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Global Agreement to share flu virus genetic data and vaccines

Re: Global Agreement to share flu virus genetic data and vaccines

gsgs said:
we did not implement methods of delaying, because the flu
was not so virulent.
In a severe pandemic we would have closed airports etc.
and people would just have been more careful
(in some countries)
Click to expand...

<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if !mso]><object classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui></object> <style> st1\:*{behavior:url(#ieooui) } </style> <![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} </style> <![endif]--> I do not believe containment would work, and neither does the WHO. Their plan always called for containment at a very early stage and they built up a stockpile of Tamiflu with which to wrestle the Ro below one. The plan however accepted that this would only work if it could be detected very early while geographically contained and with a limited number of cases.
You, I and Al all know from our readings here how these things unfold. There have been many suspicious clusters in this forum?s threads over the last few years Turkey, China, some in Indonesia, Egypt, South Africa, West Africa and Mexico (twice). Some were H5N1, some were other agents, some disappeared off the radar without explanation and only one went pandemic. What they all shared in common was confusion in the early stages.
The H1N1(2009) pandemic was fairly typical. There were reports in the local press of unusual numbers of ILIs, then deaths. We were the first, or one of the first, sites to start to pay attention to these collecting and translating them and beginning to wonder if there was something odd going on. The increasing number of hospitalisations and deaths eventually made it clear there was a problem.
If we consider these for a moment. With the benefit of hindsight we know this was a low CFR pandemic but at the time there were fears of very high virulence because of the number of severe cases. We can now back-calculate the number of cases there must have been in the community to have had that many severe cases and it shows the virus was already well and truly ?out of the box? and all this was before a causative agent had been Identified.
Now let us think about the confirmation of the causative agent. Again a lucky break. In this case the pandemic started in Mexico just south of, and with heavy cross boarder traffic with, the US. Developmentally Mexico is middle order but did not have the ability to confirm a flu pandemic. Confirmation came because it had already spread into the US and a samples from a US case happened to have been sent to a pilot sentinel lab which had recently been set up as part of the responses to the H5N1 scare. That was the system working rather better than expected. If I, and I suspect you, were to put money on a starting location for a novel flu strain I guess our pins would be stuck in SE Asia and probably, based on population size, in China - if it was H5N1 based possibly in Indonesia. Gs you like probability estimates, what odds would you give that detection and containment would have been more efficient in this neck of the woods?
I am sorry to be so cynical but I have seen no evidence that a government, let alone all governments, would act in a timely and co-ordinated fashion to isolate or quarantine. The tendency is to wait for confirmations at each stage before acting, not that that there are any measures that can do more than slow spread slightly. The level of social distancing required to stop an efficient communicable disease would also stop all economic activity which would not happen and could be as big a problem as the disease itself.
All of which brings us back to a vaccine. The blunt truth is if you can not avoid contact with a disease then you need immunity. There are three ways to achieve this that I can think of.

Perpetual Tamiflu prophylaxis ? not practical and a perfect recipe for resistance emergence.
Previous infection ? not my preferred option for H1N1(1918)-like or worse.
Vaccination either personally or of enough other people to get herd immunity.

Of the three the last is my preferred option but it requires the changes is vaccine production technology argued for in the link in my earlier post.
 
Re: Global Agreement to share flu virus genetic data and vaccines

but these were mild pandemics, where rigorous measures cost more than the expected benefit.
In a severe pandemic we would try further measures.
I remember one paper from 2006-2008 ,which we discussed here, suggesting that a
combined serious strategy of
vaccine,antivirals,social distancing would reduce the attack rate by 70%-90%
depending on R0

For a 1957 or 1968 like pandemic starting in summer in Asia, the decisive
delay could be to survive the next winter so to have vaccine available for the 2nd winter.
(as 1968 in Britain)
How to keep it away one winter ? Start another mild (asymptomatic?) pandemic.
View it as naturally replicating vax, if you want.
 
Re: Global Agreement to share flu virus genetic data and vaccines

gsgs said:
but these were mild pandemics, where rigorous measures cost more than the expected benefit. In a severe pandemic we would try further measures. . . .
Click to expand...

I agree completely with JJackson's comment above. We can never know ahead of time about the severity of a pandemic until after it has started to unfold. I think by that time it is too late implement "further measures".
 
Re: Global Agreement to share flu virus genetic data and vaccines

http://www.ip-watch.org/weblog/2011...k-deal-on-global-framework-for-flu-pandemics/

Intellectual Property Watch
18 April 2011
WHO Group Strikes Landmark Deal On Global Framework For Flu Pandemics
By Catherine Saez @ 7:22 pm

After a week of discussions, a good part of which centred around intellectual property issues, World Health Organization members agreed to a framework aimed at better addressing future influenza pandemics and facilitating vaccines access for developing country populations, with industry contributions...
 
Re: Global Agreement to share flu virus genetic data and vaccines

http://www.ip-watch.org/weblog/wp-content/uploads/2011/04/PIP-Framework-16-April_2011.pdf


seems that sequences can go to genbank or gisaid


5.2 Genetic sequence data
5.2.1 Genetic sequence data, and analyses arising from that data,
relating to H5N1 and other influenza viruses with human pandemic
potential should be shared in a rapid, timely and systematic manner
with the originating laboratory and among WHO GISRS laboratories.
(Consensus)
5.2.2 Recognizing that greater transparency and access concerning
influenza virus genetic sequence data is important to public
health and there is a movement towards the use of public-domain
or publicaccess databases such as Genbank and GISAID respectively;
and (Consensus)
5.2.3 Recognizing that in some instances the publication of genetic
sequence data has been considered sensitive by the country
providing the virus; (Consensus)
5.2.4 Member States request the Director-General to consult the Advisory
Group on the best process for further discussion and resolution
of issues relating to the handling of genetic sequence data from
H5N1 and other influenza viruses with pandemic potential as part
of the Pandemic Influenza Preparedness Framework. (Consensus)


----------------------------------------------


4
GUIDING PRINCIPLES FOR THE DEVELOPMENT OF TERMS OF REFERENCE FOR
CURRENT AND POTENTIAL FUTURE WHO GISRS LABORATORIES FOR H5N1 AND
OTHER HUMAN PANDEMIC INFLUENZA VIRUSES (CONSENSUS)

...

9. The WHO GISRS laboratories will submit genetic sequences data
to GISAID and Genbank or similar databases in a timely manner
consistent with the Standard Material Transfer Agreement.


---------------------------------------------------


====================================================
The WHO GISRS laboratories will submit genetic sequences data
to GISAID and Genbank or similar databases in a timely manner
====================================================


(GISAID) and (genbank or similar database)

or

(GISAID and genbank) or (similar databases)
 
Re: Global Agreement to share flu virus genetic data and vaccines

I see this noted a few times throughout the .pdf

9. The WHO GISRS laboratories will submit genetic sequences data to GISAID and Genbank or similar databases in a timely manner consistent with the Standard Material Transfer Agreement.
Click to expand...
 
Re: Global Agreement to share flu virus genetic data and vaccines

:tiphat: gs

Who shall live when not all can live? Intellectual property in accessing and benefit-sharing influenza viruses through the World Health Organisation.
Lawson C.
Australian Centre for Intellectual Property in Agriculture, Griflith Law School, Griffith University, Gold Coast, Queensland. c.lawson@griffith.edu.au

Abstract
This article addresses the development of the World Health Organisation's (WHO) arrangements for accessing viruses and the development of vaccines to respond to potential pandemics (and other lesser outbreaks). It examines the ongoing "conflict" between the United Nations' Convention on Biological Diversity (CBD) and the World Trade Organisation's Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS) in the context of the debates about the paramountcy of intellectual property, and the potential for other (equity and development) imperatives to over-ride respect for intellectual property and TRIPS. The article concludes that the same intellectual property fault lines are evident in the WHO forum as those apparent at the CBD and the WTO fora, and an ongoing failure to properly address questions of equity and development. This poses a challenge for the Australian Government in guaranteeing a satisfactory pandemic influenza preparation and response.
http://www.ncbi.nlm.nih.gov/pubmed/21528740

Managing the effect of TRIPS on availability of priority vaccines.
Milstien J, Kaddar M.
Center for Vaccine Development, School of Medicine, University of Maryland, Montpellier, France.
Bull World Health Organ. 2006 May;84(5):360-5. Epub 2006 May 17.

Abstract
The stated purpose of intellectual property protection is to stimulate innovation. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) requires all Members of the World Trade Organization (WTO) to enact national laws conferring minimum standards of intellectual property protection by certain deadlines. Critics of the Agreement fear that such action is inconsistent with ensuring access to medicines in the developing world. A WHO convened meeting on intellectual property rights and vaccines in developing countries, on which this paper is based, found no evidence that TRIPS has stimulated innovation in developing market vaccine development (where markets are weak) or that protection of intellectual property rights has had a negative effect on access to vaccines. However, access to future vaccines in the developing world could be threatened by compliance with TRIPS. The management of such threats requires adherence of all countries to the Doha Declaration on TRIPS, and the protections guaranteed by the Agreement itself, vigilance on TRIPS-plus elements of free trade agreements, developing frameworks for licensing and technology transfer, and promoting innovative vaccine development in developing countries. The role of international organizations in defining best practices, dissemination of information, and monitoring TRIPS impact will be crucial to ensuring optimal access to priority new vaccines for the developing world.
http://www.ncbi.nlm.nih.gov/pubmed/16710544
 
Re: Global Agreement to share flu virus genetic data and vaccines

I don't quite understand what the problem is.
is it really just only about vaccines ?

They could release the non-vaccine relevant sequences then,
which would still enhance surveillance and research and science.

Remember, I asked GISAID to do this, they won't even argue about
it.
 
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