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WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY G.C.L. BAUDAINS OF ST. CLEMENT
ANSWER TO BE TABLED ON MONDAY 2nd DECEMBER 2013
Question
Would the Minister outline her understanding of what Tamiflu achieves, what adverse reactions, if any, have been reported and why it is considered necessary to stock this drug?
Does the Minister believe that the benefits are extremely limited and, if so, does she consider this an appropriate use of taxpayers' money?"
Answer
Antiviral medicines (such as Tamiflu) can be used in two ways. They can be used as a treatment for someone with seasonal or pandemic influenza to reduce severity, complications and hospitalisation rates. This also has the coincident effect of reducing onward transmission of infection. Separately they can also be taken by well individuals to prevent acquisition of influenza when this is circulating in the community. For example, in a household where there is influenza, antivirals are a very effective way of protecting someone in the same household who would be clinically at risk of developing serious complications if they were to catch flu.
Tamiflu (Oseltamivir) has recognised side effects of nausea, diarrhoea and headache.
In 2010, the UK Commission on Human Medicines, a committee within the Medicines and Healthcare Regulatory Agency, conducted a review of all adverse reactions reported following use of over one million courses of Tamiflu during the 2009 H1N1 pandemic. The Commission concluded that the most commonly reported adverse reactions were consistent with the recognised side effects (of nausea, diarrhoea and headache) and that the balance of benefits and risks with this antiviral medicine remained in favour of its use.
Thus, Tamiflu continues to be routinely recommended by the National Institute for Health & Care Excellence (NICE) and by the UK Department of Health for both treatment of infected individuals and for prevention in well people when there is circulating influenza. It would also have a similar function in pandemics.
Jersey, like and many other countries including Guernsey, holds a stock of antiviral medicines for use, either in a severe winter flu season or in a pandemic. In a flu pandemic, without mitigation measures, infection levels would likely be widespread due to the absence of population immunity. This would threaten the ability of our small island to cope with the sick, as we have one hospital and one intensive care unit, and in a pandemic situation probably no options to transfer seriously ill patients elsewhere because NHS intensive care beds would be fully utilised. Holding a stock ensures our response can be as flexible and resilient as possible, particularly to protect those in clinical at-risk groups for whom influenza could prove fatal.
The benefits of holding antiviral stocks were very evident during the 2009 H1N1 pandemic, when its use demonstrably helped clinicians in Jersey, to sustain containment of the H1N1 virus, and save lives, until vaccine became available.
The people of Jersey have every right to expect us to take whatever steps we can to protect them and keep them safe.
The Council of Ministers has recently approved a Channel Islands Pandemic Influenza Preparedness Strategy, jointly produced by Jersey and Guernsey, the principles of which include maintaining a stock of antivirals.
The evidence from 2009 gives me great confidence that we have got that strategy right, that the benefits are proven and that maintaining appropriate stocks of antiviral vaccine is not only an appropriate, but essential use of our money.