Priority Medicines for Europe and the World 2013 Update. Background Paper 6 - Priority Diseases and Reasons for Inclusion. BP 6.02 - Pandemic Influenza
(2013; 70 pages)


The threat of an influenza pandemic and its potential impact on health, social and economic conditions has long been recognized by the WHO and EU. The 2004 pandemic influenza background paper from the Priority Medicines Report highlighted several priority research areas including: low vaccine uptake and production capacity; expensive antiviral agents; and the need for increased EU funding towards influenza virus, vaccine and antiviral agents research. These research areas were identified as critical in the ability of Europe to respond to the next influenza pandemic.

In April 2009, a new influenza A (H1N1) virus emerged in Mexico and the United States The virus quickly spread worldwide and was officially declared a global epidemic, the first one of the 21st century.

Although the 2009 H1N1 influenza virus was only moderately severe, it revealed the many areas surrounding the prevention and mitigation of influenza that require continued focus and research. The pathogenic and transmissibility mechanisms of the influenza virus are not yet fully understood. Improvements in the current methodologies of assessing the health and economic burdens are needed. Global and country surveillance systems need modification to more accurately estimate morbidity and mortality. Moreover, barriers to immunization should be identified and addressed. Despite increased global vaccine production capacity between 2006 and 2009, the number of available pandemic vaccine was insufficient during the 2009 influenza pandemic. However, increasing vaccine production capacity is not enough as universal access to these vaccines must also be assured during a pandemic. Vaccine effectiveness studies should be conducted in order to determine recommendations for vaccine use by specific age and risk groups. Strengthening global and country vaccine coverage monitoring systems will provide further insight into vaccine provision and the impact of immunization policies.

Current influenza control strategies include vaccination and the use of antiviral agents. The development of safe and effective vaccines with cross-strain and long-lasting protection against influenza will be imperative to reducing influenza-related morbidity and mortality. Antiviral therapy remains unchanged since 2004. Given the likelihood that influenza virus strains will confer resistance to monotherapy, novel antiviral agents will need to have broad spectrum activity and improved pharmacological profiles. During the 2009 H1N1 pandemic, rapid influenza diagnostic tests (RIDTs) had not been developed to specifically detect influenza A (H1N1). Numerous RIDTs have since been developed however comprehensive studies should be conducted on their diagnostic accuracy and cost-effectiveness.

Over the past 10 years, the EU has established a wide range of influenza-related surveillance networks, consortiums and research projects. These efforts are critical as pandemic preparedness is a monumental task that requires diligence, commitment and cooperation at the national and international levels in order to ensure adequate capacity in responding to the next influenza pandemic.

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