South Africa must build its vaccine production capacity if it wants to be prepared for influenza pandemics such as the current "swine flu" outbreak, a think-tank of virologists heard in Cape Town yesterday. This requires long-term planning, and private-public partnership.

The group, hosted by the African Genome Education Institution, convened to discuss local vaccine production, and how to deal with viral outbreaks in South Africa.

"Well over 100 000 cases (of swine flu) have been detected worldwide. South Africa had 125 cases by Monday this week," said Prof Barry Schoub, from the National Institute for Communicable Diseases, "fortunately they’ve all been relatively mild cases." However this figure may be the "tip of the iceberg" since many cases have probably gone unrecorded.

Swine flu – officially, the "Pandemic H1N1 2009" flu – was declared a pandemic by the World Health Organization (WHO), after it first appeared in Mexico in March year. This classification reflects how rapidly the virus spreads, rather than its severity.

A vaccination is the first line of defence against a pandemic like this, however the WHO expects that this will only be available in September. When it does reach South Africa, Schoub recommended reserving the vaccine for healthcare workers on the frontline of the disease, and high risk groups.

"With seasonal flu, people over 65 are a priority for the vaccine. But with the pandemic H1N1, the risk groups are children, who are ‘amplifiers’ of the disease, people with chronic lung and heart disease, pregnant women, and people with obesity."

There isn’t enough information yet to know how this strain affects people with weakened immune systems, such as those infected with HIV.

Pandemics of this nature are cyclical, occurring every 15 to 50 years or two to three times per century. But without the capacity to make vaccinations locally, South Africa remains vulnerable in the event of a flu pandemic. About a million doses of vaccine are given for seasonal flu every year in South Africa, all of which are imported.

"We do not have the capacity in this country to make vaccines. And you can’t decide today that you want a flu vaccine next year. It’s at least a five year project to develop a vaccine," said Prof Anna-Lise Williamson from the University of Cape Town’s Division of Medical Virology.

Local pharmaceutical companies have stopped manufacturing flu vaccines due to market forces and tightening WHO regulations controlling vaccine production.

"There are fewer and fewer companies making vaccines globally because it’s not a lucrative market, and the financial risk is so huge that to put government money into it is not feasible," Williamson said.

A possible solution to this is a public-private partnership, where the financial risk of developing vaccine capacity is spread beyond a single state institution or company.

Meanwhile, communities can reduce the spread of the disease by maintaining good cough-and-sneeze etiquette (coughing or sneezing into a sleeve or handkerchief, washing hands regularly) and keeping cases in isolation. The illness is treated symptomatically, as with a case of seasonal flu, and severe cases should be hospitalised.