Global Trends by Martin Khor

Monday 21 May 2007

Call for new avian flu system in WHA

Last week Malaysia joined 22 other countries to call for a new system to ensure that vaccines will be available to developing countries if an avian flu pandemic breaks out.  The heated debate is continuing at the World Health Assembly


Avian flu took center stage when the World Health Assembly met last week in Geneva.

The debate wasn’t about how deadly the flu is or whether a pandemic will break out.  It was widely assumed that a pandemic would take place, sooner or later, and many millions will die unless steps are now taken.

The issue was whether developing countries will get vaccines to protect their people when an epidemic occurs.

At present, countries having human cases of avian flu are asked by the World Health Organisation to contribute their flu viruses to WHO centers.  But there is no mechanism in return to share the vaccines or the technologies to make them.

Malaysia, Indonesia and 21 other developing countries presented a draft resolution at the WHA calling for a new framework to govern the sharing of viruses and to prioritise the manufacture and availability of vaccines in developing countries.

The countries also called for a review of the practices of the WHO’s research network of collaborating centers.  These centers have come under fire for questionable conduct, such as passing on parts of the viruses to companies that patent and make profit-oriented activities using the viruses. 

The result is that developing countries cannot afford to buy the vaccines. And if a pandemic breaks out, the developed countries will corner the vaccines that are in short supply as annual production capacity is about 400 million doses, when the need is for one dose per person in the world.

Introducing the resolution, Indonesia said access to vaccines for developing countries is crucial in the fight against avian influenza.

It said the current system is unfair. Developing countries voluntarily provide viruses to WHO Centres and Reference Laboratories for research and diagnosis

When companies make vaccines from this, they do not inform or seek the consent of these countries and most importantly there is no mechanism to ensure that developing countries will have access to the vaccine in a timely and affordable manner, said Indonesia. So the goal is to have transparent, fair and equitable share of benefits from diagnostic, vaccine and other technologies.

“The framework must prioritise the needs of developing countries in accessing vaccines and other medical supplies in sufficient quantities and at affordable prices.”

The countries want the WHO to convene governments to review the present mechanisms for sharing vaccines, a new framework for sharing influenza vaccines and sharing the benefits from the use of the virus.

The Thai Health Minister said it is unaffordable and unfair when developing countries who shared the virus are offered the vaccine at US$20 per dose. The main problem is the limited global production capacity for influenza vaccine production. The shortage is huge and the cost is also huge for developing countries, such that they would suffer without the vaccines.

The Thai Minister added that many developed countries are now stockpiling vaccines via advance bookings, leaving behind developing countries on a waiting list.

He said the WHO needs to arrange for stockpiling of vaccines which are ready to be deployed to developing countries in the greatest need in the event of a pandemic.

A working group was set up to discuss the issue, but it is unclear whether some concrete plan will be agreed to by the time the WHA ends on Wednesday.

Another related issue hotly debated last week was the role that patents play in increasing prices of medicines.  Brazil introduced a resolution calling on the WHO to support countries that take measures to get cheaper generic medicines through compulsory licenses.

And the Africa Group wanted drugs that fight malaria to be made more accessible to poor people through government actions to supply generic products through measures such as compulsory licenses.