Antivirals

National Stockpile:

Using a baseline scenario from a study advocated by the WHO of a clinical attack rate of 25%, occurring during a single wave, the CDC estimates that stockpiles that cover 20-25% of the population would be sufficient to treat most of the clinical cases and could lead to 50% to 77% reductions in hospitalizations.
Ref: http://www.cdc.gov/ncidod/EID/vol11no09/04-1344.htm

In line with this, the Ministry of Health currently (Dec 2005) has a national stockpile of Oseltamivir sufficient to treat 21% of the population. This currently does not include paediatric formulation, and discussions are ongoing re paediatric formulation. This is a national resource and final prioritisation decisions will be made by Government at the time of a pandemic, will be dependent upon the epidemiology and be released by direction of the national coordinator.

Under current planning, it is expected that this stockpile will be used for:

KEEP IT OUT: border control - treatment and post exposure prophylaxis (early treatment) for contacts (including health workers if they are exposed)

STAMP IT OUT: case/cluster control - treatment and post-exposure prophylaxis (early treatment) for contacts (including health workers if they are exposed)

MANAGE IT: pandemic management - treatment courses for cases.

It is important to note that there are not expected to be sufficient supplies for pre-exposure prophylaxis, and the national stockpile is currently expected to be offered to front line health staff and others who meet the criteria for treatment for pandemic influenza, but not for pre-exposure prophylaxis. This is in line with WHO advice.

Front-line health staff will need to adopt infection control practices (including appropriate use of personal protective equipment) as their first line of defence. Oseltamivir will be available for treatment, and the sooner that Oseltamivir is taken the more effective it will be at reducing symptoms and complications.

If there is a need for rationing during a pandemic, decisions about anti-viral treatment and prophylaxis will be made by the Government, advised by Ministry of Health. In turn, the Ministry is currently being advised by the Pandemic Influenza Technical Advisory Group (PITAG) and informed by ethical advice from the National Ethics Advisory Committee.

Refer Ministry of Health website for further information on antiviral supplies.