Prevention better than cure

Governments should not lower guard against H1N1

The country’s first locally developed H1N1 vaccine, Vaxiflu-S, which is claimed to provide protection against the infection for a year, has been launched and a few more are in advance stages of trials. New Delhi seems to have done well to arm itself with an indigenous vaccine to combat the dreaded H1N1 influenza (swine flu) regardless of the view that the World Health Organisation (WHO) had over-played the threat posed by this pandemic virus. So far, Oseltamivir (Tamiflu) and Zanamivir have been the only drugs available for both cure and prevention of swine flu. Total dependence on imports for sourcing these drugs may not be desirable, especially for pandemics that spread fast and generate drug supply shortages, as swine flu did last year. However, though the circulation of the flu virus has ebbed considerably in the last few months, due partly to seasonal factors, it has not ceased completely. Going by the reports submitted officially to the WHO by member countries, fresh cases of H1N1 influenza are still surfacing in parts of the Caribbean, the tropical zone of the Americas as well as in South and South-East Asia, notably Singapore, Malaysia and, to a lesser extent, Bangladesh. In India, too, some 30 cases were reported last week alone, mostly from Maharashtra and southern states, even though summer is not flu season.

There is, therefore, no room yet for slackening vigil against this disease. The WHO, too, last week decided to maintain its advisory on placing the world on maximum alert. The UN health body, obviously, remains unfazed by the level-of-threat controversy. The doubts on this count are based chiefly on the allegation that the WHO changed the definition of “pandemic” and declared swine flu as one to favour some pharmaceutical companies. A committee of the Parliamentary Assembly of the Council of Europe (PACE) has also now said that the WHO wasted large sums of public money by raising unjustified fears of a pandemic that never really was. Indeed, regardless of the merits and demerits of such allegations, the fact remains that a highly contagious infection of the H1N1 type could not have been combated without governments being on high alert. It is worth recalling that the first recorded pandemic of H1N1 in 1918, when there was no one to issue such a warning, had resulted in the death of over 50 million people. The 2009 version of the H1N1 outbreak spread to as many as 214 countries within a few months, causing over 18,000 officially confirmed deaths. Though India was not as badly affected as some other countries, notably the US, yet over 1,500 persons have lost their lives due to laboratory-confirmed H1N1 infection here. The WHO may have over-reacted, but to err on the side of caution is better when it comes to pandemics. H1N1 is an influenza-viral combination that affects humans, swine as well as birds and can mutate or re-assert itself in a more virulent form in any of them. Its new avatar may be immune even to available vaccines. This winter, the normal flu season, will show how well prepared we are.