With the outbreak of swine flu and its lethal worldwide effects, different countries have applied their own strategies to combat the virus.

Growing international awareness has brought better treatment of pandemic H1N1 virus infections, and for the most part it has been effective and saved lives through early treatment using antiviral drugs – oseltamivir or zanamivir.

Early administration of these drugs has proved particularly effective for patients who risk of developing complications as well as those who manifest signs of severe illness or those with worsening signs and symptoms.

Oseltamivir is an antiviral drug that slows the spread of influenza (flu) virus between cells in the body by stopping the new virus from chemically multiplying with its host cell. Sold under the trade name Tamiflu, it is taken orally in capsules or water. It has been used to treat and prevent influenza virus A and influenza virus B infections for more than 50 million people since 1999. Oseltamivir dissolves in the system as it passes through the liver. Similarly, zanamivir is a neuraminidase inhibitor used in the treatment and prophylaxis of influenza virus A and influenza virus B, and as such, was the first neuraminidase inhibitor commercially developed, and is currently marketed by GlaxoSmithKline under the trade name Relenza.

Medical establishments, in particular those that have treated severe cases of pandemic influenza, agree that prompt administering of these drugs following the onset of symptoms is essential because it reduces the risk of complications. The drugs can also improve the clinical outcome in patients who have entered a more severe phase of the illness. Concurrently, this further emphasises the need to protect the effectiveness of these drugs by minimising the occurrence and impact of drug resistance.

Preparations
According to the Health Ministry, as of October 6 2009 Bulgaria had 96 confirmed cases of H1N1 strain. One of them, a 30-year-old male, has already died. In most other cases, the virus was arrested early, when patients were not in immediate danger.

Subsequently, a nationwide pandemic project has been worked out by the Health Ministry and then accepted by the Cabinet in which "all elements and factors in the different stages of the pandemic have been analysed and processed", according to a ministry media statement. This includes "the supply and redistribution of surplus anti-virus medicaments, personal first aid supplements and the readiness of healthcare institutions to deal with the pandemic".

The report has been submitted to the national pandemic committee where it will be up for discussion, approval and enforcement. The report analyses deadlines for delivery, the quantity of vaccines ordered and purchased by the government and the strategic allocation of vaccines, in accordance with different risk groups. 

For the moment, Bulgaria has expressed willingness to participate in the common strategic plan organised by the European Commission for the delivery and distribution of the H1N1 jab which, according to the Health Ministry, is scheduled to occur sometime in October 2009. The vaccine, once in the country, will be distributed to appropriate institutions and will be free, paid for by the state Budget.

End of the world or lucrative sell?
Since swine flu was declared a global pandemic by the World Health Organisation in June 2009, pharmaceutical companies have been racing to get their vaccines on the market.
Australian drugmaker CSL became the first vaccine-maker to start testing its vaccine on people in Australia. Since then, more than 35 countries have placed orders with Novartis for swine flu, or H1N1 ,   vaccine. These include France, the Netherlands, and Switzerland.

The US has ordered $979 million worth of bulk vaccines. Greece has earmarked 40 million euro for vaccines and has placed further orders with Novartis, Glaxo and Sanofi for eight million additional vaccine doses, to be received gradually by January 2009, while Croatian authorities are poised to purchase 1.5 million vaccines against swine flu by the end of 2009 from Swiss pharmaceutical company Novartis, the Croatian health ministry said on September 30.

Nearly two million euro has been allocated by the Croatian government for the purchase, according to Croatian health minister Drazen Jurkovic. The inoculation campaign itself is set to begin by the end of 2009, or at the latest, January 2010.

Whether this new virus spells imminent doom for planet Earth – as most pharmaceutical companies would have us believe – is another matter. Some people feel that it’s merely scaremongering or a money-grabbing scheme. A report from Greek daily Kathimerini on October 5 said that nearly a third of Greeks will not even bother to get their free jab, while 50 per cent remained unconvinced it was necessary.

Will there be any long lasting negative side effects? Will it be effective at all? Is it really necessary for governments to spend all that money on dubious drugs and feed the pharmaceuticals industry, whom some believe manufacture these viruses themselves? Some say, better safe than sorry, and best be prepared – get the jab. Others dismiss it as just another media hype.