• FluTrackers.com Inc. does not provide medical advice. Information on this web site is collected from various internet resources, and the FluTrackers board of directors makes no warranty to the safety, efficacy, correctness or completeness of the information posted on this site by any author or poster. The information collated here is for instructional and/or discussion purposes only and is NOT intended to diagnose or treat any disease, illness, or other medical condition. Every individual reader or poster should seek advice from their personal physician/healthcare practitioner before considering or using any interventions that are discussed on this website. By continuing to access this website you agree to consult your personal physican before using any interventions posted on this website, and you agree to hold harmless FluTrackers.com Inc., the board of directors, the members, and all authors and posters for any effects from use of any medication, supplement, vitamin or other substance, device, intervention, etc. mentioned in posts on this website, or other internet venues referenced in posts on this website.
  • We are not asking for any donations. Do not donate to any entity who says they are raising funds for us.

Ethical H5N1 Vaccine Distribution & Indonesia

Sally Furniss

Sally Furniss

Well-known member
Indonesia warns vaccine inequity could threaten world peace

http://news.yahoo.com/s/nm/20070321/hl_nm/birdflu_indonesia_dc

JAKARTA (Reuters) - The inability of poor countries to get vaccines in the event of an influenza pandemic could threaten world peace, Indonesia's health minister said on Wednesday.

Siti Fadilah Supari said the virus-sharing scheme under the
World Health Organization system did not guarantee poor countries access to vaccines and urged developed countries to help the developing world with the technology to produce them.

"If the rule is not changed there will be a huge gap between rich and poor countries and this will perhaps threaten world peace," Supari told reporters.

"If we want the world to be a harmonious place, the poor should be helped with the technology. If the situation remains like this poor nations will become poorer, sicker and more helpless." Indonesia, the nation worst hit by avian influenza with 66 deaths, has created a controversy by saying it will only share samples of the H5N1 avian influenza virus if it has guarantees they will not be used to make vaccines that will profit a company or another country.

Some health and aid agencies criticized Indonesia for refusing to share samples, while others defended the stance because developing countries often struggle to get access to life-saving drugs due to patent laws and high costs.

"Do poor and developing countries have to be sacrificed just because they don't have the technology because of ignorance and poverty?" Supari asked.

Sharing of virus samples is crucial as it allows experts to study their make-up and map the evolution and geographical spread of any particular strain. Samples are also used to make vaccines.

WHO and health ministers from the Asia-Pacific region are due to meet in the Indonesian capital, Jakarta, from March 26-27 to sort out the best ways of making sure companies can make more vaccines against influenza, and that these vaccines will be available to all who need them.

The H5N1 avian flu virus has swept through poultry across Asia to Africa and Europe. Experts believe it could mutate into a form that would easily pass from one person to another, killing tens of millions in months.

Few companies make vaccines, and total world capacity is only about 300 million to 400 million doses of vaccine a year -- far below what would be needed in a pandemic.
 
Indonesia warns vaccine inequity could threaten world peace

Indonesia warns vaccine inequity could threaten world peace

Supari at its best.
Indonesia threatening with war ?

Because "rich" countries are producing vaccine to protect their population
from Indonesian created birdflu.

Should they stop producing vaccine ?
Should they distribute (not sell) the produced vaccine equally over the
world ? -- wait, then Indonesia would even get less.

So, Indonesia should somehow be preferred from India,China,Egypt,Nigeria,
America, Europe , right ?


Would somehow make sense to protect countries where birdflu
is prevalent with vaccine, so to prevent it from taking off
in the first place, but that's not Supari's argument.
And they should cooperate of course, if they want this.

So, what really do they want ?
Money from Baxter as a reward for exclusively discovering
and cultivating and sharing "their" special strain of birdflu ?



Snowy might ban ("suspend") me for this again, but he can't
change my opinion just by banning without arguments...
 
Re: Indonesia warns vaccine inequity could threaten world peace

Re: Indonesia warns vaccine inequity could threaten world peace

Gsgs -

You will not be suspended or banned for this comment. It is important that people see your true colors. Since you live in a modern European country with a sophicated health care system, you are not aware of the challenges that most countries face when trying to cope with public health delivery.

Indonesia must bargain for vaccine. Sad but true.

Look at the world distribution for seasonal vaccine. Western Europe consumes 25%, North America consumes 35%, and the rest of the world (with 95% of the global population) consumes 40%.

http://www.who.int/csr/disease/influenza/fluratio2005_02_25.JPG


Anyone who thinks that Indonesia will receive a fair share of any H5N1 vaccine without strong intervention is mistaken.

Think for yourself. Do not get caught in the trap of herd mentality.
 
Re: Indonesia warns vaccine inequity could threaten world peace

Re: Indonesia warns vaccine inequity could threaten world peace

doesn't matter, where I live - I read statistics, so I do know about the problems
of Indonesia and other countries.
Supari isn't just bargaining for vaccine here, she wants to quit WHO-agreement and keep samples
secret so to benefit from their exclusive treaty with Baxter. Just business, doesn't
matter whether it's about vaccine or ore or weapons or whatever.

The problem of birdflu vaccine availability to 3rd world countries -or even 1st world countries-
is another matter, nothing to do with this.
We have to invest in research first.
Indonesia should be happy, when the Indonesian strain is used, that increases their chances
to benefit from the vaccine - even when the supply is limited.

India e.g. might "cultivate" their own strain and make an exclusive contract with
-say- Novartis. Accusing others to risk world-peace etc. , as usual.
Then Pakistan might happen to get the same strain through migratory birds
and question India's "copyright". They have a history of conflicts and nuclear weapon,
oops there goes world peace when we follow Supari's logic.
And then we have Africa with their own "laws" of logic and peace.

WHO already had their Tamiflu-supply to be used in hot-spot regions, financed
by international money. That makes sence. They could do the same with vaccine.
But presumably they won't be able to cover large populations of hundredths
of millions unless we make some progress with research.
 
Re: Indonesia warns vaccine inequity could threaten world peace

Re: Indonesia warns vaccine inequity could threaten world peace

Frankly the only equitable solution is a truly radical one that goes against all capitalist ethics, namely that the global vaccine manufacturing capacity should be deposited into a pot controlled by WHO or similar, and allocated per nation in equal proportions to their populations as it becomes available. So everyone gets enough for 5 % of thier population or similar. Nothing to say that countries couldn't or wouldn't sell thier allocations however. This is unlikely to be acceptable to either commerce or the richer nations, so I cannot see it happening.

Therefore the slightly lesser option is that each country pays a proportion of their GDP (with a floor level at which the poorest countries didnt have to pay) into a vaccine development and manufacturing fund. This fund could be used to develop manufacturing and development capabilities at key regional centres across the globe, with the aim that it is capable of supplying 25% of the worlds population. The commercial sector would then be free to supply what they manufacture to those that can purchase, as a seasonal or demand driven production. Not quite fully equitable, but better. If cell based technology could be cracked this would permit this level of volume to be produced and in interpandemic periods other vaccines could be produced, with richer countries who may not need vaccines against JE or other infectious diseases being free to allocate their 'share' to those regions of the world that need it for global disease eradication programmes eg polio etc. Easier for them to 'donate' in such a fashion too, as it would not involve 'cash' allocations or budget approvals.

Unfortunately I fear it would take a pandemic with major reprecussions to make the world take such a pragmatic step. But if they did, who knows? We may move in time to a 'free' globalised vaccine production system for all persons, where the rich would be subsidising the poor.
 
Re: Indonesia warns vaccine inequity could threaten world peace

Re: Indonesia warns vaccine inequity could threaten world peace

vibrant62, if you require that a large proportion of produced vaccine is being
given to WHO... then, I anticipate that would discourage from vaccine
being produced and researched in the first place.
So, that's counterproductive.

I have not so much problems with some country having more vaccine
than others , principally,independent from where I happen to live,
just the global amount should be high.

It won't help Indonesia, when they know USA has no vaccine either.
It would help Indonesia, if they have some vaccine, although
not sufficient, while USA has twice as much.
And then, what happens when Indonesia has some vaccine
but e.g. Sudan has none ?
How will Supari respond to the Sudan complaints ?
Recommend them to withhold samples as retaliation strategy ?

Main problem with vaccine is research investment,
not production, though. And then it might have side effects
or might not work or might even produce resistant strains
or support antigenic mutations...
 
Re: Ethical H5N1 Vaccine Distribution & Indonesia

GSGS - the second option I proposed achieves your goals. It simply provides a baseline of production funded globally by a pro-rata donation. I agree the first option wont work. The halfway house still provides for commercial vaccine production, but also for third world vaccine production.

In general, vaccine producers are less than keen in manufacturing mass produced low cost vaccine for the WHO - it is barely profitable for them, as the amounts paid per dose are low and production capability is taken up that could be more profitably used elsewhere. This suggestion of a %of GDP funding by every country to cover off the humanitarian requirements that exist every year globally still leaves room for commercial development of first world vaccines for profit, as they exist currently. As has been indentified, few vaccine producers are interested in investing in a global vaccine production capacity unless goverenments are prepared to commit to mandatory vaccine use for all persons in a nation, every year. Few will agree to this, as it goes against human rights legislation in many countries and the budgetary issues dont help. A globally funded, WHO managed vaccine manufacturing capacity sufficient for 25% of the worlds population still leaves room for commercial enterprise but creates surge capcity for when it is needed, by taking this part out of the hands of profit making industry. As I said its a half way house that could offer the best of both worlds.
 
Indonesia plans "world?s largest AI vaccine production facilities"

Indonesia plans "world?s largest AI vaccine production facilities"

Last year the WHO held a big conference in Geneva [1] with worlds's largest animal vaccine makers to discuss production of Human vaccine at their facilities. Maybe since the IPB Shigeta plant is so new it would be more easily converted to make vaccine for people?


http://www.usembassyjakarta.org/econ/esthl_highlight_janfeb05.html
INDONESIA:
ENVIRONMENT, SCIENCE &TECHNOLOGY, AND HEALTH HIGHLIGHTS
JANUARY/FEBRUARY 2005

IPB and Shigeta Build Avian Flu Plant
[FONT=&quot]
[/FONT][FONT=&quot]The Bogor Institute of Agriculture (IPB) and Japanese firm Shigeta Animal Pharmaceuticals Inc. announced that they are collaborating to build three avian flu (AI) vaccine plants that will use proprietary genetic technology. Shigeta holds an avian flu vaccine patent developed by Shigeta Animal Pharmaceutical Inc and America Medlemmune Inc. Shigeta's initial investment of USD 945,000 will provide for software, hardware and buildings. Shigeta and IPB's first vaccine plant at the IPB campus in Darmaga has a monthly production capacity of 15 million avian vaccines and 1.5 million cat vaccines. A second plant at IPB's Gunung Gede Campus with a monthly production capacity of 60 million avian vaccines and 6 million cat vaccines was scheduled for completion in February 2005. Shigeta hopes to complete a third plant in Bogor, West Java by April 2005 that will produce 300 million avian vaccines and 30 millions of cat vaccines every month. PT [/FONT][FONT=&quot]IPB-Shigeta[/FONT][FONT=&quot] Director Widiyanto Dwi Surya told the media that once all three plants come on line, they would represent the world’s largest AI vaccine production facilities.


1. WHO/OIE/FAO consultation on the feasibility of human influenza
vaccine production in veterinary production vaccine facilities Geneva,
27th April 2006, CICG Room A
http://www.who.int/csr/disease/influenza/vaccinesconsult2006/en/index.html
[/FONT]
 
Last edited:
Re: Ethical H5N1 Vaccine Distribution & Indonesia

If existing VAX factories worked 24X7 and produced 500 million doses, then plan for 2 doses per person, we could vaccinate 250 million people - over 11 production months! Given the global population, that would be enough to vaccinate about 1 in every 26 people.

Divided strictly according to population, it comes to:

China - 50 million persons vaccinated
India - 43 million
USA - 12 million
Indonesia - 10 million
Brazil - 7 million
Pakisatan - 6 million
Bangaladesh - 6 million
Russia - 6 million
.
.
.
Japan - 5 million
.
.
.
Germany - 3 million
France - 2 million
UK - 2 million
Canada - 1 million
.
.
.
Afghanistan - 1 million
Iraq - 1 million
N. Korea - 1 million
etc.
etc.

Do you think all countries will be willing to live with their "fair share?"

(populations from http://www.geohive.com/earth/population1.aspx)

.
 
Re: Ethical H5N1 Vaccine Distribution & Indonesia

No. But if agreement were 'hypothetically' reached tomorrow, and plants were started to be built nearly immediately, we could have such a solution in place within a couple of years, and we would have to hope that a pandemic would wait that long before striking. If not, there will always be a need for mass vaccine production and surge capacity in the future, (the risk of pandemics wont go anywhere, whether influena or other viral disease) that could then be met.

An alternative option could be that WHO pressures all the global commerical companies to set aside 25% of production for poorer nations supply, and if successful in this, all the companies will do is push up unit costs to compensate for non or low paying nations, without neccesarily investing in additional manufacturing capacity as long term vaccine production demand will not be there. It would still be a 'first come first served' allocation and inequitable. Overall, this would still mean that there was insufficient vaccine manufacturing capacity generally - and if the environmentalists are correct we will see epidemics of a whole host of new and old viral diseases in the next decades with global warming.

I think WHO is attempting something along these lines at present, and it wont work becuase the numbers are unlikely to add up to encourage investment in new production plant, and commercial concerns have to keep shareholders happy.

Humanitarian supplies of vaccines will never be profitable for commercial organisations, so if we want supplies and surge capacity, some sort of solution outside of commericial enterprise and drivers needs to be found. I am not saying that my suggestion is 'it', but I do beleive that we need to be thinking to find some sort of long term solution along these lines. If we get past this pandemic risk there will be many others to come, if the global warming predictions are correct.
 
Re: Ethical H5N1 Vaccine Distribution & Indonesia

Seeing that there may well be many global changes - economic upheavals, climate change, unprecedented disease outbreaks, etc., I think all countries should plan for self-sufficiency. The haves and have-nots, resource availability, and technical expertise could be changing geo-political borders so quickly that the only defense is self-sufficiency.

As Indonesia builds their own vaccination plants, they'll also need to stockpile items such as EGGS!!! They'll need to maintain a continuous supply of correct eggs in sufficient quantity (Unless newer methods get perfected). Any country with a good VAX plant will also need a larger army to guard it!

The 25% of capacity idea sounds like an acceptable interim solution. Not sure it will stop violence, but it's a start.

.
 
Re: Ethical H5N1 Vaccine Distribution & Indonesia

Has this plant been built yet? It was scheduled to be built April 2005

How hard is it to convert a factory that produces vaccine for non-humans to one that produces for humans?

Japan: IPB, Shigeta Japanto produce bird flu super vaccine.

http://depts.washington.edu/apecein/newsbriefs/2004/0007nb16.htm

The Veterinary School of the Bogor Institute of Agriculture (IPB), and the institute's firm, PT Bogor Life Science and Technology, have cooperated with Japan 's Shigeta Animal Pharmaceuticals Inc. to develop a new vaccine for bird flu. Shigeta director Yoshiyuki Nishio, and PT Bogor Life director Thamrin Poeloengan, signed a memorandum of understanding and the team will work on an avian flu recombinant vaccine, which is claimed to be a modification of the existing vaccines currently used widely to deal with outbreaks of the H5N1 bird flu virus. Many experts said the existing vaccines could not prevent humans from being infected by the virus.

PT Bogor Life operational director Kamaluddin Zarkasie said that the new vaccine was the molecular modification of an organism that has high endurance. "We need the vaccine, because Indonesia has many poultry farms, with about 1 billion fowl," he added. Although no cases in humans have been found in Indonesia , 7.4 million chickens, ducks, geese, pigeons, and other birds were estimated to have died from the disease, and thousands of others culled. Ironically, as the central government, and the United Nations Food and Agriculture Organization (FAO) have revealed, bird flu could have been brought into the country via illegal vaccines, possibly from China, Mexico or Italy . FAO also suspected the virus was brought in through illegally imported livestock, and livestock products, which are widespread in Indonesia .

According to Kamaluddin, the team will produce 300 million dosages of the vaccine. "The first round of production will be carried out by Shigeta, which has the infrastructure. We shall produce it ourselves after we have all the facilities, maybe next year," he said. In the future, he added, PT Bogor Life would have the right to sell the vaccine to other neighboring countries vulnerable to the disease, including Malaysia, Myanmar, Thailand, the Philippines, and Viet Nam.
(Promed 7/16/04)
 
Re: Ethical H5N1 Vaccine Distribution & Indonesia

WHO/OIE/FAO consultation on the technical feasibility of human vaccine production in veterinary vaccine production facilities during a pandemic, 27 April 2006.
Meeting report [pdf 32kb] Participants
  • Representatives from national regulatory agencies for both human and veterinary influenza vaccines, veterinary influenza vaccine producers.
- List of participants [pdf 41kb] Objectives
  • To discuss and review issues on the technical feasibility of using veterinary facilities to produce human influenza pandemic vaccines.
Agenda
- Agenda [pdf 37kb] Expected outcomes
  • Preliminary assessment of the feasibility of using veterinary vaccine production facilities to reduce the pandemic influenza vaccine supply shortage
  • Explore interest from the veterinary vaccine industry and potential vaccine manufacturers
  • Inform veterinary vaccine industry on regulatory requirements for human vaccines
  • Facilitate exchange of information and activities between veterinary vaccine manufacturers, national regulatory agencies for human medicines and WHO/OIE/FAO
Presentations
- Ministry of Agriculture, China [pdf 48kb]
- Jay Eltermann [pdf 218kb]
- Richard Hill [pdf 445kb]
- Gu Hong [pdf 166kb]
- Bernardo Lozano [pdf 1.05Mb]
- David Mackay, Riccardo Luigetti [pdf 30kb]
- Declan O’Brien [pdf 196kb]
- Klaus Stohr [pdf 624kb]
- Liqiao Zhou [pdf 54kb]
 
Last edited:
Re: Ethical H5N1 Vaccine Distribution & Indonesia

are there any estimates, how much Indonesia earns with this
Baxter-deal ? How much do they consider are their samples worth ?
What does Baxter pay for it ? Is it ethical for Baxter to
withhold the data , to prevent others from researching/improving/
producing vaccine which WHO urgently recommends ?
Did they consult an ethics-consulting-company
about this , as Rumsfeld did with Gilead-Tamiflu ?
 
You must log in or register to reply here.
Back
Top