INDIA ESCAPED SARS (Severe Acute Respiratory Syndrome) in 2003 and remains as yet unaffected by the avian-flu. Mercifully, because the country is barely prepared to meet such health emergencies. Across the world, governments are planning surveillance centres and fast-tracking research to tackle this strain of influenza. They are also taking steps to stockpile medicines, though it is believed that just a fraction of the people will get drugs in the event of a world-wide outbreak. Recently, the United States outlined a $ 7.1-billion strategy to combat bird-flu should it blow up into a pandemic.

In India, the Government has initiated inter-ministerial meetings, but much more needs to be done on the ground. Tackling bird-flu involves, among other things, monitoring migratory birds; ensuring hygienic transportation and handling of livestock; regulating, if not stopping, the transportation of poultry through India's porous borders; and making sure that people do not live in proximity to livestock. Key to a contingency plan is making medicines available, and that poses another peculiar problem in India. Tamiflu from Roche-Gilead and Relenza from GlaxoSmithKline appear quite effective in mitigating the effects of bird-flu. But with the Tamiflu patent pending in India, the Government is yet to decide how to make the drug available in the country. With a product-patent regime less than a year old, New Delhi is keen on a balancing act — between making Tamiflu available locally and protecting the intellectual property of Roche-Gilead. As the Government takes time over this tricky task, Indian drug companies have responded quickly, though their motives have been variously interpreted as opportunistic or humanitarian. Cipla has offered to make versions of Tamiflu, and Ranbaxy already makes the active pharmaceutical ingredient used in the drug. Globally, Roche is under tremendous pressure to loosen its grip on Tamiflu so that generic-drug makers can produce the volumes required to meet the world demand. Compounding this complex situation is the scramble to source from China the herb star anise, whose price is sky-rocketing. Shikimic acid from the herb is used to make Tamiflu.

Making drugs available is only a part of the response required to deal with a health emergency. Disasters are not new to India, nor are infectious diseases. And yet, India, like other countries, finds itself unprepared, though the World Health Organisation had warned enough of the bird-flu. India should also consider screening at transit-points, where people and goods come from countries reporting the disease. Though insufficient, such screening was briefly done at airports in India when SARS was prevalent in other parts of the world. Whether bird-flu will mutate from birds to humans is for scientists to monitor and research. Bird-flu has killed over 60 people since 2003 and if human transmission does happen, the spread will be quick and with devastating consequences. Reason enough for any Government to hope for the best, but prepare for the worst.

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