I was going to post on a New York Times editorial that appeared this morning on Indonesia's recently announced decision to stop sharing virus samples with the World Health Organization, but then I saw this announcement on the WHO's website following a meeting between Minister of Health of Indonesia Siti Fadillah Supari, and Dr David Heymann, Acting Assistant Director-General for Communicable Diseases. At the risk of being optimistic, it looks like some real progress has been made this week....
Sharing of avian influenza viruses and pandemic vaccine production
Indonesia’s leadership alerted the international community to the needs of developing countries to benefit from sharing virus samples, including access to quality pandemic vaccines at affordable prices. The Minister of Health recognizes that both short-term and long-term solutions are needed for countries such as Indonesia to strengthen their capacity to protect themselves against threats such as pandemic influenza. In the short term, Indonesia will pursue discussions with vaccine production companies to meet its vaccine needs. WHO fully supports this. In the long term, Indonesia is working with WHO to develop its local vaccine production capacity through technology transfer. Both WHO and the Ministry of Health of Indonesia agree that local capacity to produce vaccines is the long term solution to ensuring availability and access to influenza pandemic vaccine.
The Minister expressed her appreciation that WHO will continue to work with the Ministry of Health to strengthen its laboratory capacity for emerging infections such as H5N1.
The Minister agrees that the responsible, free and rapid sharing of influenza viruses with WHO, including H5N1, is necessary for global public health security and will resume sharing viruses for this purpose. WHO will continue discussions and work with the Ministry of Health and other countries to assess and develop potential mechanisms, including Material Transfer Agreements, that could promote equitable distribution and availability of pandemic influenza vaccines developed and produced from these viruses.
To this end, WHO and the Ministry of Health have jointly decided to convene a meeting of selected countries in the Asia and Pacific region to identify mechanisms for equitable access to influenza vaccine and production.
There's been near unanimous agreement that bilateral agreements between individual countries and vaccine manufacturers isn't a particularly good approach to developing a pandemic vaccine. Even after signing the memorandum of understanding with Baxter last week, Indonesia expressed a willingness to work with other companies. And Baxter quickly reassured the world that it would continue to collaborate with WHO on vaccine development efforts.
But there's also been consistent agreement, even at the WHO, that the status quo--wherein countries share their viral samples without any assurance that they might benefit from the existing vaccine development, production, and distribution system--simply may not survive for long.
Given the limited global vaccine production capacity, and the likelihood that many countries will nationalize the manufacturing plants within their own borders (i.e., "what gets made here stays here"), it seems the solution is not simply to share the vaccine that will be produced. Better yet would be to share the technology for producing vaccines. This approach would serve two useful purposes: (1) boosting global capacity and (2) promoting more self-sufficiency in developing countries.
Of course, in the near term, inequities in the distribution of vaccine will remain, and so the problem is by no means "solved." But the joint statement by WHO and Indonesia seems to be cause for at least some optimism