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In preparation for a bird flu pandemic and in the absence of a vaccine, countries are racing to stockpile the flu drug oseltamivir, which Roche produces under the trade name Tamiflu.

In this article in The Lancet, Kenneth Tsang and colleagues suggest contingency plans.

First, governments should consider accumulating stocks of a similar drug called zanamivir, marketed by GlaxoSmithKline as Relenza. They say zanamivir is as effective as oseltamivir, has fewer side effects, and that the bird flu virus is less likely to become resistant to it.

Second, governments and health agencies should consider planning research trials that compare the two drugs. This would help decide which would be more effective in a pandemic.

Tsang and colleagues also question the merit of producing vaccines and drugs in developed countries — which could mean developing countries will not obtain them quickly enough — and the ethics of keeping drugs such as oseltamivir and zanamivir under patent.

Link to full article in The Lancet*

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