# 472
This is an abbreviated editorial that appeared in the Toronto Star this morning. First the Editorial, then a bit of discussion.
EDITORIAL
TheStar.com - opinion - Poor countries want vaccine, too
Feb 18, 2007 04:30 AM
Indonesia sent a chill through the World Health Organization recently when it refused to supply more samples of the avian flu virus that has killed scores of its people. The move, which seemed aimed at gaining access to vaccines at an affordable price, threatens the global effort to track the virus and develop vaccines. But Indonesia has raised a valid point: if a pandemic should strike, poor countries would have no protection.
In a typical flu season, the key strains emerge from Asia, while the vaccines are sold primarily in the West. This has not caused a ruckus because most developing countries consider influenza one of their lesser health threats. But with rising fears of an avian flu pandemic, the dynamic has changed.
Indonesia decided to act after a foreign company announced work on a vaccine that would be based on its samples. Indonesia stopped co-operating with the WHO and started negotiations to send future samples to another vaccine maker in return for technology that would allow Indonesia to make its own vaccine.
That may be good for Indonesia but could be harmful to global health. Indonesia needs to rejoin the global network. Unfortunately, the WHO has no good answer to the inequities Indonesia has spotlighted.
The WHO needs to work much harder to encourage the transfer of vaccine production technology to countries, like Indonesia, that have the technical ability to use it. That will increase the supply of vaccine and presumably bring prices down.
This is an edited version of an editorial in Friday's New York Times.
There can be no doubt that Indonesia's decision to withhold virus samples (since November of last year) caused a ruckus among International health authorities, vaccine manufacturers, and governments around the world. Indonesia is a hotbed of avian flu, and is one of the prime areas we look to for a pandemic strain to emerge. Having samples of that virus now, seeing how it is evolving, could give the world a headstart on a vaccine.
The editorial grants that Indonesia has a point. They would be well back in the line to receive any vaccine derived from virus samples they provided.
Of course, so would most of the world.
Our global yearly production capability today for trivalent influenza vaccine is probably on the order of 400 million doses. Enough for 6% of the world's population.
New technologies are on the horizon that could significantly increase that production, but they are one, two, perhaps as much as five years away.
The `solution' espoused in this editorial is:
The WHO needs to work much harder to encourage the transfer of vaccine production technology to countries, like Indonesia, that have the technical ability to use it. That will increase the supply of vaccine and presumably bring prices down.
This seems to me to be a half-way solution, if it is a solution at all. The nebulous `needs to work harder' admonition to the WHO simply avoids the issue.
A severe pandemic would cost our global economy trillions of dollars, and could kill hundreds of millions of people.
If we can agree that such an occurrence would be a bad thing (and it would), then why can't we agree that it would be in our best interest, as a global society, to make vaccine production a non-profit multi-national global security project?
It is to our advantage in western society that a pandemic not start anywhere in the world. Indonesia, China, Turkey, Bangladesh, Nigeria . . . it really doesn't matter where it starts. It would be on an airplane, winging its way to our shores in a matter of days or weeks.
Preventing it is surely worth the effort.
Yes, the capitalist in me see's a conflict. Vaccine manufacturers would hate the idea, and giving a multinational governmental agency billions of dollars to setup vaccine manufacturing plants could be akin to giving alcohol and car keys to a teenager. But with proper controls in place, it could be done.
It has been suggested that the way to unify this planet, the way to end the petty squabbling, the mistrust, and the infighting, would be for us to discover a common enemy. One that had the power to destroy us. Those with vivid imaginations have suggested an intergalactic invader, an armada of alien space craft threatening our skies would suffice.
I would submit we have such an enemy at hand, today. One of a terrestrial nature. A virus, fully capable of bringing society to its knees. One that could strike at any time, without mercy, and that will respect no borders or nationalities.
The choice we face is either to continue to enact half-hearted measures, or to accept that we are facing a global threat, and work together to combat it.
The H5N1 virus isn't the only pathogenic threat out there, of course. It is just the closest one on the radar screen. Zoonotic diseases are emerging every year, along with old favorites like XDR TB and Malaria. They represent a clear and present danger, and will continue to do so for the foreseeable future.
We have the technology to combat many of these diseases, and will continue to develop new technologies over time. We could, if we really wanted to, work as a global community, to fight them.
Who knows what other benefits might arise out of working together against a common viral foe? Better international relations? Increased trust between nations? Advances in science and technology?
What we lack, is the will to do so. The willingness to work together, spend the money, and accept that some things are more important than this quarter's profit margins. It requires taking a long view. It requires accepting that no nation, alone, can fight these diseases, and come away unscathed.
But perhaps, by working together, we can beat these diseases back. Limit their damage. And perhaps, someday eradicate them altogether.
A fanciful thought, I know. That the world might do something proactive, instead of reactive. That we might find a way to prevent the next pandemic, or maybe the one after next, by working together in a humanitarian effort instead of a commercial one.
Sorry. It's probably too much to expect. Too much to think that we'd put the good of mankind ahead of corporate concerns. But in my defense, the title of this piece was Vaccine Dreams.
And a guy can dream, can't he?
