Cooks spoiling the broth in Indonesia

Two news items from Indonesia, one about a new case of bird flu, one about the competency and responsibility of the Indonesian authorities. I take that back. The competence and responsibility of the Indonesian authorities are not in doubt. They have neither.

First, the new case:

Bird flu has killed a woman in Indonesia, taking the death toll in the country worst hit by the deadly virus to 75, a health ministry official said on Monday.

Two series of tests confirmed that the 29-year-old woman was infected with the deadly H5N1 strain of the virus, said Suhardaningrum, from the national bird flu information centre.

The woman was admitted to the International Hospital in Medan in northern Sumatra on May 1 and died two days later, the official said.

"There is a new bird flu victim and it is a woman, the 75th person to die," said Suhardaningrum.

It was unclear how the woman contracted the virus as she did not have any known contact with sick poultry, the most common form of infection, other officials said. (Agence France Presse)

What's unusual about this is that the Indonesian authorities couldn't find any poultry anywhere near this woman, no matter how remote or unlikely the connection, as is their usual custom. In actual fact the connection with infected poultry is often pretty murky, as we have remarked so often. Indonesia is now the human bird flu capital of the world with more deaths and more cases than anyone else.

This hasn't made them more eager to work with international health authorities. They are still refusing to share viral isolates with WHO (see here, here, here and here). Now it's reported they want a written guarantee that any country will be entitled to grant permission for use of viral isolates, in essence allowing a veto for use of isolates coming from one of its citizens, for whatever reason they wish. Or at least so it appears, and if true it is easy to see why WHO would balk at such a demand.

The virus keeps changing its recipe for making copies of itself. The recipe includes the kitchen. And Indonesia is showing itself the ideal kitchen for H5N1's recipe experiments.

Thanks to the restaurant's management.

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I find it inconceivable (and at the same time entirely conceivable) that this country that has been the recipient of so much goodwill and foreign aid from every corner of the world over the past few years now holds the welfare of the world over a barrel in such a manner.

If China gets a 'pass' from the World Health Organization, why should Indonesia be ostracized for the same behavior?

What is good for the goose is good for the gander.

Revere.

It may be just me but ethics = consistency whether it is the World Health Organization or Scientific Journals like the Canadian Medical Journal.

...for example...from adulterants to illegal food additives such as formaldehyde, sulphites, chloramphenicol etc. or third country labelling of food products specifically avoid identification of 'Product of China'.

The WHO has repeatedly criticized small inconsequential countries while leaving China alone.

In a report yesterday, it appears WHO statements are not based on scientific evidence...now there is a big surprise.

The WHO never lets the scientific evidence get in the way of a good story.

They have no respect...they deserve no respect...the silent within this agency are guilty by association.

I should have said...In a peer reviewed scientific journal yesterday, it was reported that World Health Organization statements are not based on scientific evidence...

...now there is a real shocker!!

Tom: With all due respect, I believe it is you who have no consistent respect for evidence. You have a fixed idea and no amount of evidence will alter it. I have a post coming on the WHO/Lancet critique but WHO is a large organization and some of it uses evidence in a very rigorous manner (e.g., IARC). You have little experience of WHO generally and cherry pick those things that bother you (and bother other people as well). If you applied the same standards to the gov. of Canada or the US or (probably) or your own veterinary association (I admit I haven't checked it) you could come up with the same judgments. You dismay me with your lack of constructiveness and tendency to interpret everything in one way. The world is not so simple nor do you offer solutions.

Do you really believe that ethics anbd consistency are one and the same? Because you said it and should be held accountable for it by your own lights. So a consistently evil person is an ethical one? Or would you like us to accord you the same leeway you refuse to accord others?

Revere:

Don't give me that Plato shit...I studied him too.

/:0)

Isn't China's being able to hide its human cases and samples/sequences a "pass"?

I'd like to see the US go back to manufacturing its own essential supplies,
including medicines and food.
We lack border security, we lack import/food security, we lack good regulators, we lack universal health care,
(and, public health and politicians and journalists that actually wants the public to know important things) -this is not national security.

By crfullmoon (not verified) on 08 May 2007 #permalink

Revere.
I have read your posts about the CDC with interest. I do not have an opinion because I don't pay their wages...other than to say that they saved my life once upon a time...

...the point being I think, that it is not what they were in the past but what they or it is today.

The only thing as dangerous as an agency or government etc. with no ethics and power...is an agency with no ethics and no power either.

In my opinion, like in many other instances we have both observed in our times...every agency and preliminary plan is perfect and sold as such, until it is tested.

The current (last 5 years) World Health Organization to me is exactly like the Wizard of Oz. They are this 'all being' authority who misleads with their pronouncements of authority delivered from their Ivory tower or ten million dollar bunker...

then came China and SARS etc.

Each member of the World Health Organization has diplomatic immunity...they are untouchable...

...and yet they have no professional oversight mechanism...they can act with impunity.

I didn't stand in front of the world for several months at a time and spout that a pandemic could and would only cause between 3-7 million mortality...I am not the one who slagged Dr. Nabarro when he begged to differ...and Dr. Nabarro, unlike Dick Thompson, does have an impecable reputation.

I have no doubt there are good people in the WHO as you say...we have many good people in regulatory agencies in Canada...who have crazy glued their lips shut...is silence excusable or do they have a professional and ethical obligation to speak out.

I don't know...you tell me.

Any comment about the Chinese pigs?

By shinypenny (not verified) on 08 May 2007 #permalink

shiny; I tend not to comment on breaking events as there is usually not enough info to do anything but speculate.

The way I percieve this Tom/Revere is that this is nothing more than an auction. Its in a couple of parts and follow me and agree or disagree. Supari has to know that no matter what we do, what we say there isnt going to be vaccine for most anyone. She has to know that..Right?

Next is that they/she is/are holding the samples/sequences because the WHO hasnt caved in (surprise) and offered up the vaccine carrot. What could they offer them? It doesnt exist. A written agreement for what?

It will be six months before they could possibly engineer a vaccine that might work marginally or so we are told. Told what? MIGHT.......How can they make the vaccine without egg technology? Molecular based is what 20 years away... feel free to correct me there. But those that will be dead and those that will be living will be either long gone or recovering by the time that comes around.

So the ambigously available vaccine comes available and then its starting the second wave if you ascribe to the 3 wave, 2-4 month per wave scenario. They could only manufacture enough for less than 3% of the worlds population, be unable to distribute it, and above all someone has to be around to administer the newly developed and heavily untested stuff to someone. E.g. Webster has a vaccine that he knows will work but man its so hot it might whack you in its own right.

Then take into account that the virus itself will kill right now give or take 50-83% if it maintains its CFR. Am I missing anything?

So they are holding these samples not for vaccine that they wont get, they are holding it for more money that they CAN get. Its blackmail pure and simple. The drug companies want the information and samples so they can give it a shot. This is the game of the new milllenia and he who wins gets by my estimate 2 trillion dollars up to 3 long term sales. They in effect in signing the agreement for the virus samples say that is a licensable life form and they invented it. Its theirs and they will sell it like its something they created.

Okay......

So as their life form is about IMO to take out 1/3rd of the planet, lets all calm down and just sue them for the deaths that have occured and will occur because their life form got out and killed a bunch of people. Its genocide of the human race, its obstruction and personally I think they should be hauled up in front of the Hague. Now there's a reason to go and start knocking on their door.

Supari had better wake up and smell the coffee from Java. Its not rocket science in todays world to do research and someone might get lucky. Strains are showing up every day... What are those poor bureacrats going to do if its not THEIR strain that comes after us?

I also would put them on notice that we and others wont give them one more red cent for bird flu or anything else for that matter. Their economy is tetering again and will collapse in short order if it breaks out and they can and will be begging for assistance. I dont believe in diplomacy in these kinds of things. Its a deliberate act on the part of a nation to allow a biohazard to escape. This falls under the "national security" part of the UN Charter and each nation bordering it could take the matter before the Security Council. I dont think that they will hesitate to impose sanctions on trade. Food maybe. End result is that everyone gets a bad tase for Jakarta and the bullshit that this is. Whats that quote, "Nero fiddled while Rome burned?"

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

Tom/Randy,

Njoi reading your postings in much the same way as successfully accomplishing a Bill Clinton NY Times' crossword puzzle -- a queer GenX Aussie compliment...

* "[Revere, I've] no doubt there are good people in the WHO as you say...we have many good people in regulatory agencies in Canada...who have crazy glued their lips shut...is silence excusable or do they have a professional and ethical obligation to speak out. I don't know...you tell me." -- Tom DVM

* "Its genocide of the human race, its obstruction and personally I think they should be hauled up in front of the Hague...whats that quote, 'Nero fiddled while Rome burned'" -- M. Randolph Kruger

* Date: Fri, 19 Apr 2002 03:17:00 -0700
From: "Jon Singleton"
To: photoniqueer@yahoo.com
Subject: C21 SCIENCE ETHICS RESEARCH -- LITERARY REFERENCE TO TRANSGENICS]

(((((((TRANSGENICS)))))))

Personal feelings re: the precautionary principle and good science:

To paraphrase [ISIS.com's] Dr. Mae-Wan Ho, "With transgenic DNA, nature becomes a huge uncontrolled experiment for generating horizontal gene transferred and recombinant superviruses and superbugs (ISIS ARTICLE --DEFENDING BOVE DEFENDING INDEPENDENT SCIENCE)."

LITERARY REFERENCE TO TRANSGENICS:

Brian Stableford's novel THE CASSANDRA COMPLEX (C) 2001, appears to be the first substantive work of hard science fiction referring to and warning of transgenic generated viral epidemics...

By Jon Singleton (not verified) on 09 May 2007 #permalink

Tom DVM said "Each member of the World Health Organization has diplomatic immunity...they are untouchable..."
Let me correct this statement. Only the very highest level staff (Director level and above, and WHO country reps) enjoy diplomatic immunity. The vast majority of WHO staff do not enjoy such immunity.
Tom DVM also states "...and yet they have no professional oversight mechanism...they can act with impunity." All of the WHO professional staff come from a disciplinary background -- medicine, economics, pharmacy, etc. which have professional standards and ethics. This attack is just mean-spirited. WHO is not a supranational agency -- it has no regulatory power -- and can only "advise" governments who are, of course, free to refuse this guidance and advice, as Indonesia apparently has (temporarily, I hope) chosen to do.
Full disclosure -- I worked as an economist in WHO for four years in the mid-1980s. I was impressed with the quality of the staff, if not of the top management. THAT is where the problem lies - not with the professional staff who try very hard to do a good job, sometimes in near impossible situations.

By Susan Foster (not verified) on 09 May 2007 #permalink

Jon.... I only discriminate against Aussies, not gays. I mean look at the place, happy, friendly people an all. Shit what can I do to screw that up to make you unhappy like the rest of the world?

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

Susan. I respectfully disagree with your comments.

As a UN subordinate, employees enjoy all the benefits of any other UN member.

Secondly, there is no professional or nonprofessional oversight at the WHO...

...the oil for food debacle is a pretty good example of lack of responsibility, oversight and ethics.

Tom: This is a factual matter. Susan is correct. You are not, regarding diplomatic immunity. What is the basis for your statement there is no professional ovesight at WHO? I can tell you from personal experience it is false.

You are grossly unfair and, I would agree with Susan, mean spirited about this. You were the one that equated consistency with ethics. You fail in that regard. You were the one that took WHO to task for not paying attention to evidence. You fail there, too.

I have known many veterinarians, some of them as nasty and grasping as any person I know, and cruel to animals, in addition. But most aren't like that and I am quite confident you aren't in that category either. So I won't indict all vets because of some examples that failed the test. I wish you were as generous, if you can call such a minor act, generous.

Revere. Thanks

"This is a factual matter. Susan is correct. You are not, regarding diplomatic immunity."

As you would say...could you provide a link or any evidence to back this statement up.

As it turns out, most domestic regulatory agencies are immune from prosecution as well...and most of them act with impunity and are not regulated professionally or from within the agency...

...which I expect you would already know.

That is fact...not meanspiritedness. If there was consequence or responsibility, things would be different.

Tom: You are confusing people who work for agencies with the agencies themselves and prosecution with oversight. You claim that UN employees have diplomatic immunity. Not true. You claim that agencies are immune from prosecution, although before you said people in WHO have no oversight, also not true.

Since you insist on changing the terms with every comment, let me be clear:

WHO employees do not automatically have diplomatic immunity in the countries where they work. I know this from personal experience. Second, there is extensive professional oversight of people's activities at WHO, just as at most other agencies.

These statements respond directly to claims you made that are false.

Revere.

Agency workers can not be found personally liable for any damages as a result of any regulatory action they take. That is the case in Canada. Are you saying that this is not the case in the World Health Organization and other agencies.

Secondly, the only oversight in these agencies is from the supervisors who hired them...and will lobby them in the future after the supervisors are hired by the industry they used to be in charge of regulating...

...I don't think one would call this professional oversight.

Thanks

A couple of other areas of concern would be:

1) Since I pay the wages of the World Health Organization, where do I send the freedom of information request for the internal memos and minutes from meetings...

...there is a way around this small irritation...no paper - no paper trail...which is being used very effectively in some domestic regulatory agencies at the moment.

2) Where do I go where there is a disclosure of cases where previous employees (senior supervisors) of the World Health Organization maybe employeed by private industry and are lobbying previous employees on behalf of for example the pharmaceutical industry...are these lobbyists registered?

3) Where do I go to see a disclosure that no member of the World Health Organization is not currently employeed both by the WHO and private industry including those industries with financial benefit from WHO actions.

4) Where do I go to get disclosure of whether WHO employees spouses or family members may be employed by an industry that would directly benefit from WHO actions.

5) Where would I go to see direct perks, financial or otherwise, given to WHO employees by countries or industries that benefit directly from WHO actions.

6) Where do I go to see disclosures of stock market investments of WHO employees in industries that benfit directly from WHO actions.

7) Where do I go to see disclosures that would indicate insider trading by WHO employees on stocks in industries that benefit from WHO future actions.

The information I have is that World Health Organization members benefit from the same protections as the United Nations...of course this wouldn't prevent seizure by third world dictatorships etc.