As the deadly disease, avian flu is reported for the first time in India, doubts are being expressed in the medical circles whether the Central Government is fully equipped to handle the crisis. It is reported that Central Government is stockpiling only Tamiflu (osteltamivir), one of the two drugs available worldwide, to tackle the crisis. In the eventuality of a serious outbreak of the disease like what has happened in Vietnam with many deaths due to resistance to Tamiflu, India will be in an unfortunate situation if it depends solely on one drug, according to medical experts.
Tamiflu, made by Swiss company Roche, is the favoured drug because it appears to be effective against all kinds of flu, including bird flu. GlaxoSmithKline's Relenza requires an inhaler and has not been widely tested in people with avian flu, it is learnt.
Fresh doubts are being reported about the efficacy of Tamiflu as a treatment for bird flu when New England Journal of Medicine published new reports of resistance to the drug and deaths in patients in Vietnam. The doctors from one hospital for tropical diseases in Ho Chi Minh City, Vietnam recorded in the New England Journal of Medicine that four out of eight patients suffering from the H5N1 flu strain and treated with Tamiflu had died, including two who developed resistance.
In October last year, doctors discovered in a 14-year-old Vietnamese girl who had been given low doses as a precaution because she was caring for a brother with bird flu. She survived, and doctors theorized the low doses caused the resistance. The reports increase suggested levels of resistance to nearly 10 per cent, or three out of the 31 known human cases of H5N1 treated with Tamiflu.
The study raises new questions about the drug, which more than 50 governments have ordered in significant quantities in recent months to stockpile as a potential prophylactic and treatment in the case of flu pandemic.
However, GSK India officials refused to respond Pharmabiz query asking whether the company would ask the government to make alternative to sort out if such a crisis comes. GSK spokesperson said, as it is the matter of internationally relevant, "We can't speak without discussing our head office."
Meanwhile, all the Indian pharma majors and health ministries are taking measures to tackle the situation as bird flu is reported in Maharashtra where 40,000 chickens were found to be dead. However, the Indian Institute of Virology, Pune claims the chickens were dead by Ranikhet (Newcastle disease) not because of avian flu.
The joint secretary of Maharashtra health ministry is reported to have said that the government has stockpiled 50,000 doses of Tamiflu and 20,000 doses would be delivered next week. The ministry has dispatched 9000 doses of Tamiflu and 2000 sets of personal protective equipment to Maharashtra.
The pharmaceutical companies like Hetero Drugs, Cipla and Ranbaxy are gearing up for supply of osteltamivir drugs in the country. The Mumbai-based Cipla has launched Antiflu and it is heard that the drug will be available in chemist shops next week onwards. Antiflu will cost Rs 1000 per strip of 10 tablets. Two tablets are to be taken each day in a five-day course. Roche India, the subsidiary of Roche supplied 1.5 million strips of Tamiflu to Central Government in January. Earlier, Roche had given license to the Hyderabad-based Hetero Drugs to manufacture and market Tamflu in India. Hetero's drug is priced at Rs 725 per 10 capsules. Other pharma major, Ranbaxy is also said to be preparing to launch osteltamivir in India soon.
Since 2003, avian flu has killed about 70 people, mostly in Vietnam and Thailand, and nearly all involved close contact with infected birds.