[Influenza vaccine: globalization of public health stakes]

On June 11, 2009, Dr. Margaret Chan, Director-General of the World Health Organization (WHO), declared the first influenza pandemic of the 21st century. It was the first time in history that an influenza outbreak had been tracked in real-time from the emergence of a new strain of influenza A (H1N1) up to its spread to all continents over a period of 9 weeks. In recent years the international community has been working closely to prepare for such situations. A notable example of this cooperation occurred in response to the threat posed by the highly pathogenic avian influenza A virus (H5N1). Vaccine availability is a major challenge that will require increasing worldwide production and ensuring a widespread access. In this regard it is important to underline the fact that 70% of influenza vaccine is produced in Europe and the United States. In 2006 WHO implemented a global pandemic influenza action plan (GAP) aiming at increasing the world’s production capacity for pandemic vaccine. The GAP contains three elements: (1) increased use of seasonal influenza vaccination in industrialized and developing countries (resolution WHA 56.19). (2) technology transfer. (3) development of new production technologies. Nevertheless numerous barriers still prevent people living in developing countries from rapid and fair access to pandemic influenza vaccine. Capacity for production of pandemic vaccine is limited and advanced purchase agreements between industrialized countries and vaccine manufacturers reduce potential access of developing countries to pandemic vaccine. Economic and logistic factors also limit global access to pandemic vaccine. Therefore, WHO is working with industrialized countries, pharmaceutical companies and the international community as a whole to promote global solidarity and cooperation and thus ensure distribution of pandemic vaccine in poor countries with no local production. The current pandemic situation highlights the increasing globalization of public health stakes with regard to influenza vaccination. The purpose of this presentation is to review the various challenges for production and distribution of vaccines and underline the progress that has been accomplished since 2005.