Gates Foundation - Equal Access to H1N1 Vaccine for Rich and Poor Countries

Dr. Tachi Yamada, president of the Gates Foundation's global health program believes that poorer nations without the funds or ability to produce a vaccine for H1N1 should get equal access to the limited supplies even if the richer countries paid for and developed the vaccine.

"I think that (just) because you've paid doesn't mean you should get the vaccine first. That's really the critical point," he said Thursday in an interview from Seattle with The Canadian Press.

"It is a tough nut to crack, but it's one where I think some nations are going to have to stand up and say: All right, we'll get every other vaccine (dose) out of this plant. And the other can go to the poor countries."

Only a few countries in the world have plants for manufacturing influenza vaccine, and three companies -- GlaxoSmithKline, Sanofi-Aventis, and Novartis -- account for most of the world's manufacturing capacity. The number of doses of vaccine against H1N1 influenza that could be produced with the existing capacity is very large, but the sobering truth is that even if production were switched over completely from seasonal influenza vaccine to pandemic influenza vaccine, there would not be nearly enough for everyone in the world. The size of the gap in potential supply depends greatly on the dose that is required, and it may be possible to reduce the necessary dose by as much as 75% with the use of an adjuvant. The challenging problem is that much, if not most, of the manufacturing capacity is already spoken for through purchasing contracts held by many of the world's wealthy countries.

References:

1. Rich countries shouldn't get pandemic vaccine first: Gates Foundation exec, CP

2. Poverty, Wealth, and Access to Pandemic Influenza Vaccines, The New England Journal of Medicine, Tadataka Yamada, M.D

3. Influenza A (H1N1 - "Swine Flu") Reports, The New England Journal of Medicine