Waking up at last to the Swine Flu threat

On February 17, a circular signed by the Drug Controller General of India was issued to seven companies that make the vaccine for the 'H1N1 influenza', medical jargon for what we all know as Swine Flu. The companies - Serum Institute, Panacea Biotec, Bharat Biotech, Novartis Healthcare, GlaxoSmithkline, Sanofi and Abbott - were asked to ensure adequate supplies of the vaccine.

Simultaneously, the ministry of health and family welfare has been issuing advertisements in national dailies listing out the "do's and don'ts" to prevent the spread of the disease. Private sector companies have got into the act and have started issuing advisories to their employees on why body contact should be avoided while greeting people.

India then seems to be finally waking up to the threat from swine flu. It seems hard to believe that a little over a month ago, even as the disease was spreading across India, some of the swine flu vaccine makers in the country were actually forced to destroy some of their stocks because of poor offtake. The vaccines have a short shelf life and had to be crushed.

Indeed, the government now seems to be making an all-out effort to contain the epidemic. India has seen the worst swine flu outbreak in five years with over 13,000 cases reported in recent months. The epidemic has already claimed nearly 800 lives. But why have the authorities taken so long to wake up? "It is odd that we either have a famine or a flood approach to things. Either we are so slow that we just seem to ignore it or we are so obsessed with it that we go for an overkill to the point that we begin to view every flu as H1N1," says an official with one of the vaccine manufacturers.

Some doctors naively expected vaccines to be available at "short notice", he adds. It normally takes close to three months to manufacture a vaccine and most doctors should be aware of this. With the flu season drawing to a close in some parts of the country, the stocks may not be required, adds an official with another vaccine manufacturer.

The bigger worry is the lack of a coherent policy framework to ensure adequate stock of vaccines, available at affordable prices, as seen in other countries such as the US and Europe.

For the moment, the perceived state of alertness by the government is good news. On February 17 again, the government issued a notice, which says: "In view of the current situation of spreading of swine flu in the country, the Central Drugs Standard Control Organization (the central drug authority) is continuously engaged in monitoring the availability of drugs, vaccine and diagnostic kits used for the control of swine flu. All State Drugs Controllers have been requested to take necessary measures to ensure that the drugs, vaccine and diagnostics kits of standard quality are available particularly in the affected states."

The next day, a list of all the hospitals and retail outlets where the vaccine is available was also put up on the website of the ministry of health and family welfare. Clearly, these measures were required and it is worth noting that the government is finally acting. But should these steps have been taken after the disease had spread rapidly, claiming several lives?