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HEALTH-INDONESIA: WHO Feathers Ruffled Over Bird Flu Vaccine

Marwaan Macan-Markar

BANGKOK, Feb 8 2007 (IPS) - A decision by the Indonesian government to be selective about sending local samples of the bird flu virus to the World Health Organisation (WHO) reflects fears harboured by developing countries of being marginalised in the race to find a vaccine for this deadly disease.

Jakarta’s plan was confirmed this week, prompting the WHO to express ”concern.” Indonesia wants to work in tandem with the U.S.-based Baxter Healthcare to develop a vaccine to inoculate its nationals from bird flu and secure additional benefits that would emerge from such treatment.

This route towards a vaccine is expected to rattle the prevailing global system to identify strains of flu for developing new vaccines. It was a system designed by the Geneva-based health agency with the backing of its 193 members and had been sustained through a spirit of cooperation.

”Indonesia has tossed the latest salvo into a debate that has been simmering under the surface for a long time,” says Basil Rodriques, regional immunisation officer for the East Asia and Pacific division of the United Nations Children’s Fund (UNICEF). ”It is an issue of relevance that the world needs to come to grips with.”

Indonesia’s decision forces public health officials to ask ”what is best for the public good,” he explained to IPS. ”Right now the world does not have the capacity to produce seasonal flu vaccines for everyone.”

Indonesia’s move is winning some sympathy among public health officials in Thailand who say that the WHO-established system – expecting countries to share information about virus samples isolated from among their nationals – is positive if the benefits are evenly shared.

But the reality is otherwise, they add, because developed countries gain more from the vaccines produced from virus samples collected from the developing world.

”Indonesia has a point in expressing concern to take care of the health of its people first. Any country will respond to its domestic needs first before looking at problems that concern other countries,” a senior Thai public health official in the country’s department of disease control told IPS on condition of anonymity. ”The WHO should address this new challenge from a global security point of view.”

Signs of such thinking among developing countries have emerged in the past months, most noticeably at a WHO meeting in January. On that occasion, representatives of developing nations expressed concern that their people are seeing only limited benefits from the current arrangement to develop vaccines, despite supplying the virus samples.

Late last year, Chinese authorities limited the amount of bird flu virus samples they were prepared to share with the WHO, leading to a clash between Beijing and the health body at a time when there was concern about a possible new “Fujian-like” strain, spreading through parts of southern China.

Indonesia’s decision takes on added weight because the country is the epicentre of the H5N1 virus, with a death toll of 63 people out of 83 who were infected.

Other South-east Asian countries like Vietnam, Thailand and Cambodia have had human fatalities too, placing the region on the frontline in ongoing efforts to curb an infection that threatens to mutate into one that could trigger a global flu pandemic, potentially killing millions.

So far, 160 people have died out of the total 270 cases of infection stemming from contact with poultry infected by the H5N1 strain of the virus. Human cases have been recorded in 11 countries out of the more than 50 nations across Asia, Africa and Europe where the virus has been reported.

The latest outbreak of bird flu, which began in the winter of 2003 in South-east Asia and has kept reappearing in an unpredictable manner, also triggered concern by developing countries in 2005 when there was a race to purchase limited stocks of Tamiflu. This drug was identified at the time as being the only one potent enough to respond to the spread of avian influenza.

Developed countries like the United States, Britain, France and Norway placed large orders of the drug from its producer, the Swiss pharmaceutical giant Roche, despite being free of any bird flu cases. South-east Asian countries that were more in need of the drug were forced to the back of the purchasing line.

”The U.S. and Western countries are gobbling up the drug and denying access to developing countries that need it most,” Philippines’ health secretary, Francois Duque, said in protest at the time. ”The poor countries once again have been excluded from the arena.”

Indonesia’s decision this week comes at a time when there is rising concern about a possible spike in bird flu cases following one of the worst floods the country’s capital, Jakarta, has experienced. The poorer neighbourhoods of this sprawling city, which were inundated by rising waters over the weekend, have also been under the watch of animal health officials for possible bird flu outbreaks.

The floods, which followed heavy rains, submerged close to 80 percent of Jakarta’s 44 districts, with some places going under three metres of water. The floods killed more than 30 people and forced 340,000 from their homes.

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