Category Archives: Global health

For years, scientists have warned that an influenza pandemic, similar to the 1918 Spanish flu, might cause a global catastrophe.

We will remember the 2009 H1N1 pandemic more for causing confusion than catastrophe.

Although the new H1N1 virus is dangerous for the young and for pregnant women, in otherwise healthy people it causes a disease no more severe than seasonal flu. Up till now, the new H1N1 virus eventually showed more weaknesses than strengths in the world’s ability to combat such a pandemic:

1. The World Health Organization held lengthy debates about using the name “pandemic”.
2. When the virus was discovered, it had been circulating in humans for months. It was thus too late to control its spread with quarantines and antiviral drugs.
3. Regrettably, many countries began useless travel bans and quarantines.
4. WHO used consultants from the influenza vaccine industry. Only after recommending on large-scale vaccine production, did the public learn about their conflict of interests.
5. The predictions about the extent and timing of the epidemics were poor. And, some governments, for example in Norway, scared its population by telling them that thousands would die.

Nevertheless, the biggest wake-up call has been to develop and produce vaccines on a large-scale. Unfortunately, it came too little and too late, and was only available during the pandemic’s second wave.

Each country should now review what happened. If this pandemic might serve as a trial run for the vicious killer that may come one day, there might be some important lessons that we learned.

The H1N1 influenza epidemic has received much media attention. Authorities fear a severe epidemic resembling the Spanish Flue, and they have taken their precautions. Norway has bought vaccines for the whole population, and has upgraded its hospitals to treat severe complications such as respiratory failure. The cost is uncertain, but is in the order of 1 billion Norwegian kroner (USD 160 million).

Some researchers question the government’s priorities in combating this epidemic:

Should Norway use such large funds on a mild influenza epidemic? Already in the early days of the epidemic, we got information that this was not an epidemic with high case fatality rates. The virus mainly infected young adults.

Has any estimate of the cost-effectiveness of this intervention been calculated? And, has this intervention been discussed in relation to other pressing health needs in the country? Would an intervention targeted at specific population groups be more cost-effective?

How sound is the government policy to buy 9 million doses (two doses per person) of a vaccine that is not thoroughly tested, and where the pharmaceutical industry would not cover the liabilities?

Other questions are:
How sound is the epidemiological modelling used by the Norwegian government? Should not their mathematical models have been adjusted as we learned how this epidemic evolved in other countries?

Does Norway need to strengthen its epidemiological research environment?

However, working is south Ethiopia; my most important question is how one of the richest countries in the world uses its huge wealth when meeting an irrational fear as a new swine-flue virus.
Could more lives have been saved if the rich countries used a smaller part of their influenza expenses to combat malnutrition, childhood diseases, maternal deaths tuberculosis, HIV, and malaria?