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Flu vaccine shortage raises alarms, WHO chief says

PUBLIC HEALTH REPORTER

OTTAWA

flu vaccine shortage in the United States should serve as a wake-up call to nations around the world not to take the supply of lifesaving vaccines for granted, the head of the World Health Organization says.

"This issue has highlighted the fragility of supply, the fragility of the industry," Lee Jong-wook said in an interview yesterday.

"We were all caught off guard by what happened in the U.S., but I hope we can learn from this because there are some big lessons to learn."

Dr. Lee said he has taken two principal lessons from the vaccine shortage. First, there are too few manufacturers in the world, particularly for flu vaccine. Second, in times of shortage, the fear of an infectious disease can be a problem as big, or bigger, than the disease itself.

The United States had planned to purchase more than 100 million doses of flu vaccine this season but has managed to buy only 61 million. (A manufacturing problem at one supplier resulted in the loss of more than 50 million doses.)

Dr. Lee said the United States likely has enough supply to vaccinate those at high risk such as the aged and people with chronic diseases, but the media coverage of the shortfall has created panic. (It has also sent so many Americans north that it threatens to cause a flu vaccine shortage in Canada.)

"The issue now is not the shortage of vaccine but how to allay this fear and panic," Dr. Lee said.

He said that demonstrates that good communications must be an integral part of the public-health response to infectious diseases, and to pandemic influenza in particular.

"We talk a lot about global travel and how that is a challenge for dealing with infectious disease, but communication is also globalized," Dr. Lee said. "At the very outset of pandemic flu, the news will travel to every corner of the world; it will be a global concern."

The director-general of the WHO is making his first official visit to Canada after his surprise election last year. A South Korean physician and long-time WHO insider, he became the compromise choice for a position that had many high-profile candidates.

Dr. Lee succeeded Gro Harlem Brundtland, the former prime minister of Norway, in the world's top health job. The WHO has an annual budget of more than $1-billion (U.S.) and growing clout in international health and political circles.

Dr. Lee, while he does not have the profile of his predecessor, is forging a reputation as a diplomat and results-oriented pragmatist. For example, in the past, the WHO approach to vaccination consisted of begging manufacturers to supply the drugs for free or at cost to the developing world. Dr. Lee's approach has been to work with drug companies to figure what kind of guarantees and incentives they need to stay in the business for the long term.

"We should not see industry as a troublemaker but as an ally," he said. "It's too risky to rely on a limited number of vaccine manufacturers, so we should work with them to ensure they stay in the vaccine business."

Dr. Lee came to Canada to officially accept a $100-million contribution by Canada to the WHO's flagship "3 by 5" program, which aims to get life-extending drug cocktails to at least three million people with HIV-AIDS in the developing world by the end of 2005. (The $100-million announcement was made by Prime Minister Paul Martin in May, but it was overshadowed by a visit from rock star Bono.)

Dr. Lee's visit to Canada was also symbolic, the first by a WHO director-general since the SARS crisis in the spring of 2003.

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