national stockpiles

[gsgs]

let's add and update here all the national (or states-) stockpiles
of antivirals and vaccines which we can find.

the data below could be old, feel free to add updates


PVrepandemic vaccine
T:Tamiflu
R:Relenza
MV:mock up vaccine (to be completed with actual strain)
VT : vaccine treaty
N : N95 masks
V:ventilators

 

[gsgs]

Re: national stockpiles

Russia : Tamiflu for 95% of population
Switzerland : prepandemic vaccine ("PV") for 101% of population (Glaxo, 1 dose , Vietnam/1203)
Singapore : prepandemic vaccine for 96% of population (Glaxo, 1 dose , Vietnam/1203) , T:25%
Denmark : prepandemic vaccine
USA : prepandemic vaccine for 2.2% of population (Sanofi, 2 doses , Vietnam/1203) {target is 6.7%}
USA : Tamiflu for 25% of population (target end 2007)
USA : Relenza for 5% of population (target end 2007)

Germany,Tamiflu:~10% (target=20%)
{Brandenburg:7%,Bremen:7%,Sachsen:8.7%,Schleswig-Holstein:6.3%, Hessen:8%(30%),Baden-Wuerttemberg:7.6%,Rheinland-Pfalz:12.3%, Saarland:10%,Bayern:8.1%(20%),Niedersachsen:7%,Thueringen:10%,Berlin:7.2%(20%), Sachsen-Anhalt:5.6%,Mecklenburg-Vorpommern:6%,Hamburg:6.8%,NRW:6%(30%)}
Netherlands,Tamiflu:30%
France,Tamiflu:25%, (target:35%) , N:400%,
Austria,Tamiflu:40% , VT-MV 100%
UK: 3.3% PV from Baxter, T:25%
Ireland: 50% PV from Baxter

 

[hawkeye]

Re: national stockpiles

gsgs-
are these desired (non-secured) stockpiles?

 

[gsgs]

Re: national stockpiles

I try to give actual stockpiles directly and targets in brackets.
targets are often end of 2007.
Some numbers could be from last year or even from end 2005.
Maybe we can find a page which has all the numbers...
but additions for single countries are also good for now

 

[hawkeye]

Re: national stockpiles

great. thnx gsgs.

 

[gsgs]

Re: national stockpiles

we also have the maplecroft avian influenza risk country- table:
http://www.flutrackers.com/forum/showthread.php?t=18449

"incapaity to contain risk" contributes with 28.6% :
http://maps.maplecroft.com/showtext?issue=55&topic=interpreting_the_map

but apprantly they don't consider stockpiles of antivirals at all.
"Immunization capacity" contributes with 6.1%, that could be
capacity of vaccine plants or vaccine stockpiles or
panflu vaccine delivery treaties.


still looking for a list with all countries and their Tamiflu and
H5N1-vaccine stockpiles (or/and pandemic-producing capacities)
or/and panflu-budgets...

 

[gsgs]

Re: national stockpiles

Florida1 found a document about European stockpiles :
http://www.flutrackers.com/forum/showthread.php?t=22857

I haven't yet a list with the actual amounts of Tamiflu....

(hopefully to be posted here later)


here is a 48-pages .pdf from Apr.2006 about European panflu preparedness:
http://www.lshtm.ac.uk/ecohost/projects/pandemic/HowpreparedisEurope.pdf

they have graphics about "completeness" of several things, including antiviral
stockpiles, but not how much the have.

I'm starting to wonder whether this is somehow secret - not really secret,
since it is there , but they make it (deliberately ?) hard to find


April 2006:
The true position for Europe regarding antiviral coverage remains opaque and is constantly changing. In addition, calculations regarding percentage coverage achieved through antivi-ral stockpiles may be somewhat misleading as most such calculations are based upon treatment of infected individuals whilst many plans include, in addition, prophylaxis for essential services workers and specified high risk groups.At the time of writing this report, most countries have obtained supplies ofoseltamivir, although a number have also started to purchase zanamivir.
...
Four European countries have now entered into tenders for a limited quantity of H5N1 vaccines. These are the UK (3.5 million), France (2 million), Italy (estimated 0.5 million), and Switzerland (100,000).24Additionally, one country (Spain) notes an intention to stockpile pandemic vaccine in phase three of the pandemic.

 

[gsgs]

Re: national stockpiles

France : Feb.1.2007,30%T,3%R ,450%N95,1520%SM
Cech Republic : 25%T(May 2007) , 1000%VP


T:Tamiflu
R:Relenza
N95:N95 masks or FFP2
SM:surgical masks
PVrepandemic vaccine
VP:yearly vaccine production capacity
(% in standard doses per total population)


please report the numbers from your country/state/company/community !

 

[gsgs]

Re: national stockpiles

USA:17%SM,33%N95

 

[gsgs]

Re: national stockpiles

USA has ordered additional 22.5Million doses of prepandemic vaccine from Glaxo
Finland has ordered 20.8m euros worth of vaccine from Solvay

 

[tropical]

Re: national stockpiles

Probably, the vast majority of nations have only an "order queue in factory" of prepandemic flu vaccines and antivirals, maybe for only 25pc of citizens, and small quantity realy stocked.

 

[Sally Furniss]

Re: national stockpiles

Probably, the vast majority of nations have only an "order queue in factory" of prepandemic flu vaccines and antivirals, maybe for only 25pc of citizens, and small quantity realy stocked.

Tropical, What are you basing your guesses on?

 

[tropical]

Re: national stockpiles

Tropical, What are you basing your guesses on?

Well, like I said "probably", because we don't know classified info.
The guess are based on some newspaper info 2005/06 when was a bird flu scare in CEurope. All antiviral orders was put in queue, the nations who first order first got the medicines, but not in all quantities.

Individualy - we cannot order nor vaccines not new antivirals, the states must aproved, and imported it first.
For generic production, the patent question is already actual for many nations.
The production capacity also depends on money.
Many orders was pending, and was delivered 1 year after (cause queue priority) from the factory.

For the pre/pandemic vaccines nobody knows if it will work, and for this reason, probably the mayority wait with payments. The result is that this orders remains in queue. For the remaining that are realy stocked, have anybody a real proof doc that it exist for more than 25% of population?

From earlyer WHO statements was suggested that will be enaugh to have stocked it for 1/4% of population.
Because that is not 100% quantity, it must going to first responders, health, gov., etc.

Is that changed now?
Is it released some guideline that every nation must stockpile antivirals and pre/pandemic vaccines for 100% of population?
Have some national medical establishment release an public statement where is writed that this stuff is stockpilled for 100%?
Are the GP and nurses received an official letter or an preparation how to vaccinate with this kind of vaccines?

It's enaugh to look what happen with regular seasonal flu shots.

Are this year stock higher than for 25% of population per nation?
The fact is that already, for seasonal flu shots, we must wait 2-3 months longer for receiving it from the producer (after 4 months of production), no mention what will happen with an pre/pandemic vaccine if the pandemic starts.

Finaly, some dec. 2006. news excerpts on this:

dec. 2006.
"Switzerland has ordered(only) enough vaccine from GlaxoSmithKline for one inoculation of each of its eight million citizens if a pandemic erupts. The U.S. government has ordered 2.7 million doses from three makers, which would be enough to vaccinate first responders so they could take care of those who did become ill. Eventually the country plans to stockpile 20 million doses and then presumably will increase that as well, but since the vaccines aren't yet available, even that amount is still academic."

Flu Wiki:01 October 2006
anonymous ? at 09:42
link//
> ordinary flu shots might help protect people from H5N1
> Regular flu vaccine contains the same ?N? ingredient as the deadly H5N1

so probably H1N1 vaccine not H3N2
I wonder, why they don?t produce more prepandemic vaccine. What does it cost ? Switzerland ordered 8 million doses for its population. There is some likelyhood that it will help against panflu, even if the protection is maybe only partial.
anon_22 ? at 10:05
That?s a good question. There are however many problems, the biggest one being there isn?t one vaccine with known efficacy and ?acceptable? risk. Even a rare adverse reaction may translate into many thousands of lives lost or affected when given to a large population. It is one thing to offer a vaccine against an existing risk, quite another against a ?hypothetical? one. Governments are not willing to put their money down for a product that might not work against a pandemic that might not happen, especially a product with a short shelf life. Companies are not willing to sink their millions into developing such products unless they see water-tight commitment from governments. Considerations regarding prepandemic and pandemic vaccines are also discussed on this thread
anon_22 ? at 10:07
This is a post from that previous discussion:
pre-pandemic vs pandemic vaccine:
Because of current limited production capacity and the possible need for 2 or 3 dosese, it would be extremely difficult to have enough vaccine (even if all technological and regulatory hurdles are out of the way) and enough people vaccinated in time to affect the outcome of a pandemic. Therefore, consideration is being given to a pre-pandemic vaccine, ie a vaccine to be produced and stockpiled now and given prior to (or as soon as a pandemic starts). It would not provide enough immunity for the above reasons but one would hope that partial immunity may reduce total impact, plus it could be used to ?prime? the population so that only 1 dose would be necessary with the actual pandemic strain.
This notion carries its own difficulties. The biggest one is safety. Because you are vaccinating people against a pandemic that has not happened yet, ie a hypothetical risk rather than actual risk, and because you are aiming at a large proportion of the population if not all, and the target is most likely to be young working age people, the most valuable members of society, the safety bar has to be set much higher than normal vaccines.
The next problem is cost or specifically who is going to pay for it? Unless there is definite financial commitment in the form of orders or contracts from governments, vaccine companies are not likely to sink millions or billions of dollars and make large quantities. But even if governments pay for them now, and the product is successfully made, they have a limited shelf-life as with vaccines in general. If a pandemic does not happen and the stockpiles of pre-pandemic vaccines have expired, the money could be wasted. (This is a simplified description, the commercial issues are a lot more complex when you add in companies who want to vaccinate their staff to protect their business.)
Re-examining the efficacy issue: the (relative) efficacy of a pre-pandemic vaccine is determined by how close it is to the ultimate pandemic strain. Make the vaccine too late, we won?t have enough. Make it too soon, the virus might have mutated significantly so that the vaccine is no longer useful.
anonymous ? at 10:32
safety is no issue, since the vaccine would only be stockpiled and only be given, when paflu breaks out. Now, I?d like to know, how much it would cost and how much worth our lifes are for the government resp. how likely they think a pandemic is. Similar question with Tamiflu stockpiles - just a question of money. Compare that money with the amount which we are spending for prepping ! anon_22 ? at 11:21
anonymous ? at 10:32 safety is no issue
Easy for you to say!
If you stockpile something which will only be used when panflu breaks out, then the expiration issue becomes extremely important. Start stockpiling now, the stuff may expire before there is a pandemic. Plus, when a pandemic is unfolding, you would have run out of time to vaccinate.
There are no easy answers.
Also, tamiflu stockpile is not ?just a question of money?. Again this has been discussed numerous times, there is a very limited global production capacity, from one company and now some licensees. It was boosted from 190 million doses a year to 400 million this year. Given that there are 6 billion people on this planet, how long does it take to make enough? At the moment, Roche says it will have fulfilled all back-orders by end of this year, I think. And that?s for orders placed before this year, eg the UK will receive its final batch ordered in 2005 at the end of this year. It is over-simplistic (also irresponsible from somone who want serious debate IMHO) to think of everything as ?just a question of money?. Even if it was, it?s never ?just? money, cos any money spent on your pet choice will mean money taken out of something else probably equally worthwhile for someone else. How that is decided and who decides will always be issues of contention.
What we need is rigorous co-operative thinking, not simplistic statements like ?safety is no issue? or ?its just a question of money?.
INFOMASS ? at 12:00
anon_22, thank you for your insightful comments on vaccine issues. How close are we to being able to start cell culture vaccines? The egg method takes a long time and does not work well with H5N1. Could safety be tested for a class or family of vaccines, so that final tweaking could be done but additional testing for safety would be minimal? Or does each specific vaccine need extensive safety testing? I imagine that a properly conservative establishment (and they may not be proper!) would/should be slow to experiment on millions of people?
anonymous ? at 12:06
but why is it secret, how much it costs ? They never say this. Also with peramivir. crfullmoon ? at 12:26
INFOMASS, see in MustAPanFluDecreaseInLethality Melanie ? at 18:14 Use egg-based vaccine cultivation, it will take a year following the emergence of the pandemic strain before sufficient vaccine to be available to confer even a modicum of herd immunity. Cell culture technology is 8?10 years down the road. anon_22 ? at 13:19
The only non-egg based vaccine that is close to ready is the HA recombinant protein vaccine by Protein Sciences. It?s seasonal flu version has passed Phase 3 trials and is fast-tracked for license, probably early 2007. It is IMHO the best option available at the moment, especially for the US. The only problem is that this is a relatively small and new company, and may not have enough lobby voices to make the case, as opposed to the more established manufacturers. This vaccine is discussed in greater detail here
...
INFOMASS ? at 21:18
anon_22: Thank you for the links to those threads. It sounds like the FDA would take some time to approve a new vaccine, but perhaps the Flublok (?) would be able to substitute different hemaglutin types w/o repeating complete safety testing? Or is that a misreading of that approach or the FDA policy? Sorry to be so naive. I do understand the EU policy is different for seasonal and pandemic vaccines and they might be able to approve a pandemic vaccine sooner.
Closed - Bronco Bill ? 03 December 2006, 20:29
Closed to maintain Forum speed.

 

[gsgs]

Re: national stockpiles

Baxter in Bohumil and Novartis in Marburg are already producing cell-based vaccine. Novartis' factory in USA is supposed to start production in 3 years
or such.

 

[tropical]

Re: national stockpiles

About the stockpiles...
Part of posts from Flu Wiki Forum, Aug. 20, 2007:
http://www.newfluwiki2.com/showDiary.do?diaryId=1566
Australia Flu Season - 2007
_______________________________________________

The Queensland State Government has released a stockpile of the antiviral drug, Tamiflu, to aged care homes and pharmacies.


A Tamiflu stockpile released - Queensland
Flu epidemic hits Australia
Posted at 8:10am on 20 Aug 2007
Health authorities in Australia are warning people not to panic as a flu epidemic, which has claimed nine lives, sweeps the country.
Six of the victims are children under five years old.
The Queensland State Government has released a stockpile of the antiviral drug, Tamiflu, to aged care homes and pharmacies.
Dr Ian Barr, from the World Health Organisation's centre on influenza in Melbourne, told Morning Report on Monday that the epidemic is made up of two strains of influenza A. http://www.radionz.c...


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<I>by: Okieman @ Mon Aug 20, 2007 at 12:36:09 PM CDT
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wonder what that means
releasing a stockpile of tamiflu? Cos the pharmacies have run out of them?

You gotta work the numbers.</I>

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by: SusanC @ Mon Aug 20, 2007 at 13:05:50 PM CDT
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Yeah, I was wondering the same thing.
A curious statement. If the pharmacies have ran out, they can't get anymore, so have to release the stockpile. This sounds far more serious than what I believe they are reporting. That's alot of tamiflu to dry up pharmacies, and not be able to get anymore. Hmmmm.

I believe in what I'm doing. The rest is just distraction.-DemFromCt "But H5N1 has not hit the lotto yet. Problem is, it's still playing"- Into The Woods

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by: cottontop @ Mon Aug 20, 2007 at 14:55:18 PM CDT
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Queensland Premier released stockpile,
while Federal Health Minister refused to do so.
http://www.abc.net.a...
http://www.news.com....
Last week, desperate moms were driving around Queensland to hunt for Tamiflu after getting prescription.


"Is this an unshakable fact?" - Harold Geneen, on Managing

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by: anon.yyz @ Mon Aug 20, 2007 at 15:12:35 PM CDT
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Sound like a problem
with "supply and demand." Does this show that Tamiflu is not readily stocked in pharmacies? Or that they have a low stock kept there? Can't pharmacies "draw" from other pharmacies in Austraila?

I believe in what I'm doing. The rest is just distraction.-DemFromCt "But H5N1 has not hit the lotto yet. Problem is, it's still playing"- Into The Woods

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by: cottontop @ Mon Aug 20, 2007 at 15:21:07 PM CDT
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And what is the deal with
the makers of Tamiflu? Are these drug companies not able to make any more, is there a problem?
Also, does someone have a list of the townships affected by this flu epidemic? If so, could you please list them?

I believe in what I'm doing. The rest is just distraction.-DemFromCt "But H5N1 has not hit the lotto yet. Problem is, it's still playing"- Into The Woods

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by: cottontop @ Mon Aug 20, 2007 at 15:24:43 PM CDT
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Roche/Tamiflu
Roche, the maker of Tamiflu, announced several months ago that they were going to cut back on production due to lack of confirmed orders.
If that wasn't handwriting on the wall, I don't know what would be.

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by: Clawdia @ Mon Aug 20, 2007 at 15:27:59 PM CDT
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I can't help but think
that we're in the process of looking at that part of the iceberg that sticks up out of the water. I keep thinking that things in Australia are much worse than we are being told, although if you read everything available, it certainly appears serious even on the surface.
Knowing the kinds of things that some of us do, it is looking a little more than downright alarming at the moment.
At least it is to these tired old eyes!

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by: Clawdia @ Mon Aug 20, 2007 at 15:26:55 PM CDT
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Yes, Clawdia, I agree too.
and the release of the Tamiflu stockpile speaks volumes.
That stuff is flying off the shelves!

I believe in what I'm doing. The rest is just distraction.-DemFromCt "But H5N1 has not hit the lotto yet. Problem is, it's still playing"- Into The Woods

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by: cottontop @ Mon Aug 20, 2007 at 15:31:55 PM CDT
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So, I wonder when they
bought their "Tamiflu sockpile?" And how long they've had it? And how much it is?

I believe in what I'm doing. The rest is just distraction.-DemFromCt "But H5N1 has not hit the lotto yet. Problem is, it's still playing"- Into The Woods

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Blood supplies impacted
This article is concerning a city in Queensland Territory, Australia.
Flu attacks blood stocks
LIZ McKINNON
21Aug07
[snip]
"I've never seen a flu season like this before. The situation is so widespread, it has just stopped people coming in," Mr Muller said.
Every day the service watches as the number of appointments fall - it now records a 20 per cent cancellation rate daily.
[snip]
"The winter flu season is really impacting on us. It has been happening for the past couple of months."
Twin cities workplaces have been ravaged by the winter blues with some reporting a 25 per cent loss in staff because of sickness.
Mr Muller said even the blood bank had not missed a week where one or two staff members were off sick.
"We see this as being a direct result of the flu. You only have to look at the television footage of the Ekka seeing the empty aisles to see the effect it is having on the State," he said.
"We are in a real situation at the moment. We know at this point in time that we can assure the public we are still able to supply blood and blood products.
[snip] http://www.townsvill...


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by: Okieman @ Mon Aug 20, 2007 at 15:40:35 PM CDT
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</I>

 

[gsgs]

Re: national stockpiles

update

------------------------------------------------------------------------

T:Tamiflu
R:Relenza
N95:N95 masks or FFP2
V:ventilators
SM:surgical masks
PVrepandemic vaccine
MV:mock up vaccine
VP:yearly vaccine production capacity
(% in standard doses per total population)
targets in (brackets)

April 2007:
Russia : Tamiflu for 95% of population
Switzerland : prepandemic vaccine ("PV") for 101% of population (Glaxo, 1 dose , Vietnam/1203)
Singapore : prepandemic vaccine for 96% of population (Glaxo, 1 dose , Vietnam/1203) , T:25%
Denmark : prepandemic vaccine
USA : prepandemic vaccine for 2.2% of population (Sanofi, 2 doses , Vietnam/1203) {target is 6.7%}
USA : Tamiflu for 25% of population (target end 2007)
USA : Relenza for 5% of population (target end 2007)
Germany,Tamiflu:~10% (target=20%)
{Brandenburg:7%,Bremen:7%,Sachsen:8.7%,Schleswig-Holstein:6.3%, Hessen:8%(30%),
Baden-Wuerttemberg:7.6%,Rheinland-Pfalz:12.3%, Saarland:10%,Bayern:8.1%(20%),
Niedersachsen:7%,Thu eringen:10%,Berlin:7.2%(20%), Sachsen-Anhalt:5.6%,
Mecklenburg-Vorpommern:6%,Hamburg:6.8%,NRW:6%(30%)}
Netherlands,Tamiflu:30%
France,Tamiflu:25%, (target:35%) , N:400%,
Austria,Tamiflu:40% , VT-MV 100%
UK: 3.3% PV from Baxter, T:25%
Ireland: 50% PV from Baxter

maplecroft avian influenza risk country- table:
http://www.flutrackers.com/forum/showthread.php?t=18449
"incapaity to contain risk" contributes with 28.6% :
http://maps.maplecroft.com/showtext?...reting_the_map
but apprantly they don't consider stockpiles of antivirals at all.
"Immunization capacity" contributes with 6.1%, that could be
capacity of vaccine plants or vaccine stockpiles or
panflu vaccine delivery treaties.

here a document about European stockpiles :
http://www.flutrackers.com/forum/showthread.php?t=22857

Apr.2006:
here is a 48-pages .pdf from Apr.2006 about European panflu preparedness:
http://www.lshtm.ac.uk/ecohost/proje...edisEurope.pdf
Four European countries have now entered into tenders for a limited quantity of H5N1 vaccines.
These are the UK (3.5 million), France (2 million), Italy (estimated 0.5 million), and Switzerland (100,000).
Additionally, one country (Spain) notes an intention to stockpile pandemic vaccine in phase three of the pandemic.

Febr.2007:
France : Feb.1.2007,30%T,3%R ,450%N95,1520%SM

May 2007:
Czech Republic : 25%T, 1000%VP

May 2008:
USA:17%SM,33%N95

August 2008:
USA has ordered additional 22.5Million doses of prepandemic vaccine from Glaxo
Finland has ordered 20.8m euros worth of vaccine from Solvay

Sept.2008:
Australia has $220M worth of Tamiflu

Sept.2008:
Germany,antivirals
Brandenburg, Schleswig-Holstein, Bremen, Berlin, Hamburg,
Mecklenburg-Vorpommern und Niedersachsen ~11%
Baden-W?rttemberg ~14%
Nordrhein-Westfalen ~30%
rest ~20%

 

[tropical]

Re: national stockpiles

update

-----------------------------------------------------------------------
Sept.2008:
Australia has $220M worth of Tamiflu
___

"Flu Wiki", September 11, 2007 12:00am:
From: "Herald Sun", Australia

Australia: $219m stockpile at risk - experts
http://www.news.com.au/heraldsun/sto...37-662,00.html

THE Commonwealth is not properly managing its stockpile of anti-viral drugs, a damning new government audit has found.
The Australian National Audit Office has examined federal preparations for an influenza pandemic and found faults with both the management of the medical stockpile and arrangements to distribute the drugs in an emergency.
The Federal Government owns $219.7 million worth of anti-viral drugs and medical equipment for use during a health emergency.

But the audit office's report released today found the health department had bought the drugs in a hurry in response to international events including the September 11, 2001 terror attacks in the US, SARS and the Asian avian influenza outbreak, and had not made plans to look after such a large stockpile.

The department was only checking invoices to make sure drugs were delivered, instead of physically making sure the stock had arrived.

Irregular stocktakes, the first of which was not held until June 2006, would not show whether any shortages were due to the drugs being stolen or just not delivered.
And although the department was monitoring the quantity of drugs in its stockpile, it did not have a plan to make sure they were being properly managed, including "reporting on goods that are due to expire".

Contracts with storage managers, meanwhile, did not specify storage requirements, such as pest control, cleaning and security arrangements.

"When procuring items for the stockpile, (the health department) did not adequately assess the ongoing resource requirements to procure and manage the stockpile," the report said.

"(The department) did not develop a comprehensive implementation strategy for the establishment and ongoing management of the stockpile.

"The stockpile continues to increase in size, and as components are ageing, decisions will be needed in relation to future strategies for the stockpile."

State and territory governments would distribute the drugs in an emergency, but most had not updated their deployment plans since writing draft forms in 2004 and 2005.

The health department had not reviewed the plans, or followed up with the states.

The report also found taxpayers may have paid too much for the drugs and their storage, because the health department had not followed its normal purchasing procedures.

The prices charged for storage did not necessarily equate with the quality of storage being provided, and the health department was found to be paying almost $100,000 too much to keep 100 pallets with one poor-value supplier.

The health department has agreed to the audit office's recommendations, including its call for a management plan.

- AAP
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