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  • When ?Sovereignty? Risks Global Health - commentary

    commentary

    When “Sovereignty” Risks Global Health

    by Richard C. Holbrooke and Laurie Garrett

    NEW YORK – Here’s a concept you’ve probably never heard of: “viral sovereignty.” This dangerous idea comes to us courtesy of Indonesia’s minister of health, Siti Fadilah Supari, who asserts that deadly viruses are the sovereign property of individual nations – even though they cross borders and could pose a pandemic threat to all the world’s peoples. Political leaders around the world should take note – and take very strong action.
    The vast majority of avian flu outbreaks in the past four years, in both humans and poultry, have occurred in Indonesia. At least 53 types of H5N1 bird flu viruses have appeared in chickens and people there, according to the World Health Organization.
    Yet, since 2005, Indonesia has shared with the WHO samples from only two of the more than 135 people known to have been infected with H5N1 (110 of whom have died). Worse, Indonesia is no longer providing the WHO with timely notification of bird flu outbreaks or human cases. Since 2007, its government has openly defied international health regulations and a host of other WHO agreements to which Indonesia is a signatory.
    Moreover, Indonesia’s government is threatening to close down United States Naval Medical Research Unit Two (NAMRU-2), a public health laboratory staffed by Indonesians and US military scientists. NAMRU-2 is one of the world’s best disease surveillance facilities, providing health officials worldwide with vital, transparent information. Indonesia’s government has accused NAMRU-2 scientists of everything from profiting from its “sovereign” viruses to manufacturing the H5N1 bird flu as part of an alleged biological warfare scheme. There is no evidence to support these outlandish claims.
    A year ago, Supari’s assertions about “viral sovereignty” seemed anomalous. Disturbingly, however, the notion has morphed into a global movement, fueled by self-destructive, anti-Western sentiments. In May, Indian Health Minister Anbumani Ramadoss endorsed the concept in a dispute with Bangladesh, and the Non-Aligned Movement – a 112-nation organization that is a survivor of the Cold War era – has agreed to consider formally endorsing it at its November meeting.
    Indonesia argues that a nation’s right to control all information on locally discovered viruses should be protected through the same mechanisms that the United Nations Food and Agriculture Organization uses to guarantee poor countries’ rights of ownership and patents on the seeds of its indigenous plants. Under the FAO seed accord, a nation can register plants, share their seeds, and derive profits from resulting products. This useful policy reduces exploitative practices that sometimes enable multinational corporations and wealthy governments to obtain outrageous profits from indigenous agriculture.
    It is dangerous folly, however, to extend this policy to viruses. If the concept of “viral sovereignty” had been applied to HIV 25 years ago, we would not have central repositories of thousands of varieties of HIV today; these allow scientists to test drugs and vaccines against all the different strains of the virus that causes AIDS. It is even more ludicrous to extend the sovereignty notion to viruses that, like flu, can be carried across international borders by migratory birds.
    In this age of globalization, failure to make viral samples freely available risks allowing the emergence of a new strain of influenza that could go unnoticed until it is capable of exacting the sort of toll taken by the pandemic that killed tens of millions in 1918. As the world learned with the emergence of severe acute respiratory syndrome (SARS) – which first appeared in China in 2002 but was not reported by Chinese officials until it spread to four other nations – globally shared health risks demand absolute global transparency.
    There is strong evidence from a variety of sources that forms of the bird flu virus circulating in Indonesia are more virulent than those elsewhere and that in a few cases they may have spread directly from one person to another. The WHO has tried for two years to accommodate Indonesia, without success. Under pressure from scientists worldwide, Indonesia agreed in June to share genetic data on some of its viral samples, but not the actual microbes. Without access to the viruses, it is impossible to verify the accuracy of such genetic information or to develop vaccines against the deadly microbes.
    Outrageously, Supari has charged that the WHO would give any viruses – not just H5N1 – to drug companies, which in turn would make products designed to sicken poor people, in order “to prolong their profitable business by selling new vaccines” (a charge oddly reminiscent of the plot of John le Carré’s novel The Constant Gardener ). The WHO elicited pledges from the world’s major drug companies not to exploit international repositories of genetic data for commercial benefit, but this has not satisfied Indonesia.
    Indonesia’s claim that NAMRU-2 is a biological weapons facility must be confronted head-on. The US ambassador to Indonesia, Cameron Hume, is actively trying to prevent a catastrophe. So far, there has been insufficient support from senior US officials. They must get involved. And China must use its substantial influence with Indonesia on this issue – in its own self-interest.
    Failure to share potentially pandemic viral strains with world health agencies is morally reprehensible. Allowing Indonesia and other countries to turn this issue into another rich-poor, Islamic-Western dispute would be tragic – and could lead to a devastating health crisis anywhere and at any time.

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    Richard Holbrooke, a former US ambassador to the United Nations, is president of the Global Business Coalition on HIV/AIDS, Tuberculosis, and Malaria. He writes a monthly column for The Washington Post. Laurie Garrett is a senior fellow for global health at the Council on Foreign Relations. http://www.project-syndicate.org/com...rooke4/English
    CSI:WORLD http://swineflumagazine.blogspot.com/

    treyfish2004@yahoo.com

  • #2
    Re: When ?Sovereignty? Risks Global Health-commentary

    If we look at comments among philosophers and sociologists, the WHO is totally irrelevant in managing the scientific responses to Health Treats because they are too closely bound to big pharma interests.

    Wich doesn't mean that big pharma should be pushed out.

    Again for now 5 years, let me reiterate that ROI (return on investment) should be asymetric a priori, wich would mean that poor country SHOULd benifit cheaper prices and very substantially for cures, while rich countries should pay the same percentage of their revenus.

    As long as this is not acknowledge, poor countries just have nothing to loose, they suffer, they died. SO why would they help reduce the suffering and deaths among those who refuse to help them.

    This is non sense.

    WHO is great in monitering and defining swift response but their hands are thight as for the cures.

    Embracing the actual elitist WHO production remedies means that unless you are rich you can only contribute by sharing your viruses to save the rich.

    We are heading to a common reality, a reality lived by the poors, may Insctinct rules and Big Pharma adhere to asymetric ROI.

    I have not seens in the field any inclination towards that, Greed is the ruler just like a virus.

    ATDDT

    Comment


    • #3
      Re: When ?Sovereignty? Risks Global Health-commentary

      This is a response for the above article, posted in the Jakarta Post 27/8-2008

      ================

      The responsible virus and sharing benefits

      Makarim Wibisono , Jakarta | Wed, 08/27/2008 10:27 AM | Opinion

      It was rather astonishing to read The Washington Post op-ed article entitled Sovereignty That Risks Global Health (Aug. 10) by Richard Holbrooke and Laurie Garrett that was reprinted by The Jakarta Post last week.

      I personally know Richard Holbrooke from my years as former Indonesian Ambassador to the United Nations in New York and expected him to know better than what he has expressed in the op-ed.

      The article merged the two separate issues of H5N1 virus sharing and the legal problem of Naval Medical Research Unit No. 2 into a confusing unrelated issue. While the avian influenza problem lies within the authority of the Ministry of Health, the Namru facility issue is jointly managed by the Ministry of Foreign Affairs and the Ministry of Defense.

      The article made a number of factual mistakes and misleading statements, some of which I will enumerate below.

      The existing World Health Organization (WHO) system of sharing influenza viruses, called the Global Influenza Surveillance Network, is not transparent, just nor equitable. The system takes resources from developing countries and provides little to them in return while leaving developing countries all the more vulnerable to an influenza pandemic.

      Indonesia and other countries that have taken the initiative to reform the WHO system are taking a laudable and a long-overdue step in improving public health for all by providing, among other things, fair and equitable access to the influenza vaccine at affordable prices.

      No constituency currently seeks to create a "viral sovereignty", for such a de facto sovereignty already exists in international law. Inexplicably, Holbrooke and Garret misled their readers by simply ignoring the fact that in its 20 years of existence the Convention on Biological Diversity, among other international instruments, has recognized national sovereignty over genetic resources, including microbes.

      Viruses are, unequivocally, genetic resources subject to national sovereignty. In addition, the World Intellectual Property Rights Organization did establish an inter-governmental forum to explore the possible instruments for Traditional Knowledge, Genetic Resources and Traditional Cultural Expressions/Folklore.

      Holbrooke and Garrett claim that it is "ludicrous" to apply sovereignty to genetic resources that easily cross borders. Their position belies ignorance of both biodiversity and its related law and policy. As any farmer, biologist or duck hunter can tell you, most genetic resources do, in fact, cross national borders: Birds, plants, insects, microbes, crops and practically anything else that is made of DNA (or, as in the case of flu, RNA).

      This simple biological truth has not prevented the exercise of sovereignty nor ceased international cooperation in the use and protection of biodiversity. Trans-boundary biodiversity issues have been addressed and discussed at length for over two decades by the United Nations. Diplomats assigned to New York and those familiar with issues of public health ought to be clearly aware of this pervasive topic. However, Holbrooke and Garrett apparently have no clue about this -- otherwise they would not have made such off-base assertions.

      They also further stated that "the WHO has elicited pledges from the world's major drug companies not to exploit international repositories of genetic data for commercial benefit". Such pledges, even if they existed in the form claimed, are contradicted by fact.

      First of all, a number of companies have lodged U.S. and international patent claims over hundreds of H5N1 genetic sequences, resources that were freely given to WHO by Indonesia and other countries. These resources come from the gene repositories.

      Second, major pharmaceutical companies are engaged in advanced clinical trials that are currently underway by utilizing Indonesian, Vietnamese and other viruses in vaccines. One vaccine that used a Vietnamese strain has already been licensed. These companies intend to profit from the sales of these vaccines while Indonesia and many other resource donor countries will receive nothing from the proceeds.

      This is a great injustice and the fact is that industry, large and small, massively benefits from the resources within the WHO system while no commensurate benefits accrue to Indonesia and other countries who, ironically, are facing the gravest immediate threat from H5N1.

      Furthermore, the revised International Health Regulations do not require viruses to be sent to WHO. Though the revised regulations mandate the sharing of information on disease outbreaks of international importance, the fact is that such information is already shared and will continue to be shared.

      The authors further allege that Indonesia has violated "a host of other WHO agreements". Exactly what agreements were they referring to? As former Indonesian Ambassador to the United Nations and other international organizations in Geneva, I have directly participated in WHO negotiations whereby the intricate issues of influenza virus sharing were intensively discussed and I myself unaware of any such allegations.

      In reality, Indonesia has repeatedly offered to provide more virus samples to WHO. Neither Indonesia, nor its Health Minister Dr. Siti Fadillah Supari, are intrinsically opposed to providing viruses. Rather, the stumbling block is an unwillingness of some countries to implement a just Material Transfer Agreement (MTA) in defining the rights of parties when viruses are transferred.

      The underlying proposition that Garrett and Holbrooke rail against in their editorial is that Indonesia and other countries are asking for a reasonable MTA for influenza viruses -- one that doesn't rob anybody -- and for an unbiased WHO.


      Those agreements are far more restrictive than anything that Indonesia or its allies have proposed for sharing their viruses. If the current generous stance embraced by developing countries is not appreciated, then perhaps developing countries should follow suit in restricting virus transfers similar to the manner done by U.S. institutions. Such a response would clearly be counterproductive.

      *
      The writer is former Indonesian Ambassador to the United Nations in New York and in Geneva, and is currently lecturer on Diplomacy at Paramadina University and lecturer on International Law at Atma Jaya University, Indonesia.

      Comment


      • #4
        Re: When ?Sovereignty? Risks Global Health - commentary

        Link to original opinion article by Makarim Wibisono in the Jarkata Post as posted by Ningtyas above.



        Wibisono was responding to the article by Holbrooke and Garrett in post #1 of this thread. That article was first published in the Washington Post on August 10th, 2008, and posted by ironorehopper on August 9th, 2008 in this thread: http://www.flutrackers.com/forum/showthread.php?t=76601

        Comment


        • #5
          Re: When ?Sovereignty? Risks Global Health - commentary

          There's an update in Immunocompetent blog about H5N1 related patent activity.



          excerpt :
          "The amazing thing here is that between 1983 and September 2008, 102 total matching patent applications were published, and of these applications, 83 were published after 1 Jan 2007. That is, more than 80% of the matching patent applications over the last nearly 25 years have appeared in the last 18 months.

          And where do these patent applications come from? Hint: It's not the Indonesians that are making proprietary claims over H5N1 viruses, it's the Americans and Europeans. A whopping 53% of these patent applications originate the US , and most of the rest come from Europe. What little is left over primarily comes from Australia, Japan, and Singapore.

          The results here speak for themselves. Developing countries like Indonesia are not the people trying to privatize H5N1. In fact, the real culprits of ownership claims over Bird Flu are the companies and government labs of Europe and North America."


          ====================

          Allow me to say : shame on you, Richard Hoolbrooke and Laurie Garett and the likes. Don't you think the life of Indonesians and other poor countries people is just as important as yours?!

          Comment


          • #6
            Re: When ?Sovereignty? Risks Global Health - commentary

            Indonesia legtimate request is now having snowball effects and is influencing insidiously few other countries do behave the same.

            Before, just before we get to a diplomatic lockjam on getting samples to legimitely follow the evolution of viruses, the Armies should make independant deals, aside WHO and its protocols.

            Namru labs, just has the Comfort are the world scientific reconnaissance units against the emergence of those threatening bugs.

            I cant fingd it, but I am aware that the Navy have protocols to strike deals with other army/navy that are not subdued to other protocol.

            On the matters of viruses and their evolution it would be the right time that deal be made between armies aside from policies and diplomacies.

            Traditional deals among diplomats are obviously leading to catastrophe, wouldn"t be the right time that leaders of Military on this issue agree in principle on interim deals between them ??

            There are nova exceptionalis measures that allow this.

            Maybe it is time for the navy & the army to put their pants and move toward this direction.

            My 2 cents.

            ADDT

            Comment


            • #7
              Re: When ?Sovereignty? Risks Global Health - commentary

              Thanks Sophiazoe http://birdflujourney.typepad.com/a_...sovereign.html

              'Sovereignty' That Risks Global Health By Richard Holbrooke and Laurie Garrett Sunday, August 10, 2008; B07

              In May, Indian Health Minister A. Ramadoss endorsed the concept in a dispute with Bangladesh. The Non-Aligned Movement -- a 112-nation organization that is a survivor of the Cold War era -- has agreed to consider formally endorsing the concept of "viral sovereignty" at its November meeting.

              Comment


              • #8
                Re: When ?Sovereignty? Risks Global Health - commentary

                An opinion piece -

                Wednesday, September 10, 2008[/SIZE][/FONT]
                INTERNATIONAL SOLIDARITY SECURES GLOBAL HEALTH

                Acep Somantri and Benny YP Siahaan , Geneva | Wed, 09/10/2008 10:59 AM | Opinion, Jakarta Post


                Recently, there has been a heated debate over the issue of whether a country infected with a pandemic virus effectively has "sovereignty" or property rights over samples of that virus taken from infected persons within its territorial jurisdiction.

                This issue was initially raised by Indonesian Health Minister Siti Fadilah Supari at the 60th World Heath Assembly in May 2007, and again at numerous WHO meetings on avian flu virus sharing and benefit sharing which have taken place recently in Geneva.

                Indonesia observed that global activities concerning influenza control had been largely directed at industrialized nations -- mainly for their profit-oriented influenza-related pharmaceutical industries, most of which are based in those countries.

                And Indonesia was disappointed to find that these vaccine manufacturers used Indonesian specimens for commercial purposes without first obtaining permission to do so or acknowledging that the benefits of their findings would go beyond the mere confirmation of the virus and/or research purposes for which the samples were submitted in the first place.

                Therefore, it is fair to say that unless the benefits derived from the specimens are shared, the current framework for the sharing of viruses is not equitable with the countries that submit virus samples; this is especially true of cases such as Indonesia, where the H5N1 virus is active and where the damage from it (to humans and animals) has been greatest.

                And the WHO Global Influenza Surveillance Network (GISN) actually facilitates this unjust, non-transparent and inequitable process.

                On the other hand, the global community is facing an unprecedented opportunity to develop and produce a pandemic vaccine. As part of efforts undertaken, the ongoing risk assessment for the influenza virus has necessitated particular attention and research to determine potential vaccine strains and their likely geographical spread.

                Currently, fewer than 10 countries have domestic companies engaged in the production of pandemic vaccines. This is certainly not an area in which a small number of players is in the public interest.

                Clearly, the more companies available to work and collaborate in this field, the greater the opportunity of developing interventions thus increasing the likelihood of producing a more effective and affordable vaccine.

                Furthermore, at present 90 percent of the production capacity for all influenza vaccines is concentrated in Europe and North America. This percentage, it should be recalled, consists of countries that account for only 10 percent of the world's population.

                The WHO estimates the current global manufacturing capacity (estimated at 400 million doses of regular trivalent influenza vaccine per year, when produced by 5 international manufacturers) would be utterly inadequate to meet expected global needs (at least 6 billion doses of vaccine) during a pandemic situation.

                If the right to carry out this work is restricted to companies located in only a few countries (for the sake of argument, those that are industrialized), in the event of a pandemic the majority of developing countries might have little or no access to vaccines during the first wave, and possibly throughout its duration.

                This situation would thereafter engender an explosive increase in the price of a vaccine, rendering it unaffordable for entire populations in any but developed countries.

                As we have already seen, the vaccination of poultry and poultry workers in the most affected countries is already barely affordable, while they serve as perhaps the most important target groups for preventing the spread of the virus to the wider population.

                Therefore, aside from considerations relating to the injustice of the selective use of the virus, the current virus-sharing pattern also entails an ethical and moral dilemma.

                The best way to describe this is perhaps to use the simple analogy of a situation whereby a bike is borrowed from someone and later painted a different color and modified slightly. Can the borrower later call that bike his own and then sell it back to the original owner quoting a higher price?

                "Viral sovereignty" does not mean affected countries are not willing to share virus samples with the WHO system or other individual countries or institutions. Rather it provides for the right of countries infected by the virus to decide whether it will be researched by its own laboratories or submitted to other parties, the right to information on the movements of these virus samples, and the rights to a share benefits.

                In this regard, Indonesia declared it would only share H5N1 virus samples with parties who agreed not to use them for commercial purposes, and who would provide benefits sharing from the virus for global influenza pandemic preparedness, and who accepted the Material Transfer Agreement (MTA) -- as required by Indonesian national laws and regulations.

                During the "vacuum" period of the international virus sharing mechanism, Indonesia sent virus samples in 2007 to parties who accepted Indonesia's requirements.

                Since January 2007, Indonesia has developed a new Bio Safety Laboratory 3 (BSL-3) with an international license to monitor and detect the development of potential pandemic influenza viruses.

                Through this laboratory, research for risk assessment on pandemic influenza can now be conducted within Indonesia and by Indonesian experts.

                This means global health security will not be at risk, and therefore it is misleading to assume that "sovereignty of viruses" would cause major conflicts or be a potential trigger for a new north-south or rich-poor dichotomy.


                The writers are both Indonesian diplomats based in Geneva, Switzerland. The views expressed herein are their own.



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