As of yesterday, Indonesia has suffered more confirmed human deaths (72) from the avian flu than any other country. (Here are World Health Organization statistics.) In February, Indonesia stopped sending samples of the flu to the WHO. They wanted to prevent drug companies from developing and patenting vaccines that they (and other poor countries) could not afford. In a February story (that I missed at the time), the NY Times reported:
Dr. David L. Heymann, chief of communicable diseases at the [WHO], who negotiated in Jakarta, the Indonesian capital, with the health minister, thanked Indonesia for drawing attention to the problem and said he had been assured that it “would not hold the W.H.O. hostage to the virus,” wire service reports from Indonesia said.
…
Dr. Heymann said that a fund to buy vaccine for poor countries could be discussed at the March meeting and that his agency would help Indonesia eventually develop its own vaccine factories.
At the end of March, Indonesia and the WHO reached an agreement according to which Indonesia would resume sharing samples with the WHO, on the condition that “not share virus samples with commercial vaccine makers without permission from the source country”.
Now, news comes that
GlaxoSmithKline (GSK), Britain’s largest drugs company, is in talks with the World Health Organisation (WHO) about a proposal for a subsidised mass vaccination programme against avian flu for developing countries, The Times has learnt.
Hopefully these negotiations will be fruitful. It seems as though Indonesia has played the game successfully – but what a dangerous game they were forced to play.
{ 19 comments }
Barry 04.04.07 at 2:53 pm
It seems to me that they figured that they wanted to get the vaccine, rather than furnish data and then be charged for the resulting products. If a commercial company refused to release information without charge, wouldn’t that be considered simply smart business?
revere 04.04.07 at 3:31 pm
The basic problem, however, is that current total global capacity is 500,000,000 doses of influenza vaccine per year. There are roughly half that number of people in Indonesia alone, so the question of providing vaccine for the developing — or the developed — world is moot. The rich countries have the vaccine plants and whatever the promises, will keep most of it for themselves. The small amount (compared to the need) that goes to a country like Indonesia, will go to their rich elites. They are very corrupt and incompetent, and while they have correctly pointed to a problem, they have not solved it.
Influenza vaccine must be produced outside the market system in a regionalized and internationally supported system of international vaccine institutes. The market doesn’t work for this product and the idea that a virus from a dead citizen is somehow “intellectual property” is fatuous.
So they have underscored a real problem (which we knew existed) but have not come close to solving it. All they did was save face in the context of widespread dismay at their actions.
Katherine 04.04.07 at 4:32 pm
The problem was not only that they didn’t want to be cahrged for the resulting products, more that many industrialised countries have specific laws designed to prevent the export of vaccine in the case of an epidemic. Theoretically therefore, in the case of a global epidemic, the vaccines developed from samples from Indonesia might not have just been expensive but simply unobtainable at any price.
hermenauta 04.04.07 at 5:50 pm
Some years ago (2001) the brazilian health minister, José Serra, broke the Roche´s patent for Nelfinavir, a chemical compound used to treat AIDS. It was a controverse move, even inside the brazilian government, but helped to bring down the cost of providing it to the patients by 60%.
I realize that it is a somewhat cynical propostal, but I think that Indonesia could keep providing the samples in the hope of breaking the patent for future medicines and vaccines to avian flu. I bet that Big Pharma would still profit from the sales of the medicine in rich countries (if ever avian flu becomes a pandemic illness).
Brett Bellmore 04.04.07 at 6:07 pm
I suppose that, if we were going to get into a proper pissing match, developed nations could point out that we wouldn’t need to develope so many vaccines if they’d just stop incubating new plagues, and that coughing up free gene samples of the latest bug was merely compensation, and inadequate at that, for that offense.
“and that his agency would help Indonesia eventually develop its own vaccine factories.”
Really, the only genuine solution.
Barry 04.04.07 at 8:01 pm
Brett: “I suppose that, if we were going to get into a proper pissing match, developed nations could point out that we wouldn’t need to develope so many vaccines if they’d just stop incubating new plagues, and that coughing up free gene samples of the latest bug was merely compensation, and inadequate at that, for that offense.”
Even for Brett, this is rich.
hermenauta 04.04.07 at 9:32 pm
“we wouldn’t need to develope so many vaccines if they’d just stop incubating new plagues”
I´m anxious to hear from you, Brett, some enlighted suggestion about how to accomplish this.
Of course people from developing countries could just cease to exist, but for some reason I can´t see developed countries people (americans, for example) living without mexicans (or for that matter other cheap workforce). Who knows.
taj 04.04.07 at 9:38 pm
War profiteering has been looked down upon and made illegal in societies for hundreds of years. Profiteering from disease seems to me to be far more serious, yet I have not yet seen equal public effort to portray it as such.
taj 04.04.07 at 9:50 pm
bq. “we wouldn’t need to develope so many vaccines if they’d just stop incubating new plagues”
Well, consider it a return favour for having taught Europe the benefits of personal hygiene in the 17th century.
Brett Bellmore 04.04.07 at 10:53 pm
Well, there’s not a lot they can do to avoid churning out new plagues, I’ll grant you that, so I was being somewhat sarcastic. But it’s still a bit iffy to be making demands like this when the problem is originating in your own backyard, and threatening others. Providing those samples is about the only help they’re in a position to provide when it comes to solving the problem. And it’s not a problem drug companies in the developed world created.
Strikes me as on a par with refusing to let the fire department know what’s in those drums that caught fire in your backyard, unless they promise to treat you for smoke inhalation for free.
TJIT 04.04.07 at 11:44 pm
This case is not from Indonesia but it would be helpful if things like this did not happen again.
Bird Flu Drug Rendered Useless
Chinese Chickens Given Medication Made for Humans
Michael Mouse 04.05.07 at 8:00 am
Strikes me as on a par with refusing to let the fire department know what’s in those drums that caught fire in your backyard, unless they promise to treat you for smoke inhalation for free.
Not at all. Indonesia’s concern – and a well-founded one it is – is that their samples will be used to create vaccine stocks elsewhere which they will have no access to in the event of a pandemic breaking out, since all the developed nations (where the vaccine factories are) will seize control of the supplies to treat their own citizens in such an event. And that’s leaving barriers of affordability and IPR to one side.
The parallel is more with refusing to let the fire department use your backyard for training when you know they won’t show if a firestorm breaks out.
eudoxis 04.05.07 at 12:35 pm
Indonesia needs to set up its own vaccine production facility. I believe their are working toward that goal with an agreement with Baxter. A global fairness policy is not a solution to the capacity and distribution problem of a flu pandemic.
Katherine 04.05.07 at 1:26 pm
“A global fairness policy is not a solution to the capacity and distribution problem of a flue pandemic”
Why on earth not? Why can’t it be part of the solution? Better than a global UNfairness policy, surely?
eudoxis 04.05.07 at 1:36 pm
Why not? Because of capacity and distribution problems.
eudoxis 04.05.07 at 1:57 pm
Even if a potential vaccine were made available at no cost, production of such a vaccine in large enough quantity and distribution to locations with highest need would be obstacles to a “fair” administration of the vaccine. Countries with outbreaks of avian flu recognize this and are establishing their own production facilities. Currently, there are 16 centers working on avian flu vaccines. The critical vaccine can only be produced once the virus mutates leading to a pandemic.
Cyrus 04.05.07 at 2:40 pm
Well, in the case of flu, there are some things that could be done. Outlawing the cohabitation of humans with fowl and swine would do a lot, but I’m not sure it would be enough to compensate the reduced availability of protein.
Hermenauta 04.06.07 at 12:53 am
Brett,
Concerning “problems originating in your own backyard and threatening others”, I thought of Jared Diamond and the gift of bugs europeans brought to the new world without much consideration. But I really don’t need to play such an inelegant card _ maybe just remembering you of greenhouse gas emissions should suffice.
Roy Belmont 04.06.07 at 11:13 pm
The parallel is more with refusing to let the fire department use your backyard for training when you know they won’t show if a firestorm breaks out
Not at all.
The parallel is more with refusing to let the fire department use your backyard for training because they’re a private company with obscene profit margins provably grown rich on the backs of an inevitably rising population with inevitable medical crises and no other options than using their services at whatever exhorbitant and extortionate fees they choose to levy.
Health care as a business is itself a disease.
Comments on this entry are closed.