Displeased with the current allocation of the avian-flu drug Tamiflu, Asian delegates recently questioned the efficiency of the drug distribution in Asia, noting that the region lacks a stockpile of the anti-viral medicine, said Steve Kuo, director of Center for Disease Control yesterday.
In the opening address at last week's Japan-WHO Joint Meeting on Early Response to Potential Influenza Pandemic, Dr. Shigeru Omi, WHO regional director for the Western Pacific, called for countries to enhance their "rapid response and containment ability."
However, despite the push to accelerate response time in all countries, the WHO is stockpiling 3 million courses of Tamiflu donated by Roche in Switzerland and the United States only.
"Representatives from Asian countries argued that the region is a hotbed for the virus," said Kuo. "Without a stockpile of Tamiflu at hand, many Asian countries will experience an explosive spread once small scale human-to-human transmission occurs."
In responding to the concerns, the European Union representative urged the concerned delegates not to blur the focus of the preventative measure of early detection by concentrating on the location of the drug stockpiles, Kuo added.
To strengthen Asia's defenses against the lethal virus strain, Kuo said, Japan's Prime Minister Junichiro Koizumi has pledged that his country will donate 50,000 courses of Tamiflu to the region.
"However, the question remains, where will we store the stockpile? " Kuo noted.
"Should we have the regional stockpile in one country? Five countries? Or should every country have a portion of the donation?" he asked.
Furthermore, the delegates also discussed the problem of efficient drug delivery in countries or areas with poor infrastructure.
"There are still many unknowns regarding the distribution of Tamiflu," Kuo said. "However, the global community is committed to strengthening nations' capacity to detect and respond to avian flu."
In a summary of the meeting, the WHO said on its Web site that delegates had agreed to "coordinate the development of an appropriate communication strategy, including outbreak communications."
Chang Shan-chwen, director of the infectious disease department at National Taiwan University Hospital and a member of the Taiwan delegation, said that among the 78 avian flu human fatalities in the world since 2003, the average reporting time was 16.7 days.
"A delay in reporting can be detrimental to the region," said Chang. "To avoid future reporting delays, the WHO is mandating countries to disclose any flu-related deaths within 14 days of the event.
"The 14-day threshold is not supported by any scientific evidence. It is aimed at encouraging countries to speed up their reporting time. In Taiwan, we can confirm the cause of death within two to three days."
Speculating on China's efforts to downplay the severity of the avian-flu situation there, Kuo said that post-SARS China has made improvements in transparency.
"We believe the Chinese government will not intentionally cover up any cases," said Kuo. "But, due to the immense area of the country, it is very difficult for information to be transmitted from the local level to the central government."
Although Taiwan is not an official member of the WHO, Kuo and the rest of the delegation were invited to attend the meeting under the title of "CDC, Taiwan." Many saw Taiwan's participation in the past two WHO-sponsored meetings as moving one step closer to obtaining a seat in the international health body. However, Taiwan was excluded from the list of participants at yesterday and today's WHO International Pledging Conference on Avian and Human Influenza being held in Beijing.
The Ministry of Foreign Affairs vehemently protested against what it called the blatant discrimination by the Chinese government.