Snowy Owl
Retired in 2010, In Memoriam
Confusion reigns over whether Indonesia will share bird flu viruses
HELEN BRANSWELL
<TR><TD width="100%" valign="top" height="500" text-align="top">(CP) - Confusion reigned Thursday over whether Indonesia will soon resume sharing H5N1 avian flu viruses with the rest of the world through the World Health Organization - something it hasn't done since the beginning of the year.
The country has been withholding viral samples in a bid to extract guarantees that it will be given affordable access to H5N1 vaccines. While the WHO hopes to help Indonesia achieve its goal of affordable H5N1 vaccine, the agency is not in a position to guarantee that the country will be able to buy pandemic vaccine, at low cost or any cost.
Thursday's confusion stemmed from an announcement from Indonesia's health minister, Dr. Siti Fadillah Supari, who said the country would resume sharing viruses shortly.
Supari said she had received verbal assurances from WHO director general Dr. Margaret Chan that the viruses would be used only to study the evolution of H5N1 and not for production of vaccine. Once those assurances have been put in writing, she said, Indonesia will again ship H5N1 viruses with international laboratories.
A spokesperson for the agency, Dick Thompson, told the Associated Press that Supari's suggestion she'd been given a guarantee that the viruses would not be shared for vaccine development was incorrect.
Thompson later said that a letter to Indonesia from the WHO was still being drafted and he had been wrong to imply anything about its contents.
The WHO's influenza czar, Dr. David Heymann, refused to disclose what Chan had told Supari.
"The communications between WHO and ministers are confidential. We can't give any information out about them," Heymann said from Geneva.
It seems unlikely, however, that the international health body could agree to permanently place a limit on how viruses from Indonesia could be used.
Doing so would violate a resolution approved by the agency's executive board in January.
The 34-country executive board passed a resolution reaffirming the long-standing practice that countries freely share influenza viruses with the WHO for the purposes of tracking the evolution of the viruses and for the development of vaccines. As part of that system, WHO then shares, at no cost, the viruses with vaccine manufacturers.
Indonesia is not a member of the executive board and therefore did not vote in January. But it will have a chance to vote on the resolution in May, when the WHO's 193 member states gather for the annual meeting of its governing council, the World Health Assembly.
Two weeks ago Heymann and the head of the WHO's influenza program, Dr. Keiji Fukuda, travelled to Indonesia to meet with Supari about her refusal to share H5N1 viruses.
At that meeting, Supari and the WHO officials agreed that on an interim basis sample Indonesian viruses would only be used to study how the virus is changing. And Indonesia agreed to host a meeting of developing countries concerned about access to pandemic vaccines. The meeting is to be held later this month.
The WHO has been working on a strategy to encourage vaccine manufacturing in developing countries and will shortly announce that it has approved three proposals to this end. But building and licensing vaccine facilities is not an overnight operation.
The agency will also propose intermediate steps, Heymann said, including perhaps "a virtual stockpile of vaccines should we be able to mobilize resources for something such as that."
"Those are the short-and long-term solutions that we're looking for in the meeting in Indonesia," he said. "After that meeting we hope that we will have built enough confidence with countries that . . . that free sharing of viruses for all purposes can be sustained."
But the meeting will also lay out the hard realities of the limited global flu vaccine production capacity.
Research into new types of flu vaccines - grown in cell culture rather than hens' eggs, for instance - offers hope that in the future capacity could be rapidly scaled up. But at present the world's licensed flu vaccine makers can make only enough vaccine for a fraction of the global population. And they have no significant surge capacity.
It is believed that most of that existing capacity for pandemic vaccine is already spoken for in contracts between manufacturers and developed countries such as Canada, Britain and Switzerland.
As the standoff over the country's position on virus sharing draws on, the status of four possible human cases in Indonesia remains in limbo.
The country announced four positive cases in February but none of those have been confirmed by the WHO, which requires that a country's positive tests be affirmed by an international laboratory.
Meanwhile Indonesia is sharing viruses with the UN's Food and Agriculture Organization, though delays remain, said Dr. Peter Roeder, an animal health officer with the agency.
"Although it's getting better, the process is still very slow. And it needs to be speeded up greatly if a real time analysis of genetic variation in viruses is to be realistically appraised," Roeder said from Rome.
HELEN BRANSWELL
<TR><TD width="100%" valign="top" height="500" text-align="top">(CP) - Confusion reigned Thursday over whether Indonesia will soon resume sharing H5N1 avian flu viruses with the rest of the world through the World Health Organization - something it hasn't done since the beginning of the year.
The country has been withholding viral samples in a bid to extract guarantees that it will be given affordable access to H5N1 vaccines. While the WHO hopes to help Indonesia achieve its goal of affordable H5N1 vaccine, the agency is not in a position to guarantee that the country will be able to buy pandemic vaccine, at low cost or any cost.
Thursday's confusion stemmed from an announcement from Indonesia's health minister, Dr. Siti Fadillah Supari, who said the country would resume sharing viruses shortly.
Supari said she had received verbal assurances from WHO director general Dr. Margaret Chan that the viruses would be used only to study the evolution of H5N1 and not for production of vaccine. Once those assurances have been put in writing, she said, Indonesia will again ship H5N1 viruses with international laboratories.
A spokesperson for the agency, Dick Thompson, told the Associated Press that Supari's suggestion she'd been given a guarantee that the viruses would not be shared for vaccine development was incorrect.
Thompson later said that a letter to Indonesia from the WHO was still being drafted and he had been wrong to imply anything about its contents.
The WHO's influenza czar, Dr. David Heymann, refused to disclose what Chan had told Supari.
"The communications between WHO and ministers are confidential. We can't give any information out about them," Heymann said from Geneva.
It seems unlikely, however, that the international health body could agree to permanently place a limit on how viruses from Indonesia could be used.
Doing so would violate a resolution approved by the agency's executive board in January.
The 34-country executive board passed a resolution reaffirming the long-standing practice that countries freely share influenza viruses with the WHO for the purposes of tracking the evolution of the viruses and for the development of vaccines. As part of that system, WHO then shares, at no cost, the viruses with vaccine manufacturers.
Indonesia is not a member of the executive board and therefore did not vote in January. But it will have a chance to vote on the resolution in May, when the WHO's 193 member states gather for the annual meeting of its governing council, the World Health Assembly.
Two weeks ago Heymann and the head of the WHO's influenza program, Dr. Keiji Fukuda, travelled to Indonesia to meet with Supari about her refusal to share H5N1 viruses.
At that meeting, Supari and the WHO officials agreed that on an interim basis sample Indonesian viruses would only be used to study how the virus is changing. And Indonesia agreed to host a meeting of developing countries concerned about access to pandemic vaccines. The meeting is to be held later this month.
The WHO has been working on a strategy to encourage vaccine manufacturing in developing countries and will shortly announce that it has approved three proposals to this end. But building and licensing vaccine facilities is not an overnight operation.
The agency will also propose intermediate steps, Heymann said, including perhaps "a virtual stockpile of vaccines should we be able to mobilize resources for something such as that."
"Those are the short-and long-term solutions that we're looking for in the meeting in Indonesia," he said. "After that meeting we hope that we will have built enough confidence with countries that . . . that free sharing of viruses for all purposes can be sustained."
But the meeting will also lay out the hard realities of the limited global flu vaccine production capacity.
Research into new types of flu vaccines - grown in cell culture rather than hens' eggs, for instance - offers hope that in the future capacity could be rapidly scaled up. But at present the world's licensed flu vaccine makers can make only enough vaccine for a fraction of the global population. And they have no significant surge capacity.
It is believed that most of that existing capacity for pandemic vaccine is already spoken for in contracts between manufacturers and developed countries such as Canada, Britain and Switzerland.
As the standoff over the country's position on virus sharing draws on, the status of four possible human cases in Indonesia remains in limbo.
The country announced four positive cases in February but none of those have been confirmed by the WHO, which requires that a country's positive tests be affirmed by an international laboratory.
Meanwhile Indonesia is sharing viruses with the UN's Food and Agriculture Organization, though delays remain, said Dr. Peter Roeder, an animal health officer with the agency.
"Although it's getting better, the process is still very slow. And it needs to be speeded up greatly if a real time analysis of genetic variation in viruses is to be realistically appraised," Roeder said from Rome.
? The Canadian Press , 2007
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