WHA: Pandemic Flu Preparedness Framework Praised; Vaccine Production Still Short

Adopted five years ago, the World Health Organization Pandemic Influenza Preparedness (PIP) Framework is currently undergoing its first review. Member states gathered in committee at the World Health Assembly yesterday mostly expressed support for the framework, and took note of a report by the WHO secretariat.

The 69th World Health Assembly is taking place from 23-28 May.

The PIP Framework is a mechanism through which influenza viruses with pandemic potential are shared by countries, and in return, entities which access those viruses provide benefit sharing.

Christine Mwelwa Kaseba-Sata, of Zambia chair of the PIP Framework Review Group, presented the progress of the review so far. The review group met four times since its inception in October 2015, and is expected to meet twice more, she said.

The review group met in a closed meeting on 9-11 May. The next meeting of the review group is scheduled for 27 June to 1 July, according to the WHO. The final report of the group is expected to submitted by the group on 31 October, and is expected to be presented at the WHO Executive Board meeting in January and at the annual WHA in 2017 (IPW, Public Health, 18 May 2016).

Mwelwa Kaseba-Sata said many developing countries remain vulnerable and another influenza pandemic is inevitable, so the review of the framework is critical. The review group was presented with three overarching questions: What are the achievements since the framework was adopted in 2011, how well did the framework helped in improving global pandemic influenza preparedness, and what are the challenges and possible solutions.

The group is now halfway through its review. The benefit-sharing system appears to be working well, she said, however, more viruses need to be shared with the WHO Global Influenza Surveillance and Response System (GISRS) (an international network of influenza laboratories) in a timely manner by countries, she added.

Payment of partnership contributions must continue and even improve, said Mwelwa Kaseba-Sata, as if one company fails to pay, it creates a situation of unfairness and undermines the whole system.

The review group also examined the issue of genetic sequence data (GSD), she said. Technological progress allows access to genetic material that has been sequenced into data, and the reproduction of this material without the need to access the physical form of the material (IPW, Public Health, 31 March 2016). GSD is not currently covered by the framework.

A key arching issue, she said, is how to ensure that the framework remains relevant when attention to one disease is difficult to conserve given competing health issues and emergencies.

As was suggested by some stakeholders, the group also discussed the possible expansion of seasonal influenza viruses into the PIP framework, she said. Pandemic vaccine production relies on successful seasonal influenza vaccines production capacity, she added.

The extension might make sense but there is a need to ensure that the expansion of the framework does not overburden the GISRS and the benefit-sharing implications of the expansion need to be carefully reviewed.

It was also suggested during consultations with diverse stakeholders that the framework be used as a model for other pathogens. This would be a complicated challenge, she said, as the principle of equal footing between access and benefit sharing which are at the core of the PIP Framework would have to take into account the specificities of those pathogens and the appropriate benefit sharing measures to be applied.

Countries taking the floor for comments supported the PIP Framework. China said it has shared 49 virus strains in the context of the framework in 2015 and a Chinese influenza vaccine manufacturer just signed the standard material transfer agreement with the framework.

Brazil said the PIP Framework proved to be successful to balance access and benefit sharing on an equal footing and the mechanism is a successful dynamic between the private and the public sector.

South Africa remarked that influenza vaccines remain unaffordable to a large proportion of the population in developing countries, which defies the purpose of a large vaccine coverage.

Several developing countries called for the WHO to increase its technical and financial help to reach sustainability in preparedness and underlined the fact that the current vaccine capacity still falls short for a global coverage.

Thailand suggested that part of the partnership contribution be used to support seasonal flu vaccine production in developing countries.

The WHO said the secretariat is very actively engaged in advocating the conclusion of further standard material transfer agreements. The framework has signed those agreements with four vaccine manufacturers, 41 academic institutions, and one diagnostic manufacturer, he said, and the secretariat hopes that seven further such agreements will be signed by the end of 2016.

The secretariat said that although vaccine availability is much better than some years ago, it still falls short of the global goal coverage.