WHO Raises Swine Flu Alert Level; UN Secretary-General Calls for ‘Global Solidarity’

WHO's emergency committee on Monday voted to raise its global pandemic influenza alert level and recommended that borders remain open and that governments refrain from enacting travel bans, the New York Times reports (McNeil, New York Times, 4/28).

The agency raised the alert from phase 3 to phase 4 after it considered data from confirmed swine influenza outbreaks in Canada, Mexico and the U.S. In a statement, WHO said the phase 4 alert "indicates that the likelihood of a pandemic has increased, but not that a pandemic is inevitable." According to the statement, WHO's Director-General Margaret Chan said that the "containment of the outbreak isn't feasible" given its "widespread presence" and "current focus should be on mitigation measures" (Kumar, MarketWatch, 4/28).

Keiji Fukuda, WHO's assistant director-general, said that the agency's decision to raise the alert level indicates that the virus is capable of significant human-to-human transmission (CNN, 4/28).

Deaths Only Reported in Mexico, At Least 90 Cases Confirmed Worldwide 

In Mexico, the number of probable swine influenza deaths rose to 152 on Monday, Jose Angel Cordova, Mexico's health minister, said. Health authorities have confirmed 20 deaths in Mexico and 1,614 cases are under observation, AFP/Google.com reports (AFP/Google.com, 4/27).

At least 90 cases of swine influenza have been confirmed worldwide, including 50 in the U.S.; six in Canada; three in New Zealand; two in Spain; two in the U.K.; and one in Israel. No other deaths have been reported outside of Mexico. At least 11 other countries have reported suspected swine influenza cases, CNN reports (CNN [2], 4/28).

Global Antiviral Shortage Could Hinder Preparedness in Developing Countries

According to Reuters, there is a growing concern among health leaders that global shortages of antivirals capable of slowing the fast-spreading swine influenza outbreak could hinder the preparedness of developing countries (MacInnis, Reuters, 4/27).

Though vaccination is the best way to stop a viral outbreak, health officials have already determined that current flu vaccines cannot stop the spread of swine flu, Reuters reports (Kahn, Reuters, 4/27). It could take four to six months to develop and test a vaccine that offers protection against swine influenza, and several more months to produce it, NPR reports (Halloran, NPR, 4/27).

For now, Roche's Tamiflu and GlaxoSmithKline's Relenza – two seasonal antiviral flu drugs – are being "used to try to curb transmission in the early days of an outbreak," the Los Angeles Times reports (Roan, Los Angeles Times, 4/28). But, "there are not likely to be enough doses to treat the whole world in a pandemic, and production is limited," Reuters writes.

Sangeeta Shashikant of the Third World Network, which works for increasing access to drugs in poor countries, said that "advance purchase agreements" and other deals between governments from developed countries and drug makers could exhaust the global supply of the effective antivirals (MacInnis, Reuters, 4/27).

While some countries have stockpiles of antivirals on hand, "Preparedness levels in middle income and lower income countries remain low," Shashikant said (MacInnis, Reuters, 4/27).  U.N. Secretary-General Ban Ki-moon urged the world to provide assistance to poor nations so that they "do not bear the brunt of a possible pandemic," the New Vision reports (Bugembe, New Vision, 4/27).

"If we are indeed facing a pandemic, we need to demonstrate global solidarity," Ban said in a statement. He added, "Poorer nations are especially vulnerable. They have been hit hard by other crises this year: food, energy, the global economy, climate change. We must ensure that they are not also hit disproportionately hard by a potential health crisis."  Ban said the World Bank and U.N. agencies would work together to "ensure that countries needing additional financial resources to combat an epidemic will have them."

World Bank To Give Mexico $25M Immediately To Manage Outbreak

The World Bank on Sunday announced $25 million in immediate funding for Mexico and $180 million in future loans, Reuters reports.  To expedite the preparedness of countries to the spread of swine influenza, "We put in place a funding facility for avian flu a few years ago and it is broadly defined so it can encompass this flu," said Keith Hansen, health sector manager for Latin America and the Caribbean at the Bank. He added, "if need be the bank is fully prepared to add money to that facility for Mexico and for any other countries that may be affected."

For developing countries, the swine influenza outbreak could further cripple already strained health budgets, "where there are already signs of cutbacks in treatment for HIV/AIDS," Reuters writes (Wroughton, Reuters, 4/27).