Indonesian leader meets U.S. health official over bird flu

[Snowy Owl]

Indonesian leader meets U.S. health official over bird flu
www.chinaview.cn 2008-04-14 16:29:39

JAKARTA, April 14 (Xinhua)

Indonesian President Susilo Bambang Yudhoyono discussed the issue of sending bird flu virus sample from the country to the World Health Organization with a senior U.S. health official here Monday.

The meeting between Susilo and U.S. Secretary of Health and Human Services Michael Leavitt mainly discussed procedures in the sending of virus sample to the WHO and Indonesia's access to bird flu medicines, Health Minister Siti Fadillah Supari told reporters at the State Palace.

The Indonesian government demands a fair treatment from WHO, in terms that it can easily get the bird flu vaccine produced from a research using Indonesian samples, Supari said.

Indonesia has so far confirmed 133 bird flu cases in human with107 deaths since the virus was first reported in 2003. 　

http://news.xinhuanet.com/english/2008-04/14/content_7974795.htm

[HenryN]

Re: Indonesian leader meets U.S. health official over bird flu

<TABLE style="TEXT-ALIGN: left"><TBODY><TR><TD align=middle>Indonesia, US must cooperate on bird flu - U.S. official




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JAKARTA (Thomson Financial) - Indonesia and the United States must worktogether to prevent a global bird flu pandemic, the top U.S. health officialsaid here Monday. U.S. Secretary of Health and Human Services Michael Leavitt said bird fluwas a danger to the whole world and stressed the importance of international cooperation. Indonesia, the nation worst hit by the disease, has been reluctant to share information with international scientists battling the constantly mutating viruswithout in return being guaranteed access to vaccines. "To enhance cooperation is vital amongst all nations," said Leavitt after meeting President Susilo Bambang Yudhoyono. "The United States has very important relationships here in Indonesia, that involve joint work in laboratories in various levels of research, and we havepledged to continue that. "We have the same concerns about a global pandemic. If (flu) is present everywhere then there is danger everywhere, and we must work together." Indonesia has the highest number of human bird flu victims, with 107 people known to have died from the disease, 13 of them this year. Experts fear the virus, which is usually spread directly from birds tohumans, could mutate into a form easily transmissible between people, sparking adeadly global pandemic. afp

http://orange.advfn.com/news_Indonesia-US-must-cooperate-on-bird-flu-U-S-official_25767821.html

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[Shiloh]

Re: Indonesian leader meets U.S. health official over bird flu

Source: http://www.forbes.com/markets/feeds/...fx4885097.html

Thomson Financial News
Indonesia, US must cooperate on bird flu - U.S. official
04.14.08, 8:28 AM ET

JAKARTA (Thomson Financial) - Indonesia and the United States must work together to prevent a global bird flu pandemic, the top U.S. health official said here Monday.

U.S. Secretary of Health and Human Services Michael Leavitt said bird flu was a danger to the whole world and stressed the importance of international cooperation.

Indonesia, the nation worst hit by the disease, has been reluctant to share information with international scientists battling the constantly mutating virus without in return being guaranteed access to vaccines.

'To enhance cooperation is vital amongst all nations,' said Leavitt after meeting President Susilo Bambang Yudhoyono.

'The United States has very important relationships here in Indonesia, that involve joint work in laboratories in various levels of research, and we have pledged to continue that.

'We have the same concerns about a global pandemic. If (flu) is present everywhere then there is danger everywhere, and we must work together.'

Indonesia has the highest number of human bird flu victims, with 107 people known to have died from the disease, 13 of them this year.

Experts fear the virus, which is usually spread directly from birds to humans, could mutate into a form easily transmissible between people, sparking a deadly global pandemic.

afp

[HenryN]

Re: Indonesian leader meets U.S. health official over bird flu

In the Leavit quote, the first "everywhere" should be "anywhere".

[Shiloh]

Re: Indonesian leader meets U.S. health official over bird flu

Source: http://www.pr-inside.com/us-urges-in...rd-r535273.htm

JAKARTA, Indonesia (AP) - The top U.S. health official criticized Indonesia's refusal to share bird flu virus samples with the World Health Organization, saying its government was undermining nearly 60 years of global cooperation that led to the production of lifesaving vaccines.

U.S. Health and Human Services Secretary Mike Leavitt, making a two-day stopover that included meetings with Indonesia's president and health minister, acknowledged Monday that improvements to the global body's virus-sharing system could be made.

?But linking it to the sharing of viruses is not something we can support,? he said in an interview with The Associated Press, adding that once ?people begin to trade viruses for value ... there will be no end? to it.

Poor countries are obliged to send influenza virus samples unconditionally to WHO, which then makes them available to pharmaceutical companies to use in vaccine production.

That system has made it possible for laboratories to make sure viruses are not ?mutating into a form that could become a person-to-person communicated disease,? Leavitt said, noting that almost every country in the world has collaborated effectively for 56 years.

But Indonesian Health Minister Siti Fadilah Supari argued the system is unfair and should be changed. She said any vaccine produced from her country's bird flu specimens would be out of reach for its own citizens in the event of a pandemic _ too expensive and controlled by wealthy nations.
Supari, who has withheld almost all virus samples from WHO since January 2007, has been especially critical of the United States, one of the system's main backers. She wants developing countries that hand over samples to retain the rights for any vaccines produced from them.

?I'm still pushing for a Material Transfer Agreement,? Supari said after talks with Leavitt, adding some progress has been made in recent talks with the U.S. and WHO. She did not elaborate, however. ?We don't have any objection (to sharing samples), but it has to have an MTA, with certain conditions.

Indonesia is the nation hardest hit by bird flu, with its 107 human deaths accounting for nearly half the recorded fatalities worldwide.

So far, most human cases have been linked to contact with infected birds. But health experts worry the virus could mutate into a form that passes easily among humans, sparking a pandemic that could kill millions worldwide.
Indonesia is considered a hotspot for that to happen, because of its high density of people and backyard chickens.
Associated Press writer Zakki Hakim contributed to this report.

[gsgs]

Re: Indonesian leader meets U.S. health official over bird flu

no need to meet. Just send email or telefone.

[Treyfish]

Re: Indonesian leader meets U.S. health official over bird flu

Developed countries did not yet agree the Distribution of the Profit of the Flu Vaccine Burungon Monday, April 14 08 17:52 WIBHealth Minister Siti Fadilah Supari said, from six clauses of the sample of the bird flu virus of the agreement of the sending co-operation, only concerning the problem of the distribution of the profit that was not yet agreed to between the developing country and developed countries."This had six points, five half has been agreed to."Remain at the clause benefit sharing that that was not yet concrete.That that how as justly as possible for humankind all over the world, "he said ended joined the meeting of" President "Susilo Bambang Yudhoyono with United States" Health Minister", Michael O Leavitt, in the Kepresidenan Office, Jakarta, on Monday (14/4),"Menkes said, optimistic in Health Minister's meeting a world in Geneva on May 5 2008 all the clauses could be agreed to.For 60 years, he continued, the USA enjoyed the profit from making the bird flu vaccine from the sample of the virus that was sent the developing country.However, the developing country that became the country of the bird flu sufferer precisely did not get anything.Menkes said, the visit of Menkes USA to Indonesia was the good opportunity, for delivered to the government of the country that currently during him they acted just to the sender's developing countries of the sample of the bird flu virus.<TABLE cellSpacing=0 cellPadding=0 width=400 border=0><TBODY><TR><TD vAlign=top bgColor=#ffffee>

"We already together in the good position."Was thought by me hopefully the country that sent the virus had an appropriate price, "said Siti Fadilah."Although discussions in Geneva did not yet touch the matter of the price, Menkes optimistic the clause could be about the distribution of the profit completed.Uptil now, according to him, the distribution of the profit was compared as the "gift" from the manufacturer's country of the bird flu vaccine to the sender's country of the sample of bird flu.In fact, continued Menkes, the sender's country basically had the right to get the distribution of the profit because of contributing capital in the production of the bird flu vaccine.</PRE>

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Petukaran the Secara Transparan VirusApart from concerning the distribution of the profit that was not yet finished was discussed, one clause more that still was discussed in the forum in Geneva was material Trade Agreement (MTA).Menkes said, MTA will act binding to countries a world, to arrange the mechanism of the exchange of the sample of the bird flu virus transparently.According to Menkes, Indonesia still fight for so that MTA one with current UU national.Whereas the other clause that has received the agreement between developed countries and developed was the change in the name and the forum for the organisation from Global Influenza Surveillance Network (GISN) that earlier was under the jurisdiction of the US government, became WHO Influenza Network (WIN) that currently fully was under the UN organisation that handled the health of the world.</PRE>

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WIN, according to Menkes, will be sheltered by the international law that his rule was compiled by all the member countries."Previously his rule that arranged would the USA," he said.Klasul other that was agreed to, continued Menkes, was the tracing system that could monitor the location of the sample of the virus that was sent by the member countries."The virus could be anywhere" followed by "us" with the internet.Who that brought, diapain our virus, "he revealed."Klasul other that also got the supervision, continued he, was about the supervisory body in WIN. Di Mana, Indonesia ask for to become one of the countries that sat in this supervisory body.</PRE>

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The visit two days of Menkes USA in Indonesia, according to Menkes, were at the invitation of from the Indonesian government.Discussions of the sample of the bird flu virus of the sending co-operation were the main agenda discussions of Menkes USA during in Indonesia.(the novel/ant) http://www.eramuslim.com/berita/nas/...flu-burung.htm</PRE>

[Treyfish]

Re: Indonesian leader meets U.S. health official over bird flu

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The USA OBJECT made use of the SAMPLE H5N1 from the DEVELOPING COUNTRY</PRE>

</TD></TR><TR><TD colSpan=2></TD></TR></TBODY></TABLE>Metrotvnews.com, Jakarta: United States Health Minister Michael Leavitt denied the Menkes Siti Fadillah Supari accusation the matter of the utilisation of the sample of the bird flu virus from the developing country for the US interests and the Kesehatan Body of the World.According to Leavitt, the USA worked with transparans processed the virus H5N1 to produce the bird flu vaccine.That it was stressed Leavitt in the meeting with President Susilo Bambang Yudhoyono and Menkes Siti Fadillah in Jakarta, this afternoon.Nevertheless, Menkes Siti Fadillah stressed, Indonesia continued to refuse to send the sample of the virus H5N1 to WHO before material Transfer Agreement (MTA) was agreed to by the two sides.Moreover the use of this virus was it was thought not transparent.Moreover, the vaccine that was produced precisely was sold with the expensive price to the country that needed.In the meantime, President SBY hoped various rumours that were not yet finished between Indonesia and the USA immediately could be finished.(DEN) http://www.metrotvnews.com/berita.asp?id=57203</PRE>

[Snowy Owl]

Re: Indonesian leader meets U.S. health official over bird flu

It is moving forward,

...would be great if the President of Indonesia makes a reshuffle cabinets.

Miss Supari is apparently not at the height of her post.

Since the seriousness of this, maybe some medical experts should get in the Health Ministry.

NOTA

I would like to share with you a notion, a belief a way of moving forward in Miss Supari Personna, that while it is great in some ministries (services) it appears to become more and more dangerous when used in Health Ministry function in the present context.

Hukam

Hukam is the Divine Will, no one can go against it, it is simply impossible in this Mindset. And it is totally coherent.

The problem within Hukam Khand (Realm) is the freedom to take side.

Either you bow to Hukam in submission, as it should, but as Natures teach us, just like Kabir (an Islamic Saint), the personnal ghoice of passivity in amidst a crisis, is certainly not what Natures Teach us nor Hukam shows us.

Just my opinion.

Snowy

[sharon sanders]

Re: Indonesian leader meets U.S. health official over bird flu

Quotes from Secretary Leavitt's blog on his meeting with Indonesian Health Minister Supari. The bolding and underlining is mine:

"I have met multiple times with Health Minister Supari. She has become a controversial figure within the health world, because she has stopped sharing with the World Health Organization (WHO) any samples of influenza viruses that are circulating in Indonesia. She asserts that if a nation provides a virus from which a manufacturer makes a vaccine, that country is entitled to monetary compensation of some form. This is a dangerous course that threatens to undermine a worldwide agreement honored by nations for nearly 60 years. I wrote previously about this subject.

The Indonesian Health Minister has used the sample-sharing debate and the negotiations over the status of NAMRU-2 in Indonesia to set herself up as an antagonist of the United States, a position I suspect helps her politically among the constituency of her party.

NAMRU-2 is an important public-health asset in Indonesia. The lab is a WHO reference lab, which means the level of expertise there is high enough that the world accepts its work. If a communicable disease breaks out in South East Asia, any country can send samples of the virus there to have them identified. The laboratory has been in Indonesia for decades, and exists under a Memorandum of Understanding (MOU) between our Governments, which is up for renewal.

The MOU that governs the status of NAMRU-2 expired two years ago, and both sides have been trying to renew it. When I was in Indonesia in 2005, the lab was a major topic of conversation in my discussions with various Ministers, and with the President. At that time, I received absolute assurances the Indonesian Government would approve the MOU shortly.

Minister Supari recently issued orders to prohibit Indonesian institutions from providing tissue samples to NAMRU-2, under the justification that such sharing is not legal in the absence of an active MOU and a Material-Transfer Agreement. Her action is obviously linked to her global initiative to seek specific benefits for sharing samples.

To add more drama to this picture, Minister Supari, recently published a book in which she asserts the U.S. military is using influenza samples to create biological weapons. Secretary of Defense Gates was asked about the Minister's accusation when he was in Indonesia this past February; he replied, “That’s the nuttiest thing I’ve ever heard.”

All this background created great media interest in my visit. The morning of my discussion with Minister Supari, an article appeared in the English-language Jakarta Post that said I might refuse to meet with her. The truth is, I came all the way to Jakarta quite specifically to see her. Anyway, all this added up to a minor drama.

We met privately in Coordinating Minister Bakrie’s office for a while, and then joined the rest of our delegation and Indonesian Government staff who had gathered. The conversation was refreshingly straight-forward, an outcome I attribute to the style of the Coordinating Minister. While we talked about a number of other issues, such as HIV/AIDS, most of our time focused on the NAMRU-2 and sample-sharing. After a time, the Agriculture and Coordinating Ministers left, but Health Minister Supari and I continued our conversation.

It is important to remember that, while the NAMRU-2 issue is between the United States and Indonesia, the influenza-sample issue is between Indonesia and the other 192 Member States of the World Health Organization. The United States has been part of a group that has been trying to resolve the problem for the past two years. They have held numerous meetings, and various other types of negotiations. These have yielded a short list of things the parties believe the WHO Secretariat could do to improve its influenza program. The Minister mentioned this several times as "progress."

However, I could see little real progress in the key question whether contributing countries should receive direct, monetary benefits as compensation for sharing samples. The Minister’s main point is that what she wants should not be considered "royalties" or "compensation." What she says she wants is for the contributing countries to be eligible for some share of the value commercial companies create out of the influenza samples they provide. Or, as she expressed it in a hand-delivered letter to me later in the afternoon, “Allow me to reiterate that when I raised the term ‘monetary benefits,' I was not referring to any type of royalty, nor any type of quid-pro-quo arrangement, but rather to a method that leads to the allocation of values derived by commercial interests into one commonly defined system, which will provide benefits to those that have made contributions.”

I told the Health Minister two things. First, I understand her desire to assure people in her country have access to medicines and vaccines. This is a problem in developing countries all over the world. It is a complicated issue, but we need to address it, while preserving the incentives for innovation. I pointed out that technology is improving and might well hold solutions we don’t currently have. I used as an example the billon-dollar investment our nation has made in cell-based vaccine technology. Once we are using cell-based methods of making vaccines, the capacity and cost of making vaccines will dramatically drop, which will change the entire equation. The world is working on solutions.

However, linking sample-sharing to payment in any form will immediately begin to erode our ability to make vaccines at all, because once the practice of free and open sharing of viruses stops, the slope is slippery, and there will be no end to the demands.

The issues of the availability of vaccines and the sharing of samples are both legitimate ones, and we must deal with them both, but we should not link. World health should not be the subject of barter.

The second thing I told her is that I find it impossible to distinguish a difference between what she is seeking and royalties. The bottom line in both is this: share samples, get paid.
I would summarize the conclusion of my meetings this way: We celebrated the small list of consensus recommendations that are emerging from the multi-lateral discussion at the WHO on this matter, and committed to keep looking for solutions. The Coordinating Minister suggested we could find a solution within two months. He later reported that to his President in our meeting with him.

I have instructed my representative on this matter, Bill Steiger, to work with Ambassador John Lange, Secretary Rice's Special Representative for Avian and Pandemic Influenza, to continue our discussions with the Indonesians and others for the next two months. However, we cannot be party to an arrangement that will un-do 60 years of one of the world’s great public-health successes.

There are some situations that, despite our best efforts, we cannot resolve. In those cases, we just live with the added risk. The cost of Indonesia's refusal to share influenza samples is incrementally small. However, the damage done by accepting Indonesia’s view is profound, and simply unacceptable.

We will work on this for the next 60 days. If we haven’t been successful in resolving the matter, I think it will be time for the world to just accept Indonesia’s unwillingness to participate in the WHO influenza system, and move on to other ways of making the world safer. Perhaps when circumstances change, Indonesia will rejoin the mainstream on this issue.

http://www.flutrackers.com/forum/showthread.php?p=149930#post149930

[sharon sanders]

Re: Indonesian leader meets U.S. health official over bird flu

".....We cannot be party to an arrangement that will un-do 60 years of one of the world?s great public-health successes...."

I agree.

[gsgs]

Re: Indonesian leader meets U.S. health official over bird flu

how much does she require ?
I guess, she wants this to be kept secret and
the "royalties" must be paid secretely, in a form such
that the amount paid cannot be tracked easily.

Why does Leavitt have to come to Indonesia for such talks ?
They could telefone. Does this telefoning happen ?
If not, why ? Is the content secret ?

I guess, it's just for the press who wants a picture.

[Giuseppe]

Re: Indonesian leader meets U.S. health official over bird flu

Recipe for a Pandemic [WSJ]
April 18, 2008

Over nearly 60 years, the World Health Organization has developed sophisticated systems for monitoring the emergence of seasonal influenza and possible pandemics as well as arming scientists with the tools to develop vaccines.

Now, one country is jeopardizing all that, putting itself and the rest of the world at risk.

The culprit: Indonesia.

Its Health Ministry refuses to give the WHO avian flu virus samples taken from Indonesian victims.

This matters because sample sharing allows experts around the world to track mutations of the virus and spot dangerous mutations.

Even more important, sharing allows researchers to develop vaccines.

Health Minister Siti Fadilah Supari asserts that Indonesian bird flu is a form of intellectual property, from which the country should benefit.

Whether that means Indonesia simply wants to ensure affordable access to any vaccine developed from its samples ? or whether Jakarta will demand a share in the profits ? is unclear.

Ms. Supari has complained in the past of labs using Indonesian samples for "commercial" reasons, raising the question of where she thinks vaccines come from, if not from private companies with a profit motive.

Of almost 60 bird flu cases in the past year, Indonesia has given WHO all of two samples ? but only for surveillance, not vaccine research. They were from high-profile cases in Bali, and Jakarta worried that tourists would stay away.

The dispute may partly be due to domestic politics.

Ms. Supari evidently thinks this viral nationalism plays well in public opinion. She published a book earlier this year titled "It's Time To Change: Divine Hands Behind Bird Flu," in which she speculates the U.S. uses virus samples to conduct research on biological weapons.

Next year is an election, and Ms. Supari is becoming a favorite of various Islamic groups, on which President Susilo Bambang Yudhoyono could end up depending.

Whatever Jakarta's motivation, without the samples it's much harder for researchers to develop any vaccine. Viruses mutate constantly. That's especially true in Indonesia, which has the highest number of cumulative bird flu infections ? 132 since 2003, compared with 106 in Vietnam.

Without samples from those cases, researchers can't tackle the most up-to-date form.

The worst-case scenario would be for a virulent strain to evolve in Indonesia and catch researchers by surprise, because they have no experience working with its predecessors.

Even if scientists do develop a vaccine based on samples from, say, Vietnam, they have no way of testing its efficacy against the Indonesian variety.

All together, it's a recipe for a pandemic, particularly if other countries start following Jakarta's lead.

Indonesia's leaders now say they want a speedy resolution to the sample-sharing dispute.

In a meeting this week with U.S. Secretary of Health and Human Services Mike Leavitt, the Coordinating Minister for the People's Welfare, Aburizal Bakrie, promised to finalize an agreement within two months.

There's no time to waste. Of the 240 human bird flu deaths reported in 12 countries since 2003, 107 have been in Indonesia ? 12 already this year.

The next highest cumulative death toll is 52 in Vietnam. Better to share samples now and allow scientists to develop a vaccine than scramble to do so when a pandemic hits.

But the world will have vaccines to protect against the avian flu virus only if scientists are able to carry out research.

By hoarding samples and trying to tinker with the financial incentives that drive pharmaceutical innovation, Indonesia is endangering everyone.
-

http://online.wsj.com/article/SB120846038978123721.html?mod=googlenews_wsj

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[Hoarding samples? Indonesia isn't alone! But the enemy is THE ENEMY. A more persuasive approach is urgently needed. ENEMY definition is not applicable when worldwide health security is put in discussion. See also a CIDRAP piece posted in FT NAMRU-2 thread. IOH]

[Snowy Owl]

Re: Indonesian leader meets U.S. health official over bird flu

I would not underestimate Public Health Diplomacy that Kouchner with MSF (Doctors without Borders') is an Icon and now Secretary Leavitt certainly reaching more than National Public Health Diplomacy.

He's certainly someone that might become more and more internationally important at the level of Public Health.

JMO

Snowy