With globalization, the failure to share information about new diseases increases the risk of world epidemics going unnoticed
Here’s a concept you’ve probably never heard of: "viral sovereignty." This dangerous idea comes to us courtesy of Indonesia’s minister of health, Siti Fadilah Supari, who asserts that deadly viruses are the sovereign property of individual nations – even though they cross borders and could pose a pandemic threat to all the world’s peoples. Political leaders around the world should take note – and take very strong action.
The vast majority of avian flu outbreaks in the past four years, in both humans and poultry, have occurred in Indonesia. At least 53 types of H5N1 bird flu viruses have appeared in chickens and people there, according to the World Health Organization.
Yet, since 2005, Indonesia has shared with the WHO samples from only two of the more than 135 people known to have been infected with H5N1 (110 of whom have died). Worse, Indonesia is no longer providing the WHO with timely notification of bird flu outbreaks or human cases. Since 2007, its government has openly defied international health regulations and a host of other WHO agreements to which Indonesia is a signatory.
Moreover, Indonesia’s government is threatening to close down United States Naval Medical Research Unit Two (NAMRU-2), a public health laboratory staffed by Indonesians and US military scientists. NAMRU-2 is one of the world’s best disease surveillance facilities, providing health officials worldwide with vital, transparent information. Indonesia’s government has accused NAMRU-2 scientists of everything from profiting from its "sovereign" viruses to manufacturing the H5N1 bird flu as part of an alleged biological warfare scheme. There is no evidence to support these outlandish claims.
A year ago, Supari’s assertions about "viral sovereignty" seemed anomalous. Disturbingly, however, the notion has morphed into a global movement, fueled by self-destructive, anti-Western sentiments. In May, Indian Health Minister Anbumani Ramadoss endorsed the concept in a dispute with Bangladesh, and the Non-Aligned Movement – a 112-nation organization that is a survivor of the Cold War era – has agreed to consider formally endorsing it at its November meeting.
Indonesia argues that a nation’s right to control all information on locally discovered viruses should be protected through the same mechanisms that the United Nations Food and Agriculture Organization uses to guarantee poor countries’ rights of ownership and patents on the seeds of its indigenous plants. Under the FAO seed accord, a nation can register plants, share their seeds, and derive profits from resulting products. This useful policy reduces exploitative practices that sometimes enable multinational corporations and wealthy governments to obtain outrageous profits from indigenous agriculture.
It is dangerous folly, however, to extend this policy to viruses. If the concept of "viral sovereignty" had been applied to HIV 25 years ago, we would not have central repositories of thousands of varieties of HIV today; these allow scientists to test drugs and vaccines against all the different strains of the virus that causes AIDS. It is even more ludicrous to extend the sovereignty notion to viruses that, like flu, can be carried across international borders by migratory birds.
In this age of globalization, failure to make viral samples freely available risks allowing the emergence of a new strain of influenza that could go unnoticed until it is capable of exacting the sort of toll taken by the pandemic that killed tens of millions in 1918. As the world learned with the emergence of severe acute respiratory syndrome (SARS) – which first appeared in China in 2002 but was not reported by Chinese officials until it spread to four other nations – globally shared health risks demand absolute global transparency.
There is strong evidence from a variety of sources that forms of the bird flu virus circulating in Indonesia are more virulent than those elsewhere and that in a few cases they may have spread directly from one person to another. The WHO has tried for two years to accommodate Indonesia, without success. Under pressure from scientists worldwide, Indonesia agreed in June to share genetic data on some of its viral samples, but not the actual microbes. Without access to the viruses, it is impossible to verify the accuracy of such genetic information or to develop vaccines against the deadly microbes.
Outrageously, Supari has charged that the WHO would give any viruses – not just H5N1 – to drug companies, which in turn would make products designed to sicken poor people, in order "to prolong their profitable business by selling new vaccines" (a charge oddly reminiscent of the plot of John le Carré’s novel The Constant Gardener). The WHO elicited pledges from the world’s major drug companies not to exploit international repositories of genetic data for commercial benefit, but this has not satisfied Indonesia.
Indonesia’s claim that NAMRU-2 is a biological weapons facility must be confronted head-on. The US ambassador to Indonesia, Cameron Hume, is actively trying to prevent a catastrophe. So far, there has been insufficient support from senior US officials. They must get involved. And China must use its substantial influence with Indonesia on this issue – in its own self-interest.
Failure to share potentially pandemic viral strains with world health agencies is morally reprehensible. Allowing Indonesia and other countries to turn this issue into another rich-poor, Islamic-Western dispute would be tragic – and could lead to a devastating health crisis anywhere and at any time.
Richard Holbrooke, a former US ambassador to the United Nations, is president of the Global Business Coalition on HIV/AIDS, Tuberculosis, and Malaria. He writes a monthly column for The Washington Post. Laurie Garrett is a senior fellow for global health at the Council on Foreign Relations.
Copyright: Project Syndicate, 2008.