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Analysis & Opinion
10.11.09 Masked Danger
By Tom Balmforth

A month ahead of schedule, the first phase of the nationwide A/H1N1 vaccination program kicked off in Russia on November 9, amidst “epidemic” levels of flu. As the swine flu panic escalates, so do the prices of anti-viral drugs, both those meant to help cure and prevent infection. People in facemasks are now a pedestrian sight in Moscow, but is the Russian government doing all it can to minimize the damage the new virus can do?

“Seventeen out of 84 Russian regions have surpassed epidemic levels, although the situation in the regions, where the infection rate first picked up, now seems to be ‘stabilizing’,” Gennady Onishchenko, Russia’s chief medical officer, told Interfax on November 10. In as little as a week the number of officially-registered cases of swine flu in Russia has shot up from 3,122 to 4,560, but the actual number of cases is most likely even higher – doctors making house-calls across the country say that if the patient is not in danger, there is no point in sending tests to the lab, since the treatment of swine flue is similar to what is prescribed during “normal” flu.

In the Buryatia Republic in Eastern Siberia, where 142 cases of A/H1N1 had been confirmed as of November 10, a state of emergency was declared last week. In the neighboring city of Chita, police have been told to fine those not wearing face masks. But the government has so far been careful not to stoke the nation’s panic. “The situation with regard to the spread of flu and acute respiratory viral infections should be considered moderate,” Onishchenko told Interfax. “In our country, 94,000 people die from vascular illnesses every month, from oncologic illnesses – 24,000, and from all infectious diseases, including tuberculosis, 2,600,” Veronika Skvortsova, the deputy health and social development minister said on Russia’s Channel One. The country’s A/H1N1 death toll is comparatively small: as of November 9, there have been a total 19 officially-registered fatalities from swine flu.

Nonetheless, the deaths have prompted an early start to the nation’s swine flu inoculation plan. The first phase of the A/H1N1 vaccination program, now already underway in the Altai, Tiumen, Bryansk, Voronezh and Moscow regions, will administer the jab to bus drivers, postal workers and other utilities workers. The second phase will vaccinate pregnant women and those vulnerable to infection and, from the end of November, health workers, teachers and students in higher education will then also get the shot. The government has earmarked a total four billion rubles ($137.9 million) from the 2010 federal budget for the production of 43 million doses of the vaccine by the end of January. Twenty-two million people (out of a total population of 143 million) will be vaccinated. School vacations, which were timetabled to end on November 9, have been extended by a week in Moscow, Krasnoyarsk and other regions in the hope of halting the spread of flu. “This will slow the rate of infection,” Onishchenko told Interfax.

Growing demand caused a shortage of face masks for sale at Moscow’s drug stores, which has apparently been a worry for the public, but Tatyana Golikova, the health and social development minister, suggested that the government would soon be replenishing supplies. “We are already turning our attention to manufacturing, and we are doing everything we can so that those shortfalls which have affected Moscow and the Moscow region are resolved,” Golikova told Interfax on Monday. She also stressed that, in order to even be effective, face masks must be changed a number of times per day.

The government appears confident that the epidemic is under control and has been heartened by reports that the swine flu virus has not shown any signs of mutation yet, which, were it to happen, could make the strain more lethal and contagious. “At the moment, during the work we have conducted on monitoring the flu virus, we have not discovered any mutations, which would increase the virulence of the flu virus A/H1N1,” Ilya Drozdov, the general director of virusology and biotechnology at Vektor, told Interfax on November 10.

Meanwhile, the situation in neighboring Ukraine is much worse. As of November 10, 174 Ukrainians had died from flu and acute respiratory viral infections, and almost 53 thousand people had been hospitalized. A close aid of Ukraine’s out-of-favor president, Viktor Yushchenko, suggested last week that the country’s flu outbreak could disrupt presidential elections, currently slated for January, and delay them until May, Itar-Tass reported. However, Yushchenko was quick to deny this on Sunday.

Back in Russia the worry for the government is that prices for antiviral medication appear to be artificially hiked, so as to generate greater profit for retailers. This tactic has enjoyed particular success since high demand is guaranteed during the epidemic, as seen in the recent spike in sales of Tamiflu and other antiviral drugs, such as Arbidol. According to the findings of an investigation conducted by Russia’s Health Watch, prices have jumped across Russia, with 32 regions out of 84 showing at least a three percent increase. The highest price hike of all was recorded in Murmansk, where several anti-viral drugs were being sold for 38.5 percent more than their usual value. Moscow prices were thought to have risen by eight percent.

Russian President Dmitry Medvedev was quick to condemn the price hikes. “I am now ordering the Federal Antimonopoly Service and the General Prosecutor to look into these findings. In the event that something of a criminal nature comes to light, a criminal case will be opened. To make money from the epidemic is a crime,” he told Channel One. But it is not the producers of the anti-viral medication, but its distributors who are responsible for rising prices, said Ilya Krylov, a PR manager at Pharmstandard, the company that manufactures Arbidol. “We have not raised our prices for that product since October 2008,” he said.
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