Global Trends by Martin Khor

Monday 26 February 2007

Fair system needed to share bird flu drugs

Bird-flu virus samples are provided free by developing countries, but drug companies patent vaccines using these samples and sell them at high cost.  A fairer system is needed to share both the virus samples and vaccines.


If there is a pandemic of the deadly “bird flu” affecting humans, will there be enough medicines and can the poor afford them?

It’s a life-and-death issue. Vaccines are available, but the usefulness of existing ones is being debated. New ones are being researched. But will there be enough stocks, and how expensive will they be?

With avian flu cases affecting more people in Asian countries, these issues are coming to the fore. The present global system is not working.  In fact it is most unfair.

A few days ago, Indonesia caused a storm when it said it would no longer share samples of the bird-flu virus with the World Health Organisation or its collaborating research centres.

It had good reason.   It was against big drug companies getting the samples to develop vaccines which they would then patent and offer back to Indonesia at high prices.

According to international law (the Biodiversity Convention), genetic resources belong to the country of origin. Foreigners can take and use these resources only with the permission of the government, which can insist on a benefit-sharing scheme as a condition.

However, the WHO expects countries to freely share samples of viruses that have the potential to cause a global health problem. There have been cases before of samples of other viruses given to WHO that have been used by corporations to obtain patents, without any benefits going to the source countries.

Indonesia’s decision to stop sharing bird flu samples unless the WHO stopped providing the strains to commercial vaccine makers won support from other Asian countries.

Triono Soendoro, Director General of Indonesia’s National Institute of Health Research and Development, revealed that the decision was made after CSL, an Australian drug company, developed and tried to market a vaccine using the Indonesian strain of the virus without Indonesia’s consent.

Soendoro said that several Indonesian laws regulate the sharing of virus specimens. Each specimen that Indonesia sends abroad should be accompanied by a Material Transfer Agreement (MTA) which stipulates that the permission of the sending party is required if the sample is to be developed for commercial purposes. There should also be a benefit-sharing scheme.

However, the MTA was waived when the bird flu broke out in 2005, to make sample sharing easier.  The sample transfers were based on trust, that nobody would violate the principles of the MTA.

Soendoro said:  “We screamed when we heard that an international company wanted to sell us the vaccine, which was developed from our strain without our permission.  They should have been more ethical. Just because it's the WHO does not mean that they can violate the rules.”

Indonesia has now signed an agreement with the U.S. drug company Baxter Healthcare to develop a human bird flu vaccine.  Indonesia would provide H5N1 virus samples while the company would in return provide it with expertise in vaccine production.

The move was to ensure people had access to the vaccine during a pandemic, as otherwise it would have to buy the vaccines from commercial drug-makers at high prices. They maintain that the WHO’s virus-sharing mechanism has been misused for commercial purposes.

According to the Associated Press:  “Other countries, including China, Thailand and Vietnam, have previously stalled on sharing viruses. Like Indonesia, they fear the vaccines and drugs produced from their viruses would ultimately be unaffordable for them, leaving their populations dangerously vulnerable — while rich countries add to their stockpiles.”

An IPS article quotes Philippines' health secretary, Francois Duque: ''The US and Western countries are gobbling up the drug and denying access to developing countries that need it most. The poor countries once again have been excluded from the arena.''

At a WHO meeting last May, Thailand raised the issue of the high costs of bird-flu vaccines and insisted that the price of vaccines should be brought down. It proposed that the virus samples be given to the WHO "for non-commercial purposes only”.  Under the current system of vaccine seed stock "the result will be a monopoly".

The Thai resolution failed.  A compromise was adopted, in which countries would still share samples with the WHO, and the WHO would find solutions to reduce the global shortage and inequitable access to the flu vaccine and to make them more affordable.

The New York Times in an editorial said: “Indonesia has raised a valid point that needs to be addressed: if a pandemic should strike, poor countries would be left without protection.” 

If a pandemic struck, the current vaccine makers could produce only 500 million doses of vaccine per year, far short of what would be needed to vaccinate all 6.7 billion people in the world, said the Times.

“In a crisis, the countries that are home to the vaccine makers would tend to their own citizens first — or those willing to pay the highest prices — leaving little or no vaccine for everyone else.”

Indonesia and the WHO are now planning to hold a meeting of Asian countries to identify “mechanisms for equitable access to influenza vaccine and production.”

Meanwhile, Indonesian Health Minister, Siti Fadilah Supari, maintained that Indonesia will continue withholding its bird flu virus samples from foreign laboratories until there is a new global mechanism for virus sharing that has better terms for developing countries.