World Health

Eh, who's counting anyway? Not the WHO any more (h/t Passport). But before your flabbergasted reaction -- the World Health Organization is not tracking the number of cases of a disease it has called a pandemic?!? -- consider that this is actually a sensible step.

On the one hand, unfortunately, it's only practical to stop counting; new cases are popping up all over, and, with different countries' reporting standards, keeping track would essentially be a fool's errand. On the other, the number of cases is a much less significant fact than HOW the virus is spreading, and how it is being treated. These, of course, the WHO continues to track rigorously.

There are many cases of swine flu; we know this, and we'll still have a good enough estimate of the number as it grows. But counting the global caseload can lead to a feverish panic over an ever-increasing number. I'd much rather the WHO focus on how to decrease this number.

I have no doubt that the H1N1 virus is still very dangerous. I am also confident that the World Health Organization is continuing to take extreme precautions to ensure that the pandemic does not reach catastrophic levels. But this Reuters article seems designed expressly to conjure up baselessly apocalyptic fears:

Saying the new H1N1 virus is "unstoppable", the World Health Organization gave drug makers a full go-ahead to manufacture vaccines against the pandemic influenza strain on Monday and said healthcare workers should be the first to get one.

Every country will need to vaccinate citizens against the swine flu virus and must choose who else would get priority after nurses, doctors and technicians, said Dr. Marie-Paule Kieny, WHO director of the Initiative for Vaccine Research.

The "unstoppable" comment was made in reference to the spread of the virus, not, oddly enough, its inevitable decimation of humankind. That H1N1 already isn't contained in one place should be obvious to just about anyone who's read the (equally frantic) reports of swine flu popping up in dozens of countries, or who can conceive of how keeping tiny little viruses from spreading all over an interconnected globe might be a trifle difficult.

As for vaccines, Reuters' depiction suggests a terrifying movie scene: government bureaucrats choosing who lives and dies while millions die for lack of the precious vaccine. These vaccines are necessary, yes, particularly for certain vulnerable populations, but they are not the only method of preventing contagion. The WHO describes the current severity of the pandemic as "moderate," with "most patients experiencing uncomplicated, self-limited illness." Instructing countries to implement vaccination strategies depending on local conditions is not leaving patients at the whims of capricious bureaucrats; rather, it reflects a smart realization on WHO's part that every country's epidemiological situation is different, and that each will have to incorporate vaccine and non-vaccine related strategies differently.

But an "unstoppable" virus with not enough vaccines makes for a better movie headline, I suppose.

(image from Center for Disease Control and Prevention, via Wikimedia Commons)

UNAIDS and the Kaiser Family Foundation just issued a new report on global funding for HIV. This is an annual exercise, where they try to analyze bilateral assistance on HIV to low and middle-income countries. In 2008, HIV funding reached its highest level ever. Some highlights from the report:

*UNAIDS estimates that $22.1 billion was needed to address the epidemic in low- and middle- income countries in 2008.  Of this, $15.6 billion was available from all sources.

*Disbursements have risen significantly over the past several years: Between 2002 and 2008, disbursements increased by more than six-fold, including a 56 percent increase in the last period.

*In 2008, disbursements fell short of commitments by about a billion dollars. This doesn’t necessarily represent donor failure – sometimes disbursements just take time.

*The US accounted for 51.3% of all disbursed funds.

This is a useful report, and helps to bring accountability to a field with no single tracking body. It is not, however, without its flaws. According to its methodology notes, it doesn’t include funding to Central Asia or the former Soviet Union in general. It also doesn’t count UN agency funding for HIV if that funding comes from the general UN budget and not a donor earmark for HIV.

That is, swine flu the H1N1 virus doesn't look like it's mixing with its avian counterpart to form some sort of volatile, death-defying H1N1+H5N1 (H5N2?) super-pandemic.

The World Health Organisation said on Thursday that the H1N1 virus was stable and there was no sign yet of it mixing with other influenza viruses.

Some health officials have raised concerns that if H1N1, known by many as swine flu, combined with the much deadlier H5N1 bird flu virus then the pandemic could claim many more lives.

"The virus is still very stable," WHO Director-General Dr Margaret Chan told reporters at a news briefing in Moscow when asked if there were any signs of the virus mixing with other strains such as avian flu.

A stable pandemic is still a pandemic, sure, but it befits the calm way with which the virus should be treated to make note of this relative stability.

(image from flickr user ittybittiesforyou under a Creative Commons license)