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Exploding pig flu


Vials, Flickr image by mybloodyselfLast week swine flu virus got through Australia's famously tight customs and went off to school. But a month ago, in Geneva, the first days of swine flu literally sent the World Health Organisation (WHO) to their panic stations.

For a while everything felt precarious, as images of Mexicans in masks appeared in the media. It was as if the 'fiction' in science fiction had been annihilated. The possibilities were nightmarish.

Swine flu is an unknown quantity. The language surrounding it is highly specialised. Globalisation makes it hit home faster, and sections of the media work hard to transform fear into cold hard cash. It's easy to start thinking survivalist kind of thoughts.

On 27 April, when the panic was at its height, a strange thing happened near the headquarters of WHO. Vials of swine flu, travelling on a domestic train from Lausanne to Geneva, first rattled, then exploded. Sixty domestic passengers were checked for swine flu. Two, caught in the crossfire of the exploding vials, were slightly injured.

The explosion wasn't caused by swine flu, but by the inept packing of the dry ice surrounding the vials. The incident provided light relief but, seen from a global level, it raised greater questions about who is navigating the unknown waters of swine flu and how.

In Geneva, member states are debating questions of equity surrounding the manufacture of a swine flu vaccine. In the race to produce a vaccine, developing countries are being asked to hand over strains of the flu to WHO, who will give them to pharmaceutical companies for the purpose of manufacturing a vaccine.

It has been acknowledged that, in the event of a pandemic, there is currently no capacity for everyone to receive the vaccine. So who decides who will be left out? And will the price be affordable?

Indonesia is one of the countries refusing to hand over their bacteria because, as they point out, in the event of a global pandemic, they will be forced to purchase the vaccines they helped create, at a price they cannot afford, benefiting the pharmaceutical companies and the economy of the United States.

They have a point. What's in it for them except a fuzzy feeling?

This raises questions about international intellectual property rights and highlights that the issues that surround swine flu are far from purely scientific. They are riddled with age old questions of equity, and that annoying human suspicion that someone, somewhere is on the take.

It's undeniable that life in the developing world is precarious at the best of times. Many have been left to rely upon international organisations and their own families, leaving out the second ring of protection: the nation state and its infrastructure.

Increased global interdependence means that these developing nations need extra assistance, not just to tackle this virus but beyond — after all, the appearance of new diseases doesn't mean the old ones disappear.

As scientists, pharmaceutical companies and nations scramble to understand swine flu, people are dying. A report by WHO on the burden of global disease in late 2008 estimated malaria had infected 247 million people and killed 881,000 in 2006, with 91 per cent of the deaths in Africa, and 85 per cent children under five.

At the moment the overwhelming majority of people with swine flu recover and although it's important this new microbe is understood, it is equally important to remember that out there, beyond the relatively well-funded and stable health systems of those living in the West, people still die from a preventable disease.

For most of us swine flu induces a mild panic. Our minds may entertain apocalyptic scenarios, but our bodies remain firmly rooted in an unchanged environment. News about the virus changes every hour, but for many who are removed from immediate threat, and who cultivate healthy scepticism of governments, international bodies and pharmaceutical companies, this new virus puts that scepticism to the test.

When the Spanish flu ripped through Europe in 1918 there were no antibiotics or vaccines; people were raw before the microbes. How these new medicines are distributed, what the long-term effects will be and who profits are already hot questions.

WHO has a mandate to assist those governments who are unable to care for their own people. Let's hope this mandate is fulfilled. But it is vital that funding for malaria and other diseases that affect the third world is not tampered with in order to allay the fears of the Western citizen.

As the exploding vials of swine flu reveal, this virus is in human hands, and humans easily make mistakes.

Bronwyn LayBronwyn Lay lives with her family in rural France, over the border from Geneva. She is currently enrolled in a Masters of English Literature at the University of Geneva and is working on her first novel. Previously she worked as a legal aid lawyer in Australia with post-graduate qualifications in political theory.

Topic tags: bronwyn lay, swine flu, pig flu, h1n1, geneva, world health organisation, vaccine, equity



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Existing comments

The Spanish flu appeared in a mild form initially, and then returned, mutated, with a vengeance some months later. Today may just be the calm before the storm.

Flu in all its forms is a virus, not a bacteria, and is not susceptible to antibiotics. (Relenza and Tamiflu are not antibiotics).

Peter Horan | 27 May 2009  

Two good points Peter. It is important to appreciate that antibiotics are not appropriate treatment for viral infections, but lest this observation be seen as a criticism of Bronwyn's interesting article, let's also note that although many people died from immune damage ('cytokine storm') the majority died from secondary bacterial infections, which may have been treatable with antibiotics. Just a comment.

Ted Cleary | 27 May 2009  

you raised the point of the 1918 epidemic/pandemic, but didn't go anywhere with the thought.

my dad was vaccinated/inoculated [?] at the age of five. was it a major disease in Australia? how long did it take to develop the protection measures? were they implemented Aust-wide? I think he was still living in a Sydney suburb at that time.

jaymz | 27 May 2009  

There is not much point in Indonesia refusing to hand over the viral samples it possesses if it doesn't have the capacity or expertise to manufacture their own vaccines. In answer to the hypothetical "what's in it for them" the answer would be rapid access to an effective vaccine. Influenza vaccines are generally cheap and widely available and contrary to the subtext of this article 'Big Pharma' don't usually make huge profits out of vaccines.

With regards to malaria, the global burden of disease is enormous but the past five or so years has seen remarkable progress in the control and treatment of the disease, there is really no need to hypothesise a false dichotomy between control and treatment of malaria and H1N1 virus.

chris gow | 27 May 2009  

Bronwyn's aspirations/thoughts may be admirable, however, Bronwyn, perhaps those of us who are not epidemiologists nor virologists should rely on the knowledge and decision making of those experts to manage such potentially serious viral epidemics.

Maureen T.Couch | 27 May 2009  

As a pharmacist formerly involved in research and a mother of two school age children, I applaud Bronwyn's article as it provides a refreshing point of balance to the Swine Flu hysteria.

Let's look at it in perspective. The population of Mexico city alone is close to 100 million. The number of Mexicans that have died of Swine flu to date?


Right, hardly a global crisis.

Actually, probably no more a global crisis than the usual risks associated with influenza itself.

Perhaps we should be thinking on the level of global consciousness as Bronwyn suggests and resist our characteristic Western preciousness and boost our immunity by getting down and dirty with some pigs, who we all know are the cleanest of animals. So less money on Tamiflu and more money on helping indigenous peoples fight basic diseases and subsequently right the global health imbalance.

Daniela Peers | 27 May 2009  

I enjoyed the article and think it raises some salient points. The question of where funding for the medicines that people need to survive on a daily basis is one we ought to consider. Swine may infect 20% of the Australian population as we were told today but it is unlikely to kill anywhere near as many as the regular flu we get every year. That's 2800 people in Australia annually.
There is absolutely no excuse to divert attention from other public health issues that are critical, both here and overseas. Someone commented that big pharma don't make huge profits out of vaccines is frankly ridiculous. There is an enormous amount of funding being currently thrown at the development of a swine flu vaccine. The mega-corps who are on the phat end of that money trail probably don't feel particularly poor. If you've been following any of the lobbying at an international level on where that funding goes you'd probably understand that.

The response to this emerging crisis requires a level-headed approach. We need to balance the likely emergence of a dangerous pandemic within the next few years with dealing with the real problems that exist today. Given the technological and scientific advances of the past 90 years, we really should be able to.

John K | 27 May 2009  

While some people use the term antibiotic in specific reference to chemicals that can be used against bacteria, it is also commonly used to refer to anti-infective agents more generally, as in Australia's own "Therapeutic Guidelines - Antibiotics" which detail treatment of many viral infections including influenza.

The original use of the word "antibiosis" dates back to at least 1889, when Vuillemin described it as "principe actif d'un organisme vivant qui détruit la vie des autres pour protéger sa propre vie" (active ingredient of one living organism which destroys the life of another to protect its own life). Although Vuillemin was referring to substances made by micro-organisms to kill other micro-organisms the original definition would seem to include the range of synthetic antibiotics now made by humans to kill other organisms, and at a stretch could also be seen to allude to the real subject of the article, that the investment in fighting one organism (flu) may come at the cost of the lives of the people who will die from another (TB, malaria...).

Nicolas | 28 May 2009  

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