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Twelve Asian countries agreed today (11 August) to build a regional stockpile of drugs to fight a possible flu pandemic.

At a meeting in Bangkok, Thailand, representatives of Bhutan, Brunei, Cambodia, China, Japan, Laos, Malaysia, Myanmar, South Korea, Thailand and the Philippines met with the World Health Organization (WHO) to discuss plans to enable drugs to be rushed to the site of a human outbreak of contagious bird flu within 24 hours of it being detected.

The bird flu virus (H5N1) is contagious in birds, but although it kills most people who become infected, there is no evidence that it can be passed from person to person.

Experts fear, however, that H5N1 will become contagious among people, triggering a global pandemic that could kill millions (see Time to prepare for bird flu pandemic 'running out').

In the latest developments, outbreaks of the rapidly spreading virus were confirmed for the first time this week in Mongolia and Kazakhstan. Since being identified in Russia in mid-July the virus has killed more than 8,000 domestic and wild birds there.

Russia and Kazakhstan are the first countries outside East and South-East Asia to confirm the presence of the Asian H5N1 virus in poultry.

Research published last week in Nature and Science suggested that a pandemic could be avoided, as long as local health authorities were to react quickly to an outbreak and provide suitable drugs to prevent it spreading (see Bird flu pandemic 'could be avoided if —').

Creating a regional stockpile so that drugs can reach an outbreak faster is "exactly what we would recommend," Ira Longini, lead author of the paper in Science, told SciDev.Net.

One such drug is Tamiflu, produced by Swiss pharmaceutical company Roche. It helps reduce flu symptoms, as well as the risk that an infected person might pass the virus on to others.

The WHO has stockpiled enough of the drug to treat 120,000 people, and is negotiating with Roche to obtain more.

There have been reports that Roche is considering donating a "substantial amount" of the drug to the WHO.

But competition for the limited amount of Tamiflu that Roche can produce could become a problem, as developed countries are also placing orders with the company to build their own stockpiles.

Developing countries have begun demanding that Roche allow other drug manufacturers to produce 'generic' versions of Tamiflu, which would also be considerably cheaper than the Roche's brand-name equivalent.

"We are all very much aware of the potential of this pandemic and yet the reality is we only have one drug company that manufactures this antiviral drug," said Philippine health secretary Francisco Duque earlier today.

"It is incumbent on us to exert pressure to open this up for more manufacturers to increase production," he added.

Part of the solution could be to stockpile a similar drug in addition to Tamiflu.

In this week's The Lancet, Kenneth Tsang of the University of Hong Kong, says zanamivir, a drug sold under the trade name Relenza, is as effective as Tamiflu and has fewer side-effects.

He suggests that governments should consider accumulating both drugs as part of their emergency plans.


Longini disagrees. He says that according to his team's research, zanamivir is as effective as Tamiflu at suppressing flu symptoms but 65 per cent less effective at preventing transmission of the virus from one person to another.

The Bangkok meeting did not establish details of the Asian stockpile, such as where it will be housed. These details will be decided in discussions between the participating countries and the WHO.

If the emergency plan were successful, "it would be the first time in the history of mankind that a pandemic has been stamped out before it happened," William Aldis, the WHO representative in Thailand, told reporters.

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