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An avian-flu future

It is promising news that a human bird-flu vaccine being developed by U.S. government and private-sector scientists has been successfully tested in people. The U.S. National Institute of Allergy and Infectious Diseases suggests the vaccine, to protect against the strain of avian flu that is spreading in birds in Asia and has killed 57 people, is on the near horizon. Anthony Fauci, the institute's director, says it is only a matter of months before the vaccine is tested further, licensed and ready for public use. In anticipation, the institute is ordering millions of doses and other countries may follow suit.

That is well and good, but there is no room for complacency. As the World Health Organization (WHO) says, the touted vaccine should not be mistaken for a "silver bullet." It is only one part of what should be an international, orchestrated campaign against a lethal worldwide pandemic that health officials have been warning is likely if the avian influenza strain (H5N1) mutates into one that could spread easily from human to human.

For instance, the means must be found to produce enough vaccine in time to prevent the spread of the virus and to protect people at greatest risk. Many countries may not be able to afford, let alone produce, their own vaccines. And experts say vaccine companies are nowhere near being able to meet the needs occasioned by a pandemic, especially since they are also producing regular, seasonal flu vaccine.

And, while the development and the production of enough vaccine should be strongly supported, that should not overshadow other crucial elements in preparing for an influenza pandemic. These include a beefed-up international surveillance system to pick up outbreaks, early reporting in risk-prone countries and the stockpiling of antiviral drugs such as Tamiflu to treat patients with the flu and help prevent its spread. Canada plans to keep 20 million doses of Tamiflu on hand.

The importance of an integrated, international approach is underlined in recent papers published in the journals Science and Nature. Both papers suggest that a pandemic could be snuffed out or significantly slowed by a rapid response combining antiviral drugs, vaccination, travel restrictions, keeping people apart by banning public gatherings and closing schools, and quarantines. The WHO says such measures pose immense practical challenges, "but the enormous social trauma and human suffering that an influenza pandemic could inflict creates an obligation to thoroughly explore all proposals to limit this damage." On its own, a vaccine is clearly not enough.

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