Antiviral stockpiles and value systems.

Antiviral stockpiles, against the influenza virus tell a lot about the value systems of a society. This silent action - to stock or not to stock - speaks eloquently of what is important to a government: saving money, or saving lives.

Around the world, different governments have made different decisions on this saving money, saving lives spectrum. You see the problem that some governments see, regarding stockpiles, is that it could all be money down the drain. A large stockpile of antiviral drugs may never be used because, after all, it will only have a shelf life of a few years - perhaps five or so. It will, therefore, have to be replaced if maintained. Thus, some governments are cautious as to how much money they tie up in such stockpiles. Again, what we are seeing is how much they value the lives of their citizens, versus the money on hand.

America has a stockpile of 50,000,000 courses of appropriate antivirals according to Bloomberg. That is enough for one in six of the population. Britain, on the other hand, is showing greater caution and clearly placing greater value on the lives of its citizens, by stockpiling 33 million doses (source: The Guardian newspaper). That is enough for 55% of the population: a three fold preparedness advantage over the USA.

However, the USA is not doing too badly. Canada has only 1,400,000 courses of antivirals on hand (Bloomberg), for its population of 33.6 million people. That is only enough for one in twenty-four, or just over 4.1% of the population. To my eyes, that seems rather unprepared since swine flu could easily infect a large fraction of a population, if it behaves like the flu pandemics of the past. Norway, also has 1,400,000 courses of antivirals on hand. However, they have a population of just 4.8 million - and so have enough to treat 29.1% of their population. There is some confusion as to just how much antivirals Singapore has on hand. At the beginning of the week, the Singaporean media mentioned 500,000 courses of Tamiflu, for a population of 4.8 million, allowing the treatment of 10% of the population. Today, the newly stated number for courses available is 1.15 million courses of Tamiflu and Relenza (50,000 courses). Should these newly issued figures turn out to be true (the sudden change could indicate new purchases of anti-virals, and I hope this is so, or could indicate PR spin) then Singapore now has enough antivirals for 25% of the population. This is much less than for the UK...but rather better than that of Costa Rica, whom Nacion.com says has just 3,000 courses of antivirals for a population of almost 4.6 million. This is enough to treat just one person in 1,533. (These figures for stockpiles are checkable on Wikipedia, too).

Clearly, there is no international agreement about how much a nation should plan ahead, against a flu pandemic. There is such a great range of preparedness that it is quite clear no two nations quite see the situation in the same way. Yet, the truth is, all face the same potential outcome: large scale sudden deaths in their populations, from a flu pandemic. It has happened many times before, in human history and it will happen many times, again, until there are no humans left to suffer from it. All we can do is prepare.

I am puzzled, however, that so many developed nations are so relatively undefended. The antivirals cost about one hundred dollars per person, per course. This is not a great sum for a developed nation. To my mind, it seems an easy decision to make to have enough antivirals on hand to treat the entire population. The upside is the minimization of death in the population in the face of a pandemic, the downside is the loss (if unused) of about 20 dollars per year, per person, to protect the nation. (Since the drugs will probably have to be replaced every five years or so). This assumes that only one type of antiviral is stocked. It would be wise to stock more than one type to guard against resistance. In any case, the cost of stockpiles is minimal, compared to the cost in life that would be paid, in the event of not having enough drugs on hand.

What surprises me, therefore, is how much many nations seem to value money, over human life - for so many of them are relatively unprepared for what humanity could soon face. I use the word humanity deliberately, for pandemics put all of humanity at risk, in the sense that anyone could die, of a flu pandemic.

My hope is that this particular "pandemic" turns out to be much more moderate than feared - and that all nations learn from it, to be better prepared for the next one to come. Perhaps the stockpiling of antiviral drugs should not just be a national responsibility, but should be taken up at the international level at the United Nations. It would seem to me to be sensible for the United Nations to ensure that ALL nations have good stocks of antivirals on hand - even the poorest nations. The rich nations could, in effect, buy antivirals for the poor nations. This should be done, at least to some extent, to moderate any pandemic. It would be the humane thing to do - and not only that, but moderating the pandemic anywhere in the world, will help reduce its spread everywhere in the world, for we are all interconnected.

I would like to see a shift, in national priorities, away from saving money, towards saving lives. Too many nations, seem to have chosen to guess what kind of need they might have, and so have stocked, like Singapore, an "adequate" amount. They don't seem to see that the only adequate amount is full coverage of the population. Anything less is not only short-sighted (for a pandemic could truly be one that infects almost everyone), but also immoral. It is not moral to have to force doctors to choose how they ration the medicine available; it is not moral to have doctors choose who will live and who will die. That is not a choice for humans to make. All lives are valuable, all lives should receive, therefore, the best of care, humanity presently has available...and that includes anti-viral drugs.

(If you would like to learn more of Ainan Celeste Cawley, a scientific child prodigy, aged eight years and seven months, or his gifted brothers, Fintan, five years exactly, and Tiarnan, twenty-eight months, please go to:http://scientific-child-prodigy.blogspot.com/2006/10/scientific-child-prodigy-guide.html I also write of gifted education, IQ, intelligence, the Irish, the Malays, Singapore, College, University, Chemistry, Science, genetics, left-handedness, precocity, child prodigy, child genius, baby genius, adult genius, savant, wunderkind, wonderkind, genio, гений ребенок prodigy, genie, μεγαλοφυία θαύμα παιδιών, bambino, kind.

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