fairly mild, the situation could worsen dramatically if the virus becomes more virulent by mutating, or because the southern hemisphere is moving into winter. There could then be a sudden demand for scarce supplies. Additionally, swine flu symptoms could become confused with the seasonal variety.

Worldwide reported cases of A/H1N1 (swine flu) breached 10,000 in 40 countries by 20 May, and 80 people have died of the disease, WHO reports in its virus update 34 (21 May: 41 countries, 10,243 cases). Many new cases are being reported from Japan, which now has 210 infected people, according to the latest official data.

Calls are mounting for WHO to raise its pandemic alert level to level 6 from 5 currently, but WHO’s Chan said, addressing the Assembly, that several member states at the World Health Assembly had asked for criteria other than geographical spread to be taken into consideration, especially the virus’s mortality rate. The current criteria are based on the spread of H5N1 avian flu, which had a much higher mortality rate, almost 60%, she said.