Bombs, bullets, billions

by Revere and cross-posted at Effect Measure on October 24, 2006

An urgent communication from the World Health Organization (WHO) expresses concisely how far behind we are in being prepared for a global pandemic of influenza. Currently there are a number of vaccines under development, some of which might protect against an H5N1 virus that has become readily transmissible from person to person. But none are in production, and even if some were found adequate (not the case) and large scale production begun (far from the case), we, the world, would still be in a fix:

"We are presently several billion doses short of the amount of pandemic influenza vaccine we would need to protect the global population. This situation could lead to a public health crisis," said Dr Marie-Paule Kieny, Director, WHO Initiative for Vaccine Research. "The Global Action Plan sets the course for what needs to be done, starting now, to increase vaccine production capacity and close the gap. In just three to five years we could begin to see results that could save many lives in case of a pandemic." (WHO)

Several billion doses short. Billion, as in one with nine zeros after it. With all the demand, surely the market's "invisible hand" will come to the rescue:

Relying on market-driven forces alone, it is estimated that by 2008-2009 the production of pandemic influenza vaccine will not exceed 2.34 billion doses per year. At present, the production capacity for seasonal influenza vaccine stands at 350 million doses. Such quantities fall far short of the expected demand for vaccine during an influenza pandemic when there will likely be calls to vaccinate the entire 6.7 billion world population. The anticipated shortage is, in particular, due to the expectation that a two-dose course of vaccine will be needed to protect each person.

All influenza vaccine is currently manufactured in the industrialized world. How much of this will be shared with the rest is a matter of speculation and some concern. But vaccines aren't the only missing piece of the puzzle. If there were a vaccine, it would be the easy part of preparation. The hard part -- providing the public health services that could deliver the vaccine, care for the sick, mangage the consequences of widespread absenteeism, morbidity and mortality -- is no further along in most places. We are the equivalent of a billion doses behind.

WHO is warning us, once again, to get ready. The US has already burned hundreds of billions of dollars in their ill-fated Iraq debacle. Just ten billion of that, had it been invested in vaccines for the world's population in March of 2003, would have put us much further ahead.

It's not just money, of course. It's the political (and moral) will to do what is right, rather than pursue immoral ends in ways that are deeply wrong. It's not just the errors in judgements that were made in Iraq that is so disheartening, but the absolute willingness to spend vast sums of treasure and oceans of blood for projects of war, while being so stingy with public health. No lives will be saved by the Iraq mistake. Many lives would be saved by investing in public health.

Nature's terrorist doesn't have to take off its shoes at the airport.