Mariah Tso, an undergraduate student, just posted a great summary of my article, “Biopiracy and Vaccines: Indonesia and the WHO Pandemic Influenza Plan” on the blog “Climate Vulture.” This blog is also a great resource for information on climate change. You can view the original article here. I also have a second article on influenza, which examines conspiracy theories and the 2009 pandemic, which is publicly available.
Shawn Smallman, Portland State University
In 2009 people globally learned of the appearance of a new strain of influenza named H1N1A or “swine flu” in Mexico. By June the World Health Organization had declared the outbreak to be a pandemic, the U.S. and European governments were spending billions of dollars on vaccines and medications, and the tourism industry in Mexico was devastated. For most Americans, vaccine became available only after influenza had already peaked in their communities. Predictably there was an outburst of anger when the mortality rate proved to be low, as people felt that they had been misled by authorities, and frightened unnecessarily. Conspiracy theories regarding the WHO, pharmaceutical companies, and national governments abounded on Youtube and Twitter. While the mechanisms for communication were new, the problem faced by governments was not. Indeed, the U.S. had faced a similar situation in the 1970s. A historical perspective on influenza can provide some much needed context for policymakers and health authorities. George Dehner’s recent book, Global Flu and You: A History of Influenza, is a concise, well written organized overview of influenza’s history, which can help us to better understand contemporary health issues. …
Like many of you, I’ve been carefully following the news about H7N9. A few of my favorite blogs or sites for this are Avian Flu Diary, Virology down under, the Center for Infectious Disease Research and Policy, and the Bird Flu Report. A couple of thoughts about what we know so far. First, it is always difficult to make a vaccine for an H7 virus. For this reason, it’s unlikely that sufficient vaccine could be ready in six months, even in the United States. It is true that some newer vaccine technologies are now proving their potential. But we aren’t in a fundamentally different position than in 2009, when most vaccine became available too late for swine flu. …
H7N9 Influenza and the WHO’s Pandemic Influenza PlanRead More »
I’ve just returned from a conference at Oxford entitled “Influenza 2012: One Influenza, One World.” The reference to “One World” in the
title makes the point that human and animal health are intimately interlinked. While at the conference there was discussion of the current avian influenza outbreak in Jalisco, Mexico, and since returning there is now news about the discovery of a new corona virus in Saudi Arabia (this family of viruses covers a diversity of diseases from the common cold to SARS), which has killed one person and gravely sickened another. In this context, it makes sense to talk about the global ethical and scientific problems raised at the conference. …
Pandemic preparedness is a tricky question in global health governance. How do you create a framework that will ensure the global public good, in a context in which if every country follows its national interest, all nations may wind up in a worse position than if they cooperated? What makes influenza a challenging problem to address is its episodic nature. The last highly lethal pandemic was in 1918. In 2007 the mortality from avian flu in Indonesia was 87%. This means that the global community needs to prepare for this threat, but it cannot know when a pandemic may begin. For other diseases –malaria, tuberculosis, and HIV/AIDS- there is an alphabet soup of non-governmental organizations that advocate for those who are ill or at risk. These don’t exist for influenza, because of its episodic nature, which makes influenza a distinct global health governance issue. For this reason, the World Health Organization may not be able to prepare for a pandemic on its own, although it would certainly have authority once a pandemic had begun. Within the current framework, there seems no way to address the current stand-off regarding viral seed stock sharing, which threatens to create “rogue states” out of nations such as Indonesia. In this sense, a rogue state is a nation that acts outside the framework of international law and practice, although this definition is always also political. Currently, the United States is trying to identify next-generation vaccine technologies that will create more vaccine in a faster fashion. This will help, but there is no technological solution to this ethical and political problem.
One example illustrates this point. In order to create pre-pandemic vaccines, global health authorities need access to virus samples from regional outbreaks. But countries that have avian flu outbreaks may not benefit from the vaccine, which means that they are sometimes unwilling to share this seed stock. In 2007 Indonesia decided to not share viral samples with the World Health Organization, and instead to make a private deal with a vaccine manufacturer. Indonesia was frustrated that viral samples it had shared with the World Health Organization had been shared with pharmaceutical companies to create vaccines, and that some companies allegedly intended to patent sections of the virus’s genome. For this reason, the nation tried to reach an arrangement with Baxter Healthcare, in which Indonesia would exchange viral samples in return for inexpensive access to vaccine, as well as other assistance to prepare the nation for a pandemic. Developed countries harshly criticized Indonesia’s decision, which was depicted it as a “rogue state” in the global health system. But Indonesia argued that the 1992 Convention on Biological Diversity gave it control over genetic material from within its borders, thus creating the idea of “viral sovereignty.” From Indonesia’s perspective, they were cutting out the middleman, the World Health Organization, as part of an effort to ensure better access to vaccine for their population. …
Vaccines and Global Health: Indonesia, the World Bank and Pandemic InfluenzaRead More »
