Supari wins again
Many have predicted that the odious Indonesian Health Minister Siti Fadilah Supari would be punished for blocking the release of H5N1 sequences, which puts the entire world at peril, and for alleging that a spy from the US at the WHO had secretly transferred samples to the US for bioweapons development. These predictions have been proven wrong.
US Health and Human Services (HHS) Secretary Leavitt met with Dr. Supari yesterday.
Indonesian Health Minister Siti Fadilah Supari and US Health and Human Services (HHS) Secretary Leavitt
The picture above is from a previous visit. Since Secretary Leavitt considered not meeting her, we can assume that he may not have been smiling on this trip.
To his credit, Secretary Leavitt criticised Indonesia for their refusal to share H5N1 samples:
U.S. Health and Human Services Secretary Mike Leavitt, making a two-day stopover that included meetings with Indonesia's president and health minister, acknowledged Monday that improvements to the global body's virus-sharing system could be made.
“But linking it to the sharing of viruses is not something we can support,” he said, adding that once “people begin to trade viruses for value ... there will be no end” to it.
AP, April 14, 2008
However, he did not criticise Dr. Supari for her conspiracy theory about the US using H5N1 samples for bioweapons. Further, the mere fact that he met with Dr. Supari elevates her in the eyes of other world leaders and gives credence to her claims.
I understand that Secretary Leavitt is a politician and that politicians sometimes must do things that they personally find offensive. But really, what did he gain by meeting with Dr. Supari? She is unrepentant, unapologetic and unwilling to share samples except under "certain conditions" that are never specified.
[Updated, April 17, 2008
On April 14, 2008, Secretary Leavitt wrote a blog addressing his meeting with Indonesian Health Minister Supari. He wrote:
...I have met multiple times with Health Minister Supari. She has become a controversial figure within the health world, because she has stopped sharing with the World Health Organization (WHO) any samples of influenza viruses that are circulating in Indonesia. She asserts that if a nation provides a virus from which a manufacturer makes a vaccine, that country is entitled to monetary compensation of some form. This is a dangerous course that threatens to undermine a worldwide agreement honored by nations for nearly 60 years. I wrote previously about this subject.
The Indonesian Health Minister has used the sample-sharing debate and the negotiations over the status of NAMRU-2 in Indonesia to set herself up as an antagonist of the United States, a position I suspect helps her politically among the constituency of her party.
[snip]
To add more drama to this picture, Minister Supari, recently published a book in which she asserts the U.S. military is using influenza samples to create biological weapons. Secretary of Defense Gates was asked about the Minister's accusation when he was in Indonesia this past February; he replied, “That’s the nuttiest thing I’ve ever heard.”
[snip]
I told the Health Minister two things. First, I understand her desire to assure people in her country have access to medicines and vaccines. This is a problem in developing countries all over the world. It is a complicated issue, but we need to address it, while preserving the incentives for innovation. I pointed out that technology is improving and might well hold solutions we don’t currently have. I used as an example the billon-dollar investment our nation has made in cell-based vaccine technology. Once we are using cell-based methods of making vaccines, the capacity and cost of making vaccines will dramatically drop, which will change the entire equation. The world is working on solutions.
However, linking sample-sharing to payment in any form will immediately begin to erode our ability to make vaccines at all, because once the practice of free and open sharing of viruses stops, the slope is slippery, and there will be no end to the demands.
The issues of the availability of vaccines and the sharing of samples are both legitimate ones, and we must deal with them both, but we should not link. World health should not be the subject of barter.
The second thing I told her is that I find it impossible to distinguish a difference between what she is seeking and royalties. The bottom line in both is this: share samples, get paid.
[snip]
I have instructed my representative on this matter, Bill Steiger, to work with Ambassador John Lange, Secretary Rice's Special Representative for Avian and Pandemic Influenza, to continue our discussions with the Indonesians and others for the next two months. However, we cannot be party to an arrangement that will un-do 60 years of one of the world’s great public-health successes.
There are some situations that, despite our best efforts, we cannot resolve. In those cases, we just live with the added risk. The cost of Indonesia's refusal to share influenza samples is incrementally small. However, the damage done by accepting Indonesia’s view is profound, and simply unacceptable.
We will work on this for the next 60 days. If we haven’t been successful in resolving the matter, I think it will be time for the world to just accept Indonesia’s unwillingness to participate in the WHO influenza system, and move on to other ways of making the world safer. Perhaps when circumstances change, Indonesia will rejoin the mainstream on this issue.
------
I greatly appreciate Secretary Leavitt's frank assessment of the situation with Indonesia.]
Monday, April 14, 2008
