Swine flu asks the hard policy questions

A1N1, originally dubbed "swine flu" due to alleged links with a Mexican pork production facility, is now starting to ask policymakers hard questions about reform and proper access to drugs.

The World Health Organization now deems the flu "unstoppable," meaning quarantines are no longer considered effective in limiting its spread.

Thus the issue has become one of vaccines.

The U.S. government has already committed almost $2 billion to that fight. The latest contracts, worth $884 million, are for vaccine ingredients. About $1 billion was committed to research in May.

While rich countries are going full speed ahead to vaccine all who might be at risk, with some parents asking whether they will bother, WHO Director-General Margaret Chan is asking deeper questions, like who will get a limited supply of vaccine, and how to we assure the largest supply.

Health care workers should be first in line, she says, followed by the people at greatest risk -- pregnant women, people with complicating health conditions, and small children with limited immunity.

But the first vaccine won't be approved until year-end, and even then there won't be enough. Patent rights are needed to fight the fast-mutating virus, she says, giving new impetus to the study of past epidemics.

Some Americans, and I have been one of them, still insist this is just the flu, scientists are finding that this flu replicates inside the lungs in ways that remind them of the 1918 pandemic that killed millions. The ability of this flu to incubate for years before striking is also frightening.

All this is going to ask some hard questions of those engaged in the search for health reform: Money talks. It must talk in the search for cures, and it will talk in deciding who is vaccinated.

So should money be the determining factor in how long you live or when you die?

This post was originally published on Smartplanet.com