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BMJ. Oct 7, 2000; 321(7265): 852.
PMCID: PMC1118673

Flu experts warn of need for pandemic plans

Many countries have no plans in place to deal with a future influenza pandemic, warned specialists at an international meeting last week.

Dr Daniel Lavanchy, coordinator of epidemic disease control at the World Health Organization in Geneva, reported: “Many developed countries, including the United Kingdom, France, Belgium, and Switzerland, have a plan in place. Others, such as the Netherlands, Germany, China, and Japan, are currently making preparations. However, some developed, and many developing, countries have yet to take action.” He added: “There is scope for harmonisation with the WHO plan among some of the developed countries.”

He was speaking to influenza specialists from around the world at the international conference, “Options for the Control of Influenza,” held last week in Crete.

The WHO pandemic planning document, published in April 1999, outlined the need for adequate planning by countries to deal with an influenza pandemic. It noted the separate but complementary roles of WHO and national authorities when an influenza pandemic seems possible or actually occurs.

The document strongly recommends that all countries establish multidisciplinary national pandemic planning committees, responsible for developing strategies appropriate for their countries in advance of the next pandemic.

Other key issues include the need for consideration of how to target limited vaccine supplies, and other means of slowing the spread of a pandemic influenza virus among unvaccinated populations.

Dr Lavanchy said that many countries seemed to consider planning for an influenza pandemic unnecessary. But he pointed out: “Another flu pandemic is highly likely. We don't know if this will be tomorrow or in 50 years, but it is important that countries are prepared if it happens.”

WHO coordinates data collection on influenza at four major centres throughout the world, and there is a network of 110 national influenza centres located in 82 countries. This system would allow WHO to monitor a pandemic threat that may emerge through an antigenic shift in the influenza A virus.

Previous pandemics occurred during the last century in 1918, 1957, 1968, and, to a lesser extent, in 1977. During the 1918 pandemic, at least 30 million people died worldwide.

An influenza pandemic would have particular impact in developing countries, where influenza vaccine, antiviral drugs, and health professionals are in short supply. But Dr Lavanchy said that these countries should construct a pandemic plan around available resources, with particular attention on collecting information about the spread of the disease and distributing advice to people who are affected.

Dr Stephen Schoenbaum of the Commonwealth Fund in New York warned: “New data from the 1918 pandemic showed the appalling impact in areas such as sub-Saharan Africa and India.” Of the estimated 30 million deaths, 17 million occurred in India, where there was a death rate of 30 per 100000 population, compared with 5 per 100000 in Europe and North America.

The WHO influenza pandemic plan can be found at who.int/emc (search under influenza).

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