• Antivirals (e.g. oseltamivir and zanamivir) were the only medical intervention available during the initial phases of the 2009 influenza A (H1N1) pandemic before vaccines could be developed.
• Stockpiling of antivirals for prophylactic and therapeutic use was an integral component of the pandemic preparedness plan in many countries.
• While pre-exposure prophylaxis was generally not recommended, prophylactic use of antivirals for individuals who were pregnant or had serious underlying conditions, and who had been in close contact with an infectious case may have been warranted and required clinical judgement.
• Optimal use of the antiviral stockpiles requires clear objectives, eligibility and triggers, protocols, and an administration and delivery system. The possibility of the emergence of resistant influenza strains should also be considered.
• A number of countries found innovative solutions to dispensing antivirals during the 2009 pandemic. For example, the National Pandemic Flu Service in the U.K. implemented a telephone-based self-assessment and antiviral prescription system which was linked to antiviral collection points in pharmacies and other establishments in local communities.