Indonesia said on Tuesday it would immediately resume sharing samples of its deadly H5N1 bird flu strain. It came to an agreement with the World Health Organisation, scientists and donors on a framework through which developing countries will receive greater access to vaccines for non-seasonal viruses, including bird flu.
After two days of talks in Jakarta, samples will now be sent only to four WHO collaborating laboratories, which will do diagnostic tests on them, update pandemic risk assessments and produce vaccine seeds.
The decision removes a block on international efforts rapidly to develop vaccines to tackle a future pandemic.
H5N1 has killed more than 170 people in 12 countries since bird flu first emerged in Asia in late 2003. Experts fear it might mutate to cause a global pandemic.
“Once the seed vaccines have been produced, there will be a mechanism developed so countries will know which companies are wanting to take their viruses and the [countries] will have to give permission,” said David Heymann, the WHO director for communicable diseases.
Siti Fadillah Supari, Indonesia’s health minister, said the terms of reference for permission were likely to require vaccine manufacturers to help strengthen the global influenza surveillance network for sharing of biological material, build manufacturing capacity in developing countries and improve access to “safe, effective and quality [bird flu] and other potential pandemic influenza vaccines”.
She hoped the terms of reference could be finalised by the WHO’s annual assembly in June, a deadline widely regarded as ambitious.
“[They will] accomplish our objective of achieving equitable and affordable access to vaccines for developing countries around the world,” Dr Siti Fadillah said.
“The one thing we will do is make sure they don’t in any way impede global public health security,” Dr Heymann said. “They must also not discourage companies from developing vaccines.”
All non-seasonal influenza viruses would be covered in the deal, Dr Heymann said.
Western delegations to the meeting said the negotiations went “surprisingly well”. China and Egypt were among developing countries who stressed the importance of continued sharing while the mechanisms are being negotiated.
“The devil will be in the details,” said one meeting delegate. “I think there will be a lot of pressure on Indonesia not to have blanket veto rights on what is shared.”
Jakarta stopped sharing samples in January after it accused CSL, an Australian pharmaceutical company, of obtaining Indonesian bird flu virus strains duplicitously through the WHO. CSL insisted the WHO had not acted improperly and that it obtained the samples from a network to which Indonesia had been willingly contributing for decades.
Dr Siti Fadillah appeared to back down in February but then suddenly hardened her position to demand a legal framework to ensure equitable virus sharing.
Experts were alarmed at Indonesia’s actions because it is the country worst affected by bird flu – with at least 66 human deaths since 2005 – but does not have the ability to detect whether the virus is mutating into a more virulent form that might increase the likelihood of a global pandemic.
Indonesia never, however, stopped sharing samples of the animal bird flu strain.
Dr Heymann said Margaret Chan, the WHO director-general, would also meet heads of big pharmaceutical companies to look into the feasibility of creating a system where developing countries had quicker and cheaper access to drugs needed rapidly to contain a pandemic.Additional reporting by Taufan Hidayat in Jakarta