The World Health Organization Closes the GAP on Influenza Initiative

According to World Health Organization (WHO) statistics, influenza infects 5% to 10% of adults and 20% to 30% of children worldwide. Oftentimes, these illnesses result in hospitalizations. “These annual epidemics are estimated to result in about 3 to 5 million cases of severe illness, and about 250,000 to 500,000 deaths.” The financial burden of influenza epidemics on the US economy is estimated to be between $71 to $167 billion per year.

In order to reduce a worldwide shortage of influenza vaccinations for seasonal epidemics and pandemic influenza, WHO launched the Global Action Plan (GAP) for influenza vaccines. Their approach was three-fold and included plans to: increase seasonal vaccine use, increase vaccine production capacity, and support research and development of more effective vaccines.

Recently, WHO published a paper outlining their decade-long initiative to increase access to and regulate production of the influenza vaccine. The authors wrote, “Since its inception in 2006, significant progress has been made towards all the main objectives of GAP.”

The authors of the report emphasize that WHO is not a regulatory agency for vaccines or any other types of medication. Instead, the organization works to bring together international stakeholders. These efforts play a critical role in progressing the initiative on an international scale, providing strategic assistance and technical support essential to preparing for seasonal, zoonotic, and pandemic influenza threats.

Through the GAP, researchers found that in order to address the evolving nature of influenza and its rapid spread, immunization should be carried out yearly, through seasonal campaigns. In response, the GAP established a periodic licensing process where, “two sets of influenza vaccine are manufactured in each 12-month period, [and are] distinguished as northern and southern hemisphere vaccines.”

The Technology Transfer Initiative, launched in 2007, has made important contributions to increasing the capacity of influenza vaccine production, specifically in low and middle income countries such as, Brazil, Egypt, India, and Mexico, among others. As of May 2016, 10 of the 14 National Regulatory Authorities met indicators for functionality for vaccine prequalification, a significant increase from the initial four in 2006.

The report also examined actions taken following the H1N1 pandemic in 2009. In order to provide fair and equal access to vaccinations, WHO coordinated ways to provide some of the most vulnerable nations with pandemic vaccines. According to the report, “More than 78 million doses of pandemic vaccine were distributed to 77 eligible countries, together with appropriate ancillary devices, such as syringes and safety boxes. While this unprecedented volume of distribution is impressive and had a great global impact, it should be noted that there were in fact signed agreements with donors for more than 122 million doses.”

Through the GAP, authorities concluded that regulatory factors were not the only obstacles limiting access. Poor communication, inadequate transport facilities, and complicated donor logistics contributed to a lack of preparedness, which limited the impact of the initiative.

While originally launched as a ten-year initiative, more permanent regulatory systems have been deemed necessary. The World Health Assembly has requested that “WHO continue to support Member States…in the area of regulatory system strengthening.” WHO Director-General, Margaret Chan, MD, MPH, is expected to report back to the assembly with progress made moving forward.