I have addressed the issue of Indonesia and its refusal to share the H5N1 virus samples that WHO needs more times than I ever thought there would be need of, much less have the words for. However, this issue refuses to go away or find a resolution. My last post on the issue was just last week.
WHO convened a four day meeting in Geneva on Tuesday (20Nov07) to address Indonesia's claims and demands with respect to H5N1 viral samples and vaccine end products, the fifth such meeting this year.
Indonesia claims ownership of any H5N1 virus that exists within its borders. As reported in Reuters:
Speaking at the start of a four-day meeting hosted by the World Health Organization (WHO), Indonesian Health Minister Siti Fadillah Supari said developing countries were being denied their "sovereign rights" over bird flu virus samples sent to the WHO, a United Nations agency.
"We must have equitable sharing of benefits arising from the use of viruses through a fair, transparent and equitable mechanism. It is the moral thing to do," she said. (Emphasis added)
A(H5N1) is a virus. A(H5N1) is not an invention or a product of manufacture. A(H5N1) is not an idea, or the product of talent or creativity. A(H5N1) is a virus, oh, and by the way, viruses do not even meet the biological requirements of a life form.
Put bluntly: The sovereign country of Indonesia did nothing to invent, create, manufacture A(H5N1), nor did any of its citizens. In fact, just the opposite, a great deal of effort and money has been expended by Indonesians to eradicate the virus, much of the funding, expertise, and equipment to do so was donated by the international community.
In my previous posting I quoted the WIPO (World Intellectual Property Organization) finding (PDF link) explaining the fallacy of holding Intellectual Property rights over a naturally occurring virus, and I won't belabor the point once again—although I am sorely tempted just to express my own personal indignation over this entire concept.
Now, as far as I'm concerned, Indonesia can KEEP the damnable virus, as long as they KEEP it within the confines of their nation's borders.
For the "moral" aspect, I will draw upon a few comments by some of the other major players:
Pacific News Center Correspondent 11.NOV.07
12:04 p.m. Avian influenza continues to worry the Asia Pacific region's health officials. "One of the greatest threats to the survival of the human race," is how Dr. David Nabarro, the senior UN Coordinator for Avian and Human Influenza, told told reporters in Bangkok, and that while "Nations have made progress in containing the virus' spread, there remain some problem areas." [Emphasis added]
Opening remarks at the Intergovernmental Meeting on Pandemic Influenza Preparedness
20 November 2007
Dr Margaret Chan
Director-General of the World Health Organization
The prospect of an influenza pandemic raises some very big issues for public health. For WHO, the biggest issue is the threat that an influenza pandemic poses for global health security.
Vulnerability is universal. A pandemic will, by its very nature, reach every corner of the earth, and it will do so within a matter of months. As I have said on several occasions: this shared vulnerability calls for shared responsibility, and collective action to fulfil [sic] that responsibility. In terms of the risk of disease, we really are all in the same boat.
We must never lose sight of what a pandemic can mean under the unique conditions of the 21st century. SARS taught us how much the world has changed in terms of its vulnerability to the economic and social disruption caused by a new disease.
And SARS was by no means a global event. It was not a pandemic. SARS was largely a disease confined to the hospitals of wealthy cities.
Think of what may be in store. The last influenza pandemic began in 1968. At that time, airlines were not carrying more than 2 billion passengers each year, as they do today. HIV/AIDS was unknown in 1968. Tuberculosis had not resurged as a global threat.
At that time, in 1968, the world did not have the internet, which has spawned global interdependence in so many areas. This interdependence has greatly amplified the economic and social disruption that new diseases can cause.
Pandemics are recurring events. Countries need to brace themselves for a situation where up to 25% of the workforce may be ill at a given time. They have to brace themselves for a possible meltdown of basic municipal services and a slowdown of economic activity.
And this situation will be occurring globally. There will be no fortunate unaffected parts of the world.
Analysis and comparison of viruses allows WHO to update reagents and test kits. This contributes to diagnostic precision and sharpens surveillance. The sharing of currently circulating viruses is the only way to monitor the emergence of drug-resistant strains.
But above all, the sharing of viruses is the foundation of risk assessment. The analysis and comparison of viruses give us the first clues, the first early warning, that the virus may be evolving in a dangerous way.
This is our key difference from the past – this capacity to pick up the signal that tells us to gear up our defences and prepare our populations. This is one of the biggest advantages of the advance warning we have been given.
We have been given a unique opportunity in the form of an advance warning. We must not – I can say, we dare not – squander this opportunity. The stakes are too high.
How will history judge us, collectively, as an international community, as an agency like WHO, responsible for safeguarding international health security, or as individual countries? As I said, we have a shared responsibility to pursue collective security.
With this question, I also want to give you a challenge. This is now the fifth large meeting, held this year, concerned with the sharing of viruses and access to vaccines and other benefits. Millions of people outside this hall depend on us to make progress. [All emphasis added]
Heartfelt and impassioned pleas from people who carry a heavy burden.
Quoting again from yesterday's Reuters article:
Experts fear the constantly mutating virus could change into a form easily transmitted from person to person and sweep the world in months. A pandemic could kill millions of people, shut down businesses and overwhelm health care systems, they say.
What drives this fear and passion? The simplest answer it's all in the numbers.
Using round numbers:
There are six+/- billion of us
If 30% of us become ill that equals 1.8 billion
If 2% of the ill die that equals 36 million dead.
Those figures represent the Centers for Disease Control's (CDC) threshold for a severe pandemic, termed a Category 5 Pandemic on their severity scale of 1 – 5. And, just like with the Safer-Simpson scale for hurricane strength classification, which the pandemic scale was modeled on, there is a lot of severity above the threshold, but once that threshold is breeched it becomes, in many ways, academic. Catastrophic is—catastrophic.
Further reducing human beings to numbers and percentages: Every 1/10th of 1% of six (+/-) billion equates to six (+/-) million Men, women and children. Living, breathing, laughing, loving and loved, souls.
Those figures (human beings) would drive heartfelt impassioned pleas from my lips as well. Dr. Chan is correct when she framed the issue, not in pre-pandemic or pandemic vaccines, but in seeing this monster come at us. Again, the hurricane analogy is apropos: with several days warning generally afforded for a hurricane people have the opportunity to get out of harm's way. Without knowing a hurricane is coming loss of life is needlessly compounded, even for a moderate hurricane. Pandemics are no different.
In order to see what is (or is not) headed our way pandemic wise viral samples from every human occurrence must be analyzed and vetted by the scientific community. Indonesia has a moral obligation to participate in the scientific early warning system; or to use Mdm. Supari's own phrase: "it's the moral thing to do".