COLD SPRING HARBOR, NY — Health experts wrapped up a meeting here Tuesday to formulate recommendations for vaccine policy in the event of a pandemic flu outbreak. The group acknowledges that routine annual influenza epidemics would be overshadowed by the looming calamity posed by a pandemic influenza event.

International cooperation in expanding influenza disease surveillance sites and increased global vaccine manufacturing capacity are among the prescriptions recommended by the representatives of international health organizations, vaccine manufacturers, and health agencies of the U.S. and several foreign governments, who met for a Sabin Vaccine Institute colloquium titled “Pandemic Disease Threats: Can We Develop a Global Vaccine Policy?”

“Certainly the threat of pandemic influenza is one of the preoccupations of the scientific community and (the World Health Organization) at present,” said David L. Heymann, M.D., executive director, Communicable Diseases, World Health Organization (WHO). “Public health is all about windows of opportunity,” he said. “When these windows open, as is now the case for influenza, maximum efforts must be made to address the problem at hand and also increase resources in public health in general.”

A global flu outbreak—flu pandemic—strikes approximately three or four times in a century, when humans come into contact with a new strain of influenza virus for which they have little or no prior immunity. The pandemic flu of 1918 killed 40 million people, which constituted more deaths than all casualties of World War I. John M. Barry, author of The Great Influenza: The Epic Story of the Deadliest Plague in History, related anecdotes and statistics from his book on the 1918 pandemic at the opening of the colloquium. A global vaccine strategy with advanced planning and government and industry commitments is imperative to avoid a similar outcome from the next pandemic.

Fresh ideas generated at the meeting include broadening the base of vaccine production by including developing country manufacturers in the discussions—two developing country manufacturers of quality assured vaccine were present at the meeting. According to Heymann, they are now committed to explore the possibility of technology transfer between companies to increase influenza vaccine production and to promote discussions with other developing country manufacturers. “The pandemic influenza meeting could be a launch point for a new way of working on influenza vaccines internationally if particular recommendations are followed up,” Heymann said.

The 35 meeting participants represented the World Health Organization, Pan American Health Organization, UNICEF, U.S. Department of Health and Human Services, National Institutes of Health, Centers for Disease Control and Prevention, and international organizations from Brazil, Korea, Taiwan, Singapore, India, Canada, the United Kingdom, and the Netherlands. Representatives from several influenza vaccine manufacturers attended.

“This meeting can serve as a catalyst among participants from around the globe,” said organizer Dean Mason, president of the Sabin Vaccine Institute. “Though a number of countries and regional organizations have drafted plans to address pandemic influenza, there is still much coordination and planning to be done. This meeting identified some important gaps in the planning.” The number of people who would need to be vaccinated greatly exceeds the number of vaccine doses that can be manufactured today. The time it would take to make the vaccine available using existing technologies and planning for the use of anti-viral drugs are other areas where contingent planning is needed.

A further goal of pandemic disease preparedness beyond strengthening the global vaccine manufacturing enterprise would be new vaccine technologies to prevent other killer diseases. Each year approximately 15 million people in the world die of infectious diseases and most of these diseases— including AIDS, TB, malaria, childhood diarrheal diseases, and pneumonias— are the target for research to develop vaccines or improve coverage and effectiveness of existing products. According to WHO’s Heymann, “The meeting will have direct positive impact on WHO's activities in influenza pandemic planning and adds a new, important and credible participant to the worldwide influenza partnership.” It also adds to the international coalitions working to better assure that influenza vaccine will be made available to all countries.

The colloquium, held at the Banbury Conference Center, Cold Spring Harbor Laboratory, in New York, was co-chaired by Heymann, with Lewis A. Miller, principal of WentzMiller & Associates and Sabin trustee, and Albert Osterhaus, DVM, PhD, head of the virology at Erasmus Medical Center in Rotterdam, Netherlands. It was the 11th annual vaccine policy colloquium in an ongoing series sponsored by the Bill & Melinda Gates Foundation.