By Kevin E. Noonan ---
Indonesia fulfilled its earlier promise (see "Bird Flu Flying to WHO Again") to provide the World Health Organization (W.H.O.) with samples of H5N1 strains of influenza virus (otherwise known as "bird flu"), according to The New York Times (see "Indonesia to Send Bird Flu Samples, With Restrictions"). However, the agreement was not unrestrained: Indonesia placed strict limits on permitted uses for these samples. This stance is consistent with Indonesia's earlier-expressed concerns that the samples would be used by Western pharmaceutical companies to make a vaccine Indonesians (and other Third World peoples) would be unable to afford.
Specifically, the Indonesian Health Minister, Siti Fadilah Supari, announced that the government agreed to resume 
sending bird flu samples to the W.H.O. only under the condition that the samples not be shared with pharmaceutical companies or other commercial vaccine makers. The deal was the result of a summit meeting between W.H.O. officials and representatives of eighteen Third World countries, including Indonesia, held in Jakarta this week. The source countries received no assurances that bird flu vaccine would be available to them on affordable terms in the event of a bird flu epidemic, but W.H.O. agreed not to pass on bird flu samples received from any source country without conferring with the health minister of the country providing the sample.
The exact contours of how these limitations will be implemented have not been fully worked out, but Indonesia's intent, to avoid the appearance or actuality of being exploited by the West, is clear. "We will trust W.H.O. will not violate our trust, because this is related to the W.H.O.'s credibility," Dr. Supari said.
For its part, the W.H.O. is trying to avoid being placed in the middle between its most fertile source of bird flu isolates and the companies that will be responsible for producing a vaccine that may forestall a pandemic. Dr. David L. Heymann, the assistant director general for communicable diseases representing the W.H.O. at the meetings with Indonesian government officials, stated that the agency "is not involved in financial negotiations, either in selling viruses or buying vaccine."
It seems clear that physical transfer of the virus strains, without an agreement on local access in Indonesia to a bird flu vaccine, would run afoul of Indonesia's restrictions. What is less clear is to what extent the information resulting from W.H.O studies of these isolates would be embargoed. It is unlikely that the W.H.O. could agree to any significant restrictions on scientific information, but in view of what is known (or able to be known) about influenza, the information may be sufficient on its own for a drug company's vaccine development needs. Indonesia's position on such information transfer is unclear, but it is unlikely to be satisfied by an arrangement that circumvents its restrictions without any quid pro quo access to a bird flu vaccine for its people. Those negotiations will be on-going so long as the threat of a bird flu pandemic exists.
For additional information on this topic, please see:
- "Virus for Sale" - February 8, 2007
- "Postscript: When Flu is for Sake, Who Should Pay?" - February 9, 2007
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