Whatever good reasons for the Indonesian Health Minister Dr. Siti Fadilah Supari to refuse sending Bird Flu samples to World Health Organization (WHO) seems to backfired. A lot of international media negatively covers her refusal to be a threat to the world health. For example, the editorial column at the Wall Street Journal today condemned her decision. It says that Indonesia's denial to send those H5N1 virus samples to the WHO would lead to inevitable pandemic in the region, if not the world.
As Indonesia leads the rank of country with reported H5N1 bird flu cases, the refusal to send bird flu sample for vaccine development are important. As of mid-April 2008, there were 132 confirmed human cases of H5N1 virus infection with 107 deaths in Indonesia. This represents 35 percent of the worldwide known cases of this deadly virus. Without Indonesia's bird flu samples, development of vaccines would be difficult.
Many international commentators speculated that Dr. Supari stance was mainly to gain domestic political support, in particular by bringing anti US sentiments to her personal gain. Some went further to suggest that she tried to gain support from the even stronger Indonesian Muslim's sentiments against the US.
Most international media stated the minister claims that ultimately this bird flu virus samples would be used by the US government as a potential biological weapons. Dr. Supari denies this by saying that a translation error from her original Indonesian writing to the English version of the book was to blame.
Instead, from her own word, the main reason for rejection was that the virus samples sent to the WHO laboratories would be used by Western Pharmaceutical companies to produce vaccines which later would be sold in high prices to developing countries.
It has to be mentioned that Bird Flu Vaccine development is potentially a big buck business. Although development of such vaccines are very difficult, mainly because virus strains are changing rapidly which make vaccine development such a tricky business, a successfully developed vaccine would bring a rewarding financial return as it would be required in high numbers both to people in develop world and to those in developing countries.
What is also interesting was that the refusal to send this virus samples were mostly contested by the US Government rather than the WHO itself. The latest salvo against her decision was coming from the US Minister of Health and Human Service, which on the recent visit to Jakarta pressed for Indonesia's acceptance to send the samples to the US laboratory.
The latest saga in this battlefield comes from the ban of US Navy's Naval Medical Research Unit No. 2 (NAMRU-2) laboratory from operating in Indonesia. Reports from Indonesian media mentioned that further collaboration with this institution which has long been operating in Indonesia doing virology, microbiology, epidemiology, immunology, parasitology, and entomology research is halted pending further negotiation with the US Government.
Would the Indonesian people (or its government) have a share in the development of the vaccines is the main political concern here. So far, people living in less developed countries such as Indonesia are seen more as an object and target of many western product or development in health field. Many drug trials for example are now done in the developing countries, mainly because of the less stringent requirements in accepting drug trials as well as the relatively cheaper costs to do such a trial in those countries. The profits from developing such medicines and vaccines are primarily goes to industrialists from major pharmaceutical companies. What left from the people and government of the less developed countries is the price to pay for those development created right under their nose. This is certainly a world of unfair play.
Dr. Supari effort seems to bear some fruit. The World Health Organization had commissioned a study on the 'ownership' and patent issues surrounding the Influenza viruses. Further negotiations on the issue of handing over the samples to international bodies and possibly commercial companies are still on going.
However, the most important issues facing the Indonesian Health Minister is that possible backlash to her if this struggle to achieve a stronger bargaining position was lost. Indonesia might be accused of bringing the world in danger of global pandemic of bird flu by not giving access to international effort to produce the vaccines, and in effect leaving the virus to groom in the wild.
While many prominent figures in Indonesian health sector backed her decision, loosing this battle from an international perspective would be a disaster for Indonesia. There are enough examples where Indonesian government position hung out to dry in facing negative international media coverage. There is certainly a need to turn the international media perception toward Indonesia and in particular the stance of Dr. Supari to get better bargaining position in this regard.
