Giuseppe
Emeritus
Flu outbreak plan still up in air / Response steps to outbreak under govt proposals remain unclear
The Yomiuri Shimbun
The announcement Friday that the government had included a project team's proposals on measures to combat a possible outbreak of a new strain of influenza in its latest basic policy outline of economic and fiscal reforms has brought realization of these plans a step closer.
The proposals, which cover measures for preventing a flu outbreak, argue that the issue should be considered as part of a crisis-management strategy by the government and emphasized the importance of crossing boundaries between ministries and agencies.
But the plans stopped short of mentioning how local governments and medical institutions should respond, indicating there is still some work to be done.
Bird flu, which some fear could mutate into a new strain of influenza that can be transmitted from person to person, has badly hit other parts of Asia, especially Indonesia, where it had claimed the lives of 243 people as of June 19.
The government predicts that if such an outbreak occurred in Japan, as many as 32 million people, or 25 percent of the population, could be infected, with as many as 100,000 patients a day needing to be hospitalized, and possible fatalities ranging between 170,000 and 640,000.
The proposals cover 60 wide-ranging items, including the possibility of having the Self-Defense Forces help Japanese return from a country where an outbreak occurs, and what the Japan Coast Guard can do to prevent those infected with bird flu from entering Japan.
The project team emphasized that action is needed at the highest level, and that preventing an outbreak should be taken as seriously as contingency planning for terrorism and rioting.
However, only two numerical goals requiring a budget allocation were mentioned--one on shortening the period necessary to produce a vaccine after an outbreak occurs, and one for increasing stockpiles of antivirus medicines.
Other measures proposed in the package lacked detail, and it is therefore unclear if the government can allocate funds.
"Under the tight budget conditions we face, I'm not sure it's feasible," one senior Health, Labor and Welfare Ministry official said.
Prefectural governments, which will be responsible for actually implementing any measures, have also raised concerns over the team's work and the fact it postponed making any firm decisions on key issues, such as deciding in which order of priority vaccine stockpiles should be used.
Under a 2007 central government action plan for dealing with new strains of influenza, prefectural governors can request that residents refrain from holding gatherings or even restrict the movement of residents.
But there are no laws in place obliging people to comply with such a request, and although some local government heads have pressed for some sort of resolution to this problem, the proposals only cited the need for legislative action as such restrictions might infringe constitutional rights.
"We'll have to deal with an outbreak without necessary authority," one local government official said.
Medical institutions face similar uncertainty.
Though prefectural governments are required to have hospitals set up dedicated outpatient departments for a new strain of flu, only a small number of hospitals have so far cooperated.
Prof. Hitoshi Oshitani, a researcher of virology at Tohoku University, said: "Japanese measures tend to focus on preventing a virus from entering the country. We also need an approach similar to the United States, where they prioritize preventing the spread of infections, if necessary through a a combination of measures including movement restrictions, closure of schools and vaccination programs."
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Mass production problematic
Among the proposals was a call for the mass production of a vaccine for a new strain of flu--enough to vaccinate everyone in the country within six months of an outbreak occurring--and a boost in stockpiles of Tamiflu and other flu medicines to increase coverage from the current 23 percent of the population to between 40 percent and 50 percent.
The current technique of using chicken eggs to produce vaccine would take about 18 months to produce enough vaccine to cover the whole population. Meeting the six-month goal therefore requires introduction of a new technology, cell cultivation, that is used by foreign pharmaceutical makers.
The proposals did not mention which country could provide the technology, but former Health, Labor and Welfare Minister Chikara Sakaguchi, a member of the project team, said, "This might be necessary as a last resort in an emergency that could happen any time."
However, some critics have warned that allowing foreign companies to enter the domestic vaccine market could hurt some of the nation's small-scale vaccine manufacturers.
Meanwhile, mass production of a vaccine would require the building of new production facilities.
Cell cultivation involves injecting a virus into cell or tissue cultures of monkeys, dogs, insects or humans, with the cells then multiplying as the virus does. The viruses can then be removed and made inactive to create a vaccine.
But it takes at least three to five years to build an appropriate production system, and associated research and development costs can be as much as 100 billion yen.
In addition, cell cultivation, as opposed to the egg-based technique, is still being developed, and some experts say it is still too early to confirm whether the method is safe.
(Jul. 1, 2008)
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http://www.yomiuri.co.jp/dy/national/20080701TDY03105.htm
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The Yomiuri Shimbun
The announcement Friday that the government had included a project team's proposals on measures to combat a possible outbreak of a new strain of influenza in its latest basic policy outline of economic and fiscal reforms has brought realization of these plans a step closer.
The proposals, which cover measures for preventing a flu outbreak, argue that the issue should be considered as part of a crisis-management strategy by the government and emphasized the importance of crossing boundaries between ministries and agencies.
But the plans stopped short of mentioning how local governments and medical institutions should respond, indicating there is still some work to be done.
Bird flu, which some fear could mutate into a new strain of influenza that can be transmitted from person to person, has badly hit other parts of Asia, especially Indonesia, where it had claimed the lives of 243 people as of June 19.
The government predicts that if such an outbreak occurred in Japan, as many as 32 million people, or 25 percent of the population, could be infected, with as many as 100,000 patients a day needing to be hospitalized, and possible fatalities ranging between 170,000 and 640,000.
The proposals cover 60 wide-ranging items, including the possibility of having the Self-Defense Forces help Japanese return from a country where an outbreak occurs, and what the Japan Coast Guard can do to prevent those infected with bird flu from entering Japan.
The project team emphasized that action is needed at the highest level, and that preventing an outbreak should be taken as seriously as contingency planning for terrorism and rioting.
However, only two numerical goals requiring a budget allocation were mentioned--one on shortening the period necessary to produce a vaccine after an outbreak occurs, and one for increasing stockpiles of antivirus medicines.
Other measures proposed in the package lacked detail, and it is therefore unclear if the government can allocate funds.
"Under the tight budget conditions we face, I'm not sure it's feasible," one senior Health, Labor and Welfare Ministry official said.
Prefectural governments, which will be responsible for actually implementing any measures, have also raised concerns over the team's work and the fact it postponed making any firm decisions on key issues, such as deciding in which order of priority vaccine stockpiles should be used.
Under a 2007 central government action plan for dealing with new strains of influenza, prefectural governors can request that residents refrain from holding gatherings or even restrict the movement of residents.
But there are no laws in place obliging people to comply with such a request, and although some local government heads have pressed for some sort of resolution to this problem, the proposals only cited the need for legislative action as such restrictions might infringe constitutional rights.
"We'll have to deal with an outbreak without necessary authority," one local government official said.
Medical institutions face similar uncertainty.
Though prefectural governments are required to have hospitals set up dedicated outpatient departments for a new strain of flu, only a small number of hospitals have so far cooperated.
Prof. Hitoshi Oshitani, a researcher of virology at Tohoku University, said: "Japanese measures tend to focus on preventing a virus from entering the country. We also need an approach similar to the United States, where they prioritize preventing the spread of infections, if necessary through a a combination of measures including movement restrictions, closure of schools and vaccination programs."
===
Mass production problematic
Among the proposals was a call for the mass production of a vaccine for a new strain of flu--enough to vaccinate everyone in the country within six months of an outbreak occurring--and a boost in stockpiles of Tamiflu and other flu medicines to increase coverage from the current 23 percent of the population to between 40 percent and 50 percent.
The current technique of using chicken eggs to produce vaccine would take about 18 months to produce enough vaccine to cover the whole population. Meeting the six-month goal therefore requires introduction of a new technology, cell cultivation, that is used by foreign pharmaceutical makers.
The proposals did not mention which country could provide the technology, but former Health, Labor and Welfare Minister Chikara Sakaguchi, a member of the project team, said, "This might be necessary as a last resort in an emergency that could happen any time."
However, some critics have warned that allowing foreign companies to enter the domestic vaccine market could hurt some of the nation's small-scale vaccine manufacturers.
Meanwhile, mass production of a vaccine would require the building of new production facilities.
Cell cultivation involves injecting a virus into cell or tissue cultures of monkeys, dogs, insects or humans, with the cells then multiplying as the virus does. The viruses can then be removed and made inactive to create a vaccine.
But it takes at least three to five years to build an appropriate production system, and associated research and development costs can be as much as 100 billion yen.
In addition, cell cultivation, as opposed to the egg-based technique, is still being developed, and some experts say it is still too early to confirm whether the method is safe.
(Jul. 1, 2008)
-
http://www.yomiuri.co.jp/dy/national/20080701TDY03105.htm
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