[Ip-health] NYT: Indonesia may sell but not give bird flu virus to scientists

[Suerie Moon]

February 7, 2007
Indonesia May Sell, Not Give, Bird Flu Virus to Scientists
By DONALD G. McNEIL Jr.

Indonesia, which has had more human cases of avian flu than any other
country, has stopped sending samples of the virus to the World Health
Organization, apparently because it is negotiating a contract to sell the
samples to an American vaccine company, a W.H.O. official said yesterday.

The strains of the H5N1 virus circulating in Indonesia are considered
crucial to developing up-to-date vaccines and following mutations in the
virus. The official, Dr. David L. Heymann, said the agency was =93clearly
concerned=94 about the development and was in talks with Indonesia.

Dr. Heymann, the agency=92s chief of communicable diseases, said he was not
blaming the company involved, Baxter Healthcare of Deerfield, Ill. =93But n=
ow
that this has happened,=94 he said, =93we have to sit down and figure out h=
ow to
rectify it.=94

Indonesia signed a memorandum of agreement with Baxter today.

A Baxter spokeswoman said the company had not asked Indonesia to stop
cooperating with the W.H.O. She added that the agreement under negotiation
would not give it exclusive access to Indonesian strains.

The virus has not yet mutated into a strain easily transmitted among humans=
.
But it has infected 81 people in Indonesia, 63 of them fatally. It killed
more people in 2006 than in any previous year and is out of control in
poultry in Indonesia, Egypt and West Africa, so experts fear it as much as
ever.

In addition, Indonesia=92s decision upsets the pattern for making seasonal =
flu
vaccines =97 by choosing among hundreds of samples sent in voluntarily from
all over the world =97 and could set a dangerous example for other countrie=
s.
Indonesia and other poor countries feel slighted by the system =97 justifia=
bly
so, some experts say =97 because the samples they send in are used to produ=
ce
vaccines that they often cannot afford.

=93Their concern,=94 Dr. Heymann said, =93is that their strains have been u=
sed by
several manufacturers to produce vaccines, and that Indonesia should get
some compensation. From their point of view, it=92s understandable.=94

A spokeswoman for Indonesia=92s Health Ministry told Reuters yesterday that
the country =93cannot share samples for free.=94

=93There should be rules of the game for it,=94 said the spokeswoman, Lily
Sulistyowati. =93Just imagine, they could research, use and patent the
Indonesia strain.=94

The Financial Times reported the move by Indonesia yesterday; the country
has not released a flu sample since late last year.

Getting affordable flu vaccines has not been a high priority for poor
countries, because they are worried about greater threats that can be
prevented by vaccines =97 including measles, polio, rotavirus and other
killers of children =97 and about medicine for AIDS.

But with the threat of a lethal flu looming and with Western companies able
to produce enough vaccine each year for less than a quarter of the world,
Indonesia is trying to secure an affordable supply for its people.

The Baxter spokeswoman, Deborah Spak, said the company had done nothing to
encourage Indonesia to cut off the W.H.O.

=93Baxter has nothing to do with this,=94 she said. =93Our role is in devel=
oping
vaccines. We=92re not involved in ownership decisions.=94

Some leading flu experts said they believed that Indonesia was acting on it=
s
own, not understanding the ramifications.

=93This is counterproductive =97 it will hurt Indonesia more than it hurts =
other
countries,=94 said Dr. Arnold S. Monto, an epidemiologist at the University=
 of
Michigan. =93The W.H.O. should be their biggest friend. Indonesia has a vir=
us
with a 70 percent case fatality, and we don=92t know why. If they want to w=
ork
with the best laboratories in the world, they should make sure that virus
samples can get out.=94

With human cases breaking out in Egypt, Nigeria and elsewhere, new pandemic
flu vaccines could be produced from other strains, Dr. Monto added.
Indonesia=92s Asian neighbors are the most threatened by its outbreak and m=
ay
press it to back down, he said.

In the United States, Thomas W. Skinner, a spokesman for the Centers for
Disease Control and Prevention, declined to comment specifically on
Indonesia or Baxter, but said his agency =93takes this very seriously and
supports the notion of the W.H.O. that this type of information should be
shared in a timely manner.=94

Because flu mutates so rapidly, samples are normally gathered from all over
the world. For seasonal flus, an expert committee meets each February to tr=
y
to predict which three are the most likely to be a problem by October, when
the Northern Hemisphere=92s flu season begins.

The strains are usually rendered harmless by laboratories that consult with
the W.H.O., and the genes responsible for the ability of the virus=92s oute=
r
coat to invade cells are spliced to older, well-known strains. Then this
=93seed virus=94 is given free to private companies that produce millions o=
f
doses.

The arrangement was informal until the W.H.O. started writing rules for it
last fall. To assure countries like Indonesia a supply of vaccine, Dr.
Heymann favors helping them get plants where they can produce it themselves
at low cost.

Until recently, Indonesia had been very cooperative about releasing genetic
information about H5N1 flu found in animals and humans there, said Henry L.
Niman, a Pittsburgh biochemist who runs a Web site tracking the genetics of
flu cases, recombinomics.com.

The release of sequences =97 not the virus itself, but the pattern of amino
acids in its genes, which shows what mutations it has made =97 is a touchy
subject because some scientists try to keep the data secret until they can
publish scientific papers.

A spokeswoman for the Indonesian Health Ministry suggested it might return
to releasing sequences soon.

It is not uncommon for universities, for example, to release genetic
information but require companies wanting to profit from it to pay
royalties, Dr. Niman said.


__________________
Suerie Moon
Doctoral Research Fellow
Kennedy School of Government
Harvard University