If a rogue H5N1 virus easiy tansmissible between people is to develop, the most plausible spot for it to happen is Indonesia, the world's fourth most populous with a vast reservoir of infected poultry (and who knows what else) and more human cases (113) and more deaths (91) than any other country. But Indonesia still refuses to share its human H5N1 isolates, contending they get nothing tangible from an arrangement which is likely to lead to vaccines they won't be able to afford. Under the current system, which allows intellectual property rights to cover vaccines developed from WHO supplied seed strains to Big Pharma, they are probably right. Their position is a grim example of how the crazy patenting system can come back to bite us. Of course Indonesia is acting with monumental selfishness, but they have some great role models in Big Pharma. What's sauce for the goose, is clearly sauce for the gander.
It's not just pandemic vaccine. The system in which Indonesia now refuses to participate also makes the seasonal flu vaccine possible. That system is now teetering on the edge. WHO and some member states will try resolve it this week at a four-day meeting in Geneva:
"The (WHO) secretariat is striving to listen to the needs of developing countries... Developing countries want access to vaccines on a long-term basis and we agree," David Heymann, WHO's top bird flu expert, told Reuters ahead of the talks.[snip]
Jakarta has shared just two specimens this year, both from Indonesian women who died in the popular tourist resort of Bali in August, according to Heymann. China had shared samples from all of the human cases it had reported this year, he added.
"We have no specimens from the rest of Indonesia which we would like to have more so we can do proper risk assessment ... and preparations for vaccines," he said. (Reuters)
In Indonesia's corner are some who have been fighting for the rights of the developing world and are trying to make sure they aren't just forgotten as the rich nations see to their own first, leaving what ever crumbs remain to be divided up amongst the poorer countries. But their position and Indonesia's are not necessarily the same. The Indonesian Health Minister, Siri Fadillah Supari, is considered by many to be unstable and irresponsible.
And considering the issue as one of intellectual property rights is making everything exceedingly difficult. Indonesia is even claiming ownership of the virus under the Convention on Biodiversity:
David Fidler, an international law professor at Indiana University, argues the convention is meant to prevent outside exploitation of a country's biologic and genetic resources. That protection doesn't extend to viruses, entities affected countries are actually trying to eradicate, he writes in an article that will appear in the January issue of the journal Emerging Infectious Diseases.
But [Sangeeta Shashikant of the Third World Network] sees things through a different prism. She insists the convention does cover viruses and in the current climate, H5N1 viruses are clearly a resource. "Without the virus you cannot have the vaccine. You could say it's a resource because it's what everybody wants now." (Helen Branswell, Canadian Press)
True enough. But does this mean that Indonesia should also share the liability for a festering environment that produced a global killer? This isn't a legal problem to be decided by how we parse words on paper. This is a global public health problem.
So what to do? Our preferred solution is to remove it completely from the intellectual property arena, preventing any pharmaceutical company from patenting an influenza vaccine. If this means they won't invest in the vaccine business because they won't settle for a reasonable (as opposed to an obscene) profit, then there should be public development of vaccines through subsidized international vaccine laboratories and an effort to transfer vaccine technology to the global community by investing in a crash program of regional vaccine institutes (say ten or twelve). All of this should and can be financed by WHO or the UN from international contributions. Indonesia, with 230 million people, would be a logical site, with the condition and understanding it would be a regional, not just an Indonesian resource. Europe, the US and Latin America along with South East Asia, Asia and other regions should also have them. Technology for pandemic and seasonal vaccine should be freely transferable and without any intellectual property restrictions.
It is not clear this problem will be resolved. There is no reason it must be resolved, only many good reasons why it should be resolved. In my view, the international community is reaping the whirlwind of its profligate use of the intellectual property system and in some sense is getting what it deserves. Indonesia has the virus and we don't. They make the call.
But are most of the world who never benefited from any patents or monopoly practices by international drug cartels getting what we deserve? Not as far as I'm concerned.
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An international pandemic influenza vaccine development and production program is exactly what is needed but alas seems only a remote possibility. There are a variety of reasons for this including the subject of Revere's post. In the end however it simply boils down to the primitive state of human development and our inability to stand together and meet the challenge ahead. Ignorance, greed, and mistrust are the controlling factors rather than compassion, love, and trust. Until humanity can overcome our base instincts, there is very little hope of us making the right choice.
Grattan Woodson
"In Indonesia's corner are some who have been fighting for the rights of the developing world and are trying to make sure they aren't just forgotten as the rich nations see to their own first, leaving what ever crumbs remain to be divided up amongst the poorer countries."
Pretty ballsy statement considering the treatment of the poor among the upper (and ruling) class of Indonesia.
btw her name is Siti, not Siri.
You are noticing some of the contradictions of Capitalism.
Capitalism arose when somebody realized that they could undercut the local (one man with horse & cart) transport business by building a railway line. Or the local spinners with the Spinning Jenny. However since the days when Henry Ford started manufacturing trucks the economic model we call Capitalism has started to erode.
As machinery increases in complexity and integrates with computers, the need for capital in industry is diminishing. Those people who make a living by investing capital are now having to desperately search for new and profitable havens for their cash. That is why the sub-prime mortgage problem arose. Too much cash is chasing too few investment grade opportunities.
The only safe havens left for Capital are monopolies, which includes land, copyrights & patents, mining leases, infrastructure projects and a few other niches. The rest of the economy is fast becoming small service partnerships who do not need Capital.
Henry George wrote about the problems of land monopoly back in the nineteenth century. My own suggested solution parallels his. The Commonwealth should own those monopoly assets, and license their management out by competitive bids to private management teams. Profits from the enterprise should be paid into treasury and serve to reduce income taxes.
For patents and copyrights perhaps some scheme whereby any interested manufacturer could utilize the patent or copyright, the originator to be paid a legislated percentage of the manufacturer's retail price. Such patents or copyrights to last for a fixed number of years.
As for the argument that those creative people would not create without the incentive of obscene rewards, well no, I don't think so.
Another argument is that the cost of some development (e.g. drugs) is prohibitive. Again, I suspect development costs are being artificially inflated, and that improving technology will provide a solution. Was it Edison who said that "genius is 99% sweat".
Lets put it another way. The existing developmental model is not working very well for vaccines, is it?
Niobe: Thanks for catching the typo. I know the correct spelling as we have discussed her depressingly often here. Reagarding your other point, The Third World Network is not a crature of Indonesia. It is an international NGO, so you need to interpret my statement in that light.
bar: I know you are incorrect about creative scientists not working except for obscene rewards. If that were true there would be no academic or government scientists of note, clearly incorrect. Regading profits, I am not against a "normal" return (say, the kind defense contractors get). That's not what Big Pharma wants. Their return on investment is through the roof. Take a look at it.
While I think the current system of intellectual property rights does a huge disservice to nations like Indonesia, it seems to me there is surely a middle ground on this issue. I think Indonesia is overlooking the fact that they have a lot more to gain (from releasing the samples) than they will loose. Imagine if this thing does take off into a pandemic. Given the current state of health standards and the far-flung remoteness of much of the country, chances are good that the population of Indonesia will be down to less than 100 million (from the current 230 million) before the pandemic ever gets to the West. I suspect that western governments are going to be disinclined to reward Indonesia with large quantities of vaccine at the point where their own populations are at severe risk because of the past lack of cooperation or coordination. Some might even want to inflict maximum damage on the country they perceive to be at the heart of the problem. Indonesia has a good point when they protest the current set up, but they need to realize that when they take part in brinkmanship, they play with fire.
Lets be blunt here. Supari is an opportunist. She and Indon used this opportunity to first force their way onto the WHO board and see what we have gotten for it? Demands, demands, demands that the people who develop the vaccine deliver onto them all of the complete and total production for BF when it comes available. Of course they cant afford it. WE might not be able to afford it. To boot if it starts then all currencies will likely move to zero value so what is "IT" going to be worth?
She is deluding herself and the world. Its also extortion and if she were sitting here I am sure we could find a nice unforgiving AG to indict her. Then there is the intellectual property of a virus. Uh-huh. Masturbation comes in many forms, so does corruption. She commented in Indon the other day about the money being missing from the nearly 2 billion sent to Indon in the last three years.... Her comment "Its only about 20%" really set me alight. 20% of 2 billion is.......
Micheal is right about wanting to inflict maximum damage on the country if this starts to get out of control. What would you do if you were the presidents or PM's of countries that had the capability to stop or slow it? It buys time to take action of horrendous proportions and it is an option. Supari had better get her head out of her tail and start understanding a few things. The Chinese Dragon is just to the north. This starts to break out and there is no limit to what they could do in that region. Chem/nuke's might just come up onto the table. It might be for the US, UK, France and Russia too. Its just a matter of resolve to do it. I dont recommend it and it wouldnt stop it, but it would indeed slow it.
Time is short or so many believe and when they start getting the frustration levels up, so do the backs of the necks of people in positions of authority. Those people are not stupid but they do feel the pressure of the people who put them there.
We are pandering to them but only for the samples and data. Reveres assertion that licensing of vaccines and the profits reached from them falls in line behind it. We are just going to make it equal for all...sort of. It puts the UN and WHO in control of bugs and what is used to protect and prevent. It pisses him and others off that companies charge so much for drugs and vaccines. Okay, but thats not a crime nor is it immoral but the poor of the world buy into this class warfare thing each and every time something like this comes up.
Companies have a legal entity status in every country in the world. They are people without bodies or legs. So the assertion is that we just TELL you what you are going to make, we TELL you where you are going to make it, we TELL you how to make it. Yeah, more government control is just what we need. It puts the WHO in charge of your body and someone in Indonesia too. You relinquish all incentive and rights under this idea. You charge too much so we are going to take your research, steal it and then put the government in charge.
The above para also denotes something that is patently unconstitutional. Price controls can be imposed only in a state of emergency and not by even the Congress. That has been hammered down over and over again in the courts. Even Nixon backed down after the first lawsuit was filed when he imposed price and wage controls.
Free market society Revere. It would put vaccine production into the hands of government and likely not our government but a quasi-government over which we would have little or no input. It also becomes a sovereignty issue. It already is with the Indons. Me, I vote we sit and wait and let nature do its dirty. Let the bug start to take the Indons for starts. Its a moot point for now anyway because there is absolutely no way to produce a vaccine, test and field it in under six months even with the generic crap that supposedly got as many parts of the existing virus that there is. It might help some, but very few.
They will come back from this meeting at an impasse. We and others went because we had to show that we were trying to resolve it. The Indons showed up to establish position and posture. Nothing will come of it because to do it the way you suggest Revere would decimate France, UK, Germany, Canada, Italy, other parts of the EU and of course the US's pharmaceutical business. It would take it apart in fact because it wouldnt stop at vaccines, it would be the full Monty in short order.Its a socialistic answer to a bunch of idiots on both sides of the argument posturing.
I have no sympathy for the Indons. Many there hate the West and especially the Netherlands. Sure they have some legitmate problems, but they are internal to the argument. They could fund their R&D and make the vaccine and then sell it to US, just as we have for the last century to THEM. Payback could be a real sonuvabitch though for US in the West. But they want to be a major player and the only way they can is to make this stick. Nero fiddled while Rome burned. .
Like all carrots, its starting to wilt. Each time those birds lift off on their migratory paths they hoist virus with them. Their information will mean nothing once the bug fixes on whatever level that it does. There will be millions of samples available for every country then and specific antigen at that. Just walk down to the street and grab some from the pile of dead and dying. Indonesia is willing to cut their noses off to spite the rest of the worlds face. So be it. Its not acceptable to be subjugated for any of the participants pro or con, therefore we sit and wait for the inevitable.
"I know the correct spelling as we have discussed her depressingly often here."
Ouf, just did a search. I actually met her in person last October. I didn't know she was this incompetent.
"Then there is the intellectual property of a virus."
Randolph. I'm afraid that we invented the gun that is now being used against us.
She is not the first person in history, to act in the best interest (or so she thinks) of her country rather than in the best interest of humanity...
...again, I (as a Canadian), we are also guilty as charged.
My greatest regret is that China can now make comments about Indonesia and Vietnam, as though they are the problem, and get away with it...
...Ms. Supari has become a convenient 'fall-guy' for those who invented and continue to incubate this virus...re-infecting poor Vietnam repeatedly.
If we want the eventual pandemic strain...we must travel up-river to the source...and that is China.
...and if China wants to continue saying that they have no avian influenza...then I want to know which anti-virals they have been using in their chicken feed...
...because a vaccine won't work under these conditions...or let me put it this way...I will give you a syringe and a needle and one assistant and put you at one end of a barn with 200,000 upset 'screaming' chickens...and then you catch them one at a time and inject them and get all 200,000 to the other end of the barn without not only missing some but also missing the injection and squirting it on the ground...ain't going to happen...
...and that is other than the fact that vaccines may very well not work at more then 10% efficacy...
...and the fact that I will ask you to vaccinate a new set of birds in 6 weeks when the barn is refilled...
...and by the way...biosecurity is a fiction of someone's imagination...they can't use that as an excuse either.
It's time to do some residue tests on chicken originating in China.
Forget to mention that I am going to pay you and your assistant, an excellent wage to make sure you take care when you are vaccinating the chickens...
...how does 25 cents an hour sound?
and by the way...chickens have a plethora of bacteria that live on their skin reasonably symbiotically with their host...like salmonella and campylobacter and Listeria etc. etc. etc.
I want you to disenfect that needle between each bird because you are going to inject the breast and as owner of the farm, I don't want 200,000 chickens dying of bacterial septicaemia or worse, I don't want all those breasts with abcesses in them.
Right..better add some additional antibiotics to the feed...how about chloramphenicol or nitrofurans...that should do it.
...yes, I know they are banned but it is up to the Food Inspection System in importing countries to test proactively and they don't...remember they didn't catch it in honey.
...out of sight...out of mind
/:0)
Revere:
Apologies. What I said was ambiguous. I wished to imply that creative people would work for other than an obscene financial reward.
My statement was founded on the Yerkes-Dodson law, (or a corollary or codicil) which observes that the optimum level of motivation for performance of a task is inversely proportional to the complexity of the task.
MRK:
I am not so sure that Supari is such a bad person. As a (presumably) wealthy and powerful Indonesian government minister, she would be in a position to purchase any vaccine found for her own personal use. Instead she has thought of the good of the average person, and used the only leverage that she has.
She has thrown the ball back to us and displaying the middle finger has said: "Find a solution that works for my people or go f**k yourselves".
Hey Tom, dont forget time and motion. The Chinese alone have something like 5 BILLION chickens that would be on the barbeque before we got past the one million mark. They would be breeding, living their little lives, then slaughtered in under a year. Then we get to vaccinate AGAIN. It would be a job with security no doubt. China isnt stupid though, they have someone to blame for running a petting zoo. There are apparently extreme efforts underway by the Chinese to check it, but there are just too damned many. Slowing it is what I hear in the dark world. Human cases? Yes but unreported.
Bar. Exactly my point Bubba. Its not find a solution for my people. Its pay us off or you get shit. Okay, we can just wait them out. The total cost in lives isnt going to be that much anyway (easy for me to say as long as I aint one of them). She KNOWS we aint got it, she KNOWS it will take months, she also KNOWS that they dont have the technology themselves to do it. So she can dig in her heels all she wants and we aint budging. She will though. It will happen when the first 2000 or so start popping up and the heavily regulated media stick their fingers up and says fuck you Siti and they start reporting the news. She might be lucky if they just imprison her. You may not be old enough to remember Sukarno but I do as a young man. He would imprison anyone who bucked the system, ESPECIALLY the media. Once this cat gets out of the bag Habibie is going ot need a goat to sacrifice and what better one than Supari?
I dont recommend that anyone toss in the towel just yet on this. Lots of political pressure is being brought to bear on Indonesia.
Readers may be interested in the information here:
http://www.sunshine-project.org/flu
The problem with this:
True enough. But does this mean that Indonesia should also share the liability for a festering environment that produced a global killer? This isn't a legal problem to be decided by how we parse words on paper. This is a global public health problem.
is that, if true, then "exporting" states of invasive alien species would then be liable for the damages "their" species cause elsewhere. Is Africa responsible for the damages caused by zebra mussels in the Great Lakes (of North America)? Should Australia and New Zealand, which are seriously plagued by invasive species such as South American frogs, sue all the other states that "harbored" those invasive species?
No. Sovereignty (which is not ownership, by the way), does not include responsibility for impacts elsewhere. This is not to say that Indonesia should not try to improve efforts to prevent emergence of new H5N1 strains; but it is to say that the relationship that you suggest between sovereignty and liability does not exist in law.... and if it did, it would create a huge mess.
Agitant: Here is my response to your example of alien species. If a country was the source of such a species and claimed property rights for it and wanted to charge others for some use of it (e.g., to combat another pest) but the product turned out to be defective, I would say they also had liability for a defective product.
There are a lot of issues lurking around in this that aren't being faced by WHO, Indon or most others people: the concept of "national sovereignty" doesn't work well with global public health problems, for which national borders are irrelevant. That is why I am suggesting we ditch those things that depend on sovereignty (a bad concept from the public health perspective and one whose historical moment is passing in any event). I also want to ditch the stupid intellectual property system that is stacked against developing countries and the consumers of developed countries. Rather than use sovereignty and IP as weapons we should attack sovereignty and IP as causes of the problem.
Indon is pursuing a dog in the manger strategy which will be bad for everyone. The US is defending special interests, which is bad for everyone who isn't one of those interests. I am not taking the US side. On the contrary. But that doesn't make me take the Indon side either, which is bad from a public health perspective. Since I am a public health person, that's determinative for me. With a different bias you might come to a different conclusion. But the dialog is valuable.
Agitant personally concurs with Revere in the belief that the world would be a better place if species great and small were less subject to sovereign rights. Sovereign rights .. which, again, are not the same as ownership rights ... are resurgent and appear here because the US and other countries insist upon the patentability of living creatures, and their parts. Sovereignty over genetic resources would not be what it is today, so to speak, if the US and others had a patent system that was under control.Sovereignty over genetic resources would not be what it is today, so to speak, if it had not been so heavily promoted in the 80s and 90s by major mainstream environmental groups, e.g. IUCN and WWF. So blame the tree huggers if somebody is to be blamed.
But you see, there are different public health perspectives in different places. For most developing countries, there are basically no benefit to participation in the WHO GISN. From their public health perspective, turning elsewhere, turning to somebody that might actually provide some sort of benefit in return for a virus, is a rational thing to do.
Avoiding that possible eventuality is what everyone is trying to do. But so long as the US and EU refuse to really admit there is a problem and signal a real willingness to negotiate an agreement as to how the GISN could better benefit developing countries... well, we continue to lurch further toward bilateral hell. The onus is upon the US and EU now to stop denying and start working constructively.
Problem is that Indon is right...partially. Bugs dont belong to the people, the people belong to the bugs. We are the meat for it and this has brought to the front a problem. We will never see any facilities built as regional vaccine centers because we will end up funding them all. Indon closed the NAMRU technically but oh, but by the way we would like for you to stay on and help with the transition. Said transition might take 100 years.
Agitant...The onus isnt with the US or EU. Its with Indonesia. You cant play the game if you arent in it. Supari may be suited up with the WHO now but they arent going to let her play. Why should they? To do so would upset the apple cart in a huge way. It would destroy over by my reading something pushing on a trillion dollars worth of investments in the last 10 years. They may understand her problem and feel her pain, but al they have to do is wait. She will be gone and they will still be there. Welcome to bio-politics 101. She is on the slippery slope and like Revere I am reading up on this every day.
Think of it this way. If they do nothing they win, if it comes they win, if it doesnt come they win. Like a short lived war. Some will fall, some will falter but they will weather on. Supari though is their one big shot. She either takes it and knocks them out or they will pummel her.
Its about the money and really more economics and jobs. To do what is suggested would turn the western BIG PHARMA on its ear and destroy yet another industry in lieu of political correctness. It would remove the seats of Pharma power and thats simply not going to be done. The EU was wiling to go along with it right up until the full bore of what Supari suggested came to light and now they are on her. Their ball is now in the the biggest game since smallpox and polio and are now seeing the light right or wrong that they could lose that game permanently, or a good part of it. These are not people that I would screw with, any more than I would a Bilderberg.
Supari's game is fleeting. She only has a short time before this likely broaches into the population of Indonesia. Then she is going to visit Benito M. or spend a long time in prison. The charge? Not stupidity. More like corruption, actual or percieved. If there is a trial she will be lucky. That will be based upon the numbers and how fast they pile up.
Rule 1 in Status Quo...Though shalt not screw with the Status Quo without fully knowing that you can change it and come out alive on the other end.
Rule 2 in Status Quo... Do or do not, there is no try.
If Indon is going to win they are going to have to not bend and they have to have something for the Pharma people to buy into. So far I havent seen it. The WHO seat was big enough in their minds and now she wants more. Forget it. Wait for a migration or an immigration or two with BF. We will be saying Siti who? Or is that WHO?