Jan 24 Nabarro statement (UN)

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    http://www.forbes.com/entrepreneurs/feeds/ap/2006/01/24/ap24 73088.html
Associated Press 
U.N. Urges Fast Planning for Bird Flu 
By BRADLEY S. KLAPPER , 01.24.2006, 03:03 PM 

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Countries must speed up preparations to deal with an "inevitable" human influenza pandemic, which could strike soon, a senior U.N. official warned Tuesday. 

David Nabarro, the U.N. coordinator on avian and human influenza, said countries must work fast because the H5N1 strain of bird flu could mutate into a form that spreads easily between people much faster than some officials seem to believe. 

Experts fear that a mutation in the bird flu virus, which has ravaged poultry stocks across Asia since late 2003 and killed at least 82 people worldwide, could spark a pandemic killing millions of people. 

"I say to them please act as though it's going to start tomorrow. Don't keep putting off the difficult issues," Nabarro said on the sidelines of the World Health Organization's annual weeklong executive board meeting. 

"It may not be months, it could mean we are going to get human-to-human transmission tomorrow," he said. 

So far, the bird flu virus remains hard for people to catch, with most human cases traced to contact with infected birds. The U.N. health agency has confirmed 151 human cases in the last three years. 

But when asked if he believed a human flu pandemic was inevitable, Nabarro answered: "Yes." 

"We are standing on the edge of a really deep precipice, not knowing how far we are going to fall," he said. "That's why we are so focused on getting ready." 

Two meetings earlier this month, in Beijing and Tokyo, tackled the challenge of pandemic preparedness, raising millions of dollars to help predominantly poor countries in southeast Asia prepare for the worst. 

Much of the money went toward helping countries improve their surveillance, rapid response and containment mechanisms should a pandemic flu strain emerge within their borders. 

Much of the talk behind preparedness has centered on ensuring poor countries' access to treatments believed to be most effective in the case of a pandemic. 

Nabarro was asked specifically about Swiss pharmaceutical Roche Holding AG's drug Tamiflu, which experts believe would be the best defense in the initial phases of any global influenza pandemic. 

Roche owns the right to produce and supply Tamiflu, but it has come under increasing international pressure to ease its monopoly grip on the drug as governments have sought to increase their stockpiles. 

Nabarro said it was not necessary to talk of countries breaking Roche's patent, citing the 5 million treatment courses the Basel-based firm already has donated to the global body and Roche's willingness to sublicense production of the drug to other companies. 

"I am not certain that the patent issue is the fundamental constraint to (Tamiflu) production at this time," he said. "Talk of breaking patents is not at this stage necessary." 

Under World Trade Organization rules, countries can issue so-called "compulsory licenses" to disregard patent rights, but only after negotiating with the patent owners and paying them adequate compensation. If they declare a public health emergency, governments can skip the negotiating. 

Some countries say they would like to use compulsory licensing to build their stockpiles or to export Tamiflu and other potential pandemic treatments to nations that cannot afford them. 

But while the WTO rules are clear on what is allowed, they are dissuaded from doing so because breaking patents is still a sensitive political issue, especially in countries home to large pharmaceutical industries, according to the international aid agency Medecins Sans Frontieres, or Doctors Without Borders. 

"The U.N. should really point at these provisions and be much clearer about what rights countries have," Ellen 't Hoen, director of policy advocacy at MSF's campaign for essential medicines, told The Associated Press. "They should stop being ambiguous and encourage countries to use these provisions if necessary." 

She added that Nabarro's comments sounded "like a backtracking from what Kofi Annan has already said." 

In October, the U.N. secretary-general said the United Nations would not let intellectual property rights stand in the way of access to flu treatments and vaccines in case of a pandemic, calling on rich nations and pharmaceutical companies to help impoverished countries prepare themselves. 