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Lansley: Raising our level of preparedness for an avian flu pandemic

Speech to Chartered Institute of Environmental Health

In the coming year, the principal uncertainty for our public health is whether or not there will be an Avian Flu pandemic striking this country. The World Health Organisation says it is not a matter of if, but when. We have no choice but to operate on the basis that the avian flu virus will mutate into a virus capable of readily being transmitted between humans.

For over a year now, I have been pressing the Government to take early action to raise our level of preparedness for such a pandemic. In February, after again challenging the Government that several leading developed nations had already published updated preparedness plans and procured substantial stockpiles of anti-viral drugs, the Government published a contingency plan. They also contracted to buy 14.6 million courses of the anti-viral TamiFlu. (March 1 2005)

Subsequently, and contrary to their earlier intentions, they are also purchasing stocks of a generic H5N1 vaccine, capable of offering some protection against a flu derived from the existing avian flu virus.

I support these measures, but they do not go far enough. The WHO has called for developing nations to contract for additional vaccine manufacturing capability. After last year's losses of production at the Speke plant in Liverpool, it is essential that the UK participates in this, so that if and when a virus emerges, vaccine production can be scaled up rapidly for the necessary level of inoculations.

Although our procurement of anti-virals is geared to UK needs, our plans do not yet sufficiently commit us to providing support in South-East Asia to seek to contain the outbreak where it first emerges. The use of anti-viral drugs could, according to recent modelling published in the journal 'Science', significantly restrict the spread of the disease. But the necessary stockpiles of drugs are not able to be purchased by countries where the need it greatest to contain it, like Vietnam, Laos or Thailand.

The SARS experience demonstrates that it is possible to control an outbreak. The virulence of the prospective avian flu virus we can't say, but we have to seek to prevent its rapid spread whilst we develop a vaccine.

If we do not succeed in containing the outbreak, the deployment of anti-viral drugs in this country will be vital. Unlike the French pandemic plan, we do not know what the Government's intentions are in relation to the use of the stockpile as prophylaxis for health and social care workers, or as a treatment for those contracting the disease.

Should the flu pandemic strike soon, the drug stockpiles will not suffice. The quality of our preparedness will then largely shape our success in containing the effects of the outbreak. For example, it will be vital to differentiate between those who will be needed to work and those who should stay at home. We will have to seek to treat at home many more people who would normally attend hospital, avoiding their exposure to the virus.

The quality of cross-governmental coordination, and the ability of local government alongside the NHS to secure public awareness, action and response, as well as to bring the resources to bear to secure the continuation of services to the public whilst radically changing the extent to which the public mingle.

...

The Government are preparing to legislate for a partial ban on smoking in public places. A ban on smoking where food is served is not a legislative option which has been pursued in any other country. The definitional challenges of distinguishing between "shelf-stable prepared snacks" and other foods may be surmountable, but the absurdity of this proposal is becoming increasingly evident. In many major cities, many pubs will be drinking-only establishments. This is especially true in more deprived areas, so the result will be increased health inequalities. This proposal fails to protect staff working in smoke-filled environments, yet the evidence of the effects of second-hand smoke are clear in so far as they relate to the non-smoking partners of smokers and of those who work in a persistently smoking environment.

The evidence also points to the effects of second-hand smoke in exacerbating respiratory illness in children. Yet the Government's proposals do not ban smoking where children are permitted.

The Government's proposals on smoking are unworkable and perverse. They will not deliver results and may even exacerbate health inequalities.

There are potentially two ways forward: a rigorous self-regulatory solution, which eliminates smoke in offices and workplaces, and in pubs, clubs and restaurants behind the bar. Alternatively, a legislative ban, either on a national basis or through locally approved legislation. Even those who believe in liberty, know that the limits of that liberty lie in not causing harm to others.

So I can tell you today that I will ask my colleagues to oppose the Government's partial ban, but on a free vote. I will do so on the basis that colleagues will be able to replace that, either with the provision for a self-regulated approach, or a full statutory ban on smoking in public places.

The industry has made significant steps in the right direction. They do need to be aware that I and others in the Conservative Party would support a full ban if necessary.

The Government need to know that many Labour backbenchers will also be prepared to vote against their Government's flawed proposal.

It is time for the Government to abandon this absurd plan, and get real about how to deliver a smoke-free environment for all those who want it."

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