Solidarity v. subsidiarity: tools for handling global pandemics

11 January 2010

John Ryan, Head of Unit, Health threats, Directorate-General Health and Consumers  (DG SANCO) European Commission, said the H1N1 virus is quite widespread, reaching “medium intensity” in most EU countries, but only 6.5 % of the EU population has been vaccinated.

The EU has measures in place to counter the virus, such as an EU network for epidemiological surveillance and control of communicable diseases, and is helping coordinate Member States’ efforts. 

At the start of the pandemic in May 2009, a Vaccine Task force was created to work on vaccine development and strategy, and the Commission gave rapid EU-wide market authorisation for H1N1 vaccines. The EU has identified priority groups for vaccination, but Member States remain responsible for vaccination, and it is an individual choice. As it is unclear how the pandemic will evolve, continued vigilance is important.

David Mercer, Head of Unit “Communicable Diseases and Response” at the World Health Organisation (WHO) Regional Office for Europe, said just nine weeks after reports of a flu-like illness in Mexico (the H1N1) the WHO declared a ‘Pandemic Phase Six’.

Treating pandemics and using vaccines raises a number of ethical considerations, such as who has priority to medication or hospital beds and countries’ obligations to each other. The WHO uses criteria such as global equity and epidemiology to decide on eligibility for vaccines.

The lessons from this pandemic are: the need to invest in pandemic planning, stockpile anti-viral medications and clarify public health measures; the difficulty of containing the virus, and for countries to shift from containment to mitigation; how even a moderate pandemic can overwhelm healthcare delivery systems; how the diversity of protocols complicates monitoring; and the need for clear, straightforward public information and to streamline mechanisms for equal access to vaccines and medicines.