Cut the panflu patent Gordian Knot

The intellectual property issues surrounding H5N1 and pandemic influenza in general continue to deepen and ramify into uncharted territory. Currently the usual suspects are meeting in Singapore to try to resolve issues that have arisen when some developing countries, led by Indonesia, have upset the international flu applecart by refusing to provide viral isolates to the WHO laboratory network, asserting that the practice of supplying "their" isolates to pharmaceutical companies who then make vaccines the originating country can't afford was inequitable and intolerable. I have waded into this morass a number of times (see here and links therein) and been notably unsympathetic to Indonesia. I am no more sympathetic now, but I am also losing patience with Indon's opponents, scientists, drug companies and the rich governments. They are also getting nervous:

With little fanfare or public attention, representatives of 24 countries began Tuesday to try to resolve a virus-sharing impasse that is undermining the world's ability to chart the pandemic threat posed by H5N1 avian flu.

But rather than hailing the meeting as a way to break the troubling logjam, some scientists and public health officials are watching with trepidation, worrying the process may hinder the way research into influenza and other infectious diseases is conducted.

"We're very conscious that this is a precedent-setting meeting, as are most of the delegations," said Dr. David Heymann, head of communicable diseases for the World Health Organization, under whose auspices the five-day meeting is taking place.

That's because the talks could change the conditions under which biological materials are provided to the WHO for global surveillance of and research on influenza viruses.

Depending on what is decided, the consequences could ripple far beyond the science of flu, experts say, conceivably affecting, for example, the pharmaceutical industry's ability to make and update an eventual HIV vaccine or limiting how quickly the world could respond to the next SARS-like disease outbreak. (Helen Branswell, Cnadian Press via Medbroadcast)

It's no secret there is unprecedented activity on the patenting and licensing front for vaccine technology directly pertinent to pandemic influenza. It seems to us that too much attention has been directed on how the activities of developing countries affect scientific progress and the possibility of producing a successful vaccine and not enough on the various machinations and scheming of these would-be patent holders and the scientists who enable them.

So here's our suggestion. We cut the intellectual property Gordian Knot by proclaiming all applications of a technology to combating or preventing an influenza pandemic a patent and license free zone. That's right. No patents or licenses will be valid for any technology involved with preventing a global catastrophe from a pandemic strain of influenza A. This is very limited in scope. It is not meant to apply to all patents at all times for all reasons. You can still make money making a good product. Research and development costs can be underwritten as most are now through public funding (research grants), in exchange for which all discoveries regarding influenza have a public license or be placed in the public domain. This has been done already with a process for making Tamiflu quickly and cheaply (see our post on this here).

My colleagues in the scientific community are part of the problem. Stop allowing your work to be patented. Refuse to do it. Issue it with a public license. Most of us are scientists because we want to make the world a better place or jsut to find out how the world works. We don't need this patent and biotech nonsense.

More importantly, in this context, it's wrong.

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Admirable but not going to happen.

We should call this the Banting and Best principle.

For those interested, their reaction to massive potential profit in respect to their discovery of insulin should be on the curriculum of undergraduate science programs...

...maybe the problem is that the history of the scientific method and scientific philisophical ethics and principles has disappeared from 'moral and ethical' teaching.

if Indonesia were serious about their vaccine claim,
then why don't they release the inner genes at least,
or the 3rd positions ? These are useless for vaccine
production but still tell us a lot about the
evolution of H5N1 in Indonesia, i.e. about the supposed
hidden reservoir, the difference about human and
avian viruses, the reassortments.

Revere-With all due respect. They wont get rich for becoming doctors and its very, very likely that most wont heed that request.

As for Indonesia-If they cant control it, then perhaps someone should. I look at Indonesia as a potential Bird Flu bomb, ticking if you will waiting to go off. Once it goes, it likely takes the world with it.

Its not what would Jesus do, but what would China, Russia, UK, France and the US as permanent members of the UN Security Council? The Indons are continuing their extortion campaign and its all about money. No customers if it gets loose and everyone dies.

You answer would produce the result, but the Indons aint listening.

By M. Randolph Kruger (not verified) on 01 Aug 2007 #permalink

"It seems to us that too much attention has been directed on how the activities of developing countries affect scientific progress and the possibility of producing a successful vaccine and not enough on the various machinations and scheming of these would-be patent holders and the scientists who enable them"

Exactly right...

As an aside, the internal politics of bird flu control in Indonesia are fascinating. In fact, I'd probably bet that the only reason you are seeing the Indonesian's breaking all the rules at the WHA is because their bureacracy:

A) Doesn't have the resources
B) Can't agree on what should be done domestically
C) Is paralysed by the devolution of public health authority to the provinces.

Failing unity on the domestic front, Indonesia is lashing out externally. It's classic diversionary identity politics. Fascinating...and dangerous.

By Jon Herington (not verified) on 01 Aug 2007 #permalink

I am certain that I am in the minority here but I think a pandemic would actually be a good thing for the planet. It might not be the best thing for humanity but humanity deserves to take one on the chin. We have overpopulated and abused this planet and most of us continue to do so with impunity. I see a pandemic as population control. As scientists we are also aware of the evolutionary principle of survival of the fittest. Much of the world, especially the first world, now operates in such a way that this tenet no longer applies. It's time for that to end. I sincerely believe that culling 10% of the world's population, regardless of age or location in the world, would be a very VERY good thing. Let the Indonesians hold out. A good cull now and again is a HEALTHY thing. Think long-term people!

Jeff-Exactly my point. If Indonesia doesnt quit just sitting and doing absolutely nothing but taking the worlds money then the outcome for humanity is very likely sealed. How many? Who knows.

I postured about the possibility of either a neutron strike or high yield chemical weapons against Indonesia if it went high path in the past. Both would slow it to a crawl but I got pretty beat up for even saying it. The whole group is pretty cranky right now about it in the UN and its not looking good. Tom DVM correctly stated that most pandemics (I could only find one that didnt) started in the summer months and we are moving out of ours and they into springtime in a country that is nearly perpetually summer. But it is their rainy season that approaches in October-December. I distinctly remember how fast Turkey went downhill two years ago.

For my way of thinking, Indon needs to get their act together or they could face annihilation on the far end of the scale by BF or one of the others, or invasion on the close end thus placing them into world receivership for the lack of a better term. I cant see that the UN Sec. Council will just sit idly by if it starts up there and do nothing. All things come onto the table. Let it start killing half and I doubt it would be a question of what they would likely authorize "for the good of the world". I dont advocate it but I always make contingencies and never a single plan. You can bet that they are too. They want to see some action rather than diversion of blame. I wanted to see some action two years ago. We didnt get it. We did get extorted though.

They cant afford to do it they say, but they can afford to say, "Them there virus samples bubba, how much are they worth to ya?" ZERO if it gets out into the world. Plenty of samples then, bodies too. I have said it before that I can get as shitty as the situation dictates and have in the past. There wont be any political correct if this shit gets loose in the population of the world. It IS within the parameters of "sovereign national security" for any and all countries to defend their borders... this is one that definitely does.

How they handle it is up to them right up until it goes high path and starts transmitting. After that its a world security issue. The sky is literally the limit on what they could do.

By M. Randolph Kruger (not verified) on 02 Aug 2007 #permalink

Oh dear, the pro-apocalypse people have found EM now, as well as Crofsblog.

In seriousness, who says losing 10% of the human population would be good for the planet? We could make that up in a decade, and probably would too, since breakdowns in production could lead to shortages of condoms and contraceptives.

Jeff: Why stop at 10% or 20%? Why not go the whole hog? If you really want most of the species on the planet to be better off then if we just eliminate ALL humans, that would do it. Or if some remain, they could just return to hunter-gatherer status. Nothing started ruining things more than domesticating agriculture.

Once you start down that path, why stop?

Que sera, sera. Whatever will be, will be.

And if you're not happy with that existentialist outlook, then consider another: You get what you deserve.

We (collectively, as a species) are not doing enough, fast enough to change the global outcome, whatever it is. That is the fact and it doesn't get any simpler than that.

Mr Kruger, may I ask you to assemble your thoughts and to present a cogent and fact-based argument, rather than blathering, that "The Indons are continuing their extortion campaign and its all about money." I am interested to know your sources and evidence.

Further, writing here from Singapore, the fact of this matter is that Indonesia is the only country that has tabled a reasoned, detailed, and cohesive proposal for how to reform the WHO GISN. The proposal is a for multilateral system that will reduce or eliminate patenting while improving pandemic preparedness in developing countries. It does not involve bilateral benefits to Indonesia, although it is possible that if our government and its allies refuse to seriously come to the table, we may find ourselves in bilateral virus hell.

The US proposals? Just a bunch of vague rambling crap. Nothing cohesive. They don't have system other than "gimmie virus". Ask your HHS or CDC for a copy of their standard terms and conditions for virus transfer. The US government has agreed that such terms need to be used. But you know what? They don't have them. They haven't thought it through and developed a structure. They have no serious written proposal to put on the table. Chew on that for a while.

Agitant-You must not have been here for long. The Indons have deliberately witheld the samples, isolates and information from Genbank from the rest of the world for pushing on two years. We sent almost a billion dollars in there and they just got thru indicting several of their higher ups after it was found the money was being used to build condo's in Thailand. For nearly a year continously have used their samples for the detriment of the world and to force their way onto the world stage. I bet there arent 30 people out of 100 who know where Indonesia is definitively, but they are learning fast.

And Agitant, make sure you hold that thought if BF strikes. Your argument is pretty lame in the face of even one person dying. If you are truly bio-defense then you know you absolutely have to have a counter to any and all agents and one that doesnt leave you worse than before. This isnt about one country, its about the rest of the world. Indonesia has wrangled a seat on the board because they think that viruses are intellectual property. I say bull crap to that and if it does get out, then I also think they should be held accountable for it. Want to pay the claim on 3 billion dead?

Make sure you keep up with the information from "Proceedings" which is a Navy magazine... You might ask about those Chinese ships that are cruising in the far reaches of the S. China Sea. Sightseeing I'm. sure. Nuclear tipped ones on a sight seeing tour..... How nice to be in Singapore.

Its extortion when you withold something that has the possibility to destroy the human race from research that can stop it. Or maybe they cant but they sure cant do crap without it. They gave Webster Hell because he used their samples. So what!???

Oh, screw it. Just send the money back that we threw in there and I'll be a lot happier. I am sure Revere would agree that 500 million divided by 50 states would go a long way to beefing up the preparation levels here. And by all means leave them hanging in the lurch. I can think of 62 countries that are on the verge of dying right now because one is being what I consider to be an asshole. You are talking about reform when the cow is already out of the barn.

Sunshine wont get this one. Crap about policy while people are dying is pretty much horseshit when you get right down to it. Gimme virus? I'll be sure to put that on all the headstones, "Died while Indonesia was wrangling a deal." They are all trying to make a deal and they are extorting the rest of the world even though they know they'll suffer horrendously there.

I guess you think its better to just NOT hand it over? Beter than that, I would cut off all of the foreign aid to them period. See how long their government lasts when the Big Five and the Spare put their feet to the fires of what will surely be Hell on earth if it comes. Wouldnt last anyway if it does. Fish or cut bait? I can still say I went out on the boat while they wrangled over "policy." .

As for the WHO.. It should be abolished in lieu of say a NATO run organization. If they want to play afterwards, they can join but the days of the WHO as an organization are numbered and its on the same countdown as it is to when this or the next pandemic hits. They have gone too long without a bloodletting and putting the Indons on it has been a deteriment. That plan you are pushing sound like you might be working for them.

By M.Randolph Kruger (not verified) on 02 Aug 2007 #permalink

Mr. Kruger - I do not believe that your post deserves a substantive reply because you have not substantiated your assertion. All governments have corruption to one degree or another, including our own. The fact that Indonesia has its share of crooked public officials does nothing to establish your claim that "The Indons are continuing their extortion campaign and its all about money." You seem to have nothing to back your statement. It is just uninformed and inflammatory verbiage.

You fundamentally misunderstand the debate with respect to IPRs. The truth of the matter is that a) thus far (cross your fingers that Uncle Sam doesn't keep pushing them), Indonesia has made no claim of intellectual property, and b) the problematic people with respect to patents are our own industry and, even, some WHO Collaborating Centres. You can read the paper on my website.

You are correct that I have not been around this blog for long. I came in the hopes of a more reasoned and productive exchange. It is very important for the US public health community to understand what is actually going on in the WHO discussions. There is too little accurate information out there.

Jeff: Agree with you. Yes we are a minority who believe It might not be the best thing for humanity but humanity deserves to take one on the chin.

Only thing lacking from my end is the ability to explain it in such a way to enable the other's to understand. Until then we will be labeled horrible for even entertaining the notion.

Nothing started ruining things more than domesticating agriculture.

The U.S.A. sure doesn't have much of that anymore so what difference does that make?
We are screwed anymore in the agriculture area with inept people who couldn't feed themselves if their lives depended upon it.

It is unconscionable that nations, international public health organizations, scientists and multinational pharmaceutical companies would place prestige or profit ahead of the dire need for a safe and effective pandemic vaccine. We can prevent the worst affects of the pandemic but only if we act together and now to develop the technology to produce several billion effective doses of a specific vaccine soon after outbreak and distribute it free to enough people to halt the spread of the virus.

We can do this now with off the shelf technology and 10 or 20 billion dollars, a couple of months spending on the Iraq war.

If we fail to do this history will brand our society as guilty of the greatest genocide in human history. We will have sat by and watched the world burn when we could have stomped out the fire with very little effort. It will make our error of omission during the Rwanda genocide and the present one in Darfor pale by comparison. We will replace the Nazis as the greatest criminals of all times forever and every American will share this guilt just as the German people do for allowing the Holocaust to happen during WWII.

The Doctor

By The Doctor (not verified) on 02 Aug 2007 #permalink

It is my guess that the US has more Indonesian H5N1 specimens than Indonesia has. We have been quietly collecting them for a couple of years at the US Naval labs located there that were set up during the Vietnam War for VD testing of US sailors on R&R. These specimens have probably been fully sequenced and deposited in the restricted area of Los Alamos bank and at the CDC in Atlanta.

Second, IMO the best case for a severe pandemic is the deaths of 6% of the world's population with the worst case approaching 50%. The difference in the two estimates depends more on the secondary effects of pandemic rather than the direct ones. These principal secondary effects leading to high numbers of death include civil disorder and worldwide crop failure. Both extremes though are catastrophic and will result in a worldwide economic depression but the later would also be likely to usher in a new dark age of prolonged international conflict including regional nuclear exchanges. Think Orwell's 1984.

It is an undeniable fact that Nature has employed the influenza virus to control the mammalian and avian populations for millennia. The exponential growth in our population that occurred during the 20th century has placed our species at great risk because we have moved well past the point of a sustainable level on this planet. In every other species where this has occurred in the past a huge die off due to predation, famine, or disease has always followed it. This can be viewed anthropologically as Gaia acting to restore balance among Her species. While hubris may cause most people to think humankind is not subject to these forces, the truth is we are and at the present time extremely vulnerable to them.

It would be preferable for us to take responsibility for paring our own population by choice and through humane joint action. Unfortunately, humankind is too primitive to understand the need for this and is unwilling to make the necessary sacrifices to accomplish it. This then leaves us in the hands of the final arbiter of life and death on Earth, our Great Mother in Her guise as the Grime Reaper. No doubt, She will visit us soon.

The Doctor

By the Doctor (not verified) on 02 Aug 2007 #permalink

Jeff, Lea and Rob (and others),

I'm curious who you think "deserves" to be culled? Any particular group...or just everyone? I can only assume you realize this means yourself and your family and friends as well?

Doctor, I'm wrestling with the fact that nature has a way of controlling populations and flu is her mammalian tool. Perhaps. But to some of the other posters, I hope I never value life so little as to suggest that we NEED a good culling.

I highly recommend you folks visit a therapist. Cause if you aren't enjoying life enough to want to avoid a "pandemic cull" (or even witness one), then you need some help.

Please.....try to enjoy the weekend!!

Patch: Your comments do not touch on how I feel about the human race nor the value of life. Human life, value of life = priceless.
Top your assumptions off with trying to explain my viewpoint to atheists and a real conundrum surfaces.
I've started to give the subject greater thought and if "time" permits there will be another sincere attempt to explain.
If I come to the conclusion that I'm spinning my wheels and perpetuating an anger fest then nothing will come forth.
It's a no brainer that all of us are at risk, that no one is exempt.

Agitant- http://www.businessweek.com/ap/financialnews/D8QRNJF80.htm

So much for the cognizant Indon response...." The fact that Indonesia has its share of crooked public officials does nothing to establish your claim that "The Indons are continuing their extortion campaign and its all about money." You seem to have nothing to back your statement. It is just uninformed and inflammatory verbiage."

How is Ben Liu?

By M. Randolph Kruger (not verified) on 06 Aug 2007 #permalink

I would without question lay down my life or say goodbye to my relatives for the sake of the planet. I think I have developed a scientists dispassionate view of life and humanity. I see a bigger, longer term picture and it's a better picture with fewer humans in it. Whether it's my family or yours or someone from the middle of who knows where, we must decrease the population on this planet. Someone mentioned that a flu pandemic might take out up to 50% of the population. I say BRING IT ON!

Man, you guys have the worst trolls. Trying desperately hard not to bite on the neo-malthusian revenge of gaia hook.

Here here to the idea of a patent free zone for pandemic prevention technology. I simply can't see how any enforcement of intellectual property (beyond basic academic honesty) is of utility in our efforts to head off this potential catastrophe.

I'd be thrilled to see scientists taking a stand in this, but I'm ashamed to admit I don't have a lot of faith in my commercially contracted colleagues.