Developing nations' vaccine shortage may threaten security, former WHO official says

Flu vaccine shortages in developing nations may destabilize global security should the H1N1 virus become more deadly, said David Heymann, a former deputy head of the World Health Organization.

Inequitable access to immunization against a highly lethal virus could inflame international tensions, Heymann, 63, said in an interview Dec. 7 with Bloomberg in Singapore.

While the H5N1 bird flu virus helped industrialized nations prepare for the swine flu pandemic that is sweeping across the globe, there aren’t adequate measures in place to ensure less developed countries have access to vaccines, he said.

“Globally I think we’re not probably as prepared as we need to be in more equitable access to vaccines,” Heymann said. “An acute pandemic with high mortality and no vaccine in developing nations, and vaccine in industrialized countries, could cause various scenarios, and one of those could be an extreme destabilization of global security.”

About 200 million doses of swine flu vaccine have been donated to the WHO for distribution to 95 low- and middle-income nations, according to the Geneva-based agency’s Web site. The United Nations health agency plans to provide enough vaccine for developing nations to immunize 10 percent of their populations.

“Countries that had good national plans and the financial ability to get vaccines were able to get them, and those countries that didn’t have the financial resources have not been able,” Heymann said. “For this virus it may not be so important because of the lower mortality rate, but if this were an H5N1-based pandemic with high mortality, it would be a major crisis.”

The H5N1 bird flu strain, which isn’t easily transmitted among people, was deadly in more than half of all laboratory- confirmed cases between December 2003 and April 2006, according to WHO data.

H1N1 flu kills 1 in every 2,000 to 14,000 ill patients, depending on whether scientists relied on medically evaluated cases or included self-reported flu symptoms. The research was published Dec. 7 by the journal PLOS Medicine and used data collected in Milwaukee and New York from April to July.

Equitable vaccine distribution was among issues discussed by health ministers from the Group of Seven nations and Mexico last week, the group said in a Dec. 4 statement.

“We reaffirm our commitment to work in close partnership with the WHO and other international partners to support developing countries and other countries in need of assistance in responding to the pandemic,” the ministers said.

Access to vaccines is an issue of national and global security, said Heymann, who is head of global health security at Chatham House, a London-based independent research and policy center. “It’s not just a health issue. This may really cause some tensions.”

In his previous capacity as the WHO’s assistant director general for communicable diseases, Heymann negotiated with Siti Fadilah Supari, then the Indonesian health minister, on providing samples of the H5N1 virus. Supari had refused to share the samples unless the WHO guaranteed free supply of vaccines developed from them.

“Minister Supari raised a very important issue,” Heymann said. “The way she raised it put the rest of the world at risk.”