When it comes to bird flu - will Indonesia play the game?

Apr 26 2007

Despite the fact that bird flu does not appear to have the news value it had a year ago, the deadly virus continues to circle the globe causing mayhem by killing humans and decimating bird populations.

To date the virus has been responsible for the deaths of almost 180 people worldwide since it re-appeared in 2003 in Asian poultry.

The majority of the human fatalities have occurred in Asia and almost all have been the result of handling infected poultry.

Indonesia has been one of the worse hit with 74 reported deaths (more than a third of the world's total) and the vast archipelago continues to battle with controlling the spread of the virus.

Indonesia has repeatedly refused to share its samples of bird flu virus with the World Health Organization amid fears a vaccine produced from its specimens would be out of reach of its own citizens because of expense and because it's distribution would be controlled by the richer nations.

The sharing of samples is regarded as vital because if viruses mutate they can become drug resistant or more transmissible.

Both Indonesia and Thailand have both been badly affected by bird flu and have protested that commercial drug makers use samples from developing countries to make costly vaccines that affected countries would not be able to afford.

Indonesia has been accused of holding the virus to hostage and resisting the monitoring of the virus by experts as to whether the bug is mutating into a dangerous form; such a mutation could potentially spark the next pandemic and kill millions because no effective vaccine was available.

Despite agreeing last month to share samples the WHO has yet to receive any and accusations are again being levelled at Indonesia.

Many experts however say that a pandemic that starts in Asia would not only kill indiscriminately but would also cripple economies elsewhere and Indonesia is making a valid point.

Although the WHO has been careful not to be critical of the Indonesian government since the country stopped sending samples, WHO has stopped logging cases of bird flu there and the official count remains at 63; Indonesian officials have recorded 11 deaths since that time.

The WHO has worked at settling tensions by meeting with developing countries in Jakarta last month in order to ensure the poor are not excluded when it comes to accessing expensive drugs.

It was at that meeting that Indonesia promised to resume sending specimens on the proviso that drug companies seek permission before using its viruses to make vaccines.

Dr. David Heymann, WHO assistant director-general for communicable diseases says the deal is a major departure from the WHO's free sharing system used to develop seasonal flu vaccines and only applies to Indonesia.

Dr. Heymann says the organisation is considering building a stockpile of up to 60 million vaccine doses to be used by developing nations to counter any influenza pandemic.

This stockpile would resolve the demands from Indonesia as well as Thailand and ensure that they benefit from sharing their samples of the H5N1 virus.

The global stockpile would be administered by WHO and could feasibly consist of 40 to 60 million doses.

WHO Director-General Margaret Chan says the global manufacturing capacity for a pandemic vaccine against three strains of virus, was about 500 million doses per year; for a single strain vaccine that rises to 1.5 billion which is still not enough for a world of well over 6 billion people.