A(H1N1) and the financial crisis

State budget is severely damaged by the financial crisis, in european countries. Consequently it is mandatory to evaluate the appropriatness of public spending in swine flu vaccination. It is more urgent than in better economic times. France engaged recently on a 1 billion spending for purchasing 94 million swine flu vaccine doses. It is about 1% of our health care cost. If following this policy EU could spend 10 billion at least for the vaccination program in the next months. This amount will not be available for other important public health issues. At the present time our plans are only based on expectations about the severity of the pandemic. That is the reason why a very solid statistics of both morbidity and mortality of the A(H1N1)is needed with detailed structure of risk. Online sharing of the data and methodological improvments to avoid big flaws must be encouraged. The challenge is not to show that we do some thing about the flu, it is clearly to spend money very carefully but with a very limited period of time to decide about the targets. In this perspective the risk of conflict of interest is great as both politicians and firms favor spending money even inappropriatly. Prevention and preventive care are of two kinds:

-those about diet, exercise and avoiding bad habits whose cost is mostly carried on by individuals

-those where a medical intervention is needed.

In the second category of policy efficiency is not mandatory, costs could be very high and secondary effects are not null. It is our responsability to look after scientific research about flu, best prevention based strategy and the role of vaccination in this setting.