Final Paper: America and Vaccinations
April 2009 saw the beginnings of a worldwide flu pandemic in the H1N1 flu virus (also known as “swine flu”). With the media spreading fear about our inability to contain the virus, and our immune system's inability to fend off the flu as easily as the general human influenza virus, the need for some sort of vaccination became paramount. According to the article “U.S. Should give away H1N1 swine flu vaccine” by Ruth Karron, Orin Levine, and Ruth Faden, the U.S. is promising 10% of its swine flu vaccination supply to low-income countries. Unfortunately, this will only protect, at best, 10% of the population in 95 of the poorest countries in the world. The authors suggest that the U.S. and other wealthy countries give away 10 percent of their vaccine supply immediately to the poorest countries, and continue to donate portions of our supply to these countries. It is definitely an altruistic thing to do, and as the H1N1 threat begins subsiding, whether due to vaccination or other measures taken against it, there is less of a reason to hoard the vaccines, and it would be better to squander any potential areas that reemergence could happen.
Due to the differences in the H1N1 virus from the seasonal human virus, the general vaccinations did nothing to change the infection rate of the swine flu (CDC website). Without a readily available means to combat the swine flu virus, the need for a newly developed vaccination was dire, and it was not until the end of September that a successful vaccination was developed. The amount of media attention around this period was also still heightened, keeping it at the forefront of the population's minds. The process for developing a successful vaccination and then producing a sufficient quantity is a very long process. There is definitely a larger capacity for generating these vaccinations than in previous years, but it still takes time, and creating enough vaccinations to provide for the whole world is still difficult (Financial Express).
Another concern for the vaccine that was produced was that the H1N1 strain would return in a more lethal form, similar to the outbreak in 1918, where a mild influenza virus turned into a very dangerous form a few months later and killed millions (Financial Express). If the H1N1 virus did this, the currently developed vaccine would be essentially useless, and a whole new vaccination would need to be created and distributed. This could also severely hurt those developing nations that would be the most vulnerable. After trying to mass produce and donate the first round of vaccines, some of the wealthier nations may be more reluctant to hand out yet another batch of vaccines, especially if the virus became deadlier. Not only would the wealthy nations be losing more money, but there would be significantly more outcry from their citizens if vaccines were not readily available to them.
I would say the world was relatively lucky that the H1N1 virus outbreak was not quite as severe as it could have been. It sort of provided a test run for our current disease prevention frameworks to help work out any kinks or bottlenecks. Having this kind of real world feedback can only help against future threats that may happen in the future. As was mentioned earlier, if the world were faced with a more severe or lethal threat, citizens in the wealthier nations would demand vaccinations or medicine at a greater rate, and could potentially become outraged if the governments decided to donate some percentage of those vaccines or medications before their own people had sufficient access. This definitely becomes an issue because it forces the question of who is more important. Is there more value in one citizen's life than another? Are people in wealthier nations just luckier, and people in the poorer, developing nations are up the river without a paddle?
Any country has an obligation to its citizens over any other country I would say, no matter what the case. It unfortunately just becomes survival of the fittest, and it is truly a sad thing for the people in the nations that can not afford to develop their own vaccines. Wealthy nations should definitely do all they can to aid the poorer countries during a severe outbreak, but I would say donating is out of the question. There would be very few supporters of such a decision if the situation was that dire. Everyone's self preservation instincts would be kicking in, and each nation would need to appease its citizens before turning to the rest of the world to aid them.
Luckily, America is seeing the H1N1 panic slowly subside, but that is not the case in poorer regions of the world. Many Americans are probably not aware of that fact, but countries in Africa, Asia, and Eastern Europe are still suffering from the virus (McNeil). Karron, Levine, and Faden should be seeing their wishes fulfilled, seeing as there is significantly less demand for the vaccine, and countries are trying to get rid of their surplus. Unfortunately, these poor countries are still receiving very few doses. One would think that transferring surplus vaccines to these developing nations would be a relatively simple process, but these vaccines have to go through the World Health Organization. According to Dr. Keiji Fukuda, the chief of pandemic influenza, “It's a mammoth effort by an awful lot of people and organizations and countries, but holy moly, it's a very complex operation” (McNeil). Each country has to follow a certain set of procedures and meet a certain standard before being able to obtain and distribute the vaccines. This includes things like providing plans for storage and the W.H.O. has to certify the vaccines as safe if the country has no means itself.
As the mania that surrounded H1N1 fades, and it proves to be less dangerous than previously thought, many of the wealthy countries that placed large orders are trying to cancel these orders, since they are not needed. France is attempting to sell 50 million doses since public interest has waned and the doses are no longer needed. Many of the countries that placed large orders could find themselves in a dangerous position the next time a pandemic comes around if they tried backing out of their commitments. These countries should just let the orders go through, store some, and donate or sell at drastically lower prices to the countries that still need these vaccines.
According to the W.H.O., there is definitely a decline in the transmission of the virus worldwide, but vaccines are still needed. So far, the W.H.O. confirmed that there are over 209 countries with confirmed cases of H1N1, and there are at least 15,000 deaths. While the fatality of the H1N1 seems relatively low, keeping the H1N1 from reemerging should be a priority to prevent a more lethal recurrence. The first outbreak officially recorded happened in Veracruz, Mexico, which has an Human Development Index of 0.7457 as of 2004 (Wikipedia), which ranks it as a moderately developed area. Keeping the poorer countries healthier can only help the global population as a whole, since it helps prevent such outbreaks from spreading too severely. There is evidence that the H1N1 virus had been spread prior to that first official finding, but this situation is similar to any containment policy. Being from New Hampshire, I experienced the West Nile panic that was predominant around 2005 and 2006. In order to limit the potential spread of the disease through mosquitoes, disease control attempted to contain the mosquito population by spraying breeding grounds and recommending that people do not leave standing water on their properties. Being able to keep poorer nations vaccinated and healthy helps reduce the ability for diseases to breed and reach dangerous levels.
While I am skeptical about America being required to play big brother to parts of the world, I do believe that it is our responsibility to aid developing nations with vaccinations and to try our best to keep people of those areas healthy. It can be expensive, but prevention tends to be cheaper in the long run than reaction. If we can keep humanity healthier as a whole, then we will have less to worry about, and should a pandemic arise, we will hopefully have a sufficient infrastructure in place. The H1N1 outbreak definitely provided a good test for our current pandemic handling methodology. Hopefully procedures and policies can be tweaked to prevent bottlenecks from forming in the system, and hopefully a better method can be developed to get surplus vaccinations to where they are needed the most.
Works Cited
"2009 flu pandemic vaccine." Wikipedia, the free encyclopedia. Web. 01 Feb. 2010. <http://en.wikipedia.org/wiki/2009_flu_pandemic_vaccine>.
"Effectiveness of 2008--09 Trivalent Influenza Vaccine Against 2009 Pandemic Influenza A (H1N1)." Centers for Disease Control and Prevention. 09 Nov. 2009. Web. 01 Feb. 2010. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5844a5.htm>.
Karron, Ruth A., Orin S. Levine, and Ruth R. Faden. "U.S. should give away H1N1 swine flu vaccine." San Francisco Chronicle. 16 Dec. 2009. Web. 01 Feb. 2010. <http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2009/12/16/EDD51B4JTJ.DTL>.
McNeil Jr., Donald G. "Progress Is Slow on Moving Surplus Swine Flu Vaccine to Countries That Need It." The New York Times. 01 Feb. 2010. Web. 02 Feb. 2010. <http://www.nytimes.com/2010/02/02/health/02flu.html>.
"Pandemic (H1N1) 2009 - update 86." World Health Organization. 05 Feb. 2010. Web. 06 Feb. 2010. <http://www.who.int/csr/don/2010_02_5/en/index.html>.
"Preparing for the worst." Financial Express. 08 May 2009. Web. 02 Feb. 2010. <http://www.financialexpress.com/printer/news/455987/>.
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