NHS must innovate to beat swine flu, says Lord Darzi

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• david hill | 28-Apr-2009 4:52 pm

  There is a great deal of misinformation in the West that we have an antiviral vaccine to combat the new Swine Flu killer virus. But in truth, there is no antiviral drug presently that will protect the global population against this deadly new virus if it spreads. That is fact not fiction and why the WHO and others are so concerned.
  
  The present state of preparedness for a pandemic caused by pigs, birds and other animals is wholly inadequate and if a pandemic happened today, hundreds of millions would undoubtedly perish.
  
  Pigs are one of the closest matches to humans. That is why we use their organs for human transplantation operations. Therefore the mutation from pig influenza to human influenza, is probably the most dangerous of all due to the nearness of match.
  
  The link between pig and human influenza has been known for a long time. Two important studies are Evolutionary pathways of N2 neuraminidases of swine and human influenza A Virus: origin of the neuraminidase genes of two reassortants (H1N2) isolate from pigs by Kuniaki Nerome et al, National Institute of Health, Japan – Journal of General Virology (1991), 72, 693-698 and Ito T, Couceiro JN, Kelm S, et al. Molecular basis for the generation in pigs of influenza A viruses with pandemic potential. J Virol 1998; 72:736773.
  
  The problem with the present strategy is that it is predominantly targeted and dependent upon at a drug cure which is a totally false strategy. There are two main reasons for this.
  
  1. Flu viruses are constantly remodelling themselves and where when a
  new strain occurs, like the present state in Mexico, it will take
  6 months to develop a drug to combat it. It has to be noted that
  the Spanish flu (swine flu) that killed between 20 million and 100 million
  nearly 100 years ago (there is no definitive statistic in this
  respect as in 1918 the analysis was rudimentary, but where modern
  pandemic statisticians estimate that it was somewhere between the
  two huge figures), did its worst in the first 26 weeks. Therefore
  an antidote would be a fool’s way of solving the problem.
  2. Distribution of any new antidote would be a problem of enormous
  proportions and all affected would be dead by the time it got to them.
  
  Therefore the present strategy is futile.
  But unfortunately now again, Tamiflu is in 99% of flu types, not resistant against the viruses.
  I cite only a few points of information that confirm this fact.
  
  (i) HONG KONG(Reuters) - A strain of the H5N1 avian influenza virus that may unleash the next global flu pandemic is showing resistance to Tamiflu, the antiviral drug that countries around the world are now stockpiling to fend off the looming threat. Experts in Hong Kong said on Friday [30 Sep 2005] that the human H5N1 strain which surfaced in northern Viet Nam this year had proved to be resistant to Tamiflu, a powerful antiviral drug. – Reuters, 30 September 2005
  
  (ii) U.S. health authorities (Center for Disease Control & Prevention) alerted doctors Friday that a prevalent strain of the flu is resistant to Roche Holding AG's Tamiflu antiviral drug – Wall Street Journal: Health (December 19,2008).
  
  (iii) Virtually all the dominant strain of flu in the United States this season is resistant to the leading antiviral drug Tamiflu…This season, 99 percent do… If a Tamiflu-resistant strain is suspected, the disease control agency suggests using a similar drug, Relenza. But Relenza is harder to take; it is a powder that must be inhaled and can cause lung spasms, and it is not recommended for children under 7…Relenza, made by GlaxoSmithKline, is known generically as zanamivir. Tamiflu, made by Roche, is known generically as oseltamivir… – The New York Times: Health (January 8, 2009).
  
  (iv) /Tamiflu found to be 99% ineffective against primary flu strain /– USA Today (January 8, 2009).
  
  (v) There is no provision for a vaccine for swine flu and it will take at least six months to identify, produce and manufacture a vaccine in large enough quantities. This was the statement by Dr Iain Stephenson, a consultant in Infectious Diseases at the University of Leicester who has just completed successful research on a pre-pandemic vaccine for bird flu. "We are in a position where if a swine flu virus becomes a pandemic we don't currently have a vaccine for it," he said. "I think that it is unlikely there will be widespread vaccine in less than six to eight months." – Daily Telegraph, 27 April 2009
  
  (vi) Dr Ian Barr, from the WHO Influenza Center in Melbourne, said it was unlikely any existing vaccines would be effective against the new swine flu strain. – China View, 27 April 2009
  
  There are only two modern-day drugs supposed to save human life from any pandemic. These are Relenza and Tamiflu as stated above. But both are ineffective (more-or-less totally ineffective in the case of Tamiflu) in certain areas when dealing with new strains. Unfortunately zanamivir (Relenza) is less active against influenza A/N2 neuraminidases (found in Pigs etc). For zanamivir is inhibitory for only certain influenza A neuraminidase variants but not A/N2 neuraminidases.
  There are also some nasty side-effects with Tamiflu –
  http://209.85.229.132/search?q=cache:uNFhMaU3GLEJ:www.topix.com/forum/drug/tamiflu/T5T8TK967U6DPFEL8+usa+today+tamilflu+april+2009&cd=8&hl=en&ct=clnk&gl=uk
  
  Both these drugs have to be taken within 48hrs of infection, but where the prerequisite is that the host body has to be strong against infections at the time of the start of the dosage for survival (common sense really). After 48 hours, both become increasingly useless according to medical scientists working at the coal-face around the world. Therefore the question is, how does anyone identify that they have flu quick enough and get a dose within 48 hours ? For fully identified symptoms can take several days to raise their ugly head. Indeed, medical advice is to stay at home if you think that you have flu and to not visit surgeries. This means any flu infected people will have to wait until the doctor or nurse visits with medication. In proportion though, there are few doctors and nurses compared to the population and therefore if a pandemic happened, few would receive medication in time.
  
  Therefore for all the above reasons an international and national strategy based upon a drugs solution is not the answer and where if we continue to pursue this as our primary strategy, there is no doubt that eventually more people will die than has ever been witnessed before in the history of humankind, and potentially over a billion people.
  
  Considering these true facts we have to look at the ‘source’ and therefore not fight the war on the grounds of trying to find a drug solution that will never happen in time. This is common sense and governments should not be pursuing such a basically useless strategy to nowhere.
  
  For this alternative strategy (the only one that will really work) we have to look at how animal flu jumps into humans.
  In this respect there are predominantly two main reasons how killer flu spreads like this.
  (a) In Asia, Mexico and the major rural areas of the world we are talking about cultures where a lot of roosters are used for cock fighting. It is very possible for those handling the roosters to get scratched and pecked with a little break in the skin which leads to bleeding. That's one way they get infected.
  
  (b) Another way is that it is very common for villagers in these developing countries to have roosters, chickens and pigs (their livestock) tied up or running around freely. A lot of houses are on stilts and the pigs and poultry are tied up under the house. During cold tropical evenings it is also common to see people sleeping in hammocks, or whatever they use as beds, outside amongst the pigs and the poultry. This is very common.
  
  Therefore the world’s resources should primarily be addressing good farm husbandry around the world and not a drug solution, but where it has to be said that the extremely powerful pharmaceutical company lobby group, do not want this. The reason, both Tamiflu and Relenza have realised for the multinational drug firms, billions upon billions of revenues. It is therefore about time that human life was placed above corporate profits and where in this case, it is fundamental to the survival of a large proportion of the human population.
  
  Dr David Hill
  World Innovation Foundation Charity
  Bern, Switzerland
  
  Ps. For anyone interested, one of the best websites for unbiased and independent information is
  http://209.85.229.132/search?q=cache:5r085nr4Hm0J:birdflubook.com/+bird+flu+by+dr+michael&cd=1&hl=en&ct=clnk&gl=uk

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• Anonymous | 29-Apr-2009 7:19 am

  Thank you, Dr Hill
  Someone speaking sense and giving intelligent information.
  Someone needs to inform Lord Darzi and then tell him that we are so fed up hearing him tell us to 'innovate'. What we need is much more simple than that - STAFF!

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