Does India have enough drugs to beat swine flu?

By Dipankar De Sarkar,IANS,

London : Indian stocks of the anti-viral drugs that are effective against swine flu may be well below internationally-recommended levels.


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The Geneva-based World Health Organisation (WHO) says only two types of anti-viral drugs – Tamiflu, also known generically as oseltamivir, and Relenza, which is known as zanamivir – are effective against swine flu.

The drugs, which are under patent, are manufactured by three major multinational companies – Tamiflu by the Switzerland-based Roche and the US-based Gilead, and Relenza by Britain-based GlaxoSmithKline.

The recommended level of protection in an emergency, according to the British media, is for a country to have enough doses to treat 10 percent of a country’s population.

It is not known whether WHO supports such a recommendation and its official wasn’t available to comment.

However, global preparedness for meeting a potential swine flu epidemic is clearly marked by a divide between rich and poor countries as far as stockpiles of these two essential drugs are concerned.

Some 220 million doses of Tamiflu are in the hands of governments across the world, but rich countries hold most of them – a fact that first came to light after the bird flu epidemic of 2004 (Tamiflu can also cure bird flu).

Britain’s state-funded health system has stockpiled enough doses of Tamiflu to treat 30 million people – roughly half the country’s population – if there is a swine flu outbreak.

The US has 50 million doses of Tamiflu and Relenza.

By contrast, Indian health authorities say they have a million doses of Tamiflu.

In addition, the Indian pharmaceutical company Cipla, which makes generic copies of Tamiflu, has said it can make 1.5 million doses within a period of four to six weeks.

But the Cipla statement was made in the context of supplying countries that are faced with a swine flu emergency – such as Mexico – rather than India itself.

However, India has not been mentioned in a WHO list of countries where either pigs or humans have been affected by swine flu.

Rich countries, including the US, Japan, Australia, Italy and France, have been stocking up on huge quantities of Tamiflu since the bird flu outbreak in 2004.

China is yet to specify its stockpiles, but health authorities in Hong Kong said the territory has stocked 20 million doses of Tamiflu and Relenza, which can treat a million people. The stock is enough to handle an outbreak of swine flu.

Neighbouring Taiwan has enough Tamiflu to treat 2.3 million people – a tenth of its population – and South Korea is acquiring more drugs to double coverage from the current five percent of population.

WHO, which Tuesday raised the alert level for swine flu to level 4 – two short of its highest ‘pandemic’ level, where a disease has broken out in at least two regions – also holds stocks of Tamiflu.

Keiji Fukuda, assistant director general at WHO, told reporters the UN body has enough Tamiflu stocks to make about five million treatment courses.

“These have been developed and held both to assist in rapid containment operations if that were to be conducted but also to provide to countries in terms of assistance when it’s needed,” he said.

In addition to the stockpiles held by WHO, Fukuda said, there are regional and national stockpiles “in many different countries” but “not all countries”.

Roche spokeswoman Martina Rupp said three-fifths of the WHO stockpiles of Tamiflu are held at Roche facilities in the US and Switzerland and the remaining quantity is stored by WHO at different locations around the world.

Both Roche and GSK are looking at how to increase production of the two drugs.

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