Jakarta's vaccine deal worries WHO

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 (WHO), apparently because it is negotiating a contract to sell the samples to a US vaccine company, a WHO official said on Tuesday.

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, David Heymann, said the agency was "clearly concerned" about the development and was in talks with Indonesia.

Heymann, the agency's chief of communicable diseases, said he was not blaming the company involved, Baxter Healthcare of Deerfield, Illinois.

"But now that this has happened," he said, "we have to sit down and figure out how to rectify it."

Indonesia signed a memorandum of understanding with Baxter yesterday. Under the memorandum, which has yet to be finalized, Indonesia would provide samples of the H5N1 strain of bird flu and Baxter would develop a vaccine and help Indonesia set up its own production facilities.

Health Minister Siti Fadillah Supari said the agreement would secure an affordable supply of vaccine in the event of a national emergency in Indonesia.

"It is for our own use. If in the near future we need it, we would be ready," she said.

When approved for licensing, Indonesia would also have the right to market it domestically and export it to other countries, she said.

A Baxter spokeswoman said the company had not asked Indonesia to stop cooperating with the WHO. She added that the agreement 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 last year than in any previous year and is out of control in poultry in Indonesia, Egypt and West Africa.

Indonesia's decision upsets the pattern for making seasonal flu vaccines -- by choosing among hundreds of samples sent in voluntarily from all over the world -- and could set a dangerous example for other countries.

Indonesia and other poor countries feel slighted by the system -- justifiably so, some experts say -- because the samples they send in are used to produce vaccines that they often cannot afford.

"Their concern," Heymann said, "is that their strains have been used by several manufacturers to produce vaccines, and that Indonesia should get some compensation. From their point of view, it's understandable."

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 -- including measles, polio, rotavirus and other killers of children -- 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 WHO.

"Baxter has nothing to do with this," she said. "Our role is in developing vaccines. We're not involved in ownership decisions. We believe that the timely sharing of information is critical for improving international responses to the threat of a pandemic and are proud to be part of the global effort."

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

"This is counterproductive -- it will hurt Indonesia more than it hurts other countries," said Arnold Monto, an epidemiologist at the University of Michigan. "The WHO should be their biggest friend. Indonesia has a virus with a 70 percent case fatality, and we don't know why. If they want to work with the best laboratories in the world, they should make sure that virus samples can get out."

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