WHO Enters Next Phase Of Global Plan To Increase Flu Vaccine Production

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The World Health Organization will be entering a new phase of its global action plan for influenza vaccines, a WHO representative told reporters today. The goals of the first phase of the programme should be furthered but with more attention given to the local health and policy environment, WHO said.

The WHO held its first review of its Global Action Plan for Influenza Vaccines (GAP) on 12-14 July. GAP was developed in 2006 by WHO, public health and academic experts, vaccine manufacturers and funding agencies from developed and developing countries, according to the WHO.

WHO Assistant Director-General for Innovation, Information, Evidence and Research Marie-Paule Kieny, said at a press conference today that GAP had been put together in 2006 in response to worries from the international community about the gap between demand and supply of flu pandemic vaccines. The project is so designated as “GAP 1.”

The increase in capacity of seasonal flu vaccine production is considered as a prerequisite for the world to be able to produce sufficient vaccine in the event of a global pandemic.

Significant success has been noted since the start of the action plan, she said, in particular in surveillance and understanding of epidemiological patterns for influenza, in developed and in developing countries. GAP 1 has been a catalyst in the significant expansion of global flu vaccine manufacturing capacity, she said. The past five years have also seen a change in the landscape of vaccine production, with 11 additional developing country manufacturers. Research and development has also progressed in antigen production methods, she said.

GAP 1 was constructed around three pillars, Kieny said: an increase in seasonal vaccine use to combat seasonal influenza, driving the market and increasing production capacity; an increase in vaccine production capacity both in developed and in developing countries; and an increase in the efforts of research and development for better vaccines with broader spectrum.

This week’s meeting launched the second phase of the action plan, she said.

According to the Chair of the GAP Advisory Group, Pathom Sawanpanyalert, director of the Center for International Cooperation and National Institute of Health, Nonthaburi, Thailand, the three objectives of GAP1 will be furthered and influenza vaccine will be used as a tool to combat influenza pandemics, not to increase profit, he said. More information is needed to assess the influenza situation, he said. In some economies, the information is not available for various reasons, one of which is that some countries do not include influenza in their immunization campaigns. However, influenza vaccines have improved the health of people, he said.

The next step is to consider influenza vaccine in the context of the different parts of the world, with different needs and different policies, Sawanpanyalert said.

The WHO Chair of the International Health Regulations Review Committee, Harvey Fineberg, president of the Washington DC-based Institute of Medicine, said the review showed that the world is still ill-prepared for a major pandemic, “in good measure because we do not have the capacity in a timely manner to produce sufficient vaccines to protect the world’s population.”

GAP 1 “has been one of the bright spots” in the success of WHO in the last five years, he said, considering the situation of vaccines production capacity in 2006.

The WHO had come under criticism in 2009 after declaring a world pandemic and the pandemic proved to be a modest outbreak, which looked like it had acted to the advantage of the pharmaceutical industry. A WHO review committee exonerated the WHO [pdf] from malfeasance and gave a set of recommendations (IPW, WHO, 29 March 2011).

More successful and intensive communication to the public and professionals is needed, Fineberg said, to engage them in the decision-making in a constructive way. Additional research is also needed as is a focus on the delivery, distribution and use of vaccines.

GAP and the Pandemic Preparedness Framework

To a question about the relationship between GAP 2 and the newly adopted Pandemic Influenza Preparedness (PIP) framework [pdf] for the sharing of influenza viruses and access to vaccines and other benefits, Fineberg said that the PIP framework involves two basic elements: the sharing of the virus, and the availability of vaccines. The PIP framework “ is not so much concerned with the total production capacity of vaccines as it is focused on distribution of either fixed amount or fixed proportion of production to a pool that can be redistributed by WHO where it is most needed,” he said.

“PIP deals with the availability of a portion of the world’s production for use in countries in which otherwise we do not have access to vaccines, and GAP deals with improving the world capacity to produce, distribute and have available sufficient amounts of vaccines,” Fineberg added. “In that sense the two work in a highly complementary fashion,” he said.

The WHO estimate of the seasonal flu vaccine manufacturing capacities is 800,000 million doses per year, compared to 350,000 in 2006, Kieny said. The estimate rises to 1.7 billion doses by 2015 if all the projects going on now are successful, she said.

There are currently 37 manufacturers of influenza vaccine in the world, either operating now or operational by 2015 Kieny said. According to a WHO document, 10 manufacturers are in Europe, 14 in the Western Pacific region, 6 in the South East Asia region, and 5 in the Americas region. Included in the 37 are 11 new manufacturers in 11 low or middle-income countries are part of the GAP programme, she said. Those countries have been working with WHO to acquire technologies to produce influenza vaccine, she said.

The documents from the meeting should be posted on the WHO website early next week, according to WHO officials.

Catherine Saez may be reached at info@ip-watch.ch.

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