Bioethics Blogs

Storage and stockpiling as techniques of preparedness: Managing the bottlenecks of flu pandemics by Frédéric Keck

In the last twenty years, influenza has been considered by global health experts as a model for the emergence of new pathogens from animal reservoirs. In the logic of zoonoses, human disease is the tip of the iceberg constituted by a wide circulation of viruses – often asymptomatic – in animals; it is often described as an “evolutionary dead-end”. As the influenza virus is composed of a single-stranded segmented RNA, it mutates and reassorts between birds and pigs before spreading to humans and causing pandemics. The regularity of flu pandemics – 1918, 1957, 1968, 2009 – is explained by that the fact that the seasonal flu is replaced regularly by new flu viruses to which humans have no immunity. Consequently, to prepare for the emergence of new flu viruses, events whose probability cannot be calculated but whose consequences are catastrophic, samples have been stored and vaccines have been stockpiled, as if the iceberg of the animal reservoir could be visualized and controlled in the fridges where humans conserve live and attenuated viruses. Storage allows public health authorities to identify a new virus as it emerges by comparison with circulating viruses, and then to raise alarm from this early warning signal. Stockpiling provides a quick immunization of the population considered as having priority in the exposure to the new virus.

I am interested in storage and stockpiling as techniques to plan and visualize the mutations of flu viruses in the ordinary work of global health, in contrast with the extraordinary management of health crises. While stamping out the animal reservoir and vaccinating the human population are techniques used during the emergence of new flu viruses, storing samples and stockpiling vaccines is practiced before and after the emergence, as part of ordinary surveillance work.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.