TWN Info Service on Health Issues (February 07/08)

22 February 2007

Indonesia to share bird-flu samples only if there is new system

Indonesia’s reluctance to provide flu samples to the WHO stands unless and until there is a new global mechanism for virus sharing that is favourable to developing countries.

The following story is reproduced with the permission of South-North Development Monitor (SUNS) #6195, 21 February 2007.

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Evelyne Hong
TWN

Health: Indonesia to share bird-flu samples only if there is new system

By Martin Khor, Penang, 20 February 2007

The Indonesian Health Minister, Siti Fadilah Supari, has 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.

She conveyed this message last Friday (16 February) to Indonesian media after a meeting held with officials of the World Health Organisation.

The Indonesian daily, The Jakarta Post, quoted the Minister as saying: "Indonesia will insist on a material transfer agreement before sending the Indonesian strain of bird flu virus to foreign laboratories to prevent them from being used for commercial purposes.

"We agree to send the virus to the WHO with new conditions or mechanisms approved by both parties as well as by other developing countries. Until then, we won't share the samples."

Siti also remarked that the WHO had often been in favour of capital owners. "The organization sometimes forgets the good of the people in general and we want to change that," she said.

The Jakarta Post report added that Indonesia and several developing countries from the Asia Pacific region will meet in March to discuss a more equitable mechanism for virus sharing and access to vaccine production.

The Health Minister met senior World Health Organization officials, including acting assistant director general for communicable diseases David Heyman, acting director for the Global Influenza Program, Keiji Fukuda, and WHO representative to Indonesia George Peterson.

The comments of the Minister, after her meeting with the WHO officials, seem to have a different shade of meaning than what she was purported to have said in a WHO press release of 16 February.

According to the WHO release: "The Minister agrees that the responsible, free and rapid sharing of influenza viruses with WHO, including H5N1, is necessary for global public health security and will resume sharing viruses for this purpose.

"WHO will continue discussions and work with the Ministry of Health and other countries to assess and develop potential mechanisms, including Material Transfer Agreements, that could promote equitable distribution and availability of pandemic influenza vaccines developed and produced from these viruses."

The Jakarta Post report implies that Indonesia will resume sharing the bird flu virus only after a new and fair global mechanism for ensuring that developing countries obtain equitable access to vaccines is in place.

Indonesia and several other Asian developing countries have been unhappy with the present system under which WHO member states are obliged to share virus samples with the WHO and its collaborating research centres, but there is no regulation over the commercial use and patenting of these viruses.

When new vaccines or anti-viral drugs are produced, they are usually priced high, and the developing countries, including those that donated the virus samples, are unable to afford them. Health officials of several countries have been demanding that a more equitable system of access to vaccines for the human version of bird flu and other diseases be established.

Earlier this month, Indonesia signed an agreement with the US drug company Baxter Healthcare to develop a human bird flu vaccine. Indonesia would provide H5N1 virus samples while the company would provide it with technology and expertise in vaccine production. As part of the agreement, the WHO and other organizations would have access to the samples only if they agreed not to distribute them to commercial companies.

The Jakarta Post has also published an interview with Triono Soendoro, Director General of Indonesia's National Institute of Health Research and Development, one of the main officials managing the issue, that throws more light on the events leading to Indonesia's controversial actions.

The report, entitled "WHO must follow rules, like everyone else", revealed that Indonesia stopped sharing its bird flu samples with the WHO after CSL, an Australian drugmaker, developed and tried to market a vaccine using the Indonesian strain of the virus without the Health Ministry'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 is internationally recognized.

"The agreement stipulates that the permission of the sending party is required if the sample is to be developed for commercial purposes," he said. "It also states that there should be a benefit-sharing scheme if it is to be used commercially.

"However, when bird flu broke out in 2005, health officials and scientists around the world were in a panic. Because of the chaos in the global health world, the MTA was scrapped in order to make sample sharing easier.

"Since then, every sample transfer was done based only on the trust that nobody would violate the MTA. If we had insisted on using the MTA, many countries might have accused us of being overly bureaucratic in the midst of a global health scare."

Asked why Indonesia felt that it had been treated unfairly since there is no MTA between Indonesia and the WHO, 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.

"Although there was no MTA at the time, they should have been more ethical. Just because it's the WHO does not mean that they can violate the rules. There are only four places where WHO Collaborating Centres are associated: London, Tokyo, Atlanta and Melbourne. All were selected by the organization to do diagnoses or research under the WHO."

Soendoro also remarked that the WHO Collaborating Centres "act like Santa Claus. They are generous in sharing data. It has been a tradition over the decades that a country with a seasonal flu gives out virus strains to whoever asks for it. In Indonesia, we are concerned about bird flu because it has a higher risk of fatality, with an average of eight deaths in 10 cases."

He said that Indonesia had decided to cooperate with Baxter as it was "the only company that contacted us and was ready to follow all of our conditions. They even agreed to sign the MTA agreement."

On the consequences of stopping the sharing of the bird flu samples, Soendoro said many foreign media had criticized Indonesia because of its decision, "but health officials and the media in Asia have supported us for our effort to ensure fairness. We have no commercial interests; we want the whole world to benefit."

He added that the bird flu virus strain in Indonesia matters because 80% of bird flu deaths have been caused by the distinct Indonesian virus. Producing a vaccine from the local strain would protect other countries from the virus.

The health official concluded: "Based on scientific predictions, it's just a matter of time before the next pandemic occurs. If every pharmaceutical company was forced to produce the vaccine, they would still only be able to produce about 500 million doses. This means that only 250 million people in the world would receive the vaccine, and Indonesia would get nothing."