Canadians will have a better chance of getting vaccinated against the pandemic influenza than people in many other countries, including the United States and Britain, thanks to nearly a decade of planning for the disease's arrival.
"We're actually in a fairly unique position of having domestic capacity, of having planned for that in Canada now for many years," David Butler-Jones, Canada's chief public health officer, said in an interview with The Globe and Mail Thursday.
In 2001, the federal government began a 10-year agreement with a drug company that was eventually sold to GlaxoSmithKline. That contract obligates the giant pharmaceutical manufacturer to provide vaccine to every Canadian who wants it in the event of a pandemic.
Canada was the first country in the world to sign such an agreement, and, in exchange, it has given the company money to expand the capacity of its plant at Ste-Foy, Que.
"Three or four years ago, we could fill about eight million doses a month," said Dr. Butler-Jones. "Now it's up closer to 14 million. So, within a couple of months, we have enough vaccine essentially for everybody living in Canada to get at least one dose, which would probably be sufficient for most of us."
More important, because the vaccine will be produced in Canada, Canadians will not have to fight other countries to guarantee their supply.
The U.S. and Britain are on much less solid ground, because they do not produce enough vaccine to meet their own needs. The U.S., for instance, has the ability to make just 20 per cent of its domestic requirements, and relies on European countries for the rest. And all of Britain's vaccines are made abroad.
If a pandemic hit, it is possible that countries with vaccine production facilities would insist that their own citizens get inoculated before any vaccine exits their borders. International contract law does not supersede any government's ability to stop goods from being exported.
Michael Osterholm, director of the Centre for Infectious Diseases Research and Policy at the University of Minnesota, said that American fears of being left without a reliable supply of vaccine are very real.
"If there is widespread disease and it's serious in nature, we could very clearly see a situation [in]countries in Europe where the vaccine's manufacturer would not release it until all of their citizens are covered first," Dr. Osterholm said.
U.S. President Barack Obama designated $1.825-billion (U.S.) on Thursday for emergency use to fight the new pandemic of H1N1 swine flu. The money be used to buy vaccine ingredients to help health officials plan for immunization campaigns and to help get the vaccines approved.
Ottawa devoted $1-billion in the federal budget of 2006 toward pandemic planning and emergency preparedness. Dr. Butler-Jones said that measure and the vaccine deal will leave the Ste Foy facility with enough excess supply to send to other countries, including the United States, at the same time it is shipping the medicine to Canadians.
But no amount of money will ensure that a vaccine will be available to Canadians - or to anyone else in the world, if science does not co-operate. The World Health Organization said earlier this month that companies were having more trouble than expected growing the virus on eggs, a key part of the vaccine-making process.
GlaxoSmithKline said in response to questions that the first doses are expected to be available in three to four months, subject to regulatory approval.
Even if a vaccine is ready by mid-fall, it will still be necessary to decide who goes first.
"We will be working through the guidelines," said Dr. Butler-Jones. The priority groups will likely include remote communities, people with underlying chronic disease, health care workers and essential workers, he said.
Meanwhile, health officials are still assessing the potential course of the H1N1 virus which could come back in a mutated and more deadly form in the fall, the traditional flu season.
Britain's Chief Medical Officer, Sir Liam Donaldson, said yesterday that as many as 65,000 people in his country could die if the pandemic achieves it worst possible potential.
Dr. Butler-Jones is unwilling to offer those kinds of predictions.
"I guess I am less worried about the numbers because it risks giving you a false impression, good or bad," he said.
Pandemics can be far more deadly that ordinary influenzas.
"We see an average of 4,000 deaths a year. If you multiply that by three or four and you've got a lot of deaths," said Dr. Butler-Jones. "But we're not going to see that because we're going to do everything we can to prevent it."
With a report by Erin Anderssen in Ottawa