More on the Indonesian vaccine affair

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.

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When Indonesia withdrew from the longstanding system whereby countries shared influenza virus with WHO there was widespread consternation in the public health community. The sharing system has been used for many years to determine the candidate strains for the following year's vaccine. The regular…
Indonesia, as usual, presents us with a dilemma. It is one of the least effective nations in dealing with their bird flu problem, exhibiting massive incompetence spiced by corruption. This has helped make them the bird flu epicenter of the world, with more deaths (by a long way) than any other…
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you compare it with seasonal flu-vaccine,
and indeed, this could lead to, that countries
might claim for copyright on those samples too.
Who owns "A/Wisconsin/67/2005(H3N2)" as included in this
year's vax ? Wisconsin ? USA ? And then almost the same strain occurs worldwide. Spread by humans.
That would be nice, if we could sue them
for copyright infringement at least, while spreading
infectious disease is still legal in most countries ;-)

And one day China might sue Indonesia to share
copyright-royalties, since they have a proof that the
Indo-strain first developed in China...

Ballpark figure, what would it cost to build a global regional network of vaccine production facilities?
My guess is about a week of Iraq war?
Which would make us safer?

About 500 billion dollars. Just about the amount that Iran has spent on their nuke and missile programs which makes me feel a lot less safer.

By M. Randolph Kruger (not verified) on 08 Feb 2007 #permalink

Randy: How about the Indian nukes, which we are helping along, or the Pakistani nukes, or the Israeli nukes? Why single out Iran (who don't even have them yet)?

So everyone go and build vaccine programs and that will make the world safer. Non sequitur.

By M. Randolph Kruger (not verified) on 08 Feb 2007 #permalink

Randy: Read it again. A dozen or so regional centers, international support and sponsorship. Better than sending nuclear help to India.

I expect that the Indonesians know more about what happens when the powerful west gets their hands on something than we in the powerful west do. Before Mr. Bremer left Iraq he made sure a law was passed that forbade the saving of seeds In Iraq - see http://www.organicconsumers.org/patent/iraq111704.cfm

And the attempt in India to patent a traditional medicinal/insecticide - Neem. These countries don't trust the west for good reason.

http://news.bbc.co.uk/2/hi/south_asia/4916044.stm

"The Neem tree grows prolifically throughout South Asia, especially in India, Sri Lanka and Burma.

Its medicinal properties have been known about for thousands of years - Neem features in ancient Sanskrit texts - and its uses are so varied that this tree is called the "Village Pharmacy" of South Asia.

Recently, there has been a growing interest from the international agro-chemical business over the potential of Neem as an organic alternative to industrial pesticides.

Patents on the use of Neem have been taken out by international companies, one of which was at the centre of a 10-year court battle.We wanted to reveal what bio-piracy is, this patenting of indigenous knowledge and bio-diversity Vandana Shiva Indian environmentalist

An international group led by the Indian environmentalist Dr Vandana Shiva took the case to the European Patent Office, claiming you can't patent ancient knowledge, and calling it bio-piracy. "

And the Paki's and Indians fully understand the effects of popping a nuke. Iran popping one on Israel would likely indeed start WWIV. It is to their advantage to stall and cry we are just making electricity. Sorry, centrifuges do not make plutonium for electricity. It is an offensive weapons program and they now have a launch capability for the weapon. I prefer not to let them get one if for no other reason that the law of averages that someone will do something incredibly stupid eventually with ramifications for all.

I do agree though that using even a shitty vaccine might be better than nothing. Webster has one in the freezer but he says that even with it reengineered that its about the same as a very close pass on a blow torch, many will get burned but survive it. Some will end up too close to the flame. I dont believe that we have the technology to develop a vaccine that will even be more than slightly effective. The Indons are crazy to hold their attitude in the face of whats coming. How can a doctor take that stance? First do no harm.

By M. Randolph Kruger (not verified) on 08 Feb 2007 #permalink

Randy: Ahh. India and Pakistan and the Isarelis are sane but the Iranians are crazy? Whereas it's likely to the US to use nukes first in the US (with your blessing). I get it. I think.

And the WTO rules come back to bite us all in the ass. After all, if Monsanto can patent seeds, why can't Indonesia patent a virus? (While avoiding responsibility for all damag therefrom, of course.)

In the name of enlightened self-interest if nothing else, richer nations should share vaccine with poorer ones. Didn't a recent model show that would save the most lives, even in the so-called donor nations? In which case, couldn't countries come to some sort of agreement about doing that?

Speaking of models, I heard second-hand recently about a flu modeller who had the following provocative (and thought-provoking) suggestion for reducing the number deaths during a pandemic: Close the hospitals.

The implied use of a weapon requires that you have it of course first. The Indians and Paki's have been eyeballing each other for years. No one has blinked and no one has fired it off. Both know that if they do they will lose approximately 13 million total on each side. India would suffer the most because they would not only get hit but they would get fallout from both shots. They also have a lot of distance before the radiatoin would drift onto a major powers soil. Measurable but likely not lethal.

On the other hand the Iranians placed their nuke development sites right on the border with Russia. It was of course intentional. The bunker busters can penetrate to about 200 feet now, but the concussion wave can travel downward as a result to about 500 feet using a nuke type. This would make it nearly an underground test. The Ruskes could do two things if it happens. Go to war or not. Diplomacy at that stage I think would be over with. Then a decision would need to be made here. Would we attack Russia over Israel? I dont know. The end result is the same. If Iran gets a bomb or two, they use one on Israel and its over. If Israel hits Iran preemptively and the Russians respond, its over for Israel at the least. It would of course be a nuke attack against them. Hence the reference to this starting WWiV. The Indians and Pakis's are perfectly content to shoot at each other in the Kashmir every couple of years.

This is sane Revere. No on is dying or is about to die and its a balance of sanity against something thats insane. On the other hand you get one guy on the block thats got a death wish, you generally have to take him out if you see him loading dynamite into his garage. Especially when he yells at you and tell you that you are going to die in the fires of Hell. Seems I saw that out of Amadinijad this week. We know the Iraqi's supported terrorists now because they wanted to negotiate as late as two weeks prior to the attack. It would have left Saddam in power though and that was the sticker.

We have toys that can hit Bushehr and eliminate the threat. Remember Al-Baradei himself said they are now only a max of 3 years away from getting a bomb to as little as a year. We are just sharpening our knives. Fur ball starts in about a month. Might hold up until fall but come it will. Iran by the way Revere signed the nuclear non-prolif treaty. All except the one key provision that would allow us to attack them now for violations. They get the bomb we attack.They get any closer to making it we attack. WE get to be the bad guy, again. We can do it conventionally as well and might topple Iran in the process. They get to say those asshole Americans again.

By M. Randolph Kruger (not verified) on 08 Feb 2007 #permalink

There is one thing, and one thing only that works in Indonesia. MONEY. If you have the money to pay the bribes, things start happening. I willing to bet that when enough money crosses a few palms we will see a great willingness to share blood samples.

Why should Indonesians be different from Americans?

Revere-my which I think was misinterpreted is that Iran isnt going to be allowed to get a bomb by the US or Israel period. The reason we are more likely to do something about it is that Israel really only has one shot to get this done and thats with a nuke. Wont matter if it punches a hole in the ground or not to stop them. They (or the US) would have to drive thru some of the most formidable Triple A batteries in the world to get it . It would require one hell of a lot of SEAD or a wilingness not to engage anything more than enough to create a tunnel to get there on the part of the Israeli's. They also know that the only way to stop them is likely with a nuke that poisons the earth in the area for several million years. Thus it prevents them from ever using that facility again.

I also submit that there are alternatives to a nuke, like quit building it and we wont come. If they attack Israel, they will retaliate with a nuke without a doubt and they will do so with extreme predjudice. If they attack pre-emptively with the nuke facilities as their primary they would be foolish not to target Teheran as a secondary. That is of course if they couldnt fight their way into Bushehr. The USNavy is working on a non nuke Trident II version that would hit the earth at 22,000 miles per hour. If the coordinate are exact the warheads would kill everyone inside of a bunker as the dirt would turn to superheated plasma. Its not out there just yet, but this is far superior to a nuke. We wouldnt target Teheran, but they might.

By M. Randolph Kruger (not verified) on 09 Feb 2007 #permalink

The Isarelis aren't going to nuke Iran as the consequences would be catastrophic and the Iranians aren't going to nuke anyone for the same reason. The Iranians want the bomb for the same reason NK and others do. Because we showed in Iraq what we think of countries that don't have it yet and what we do when a country does have it. Thanks for Iraq, Randy.

So resurrect Saddam and put him back in power Revere. Somewhere along the way you would be saying that we didnt do enough to take him out of power. Please....

The inevitability of a second war was out there 15 minutes after we concluded ops in the first one. Clinton should have hit them the minute they targeted one of our airplanes enforcing the no fly zone. So what Revere, I should just accept what you say as being fact. Be sure to tell the Kurds and now plus 400,000 in unmarked graves that you think Iraq was a bad deal. Fact is that this is now a political war rather than a real war. Cant hit this target, cant hit that one. Kind of reminds me of a little country called Vietnam. We could have rolled over them in under six months but didnt. Same applies here because we dont want to screw up some Muslim interpretation of what a legit target is. Its a war. Scorch the earth and leave the mess for them to clean up. They wont be attacking anyone if we smack most of the ones attacking us six feet into the ground. We have achieved the military goals, the political one has not appeared and I will say first hand that they would be negotiating if we were killing them in large numbers. So instead we send out patrols that are GUARANTEED to get our people dead. Dumb!

Dont thank me for Iraq as I think militarily which is from where I speak that it was handled near flawlessly. Its the post major hostilities that didnt work out. Out of my venue and out of my pervue. I can negotiate but not with people that wont enforce their own laws. I wouldnt be nice to anyone if I were in charge. They would know that to raise their hands to our troops would result in extreme casualties on their part. I give them something, they give me something. You want us out? Take over control of the streets.

By M. Randolph Kruger (not verified) on 09 Feb 2007 #permalink

Randy: Saddam was bad but the alternative has been worse. There are a lot of other bad actors out there but they aren't sitting on oil or were sitting on oil or were our friends. We didn't invade them. We shouldn't have invaded. And as for, "Don't blame me, I'm just looking at hte military angle," there's no such thing as "just military." Military actions have consequences and they are easily foreseeable and were foreseen by many. And they were done anyway. Thanks.

Everything has consequences.
Every thought, every word, every deed, every action.
Everything.

Kruger, you are making one huge assumption which you are not telling us.. you are probably not telling you..

You are assuming that the victims of our bombs are cowards like us, and our kids over there, riding around in our tanks and helicopters.

You are wrong. They are not cowards. They are merely crushed by our machines.

It's evolution live and up close. If you do not successfuly exterminate every last one of them, the survivors will come back and they will be stronger.

Can you do that, Kruger? Can you murder every one? Do you have enough machines?

Will we allow you? We are evolving, too.

Greg... You are damned skippy I could. That area of this planet would have been pacified. I can remember a certain Colonel in WWII who was viciously derided by the media for personally rappelling down the side of hills with satchel charges strapped to 5 gallons of gasoline. His orders to his men were to shoot them as they came out burning alive. His men had been attacked in frontal banzai attacks, his men beheaded when captured, disemboweled and tortured by placement on a pole over a hot fire. His comment was, "The Japanese have their butcheries, leave me to mine."

He was later promoted to four star general.

I never said they were cowards, just motivated. I seek to stop that motivation by any means necessary. Seems to me that you might be on the wong side their Greg. Feel free to walk thru Fallujah and tell them you are a Brit or American and that you are there to help. Pacifism was never my game. Pacification is. If they want to shoot at us from a known terrorist hangout then post the notices that you are no longer going to use bullets when they use a roadside bomb. We will just drop a few on them. Its not a war, its a joke now. The single aim now will be to take Iran out of the equation for a generation. A failure to do so will result in the most extreme consequences. I am not auto-anti war like so many here. Far from it. But if you go in for whatever reason you had better win it. Revere will be auto-wrong when Iran gets a nuke and whether he agrees or not, no one is going to let them have one. Simple as that.

By M. Randolph Kruger (not verified) on 09 Feb 2007 #permalink

Randy: "Pacifism was never my game. Pacification is. . . . I am not auto-anti war like so many here. Far from it."

Well we can agree on that. Auto-war, maybe. And a 100% record for being wrong on every thing so far in the Middle East. How many times has the balloon gone up, Randy? I guess it's bad flying weather for balloons. Hope that keeps up. Simple as that.

Well I guess its all about interpretations now isnt it Revere. Just cause you say it doesnt make it so. History is going to have to decide this one I think.

Lets see, first set them free-Revere calls that bad.
Next, free elections for the first time like 25 years or so-Revere bad.
Killing two sons that were clearly nut cases-Revere bad.
Newly constituted government and not a puppet one either-Revere bad.
Rebuilding Iraq-Revere bad. Women not being repressed-Revere bad.
Trial by Iraqi government of former dicator, resulting in hanging-Revere bad.
Kurdistan no longer repressed-Revere bad.

I could go on. Except for premise of reasons to go in I dont think that the few thousand insurgents from other countries along with a few Muslim extremists getting killed is going to be the return. Even if you do, I would be able to counter it with something good about this. We are out of Iraq by 08 anyway with fewer casualties in the first three years than we took on the Mayaguez incident.

By M. Randolph Kruger (not verified) on 09 Feb 2007 #permalink

Randy: First, thanks for the sentiments on the other comment (for those of you who haven't read it, this is NOT a sarcastic comment). I've come to expect this from you. You are one weird bugger. Now back to combat:

Lets see, first set them free-Revere calls that bad. [and I think most of them would agree with me. They aren't free. They are terrified and many are dead.]

Next, free elections for the first time like 25 years or so-Revere bad. [Clearly they are worse off and have no functioning government. So much for a free election.]

Killing two sons that were clearly nut cases-Revere bad. [And 3100 Americans and god knows how many Iraqis. Worth it?]

Newly constituted government and not a puppet one either-Revere bad. [The thing Bush hates about it is that it isn't a puppet. Of the US, anyway. Of the Iranians, maybe.]

Rebuilding Iraq-Revere bad. Women not being repressed-Revere bad. [Rebuilding? Don't you mean dismantling? Ask the mothers and young girls what they think.]

Trial by Iraqi government of former dicator, resulting in hanging-Revere bad. [Yes, bad.]

Kurdistan no longer repressed-Revere bad. [Kurdistan was independent before the invasion.]

Yeah, Revere, Kruger would never do dirty like that.

Kruger, you are full of shit on many things, but you are honourable as far as you can see. We got you a new pair of glasses. You can try them on any time you want to see further.

It is as I said Revere, perception. With two units on the ground there that I served with and having trained quite a few of them who send me the real story I guess you guys will have to rely on Pelosi and Katie Couric.

You easily dismiss what happened on 9/11 and feel that there was no linkage. I will simply disagree and let that go at that. Greg have a nice day.

By M. Randolph Kruger (not verified) on 10 Feb 2007 #permalink

Thank you, Kruger.

It's nicer when you are not surrounded by people giving you black looks because they're wondering when you are going to panic and start bombing their families and their families' families.

No Greg, I see that black look when the realization that with the right combination of factors including Revere's lets get outta there could end up having a WMD go off in my back yard. We are a VERY soft target here, better to give them a lightning rod there.

You be sure to tell the Spanish, Brits, French and Germans all about that black look as they have had terrorist attacks for years. Perhaps you forget the London bombings. You'll turn around and say its because we are in Iraq. No its not. Its because we are at war and you for the time being get to sit back and say the things you do. Right up until the time that something major happens and we get hit again. We are out of Iraq by March of 08. Then what?

You had better hope that then what doesnt come.

By M. Randolph Kruger (not verified) on 11 Feb 2007 #permalink

You have forgotten a few things yourself, Kruger. We've been bombing them and families etc, murdering them, for fifteen years. We imposed on them some of the most vicious regimes in the world for half a century before. Now, we have saddled them with a dysfunctional government, a cruel joke of a constitution, and one of our most sophisticated fortresses right in the middle of their capital city. It seems unlikely that when we "leave" we will so much as apologize; we will humiliate our purchased Quislings by making them thank us for the abuse.

We can expect some of the grieving survivors to attempt something foolish. We better keep our eyes open, don't you think?

Also, we better keep an eye on our own black-ops freaks, guys like Ollie North.