摘要：Prompt treatment of ill persons with influenza antivirals will be an important part of a future pandemic influenza response. This essay reviews key lessons learned from the 2009 H1N1 pandemic and the changing landscape of antiviral drug availability, and identifies and describes the multiple components needed to ensure the timely administration of antiviral drugs during a future pandemic. Fortunately, many of these planning efforts can take place before a pandemic strikes to improve outcomes during a future public health emergency. Over the past decade, pandemic influenza planning efforts have been a major priority of the global health community. Preparedness planning has focused on a multifaceted approach to mitigate widespread morbidity and mortality from a novel, highly transmissible influenza A virus. Medical countermeasures such as vaccine and antiviral drugs play a critical role in a pandemic response. A vaccine that is effective against a circulating virus would have the greatest overall public health impact by preventing persons from becoming ill. However, antiviral drugs are also critically important for use in treating persons who are sick, and can thus mitigate the effects of emerging pandemics before effective vaccines become available. When used appropriately, antiviral drugs can reduce the severity of influenza symptoms and shorten the time of illness by approximately 1 or 2 days. Research also suggests that in past pandemics, hospitalizations were likely averted through use of antiviral drugs. 1 Since the 2009 influenza A H1N1 pandemic, the antiviral drug landscape—from drug availability to usage—has evolved significantly. In addition, the 2009 H1N1 response demonstrated many factors crucial to the well-timed distribution and dispensing of antivirals during a response that need to be considered. Influenza antivirals are used to treat seasonal flu, and the high demand for these medications during the 2017–2018 season illustrates the importance of additional planning to ensure access to antivirals when needed. We examine these factors and identify areas in which preparedness efforts can improve the timely administration of antiviral drugs during a pandemic influenza response.
