H1N1 outbreak could spell major financial implications for Namibia

Keeping on top of the H1N1 flu virus – commonly known as swine flu, and ensuring that an outbreak is not experienced in Namibia, is not only a public health concern, but also a national finance issue.

So far, six of the eight test results for suspected cases of H1N1 have returned negative, with the other two currently being awaited. At a meeting of the National Health Emergency Management Committee (NHEMC) yesterday, it was reported that the two cases reported in Windhoek on Saturday and Monday both returned negative results, while the cases reported in Okahandja on Tuesday and in Tsumeb last week are expected today.And while the waiting continues as suspected cases continue to be reported, the NHEMC is doing everything it can to ensure that an outbreak is avoided, as the costs of handling it would be ‘exceptional’.At a meeting of the committee yesterday, NHEMC Chairperson, Dr Jack Vries, noted that if H1N1 is confirmed in the country and ‘we don’t contain the spread, we will become economically bankrupt.’ He pointed out that in Europe, given the high incidence of confirmed H1N1cases, suspected cases are no longer being tested, but simply treated as patients.This is part of Britain’s flu strategy, announced last week, where Health Secretary Andy Burnham said ‘GPs (general practitioners) will now provide clinical diagnosis of swine flu cases rather than awaiting laboratory test results and primary care trusts will now begin to establish anti-viral collection points where necessary,’ Burnham said. Britain has been seeing its flu infection rate roughly double each week, with Burnham projecting that ‘We could see over 100,000 cases per day by the end of August, though I stress this is only a projection.’ Currently, 8 000 cases have been confirmed there.As part of the new strategy, it has also been reported that ‘People who think they might now have the virus are being urged to call their doctor and describe their symptoms over the phone. The doctor or general practitioner can then issue a prescription voucher that a friend of the affected person can pick up.’Namibia currently holds a stock of 20 000 units of Tamiflu – the antiviral drug used for the treatment of H1N1, and these alone came at a cost of N$2,4 million. The current stock would only be able to treat one per cent of Namibia’s population in the case of an outbreak.Meanwhile, three cases of Tamiflu resistance by the H1N1 virus in laboratory testing have been reported in Japan, Denmark and Hong Kong, China.But because of the small and sporadic incidence of reporting on this matter, as well as studies that show that the flu is generally sensitive to Tamiflu and another drug used for H1N1 treatment – Relenza, the World Health Organisation (WHO), says it will continue to recommend the drugs for treatment of the flu.’At this time, there is no evidence to indicate the development of widespread antiviral resistance among pandemic H1N1 viruses. Based on this risk assessment, there are no changes in WHO’s clinical treatment guidance. Antiviral drugs remain a key component of the public health response when used as recommended,’ reports the WHO.In considering other economic implications, Vries also noted that even preventative measures of the flu would come at a high cost.’With the production of a vaccine, this would come at a cost of about US$10 (approximately N$80) per person, and if we looked at ordering the vaccine for just half the population, the cost comes to about N$ 80 million,’ Vries said.He said that for this reason, ‘we have to continue to monitor and make sure that people are reporting,’ noting the need to ensure that both public and private doctors are inundated with information on the H1N1 case definitions.In agreement with Dr Henriette Roux of the Namibia Institute of Pathology (NIP), Vries also pointed to the importance of early reporting on suspected cases of H1N1 to ensure that test results are not compromised by delayed reporting.Training exercises for health personnel are ongoing in the various regions, and the NHEMC’s information campaigns remains in full swing.Globally, as at Monday, WHO reported that 94 512 cases of the flu have been confirmed, with 429 deaths.nangula@namibian.com.na