21 October 2002 17:37 GMT

by Julie Clayton

[caption and credit]

Malta - Europe is not yet prepared for an influenza pandemic, but it is making a start in the right direction, which is all credit to the scientists who have lobbied hard for action at the European level, today heard delegates at the opening ceremony of the First European Influenza Conference here.

The conference marks the 10th anniversary of ESWI, the European Scientific Working Group on Influenza, which has seen its role change dramatically from focusing on basic research to making demands for European-level preparedness for a new pandemic that is "imminent," according to ESWI chairman, Albert Osterhaus, professor of virology at Erasmus University in Rotterdam.

The direction of the group has been driven, in part, by the realization that without political backing, much of the progress in scientific understanding of influenza will have little impact.

"We will, more than in the past, start to target policy makers because, as scientists understand flu, our knowledge is increasing all the time," said Osterhaus. "But whatever knowledge, technology and skills we develop, eventually it's the policy makers and the politicians that decide what is going to happen with the tools that we develop."

The need for pandemic preparedness first appeared on the European agenda at a meeting in Brussels last November between scientists, policy makers, and representatives of the World Health Organization (WHO). ESWI members stressed that with the extraordinarily high death toll of the past three major influenza pandemics, in 1918, 1957, and 1968, there is great urgency to prepare for the next one.

A key conclusion of the November meeting was that planning needs to be in place first, with a "genuinely European strategy," according to Robert Coleman, director general of Health and Consumer Protection at the European Commission (EC).

"The action we take now will determine how well we combat the next major influenza threat that we will face," he said. "Once the virus arrives it will already be too late for improvisation."

Colman revealed that the EC is now developing a Community Influenza Pandemic Preparedness and Response Plan to be able to respond more quickly and limit deaths in the event of a large outbreak. Should that happen, "European citizens will expect everything possible to have been done at every level of public authority," he said.

One of the main elements will be to improve surveillance, and to hold workshops on pandemic modeling, in order to try to predict the need for vaccines and antiviral drugs. When it comes to vaccines, a common European strategy could help to alleviate potential problems with vaccine supply. At present, production capacity does not match the anticipated demand of a major influenza outbreak. For example, only five member states have resident vaccine manufacturers, Coleman notes.

The potential problems are clear, says Osterhaus. "You can imagine a situation where national authorities might want the manufacturers to nationalize their production facilities, which would mean that the vaccine would only be used in those countries before it is exported to other countries," he said.

The stark message is that currently Europe is not prepared for a pandemic. And vaccines alone are not the solution, says Coleman.

"It will be several months at least after the start of the pandemic before a vaccine is available," he said. "Antiviral drugs could help during this period, given their potentially broad effectiveness. But to be useful in this initial phase, stockpiles of antivirals would need to be in place well in advance," he added. "This is not yet the case."

Coleman also announced that a WHO specialist is soon to join the European Commission Directorate in order to strengthen coordination between Europe and the rest of the world.

WHO, meanwhile, is forging ahead with its recently launched WHO Global Agenda on Influenza, which attempts to prioritize areas of action. These fall into four main areas: surveillance, assessment of disease burden, vaccine usage, and national and international preparedness. The need for improved surveillance and vaccine coverage is most urgent for developing nations, according to "rising star" Klaus Stohr, of the WHO Department of Communicable Diseases Surveillance and Response.

Picture caption:
Transmission electron micrograph of influenza A virus, late passage, CDC/Dr. Erskine Palmer.

Send us your comments for publication.

Sign up for BioMedNet News weekly email alerts.