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JEB SHARP: I’m Jeb Sharp and this is The World, a co-production of the BBC World Service, PRI, and WGBH/Boston. The United States appears to be scaling back plans to stockpile the swine flu vaccine. An Australian drug maker said today that the U.S. government has cancelled half its original order for the H1N1 vaccine. This news comes as many European countries are also cancelling orders due to an oversupply of the vaccine. And that’s left European politicians  explaining why they ordered so much in the first place. The World’s Gerry Hadden reports.

GERRY HADDEN: Spain says it’s facing an excess of 17 million doses of H1N1 vaccine; Germany, 50 million doses; France, 50 million as well.  These countries have ended up with much more vaccine than they can use for several reasons. Sophie Delaporte is with the French Healthy Ministry.  She told French public radio that one reason is there’s been is a shift in expert opinion.

SOPHIE DELAPORTE: [Voiceover] You have to understand that back in July when we planned the purchase of the vaccine, the experts recommended two doses per person, so we made our purchase accordingly.

HADDEN: European health authorities now recommend just one dose per adult and per child age 10 and older. So that’s left a lot of extra vaccine.  Added to that Europeans are wary of the vaccine. Far fewer than expected have stepped forward to get it.  In France less than 10 percent of citizens have received it.  The percentage is lower in Germany.  Many Europeans say they want to see more thorough safety trials or proof that the H1N1 flu is really dangerous. But critics say there are other reasons for the vaccine glut.  Opposition politicians in France accuse the government of wildly over-spending under the guise of preparedness.  Socialist Party spokesman Benoit Hamon says the government gave in to pressure from the pharmaceutical industry.

BENOIT HAMON: [Voiceover] These days the pharmaceutical industry plays an important role in these sorts of decisions, and that’s why the Socialist Party is justified in asking for an inquiry in Parliament.  We want to know who made the decision to buy so many doses and how that decision was made.

HADDEN: Pharmaceutical companies have already sold billions of dollars worth of H1N1 vaccine.  They say the vaccine has been necessary and was expensive to develop.  The former president of the French Red Cross, Marc Gentilini, also criticizes what he calls Europe’s monstrous over investment in vaccines.  But he doesn’t blame big business or political leaders.

GENTILINI: [Voiceover] I don’t blame the health minister, but the medical experts.  They created an apocalyptic scenario.  There was pressure from the World Health Organization, which began waving the red warning flags too early.  It hasn’t turned out to be the great mortal illness as predicted.

HADDEN: Of course last spring and summer no one knew how bad the H1N1 pandemic would become.  French authorities insist erring on the side of caution was better than getting caught in a major epidemic with not enough vaccine.  France’s foreign minister, Bernard Kouchner, told public radio that he’s scandalized by the fact that this is a scandal at all. What would we have said if the outbreak had been more severe?  To calm the political storm, European governments are trying to negotiate out of last year’s contracts with the big vaccine producers.  And they’re looking to sell doses abroad, to developing nations still waiting for their share of the vaccine.  One potential client for France is Mexico, where the H1N1 virus first appeared early last year.  Though Mexico was ground zero for the disease, it’s still waiting for most of its vaccine orders to be filled.  At a café in Mexico City, 67-year-old resident Pedro Cuevas says he wants to be vaccinated, but he can’t be because there are still no doses available to the general public.

PEDRO CUEVAS: [Speaking Spanish]

HADDEN: He says I listen constantly to the news about how we old people are going to get vaccinated.  But only god knows when that will be! Only healthcare workers have gotten it so far.  It’s absurd. I can’t go to the pharmacy and buy, he says, because there’s none for sale.  European countries would like to sell their excess doses for the same price they paid, between $9 and $14 each, but competition between countries will likely drive prices down. Some charity groups  say many developing countries can’t afford the vaccine even at discount prices.  They’re calling on Europe to donate its unwanted vaccines.  For The World I’m Gerry Hadden in Barcelona.

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• BBC coverage
• Survival International – The movement for tribal peoples

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This text below is a phonetic transcript of a radio story broadcast by PRI’s THE WORLD. It has been created on deadline by a contractor for PRI. The transcript is included here to facilitate internet searches for audio content. Please report any transcribing errors to theworld@pri.org. This transcript may not be in its final form, and it may be updated. Please be aware that the authoritative record of material distributed by PRI’s THE WORLD is the program audio.

MARCO WERMAN:  Just to give you an idea of how far swine flu has spread, it has now reached an indigenous group deep in the Amazon.  The government of Venezuela has sealed off part of the rainforest to prevent the flu from decimating the Yanomami Indians.  A thousand members of the tribe are believed to have caught the flu, seven have died.  Survival International is a London based indigenous rights group.  Fiona Watson is research and field director.  Fiona, how is it that this isolated group was exposed to swine flu?

FIONA WATSON:  Well, we think it came in through a place called Novaka which is the place in the Yanomami territory in Venezuela which has the most contact with national society.  There’s an air strip there, there’s a Catholic mission station so people who are working with the Yanomami or visiting for whatever reason, it could be doctors, government officials, people working on health and education programs, come in and out so I think it has come in that way.

WERMAN:  And remind us who the Yanomami are.

WATSON:  They are one of the largest relatively isolated indigenous peoples living in the Amazon rainforest.  There’s about thirty two thousand in Brazil and Venezuela.  They’ve lived there for hundreds, if not thousands of years.  They live by hunting and gathering and it very much a people who are living in the forest, completely self-sufficient and came into contact with outsiders really in any great way from the fifties onwards and the Yanomami have very little immunity; many Amazonian tribes, remote tribes have very little immunity to common diseases you know, which for us don’t present too much of a problem like the common cold or flu.  They haven’t had this immunity because they’ve been so isolated.

WERMAN:  As you say the Yanomami have suffered from other epidemics that were introduced from outside their community.  How have previous epidemics come into their community and what were the consequences?

WATSON:  Well the epidemics almost invariably come in through outsiders.  I mean in the fifties when you had the border commission authorities from Brazil went up to the border area to survey the border and then missionaries came in shortly after that, there were devastating epidemics of particularly measles and then I think possibly the most devastating, certainly in terms of numbers who died were the invasions in the 1980’s where you had forty thousand gold miners invaded the Yanomami territory in Brazil and twenty percent of the Yanomami died and that was through these diseases like malaria, like measles, like flu to which they had no resistance.

WERMAN:  Can you tell us specifically what Hugo Chavez and the Venezuelan government are doing right now?  I mean they’ve been quite outspoken on indigenous rights.

WATSON:  It seems to me they have acted fairly quickly.  They’ve got the doctors in there trying to contain the epidemic but I think this raises a wider question and it’s a question really for both the Brazilian and the Venezuelan governments is that there has not been, in my view, sufficient attention given to permanent healthcare in the region so that they are in place when these epidemics do happen.

WERMAN:  Isn’t there a risk though of bringing in more outsiders and creating more transmission of disease?

WATSON:  That’s always a risk but I think if you’ve got a few dedicated teams of people who speak the language, who know the Yanomami well, who are trusted by them and who, themselves are screened before they go in, I don’t think that poses a problem.

WERMAN:  Fiona, your group, Survival International, has been typically fighting for indigenous land rights.  I’m wondering, is disease a game changer now for you?  I mean these indigenous people now have a really dire fight for survival, literally, on their hands.

WATSON:  Yes, I mean, certainly the question of disease is a huge challenge and a problem and survival is working particularly on contacted Indians.  This is tribes mainly in the Amazon region, but also in the Chako Forest of Paraguay and the Andamin Islands of India where you have isolated, if not uncontacted tribes and these people have absolutely no immunity at all, even less than the Yanomami because they have been isolated for hundreds of years and this is a very, potentially very serious problem and in areas like Brazil, in parts of the western Amazon where you’ve had massive penetration of colonists, of loggers, of miners, this is becoming an increasing threat to these very small, fragile groups where you may only have, I mean I know of cases where you might only have five survivors or twenty survivors of a tribe who are literally on the run, fleeing these invaders and if there is any casual contact, then they will be exposed to diseases and we simply won’t know.  It’ll be you know, like a hidden genocide.

WERMAN:  Fiona Watson, research and field director for Survival International, speaking with us from London.  Thank you very much, indeed.

WATSON:  Thank you.

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>>> Click here to start the cartoon slideshow

• BBC coverage
• Flu.gov

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This text below is a phonetic transcript of a radio story broadcast by PRI’s THE WORLD. It has been created on deadline by a contractor for PRI. The transcript is included here to facilitate internet searches for audio content. Please report any transcribing errors to theworld@pri.org. This transcript may not be in its final form, and it may be updated. Please be aware that the authoritative record of material distributed by PRI’s THE WORLD is the program audio.

MARCO WERMAN: We turn now to Europe. Health authorities there are also encouraging swine flu vaccination especially for people in high risk groups. But there’s a lot of skepticism among patients and health workers.  The World’s Gerry Hadden reports.

GERRY HADDEN: The German Government is urging everyone to get a swine flu vaccination.  But according to a recent poll just 20% of Germans say they’ll seek it out. One reason many give for not getting the vaccine is that the H1N1 virus has so far turned out to be relatively mild.   Misha Ude is a medical worker in Hamburg.  She says she sees swine flu patients daily and isn’t worried about catching the disease.

MISHA UDE: [In German]

GERRY HADDEN: She says I’m a nurse in a hospital.  In the last month we’ve had about 30 swine flu cases come in.  They get checked out and go right back home.  It’s nothing serious.   Many health experts in the U.S. would disagree with that statement.  Yet in Germany among doctors concerned about any serious swine flu outbreak remains muted.  Frank Ulrich Montgomery is Vice President of the German Medical Association. He says fears of swine flu are overblown.

FRANK ULRICH: I think it is just an ordinary normal flu and if we hadn’t had the pandemia planning, if we hadn’t had the most alarming reports from Mexico and the U.S. at the beginning, we probably would never have done so much about this disease.

HADDEN: Montgomery says his group only recommends the new vaccines to high risk patients.   He says preliminary tests have shown the vaccine to be effective, but he wants to see more research on the possible risks before recommending the vaccine to the public at large.

MONTGOMERY: You have to test very large numbers of persons to find out the real risk and the long-term risk of vaccinations. Therefore, more important for us is to balance out the risk of vaccination with the risk of the disease itself.

HADDEN: Montgomery says his skepticism is shared by doctors across Europe.  In Spain, leading swine flue Epidemiologist Antoni Trilla says he hears the same thing from physicians, but he doesn’t share their doubts.

ANTONI TRILLA: There is some sort of non-scientific reasoning in saying that this is not a safe enough vaccine.  I don’t think there is strong evidence for saying that.

HADDEN: But on the other hand Trilla does think U.S. health officials are pushing the vaccine a little harder than necessary.  For instance, when it comes to healthy children.

TRILLA: We don’t recommend now to have the vaccine to healthy young kids. It’s quite different from the United States where they are pushing forward the vaccination of the younger people.  Here we only restrict the vaccine to the higher risk.

HADDEN: Last month the E.U. described three groups as high risk, health care workers, pregnant women, and anyone over six months with pre-existing conditions, such as lung or cardiovascular disease.  The fact that otherwise healthy people are not on that priority list might explain why the European public isn’t rushing out to get vaccinated.  Trilla predicts that if the disease doesn’t become more severe over the flu season, by next spring Europe will be awash in unused doses of swine flu vaccine.   For The World I’m Gerry Hadden in Barcelona.

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