By Kevin Noonan
On first blush, it might appear that Indonesia's decision to stop supplying avian influenza virus samples to global public health organizations, such as the U.N's World Health Organization (WHO), is short-sighted or greedy or both (see "Virus for Sale"). However, the "rest of the story," at least in part, is supplied in today's New York Times.
An Op-Ed piece by Ruth R. Faden and Patrick S. Duggan
from the Johns Hopkins Berman Institute of Bioethics and Ruth Karron from the
Center for Immunization Research at the Johns Hopkins Bloomberg School of
Public Health describes more about the economic consequences of bird flu in
Indonesia. The biggest economic impact has been the result of Indonesia's only current response to a bird flu outbreak - killing the infected birds. The killing
of birds is necessary because it is believed that persistence of the virus in bird
populations, especially ones close to human populations, increases the chance
that a strain capable of human-to-human transmission will arise, due to the
high mutation rate of influenza viruses. Obviously, the benefits of these prophylactic measures are global
insofar as they forestall a pandemic of this lethal flu strain (70% mortality
for infected Indonesians).
According to the Hopkins authors, Indonesian Health Ministry
officials have imposed a ban on household poultry farming in Jakarta, the
capital. Indonesians were given a
deadline of February 1 to 
"consume, sell or kill" approximately 1.3
million birds, and the ban was enforced by door-to-door inspections by officials
empowered to kill any remaining birds.
While the government promised to pay a ransom of about
$1.50 for each flu-infected bird (which is approximately its fair market
value), the government will pay nothing for any healthy birds (the overwhelming
majority). Thus, thousands of
Indonesians lost an inventory of substantial value from this edict. Moreover, it is the small local farmers,
rather than multinational companies with poultry farms in Indonesia, that
suffer disproportionately, since they cannot replace the destroyed birds.
Although the authors are part of a group attempting to
influence governments, international organizations, and multinational
corporations to provide compensation for the world's disadvantageous populations
when the costs of avoiding (or at least postponing) a bird flu pandemic fall on
their shoulders, there is no compensatory plan now in place.
The costs are daunting - about $2 million for the
current program, which could expand to as much as $450 million should a similar
program be needed throughout Indonesia. Indonesia has less than $50 million in its budget for all aspects of
bird flu, so some form of assistance is necessary.
Under the circumstances, Indonesia's attempt to be
compensated for providing avian flu samples to Western scientists,
organizations, and in particular, vaccine-producing companies, may be
justified. It is true that Indonesia,
and many other Third World countries will be disproportionately affected by a
flu pandemic, or even a localized epidemic. However it is also true that governments, global organizations and the
world's population needs to be more willing to provide the funding necessary to
prevent the pandemic. Poor countries
like Indonesia cannot do it, and we are all in danger if the rest of the world
does not step up to do our share.
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