I sympathize with the Indonesians up to a point. Their outrage over what they perceive as the plundering by vaccine makers of their natural resources (in this case a lethal virus isolated from Indonesian bird flu cases) is understandable — barely. Their subsequent actions to stop sharing samples of the virus with WHO and their attempt to justify it by blaming WHO is not understandable. Nor is it intelligent. But then very little in the way of effective and intelligent bird flu policies has come out of Indonesia anyway. This is part of the package, alas.
The complaint of the Indonesian authorities that H5N1 viral isolates from Indonesian nationals supplied to WHO were then passed on to pharmaceutical companies to make vaccines is a bit disingenuous. WHO’s practice has been to allow free access to potential vaccine seed strains to vaccine makers. For seasonal flu, WHO makes a decision on which strains to include for the next flu years and then releases the seeds to makers on a non-exclusive basis. In the case of H5N1 we don’t know which strain will be the best match if a pandemic develops, so apparently WHO is making candidate strains available to whoever wishes to make a pre-pandemic vaccine, at their own risk. Thus this is not a new or nefarious development. The possibility that the virus will be too costly for countries in the developing world is justified and needs to be addressed. To that extent, the Indonesian move can be seen as an attempt to get that addressed. I would have more sympathy if it were a thought out tactic meant to solve this problem quickly. Unfortunately I am more inclined to believe it is another case of the Indonesian Ministry of Health shooting the world in the foot.
Even a partially effective vaccine against H5N1 is a global public good. A pandemic strain cannot be contained, but targeted use of a pre-pandemic strain might slow the spread enough to allow additional days or weeks for preparation. Extra time to prepare for a pandemic is measured in human lives. The compromise on the part of the developed world is that they cannot reserve the first use of the vaccine for themselves.
A virus is not Indonesia’s intellectual property. Nor is it a resource to be monopolized by rich countries. It should not be bought and sold and vaccines that might slow a pandemic should not be subject to market forces. WHO should commence as soon as possible to build a global regional network of vaccine manufacturing facilities to produce vaccines at cost. This cannot be done in a three year time frame but it could be done in a five to ten year period. Many people doubt we will have that much time, but if we don’t start now, that question will answer itself. If we run out of time, we do. There’s nothing that can be done to make this appear magically. But now we know what to do we ought to get busy doing it, and hope we beat the clock.