The current outbreak of H1N1 virus has again highlighted concerns that people in developing countries will have little or inadequate access to much needed influenza vaccines or anti-viral treatments. Thus, there is an urgent need for establishing a global system of fair and equitable system for the sharing of the anti-viral vaccines and treatments on the basis of need.... The current discussion at the World Health Organisation (WHO) needs to conclude [with an assurance that] developing countries...will have access to affordable anti-virals and vaccines and the appropriate technology to make such products.

Last week, WHO alerted the international community to the possibility of a full-scale pandemic, as it raised its pandemic alert for the H1N1 to stage 5. As of 3 May 2009, 17 countries have officially reported 787 cases of influenza A(H1N1) infection.

The H1N1 outbreak is a stark reminder that if a deadly pandemic were to develop, there will be a desperate fight over limited supplies of anti-viral treatments and vaccines, in which the developing countries will be at a vast disadvantage.

Today more than 90 per cent of the global capacity for vaccine manufacturing is located in Europe and in North America[1]. Developed countries through advance purchase agreements with manufacturers have already reserved a good portion of the limited current manufacturing capacity[2]. Thus in the event of a pandemic, the world would be several billion doses short of the expected demand.

If there is a worldwide pandemic of a new deadly influenza billions of doses of anti-viral treatments and vaccines will be required in the developing world and manufacturers will only be able to supply a small portion of what is needed. The anti-virals and vaccines sold to developing countries are also likely to be expensive, making them unaffordable for those in need.

Similarly the latest technology and know-how needed to produce the necessary vaccines or anti-viral treatments are with manufacturers in developed countries, and often protected by patents and trade secrets, and thus inaccessible to manufacturers in developing countries...

For the past two years, developing countries led by Indonesia, Thailand, India, Nigeria and Brazil have been fighting for reforms in the WHO influenza system to ensure that developing countries (many of which contribute their viruses for research and for manufacturing vaccines) are assured of access to technology and know-how to prepare [for] a pandemic....However there has been fierce resistance from developed countries particularly the US, EU and Japan, that would like to ensure that no obligations are placed on their manufacturers to share their technology and know-how, or treatments that developing countries need.

For developing countries to prepare for or combat a pandemic, there needs to be international solidarity, a call made ALSO by WHO Director General Dr. Margaret Chan.

This international solidarity needs to be realized in the upcoming negotiations on influenza virus and benefit sharing that resumes on 15 May in Geneva....Developing countries have proposed several measures on benefit-sharing including:

• Obligating manufacturers that receive virus samples to contribute to a WHO stockpile and to provide developing countries with vaccines and anti-virals needed at a reasonable costs;
• Providing technology and know-how licences to allow manufacturing in developing countries; and
• Obligating manufacturers to contribute a portion of their profits to a fund which could be used for purchasing the needed vaccines or anti-virals as well as building manufacturing and other relevant capacity in developing countries.
• Ensuring that patents and intellectual property rights (IPRs) do not block access to needed vaccines and anti-virals as well as the technology to produce such products....

[1] See WHO's Questions and answers related to vaccines for the new influenza A(H1N1)
[2] The 2006 WHO Global Pandemic Influenza Action Plan to increase vaccine supply estimates that if manufacturers optimize current output, the production capacity for potential influenza vaccine would be 500 million doses (inactivated trivalent vaccine).