Concerns Remain Over WHO’s Flu Pandemic Definition

As more countries around the world report cases of the H1N1 (swine) flu virus, there is growing confusion over just what might tip the WHO to declare the flu to be a pandemic, NPR reports. "This isn't a question of semantics or science; it's mainly a question of politics within the WHO," NPR writes. Instead of declaring a pandemic, some of the WHO's 193 member-states are pulling for the WHO tweak their definition of what dictates a pandemic – so as not to disrupt travel and trade, and worsen public anxiety over a virus that so far has appeared no worse than the seasonal flu for the majority of those infected (Knox, NPR, 5/22).

Such fears may be causing countries outside of North America to "be reluctant to admit they have a bigger outbreak on their hands, since that could prompt WHO to declare a pandemic," the AP/Los Angeles Times writes (Cheng, AP/Los Angeles Times, 5/21).

The WHO on Friday reported that 42 countries have confirmed 11,168 cases of H1N1 infection, including 86 deaths. A full list of country cases and deaths is available here (WHO Influenza A(H1N1) - update 36, 5/22).  

Though WHO Director-General Margaret Chan has said she will not hesitate to declare H1N1 flu a pandemic if the evidence supports H1N1 to be a "global phenomenon"  (Kaiser Global Health Policy Report, 5/21), there is mounting evidence "that the world has indeed entered a flu pandemic - by the WHO's current definition," according to NPR (NPR, 5/22).

Chan said on Thursday that WHO is exercising caution in determining whether to raise the threat level because the H1N1 flu symptoms have been mild so far, according to AFP/Google.com. A WHO official added, "One of the things we're not seeing is the same spread in the southern hemisphere that we've seen in the first three countries" (AFP/Google.com, 5/21).

"Up to now, the WHO has said it was uncertaint about what was happening in Japan that prevented it from crossing the pandemic threshold," NPR writes. However, over the past week the numbers of confirmed cases of swine flu in Japan have jumped from four to 259, which put it "on the verge of qualifying as the second region."

The NPR article also examined the idea that the WHO will soon "rewrite its 'flu pandemic' definition," to include a "danger rating," a hurdle that experts say is not impossible, but will be difficult to put "into language that the world's health ministers can agree on" and yet accessible to the public. Without some fast action, however, the "WHO will find itself twisting even more in the wind if it has to keep pretending that events don't yet satisfy the current definition of a full-fledged pandemic," NPR writes (NPR, 5/22).

Developing Countries' Ability To Track, Diagnose H1N1

WHO's Director of Health Statistics Ties Boerma on Thursday voiced concerns over whether developing nations are capable of tracking the swine flu, the AFP/ABS-CBN News reports. "In most countries there is no good cause of death reporting system, so we do not get any data on any cause of death," Boerma said. "So there is still a big gap in information there that we and our partners are working on but that's a huge undertaking" (AFP/ABS-CBN News, 5/21).

Nigeria's Minister of Health Babatunde Osotimehin on Thursday announced that he has requested assistance from the WHO and CDC to strengthen the country's laboratory systems to better diagnose and track the H1N1 virus in the event of a swine flu outbreak, Guardian News reports. Currently, the country has two WHO-certified laboratories – in Abuja and Ibadan – and one "yet-to-be-certified" laboratory located in Maiduguiri. "We need to further extend our laboratory detection system," Osotimehin said, adding, "Though we do not pray for it, if we start getting cases coming up here and there, these laboratories would not be able to handle it" (Muanya, Guardian News, 5/21).

International AIDS Society Head Calls On WHA to Not Lose Sight Of Fight Against HIV/AIDS

VOA News examines recent comments by the head of the International AIDS Society Julio Montaner to keep the H1N1 flu outbreak or the current economic situation from distracting from ongoing worldwide efforts to fight HIV/AIDS. While calling upon members international leaders gathered this week at the World Health Assembly (WHA) to continue their commitments to HIV/AIDS, Mantaner admits his greatest fear regarding HIV/AIDS funding: "At a time of competing needs or hypothetical epidemicsnational or international donors, multi-lateral donors are losing their interest. This is a long-term battle" (DeCapua, VOA News, 5/21).

Senate Bill Sets Aside $1.5B To Fight Flu Pandemic

The U.S. Senate on Thursday worked to push through a $91.3 billion military funding bill, which includes $1.5 billion "to fight a possible flu pandemic, including the current outbreak of H1N1 swine flu," the AP/Guardian writes (Taylor, AP/Guardian, 5/22).