The risk of a new flu virus spreading from animals to humans and causing a pandemic is constant and real. The question is not whether there will be a new flu pandemic, but when it will occur. We must maintain vigilance and prepare ourselves, because the cost of a great epidemic will be much higher than that of prevention ”. This is how restrictive Tedros Adhanom Ghebreyesus, director general of the WHO, was when last March he presented the global strategy against Influenza 2019-2030, the most ambitious initiative devised to date to try to prevent and combat this disease.
His words are more than justified, since the flu constitutes one of the greatest threats to global public health: each year there are about a billion cases, of which between 290,000 and 650,000 are fatal. In fact, it was the cause of the 1918 pandemic, one of the greatest health crises in history. WHO’s strategies are focused precisely on avoiding a scenario like that.
Spanish flu
It is estimated that between 1918 and 1920 some 500 million people suffered from the so-called Spanish flu – different studies indicate that, in reality, it could have originated in the United States, France or China. Between 50 million and 100 million of them died, almost 5% of the world’s population. In just two years, it caused more victims than those attributed to the HIV virus, which has caused AIDS since the 1970s – some 39 million deaths. Since then, there have been three other flu pandemics, in 1957, 1968 and 2009, but none of the magnitude of 1918.
WHO experts recognize that these types of outbreaks are unpredictable. For example, in 2003 the reappearance in Asia of the A (H5N1) strain of the avian influenza virus showed that this disease could be transmitted from animals to humans. However, on that occasion it did not declare a pandemic, as the virus did not retain the permanent ability to spread from one person to another.
In 2009, the one that caused the H1N1 strain of swine flu, which started in Mexico, quickly spread around the world. It is estimated that between 105,000 and 395,000 affected died. Although some seasonal flu epidemics can cause even more deaths, this case convinced health authorities that we were ill-prepared to respond effectively to these types of cases.
In 2011, the 194 WHO Member States created the Pandemic Influenza Preparedness Framework – also known as the PIP Framework – to strengthen the exchange of potentially pandemic influenza viruses through a network of laboratories , allowing for detailed study , and promote access to vaccines, especially in developing countries, to face potential threats. WHO selects vaccine strains twice a year; one for the flu season in the Northern Hemisphere and one for the Southern Hemisphere.
A planetary plan against the flu
The latest strategy from the World Health Organization (WHO) is the most comprehensive and far-reaching that has been developed to date to contain this virus. To do this, the intention is not only to strengthen the existing prevention mechanisms, but also to establish guidelines that allow each country’s response to a pandemic to be improved.
In essence, the WHO approach has two objectives. The first is to improve surveillance and response systems, as well as prevention, treatment, and the means to prepare for future crises. To achieve this, each country must develop a specific program tailored to its needs that also contributes to global health security.
The second is to design better instruments to prevent, detect, control and treat influenza, from vaccines to antivirals , and ensure that all countries have access to them. As WHO Director-General Tedros Adhanom Ghebreyesus points out, thanks to the partnerships and actions taken in recent years, we have never before been so prepared to face the next pandemic. However, it is still not enough. “The PiP Framework – the tool that brings together administrations, industry and WHO for a global response – needs to continue to function effectively to facilitate access to vaccines and treatments and help countries prepare for the disease. pandemic flu through contributions from manufacturers ”
Expert opinion
Raúl Ortiz de Lejarazu is head of the Microbiology and Immunology Service at the Hospital Clínico de Valladolid.
“The truth is that we are not sufficiently prepared to face a flu pandemic, since we must bear in mind that the organization to contain a phenomenon of this type has to be global; not only in rich countries, but also in those with more limited resources. The Achilles heel in this situation is the availability of vaccines: producing countries are always the first to access them, while developing countries are usually the last.
In addition, it is not possible to know which strain of flu is going to circulate, so in the event of a pandemic, the vaccine will take between four and five months to manufacture. In the first moments, we can only have antiviral drugs. For this reason, while the vaccine is being manufactured, it is necessary to adopt containment measures, such as diagnosing people, treating them and isolating them. Three of these crises usually occur in each century. In this one there has already been one, but, according to the WHO, it is possible that another will take place before 2030 ”.
By: Sandra Pulido
