Broad stockpiling advised for pandemic

NEW YORK, Nov. 18 (UPI) -- Health experts warned this week that a potential avian-flu pandemic could have far-reaching trade implications for medical services and supplies unrelated to flu.

Speaking at an avian-flu conference held by the Council on Foreign Relations in New York, Michael Osterholm, director of the Center for Infectious Disease Research and Policy, said the United States is dependent on overseas sources for many medical products, medicines and tools of administration like syringes.

"Vaccine's not going to save us right now. Drugs are not going to save us right now. We need a whole new level of preparedness right now," Osterholm told the conference.

Even U.S.-produced items often rely on overseas imports at an early stage in the supply chain, and the shutting of borders for trade in the event of a pandemic could have catastrophic implications on the nation's welfare, and not just on the economy as has been widely predicted, Osterholm said.

If cases of human-to-human transmission were established in Southeast Asia before the end of this year, suspending trade in the region, it would have severe consequences for U.S. preparedness against a flu pandemic, and great repercussions for those Americans reliant on medicines manufactured in that part of Asia, he said.

Writing in the journal Foreign Affairs, Osterholm warned, "Foreign trade and travel would be reduced or even ended in an attempt to stop the virus from entering new countries. ... The world relies on the speedy distribution of products such as food and replacement parts for equipment. Global, regional and national economies would come to an abrupt halt -- something that has never happened due to HIV, malaria, or TB.

"The pandemic-related collapse of worldwide trade and its ripple effect throughout industrialized and developing countries would represent the first real test of the resiliency of the modern global delivery system," he wrote.

"Given the extent to which modern commerce relies on the precise and readily available international trade of goods and services, a shutdown of the global economic system would dramatically harm the world's ability to meet the surging demand for essential commodities such as food and medicine during a crisis. The business community can no longer afford to play a minor role in planning the response to a pandemic," Osterholm warned.

In the face of that grim scenario, he told the conference that stockpiling should extend far beyond hoarding drugs that treat flu.

"For the world to have critical goods and services during a pandemic, industry heads must stockpile raw materials for production and preplan distribution and transportation support. Every company's senior managers must be ready to respond rapidly to changes in the availability, production, distribution and inventory management of their products," Osterholm advised.

However, he added, the impact of a flu pandemic on global trade and transport will not only be felt by the business community.

"The private and public sectors would have to develop emergency plans to sustain critical domestic supply chains and manufacturing and agricultural production and distribution," Osterholm said.

"There would be major shortages in all countries of a wide range of commodities, including ... medicines, including vaccines unrelated to the pandemic. ... Aside from medication, many countries would not have the ability to meet the surge in demand for health-care supplies and services that are normally taken for granted," he said.

"Virtually every piece of medical equipment or protective gear would be in short supply within days of the recognition of a pandemic. Throughout the crisis, many of these necessities would simply be unavailable for most health-care institutions."

Osterholm's dire warnings about U.S. dependence on international trade -- including medical supplies -- also appeared in a recent issue of Nature magazine.

"Today, we have virtually no surge capacity for any consumer product or medical service that might be needed during the 12 to 36 months of a pandemic."

These are sobering thoughts indeed. And in the face of a media storm surrounding the production of a H5N1 vaccine and global shortages of Tamiflu, it behooves us all to take a longer-term approach, aware of the duration of a pandemic, and ensure that governments and local health-care authorities are aware of the need to stockpile non-influenza related medicines, and to ensure the continuation of global supply chains in the face of a crisis that could last years.