Supari against an unfair global system

Indonesia’s health minister Siti Fadilah Supari has been seen as a brave heroine for withholding viral samples of H5N1 from WHO and the world’s influenza researchers.  She views the system of providing samples while receiving little or nothing in return as inherently unfair.  She has further stated that the viral samples are turned into biological weapons to be used against poor countries so those same countries will be forced to purchase expensive vaccines.

There are many in the world, and many in the West, who sympathize with Mme. Supari, much to my surprise and consternation.  I’ve thought about this issue a lot, twisting it this way and that, both in an effort to understand the logic of those who believe other than myself as well as to to attempt to hold out hope for a solution to the problem.  After all, as long as one works on a problem one has not admitted defeat.

Today we have this report [via AFP] on where the issue stands currently:

Alarm as Indonesia thumbs nose at West over bird flu [excerpt]

JAKARTA (AFP) — With nearly half the world’s human bird flu deaths, concern is building over Indonesia’s refusal to share virus samples and its health minister’s increasingly strident denunciations of global “conspiracies”.

Indonesia stopped sharing the samples with the World Health Organisation (WHO) in December 2006 on fears pharmaceutical companies would use them to make vaccines that are too expensive for poor countries.

The initial move by Health Minister Siti Fadilah Supari earned international plaudits for taking on an unfair global system, but with WHO negotiations at an impasse, Supari’s increasing belligerence is raising alarm.

The minister has broadened her critique of an “unfair, neocolonialist” global health system, raising the possibility earlier this year the United States was using the virus to develop biological weapons in her book “It’s Time for the World to Change: Divine Hands Behind Avian Influenza.”

Supari told a rapturous crowd at a book discussion last week that rich nations were creating “new viruses” and sending them to developing nations in order create markets for drug companies to sell vaccines.

“Indonesia sends a virus to the WHO but it suddenly it ends up with the US government. Then the US government turns the virus into dollars and we don’t know what kind of research,” Supari said.

[Emphasis added]

Those supporters referenced above may have been operating under the assumption the US and WHO would have to meet any demands so “no harm — no foul” as the saying goes, Supari would get what she wanted, the West would receive a bit of a public smack down, and the world would have the virus.  Where’s the downside in all of that? These are the people who generally don’t appreciate the consequences of what medical malpractice lawsuits have done to our healthcare system, or the generally equally frivolous [and sometimes malicious] civil lawsuits in nearly every aspect of modern Western life.

The flaw in the above is there is a limit to what can be done by the US and WHO, what they can and cannot agree to do now and in the future.  Neither entity own vaccine manufacturing facilities.

Bird flu scientists abroad and in Indonesia have raised concerns that while Supari seeks to reshape the global order, time is being wasted in understanding a virus that could potentially kill millions if it mutates into a form transmissible between humans.

Since no solution has been reached an understanding of the potential consequences of Supari’s actions are beginning to be realized, not only realized but those consequences are now compounding.

[...]“I’m a bit suspicious what she’s doing is more politics and not in fact for the global health system,” said Ngurah Mahardika, a virologist from Udayana University on Bali island.

“This will lessen the strength, the power of the preparedness of the global system … (withholding samples means) we don’t have any epidemiological and virological signal now of what the virus looks like,” Mahardika said.

“This is really increasing our pandemic risk (because) we don’t know about any signals of a pandemic.”

While Supari has insisted Indonesia and other developing countries can stand on their own in researching the virus, Indonesian scientists say they too have been shut out from access to flu samples.

“The minister of health is keeping the virus in the laboratories but they are giving no access to Indonesian scientists at the moment,” said Amin Subandrio, the head of the national bird flu committee’s expert panel.

Subandrio, who has supported Supari in trying to extract a change in WHO rules to allow developing nations to secure supply of and revenue from vaccines taken from their virus strains, said withholding samples was nonetheless risky.

[Emphasis added]

I have previously made the statement that Indonesia isn’t interested in supplying anything to the greater world with the control of their “resource”, be it product, data, or knowledge expansion.  Instead, they wish only to benefit from the work and investment of others.

This from The Jakarta Post from 26Aug08:

On the importance of shame culture [Excerpts]

Setiono Sugiharto, Jakarta

The paradoxes of Indonesia’s present are many: There are more educated people, but fewer judicious leaders; we have higher incomes, but lower morals; we expect to get more, but work less.

[...]We need not be ashamed to admit that all of these are the true portraits depicting our societal life today. While poverty, illiteracy, unemployment and malnutrition rates remain relatively high, corruption, misappropriation of state funds, abuse of power, bribery, illegal levies and other forms of immoral acts and injustices still prevail, making headlines in almost all local newspapers as well as electronic media, and becoming everyday public consumption.

This corrupt mind set has been so ingrained in our culture that it is difficult, if not impossible, to diminish it in a short period of time.

[...]

The seemingly never-ending corrupt practices which implicate state officials in important government institutions form a clear sign that Indonesians feel no shame.

We are never ashamed of our greed or other disgraceful deeds that have created misery for thousands and even millions of people in all areas — the same people who are guaranteed prosperous and decent livelihoods by the Constitution.

[...]

The notoriety of corrupt government bureaucracy has also long been with us, with those who are supposed to serve the public for free extorting money from them. It comes as no surprise that the public perceive the House of Representatives as one of the most corrupt institutions.

Korupsi berjamaah (collective corruption), a recently coined catchphrase, has seen a lot of use of late. It is used to describe collectively high-profile corrupt practices implicating those in the legislative body, the Indonesian Central Bank (BI) and the Supreme Court.

[The writer is chief-editor of the Indonesian Journal of English Language Teaching and teaches English composition at Atma Jaya Catholic University, Jakarta. He can be reached at setiono.sugiharto@atmajaya.ac.id]

There doesn’t seem to be any easy answers to the issue of viral sample sharing, and there may not be any answer to it.

It’s a weird world when those attempting to find answers to the world’s vaccine needs are cast as villains and that perspective is widely held.  It’s a weird world when a corrupt government is seen as a hero safeguarding the interests of the world’s downtrodden poor nations.  It’s a weird world when a deadly virus is seen as a resource, but only a resource in its release [or withholding] to those selfsame villains working on the vaccine issue.

It may be a weird world but it’s the only one we have right now, and we will either solve this problem or we won’t.  Ethics, morality, obligation, and capitalism are not mutually exclusive of each other.  As a country Indonesia receives a great deal, a great deal from the very country Supari is actively slandering and villifying

U.S. Foreign Aid to East and South Asia: Selected Recipients

Among East Asia and the Pacific (EAP) countries (excluding the Pacific Island nations),11 in FY2007, Indonesia was the largest recipient of U.S. foreign aid, particularly ESF, health, and development assistance (CSH and DA), followed by the Philippines. The Philippines was the region’s largest beneficiary of Foreign Military Financing (FMF) and International Military Education and Training (IMET). Counter-narcotics and law enforcement assistance (INCLE) were provided to Indonesia, the Philippines, Laos, and Thailand. Indonesia, Cambodia, and the Philippines were the largest recipients of Non-proliferation, Anti-terrorism, De-mining, and Related Programs (NADR).12 Vietnam, as one of 15 focus countries under the President’s Emergency Plan for AIDS Relief (PEPFAR), received $118 million from the Global HIV/AIDS Initiative (GHAI) account between 2005 and 2007 and is to receive $86 million in 2008.

U.S. Foreign Aid (Non-food) to East Asian Countries, FY2007 est. ($million)

And this from Australia…

Australia’s aid strategy in Indonesia

The long-term goal of Australia’s aid program with Indonesia is to assist that country to reduce poverty and achieve sustainable development. Australia’s aid to Indonesia aims to:

• Support improved economic management through support for key structural reform measures
• Help strengthen the institutions and practices of democracy through assistance for legal and judicial reform and democratic institutions
• Improve security and stability through support for counter-terrorism, conflict prevention and humanitarian assistance
• Help increase the accessibility and quality of basic social services, particularly in education and health.

In responding to the challenges facing Indonesia in the medium term, and in seeking to support Australia’s national interests, the aid program will:

• Continue to expand assistance to governance through support for economic reform, legal and judicial reform, the promotion and protection of human rights and on-going support for counter-terrorism initiatives
• Increase the impact of poverty-focused programs intended to improve education, health, water supply and sanitation services to the poor, by incorporating governance dimensions and focusing on a limited number of provinces to promote synergies across activities eg between assistance for better planning and administration, and improved service delivery.

The Australia Indonesia Partnership

Country program estimate 08-09: $182.7 million
AIPRD: $230.9 million
Total ODA: $462 million

Australia’s aid program in Indonesia reflects Australia’s national interest in Indonesia’s stability and prosperity by helping Indonesia improve governance, reduce poverty and achieve sustainable development.

The enormous complexity of Indonesia’s economic, political and social change agenda has been compounded by terrorism. Australia is helping Indonesia build its counter-terrorism capacity, including building the capacity of the Indonesian police force on counter-terrorism and transnational crime, restricting the flow of financing to terrorists, and enhancing travel security by strengthening airport, immigration and customs control capabilities.

The above are from only two countries, there are other countries representing other contributions.  I will re-quote the opening article:

The initial move by Health Minister Siti Fadilah Supari earned international plaudits for taking on an unfair global system….

Perhaps I need a lesson on what is “fair” in 2008, maybe it has changed since the time I learned the term.

SZ