What Do Stakeholders Think About the GAP for Influenza Vaccines' First 10 Years?

Ten years ago in Geneva, the World Health Organization (WHO) unveiled what is now called the Global Action Plan for Influenza Vaccines (GAP), a comprehensive approach to meeting the demand for vaccines should there be a pandemic anywhere in the world. The plan was a direct response to the 2005 avian flu pandemic in Asia, which spread from birds to humans and killed dozens of people. WHO consulted with a variety of international experts and came up with a program designed to boost production of the influenza vaccine, increase seasonal vaccine usage, and develop new vaccines that will offer long-lasting protection against more strains of the flu.

The first objective of the plan involved pushing for an increase in seasonal vaccine usage. By encouraging as many people as possible to get vaccinated in advance of the flu’s “high season,” WHO aimed to lower the overall disease incidence, encourage manufacturers to speed up and improve their vaccine-development processes, and help countries better prepare for a possible pandemic. The second objective was to create enough vaccines for two billion people worldwide, and to have these vaccines produced within six months of a prototype strain being delivered to manufacturers. Ultimately, WHO wants enough vaccine to protect 70% of the world with as few as two doses, with a focus on increasing vaccine capacity in regions where the vaccine has not been readily available. The final objective is to facilitate the development of more potent, broad-spectrum vaccines that cover a variety of flu strains, deliver immunity with a single dose, and are safe for all members of the population including infants, the elderly, pregnant women, and immunocompromised individuals. Fourteen countries have received grants to produce the seasonal vaccine instead of depending on a handful of other countries for a supply that may or may not arrive, and five of these countries already have created licensed vaccines. The rest are near completion.

So, how do public and private stakeholders such as vaccine manufacturers, medical doctors, regulatory agencies, administrators of national vaccine programs, and public-health officials feel about how the GAP has performed in its first decade? WHO received 77 responses to a recent survey, coming from 28 different countries in all six of the regions WHO represents. Overall, respondents applauded what they saw as improvement in the availability of seasonal vaccines and an increase in their use. Indeed, WHO reports that availability of the seasonal flu vaccine was less than 500 million doses per year 10 years ago; as of 2010, the number was at nearly 1 billion.

The stakeholders reported that they perceived less progress in the area of research and development. Although there is not yet the potent, broad-spectrum vaccine toward which WHO and its partners are working, WHO has helped facilitate the process by offering reviews of needed technology and intellectual-property rights in certain countries, holding productive consultations with researchers and vaccine makers, and creating a regularly-updated online database offering information on clinical trials for potential vaccines. The respondents noted that obstacles to the creation of these vaccines include onerous regulatory and licensing processes, lack of financing, and an incomplete understanding of the scientific processes that trigger a protective mechanism against influenza.

WHO survey’s limitations include the fact that it was written in English and offered online only. The number of respondents also was small, with a particular dearth of answers from lower-income countries such as those in Africa and Southeast Asia.

Laurie Saloman, MS, is a health writer with more than 20 years of experience working for both consumer and physician-focused publications. She is a graduate of Brandeis University and the Medill School of Journalism at Northwestern University. She lives in New Jersey with her family.