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To Better Fight Bird Flu: Wishing the World Would Come Around (Again)
Emmy Fitri | January 25, 2012

Indonesia, the country most affected by the bird flu virus and the one with the highest death toll, is still considered an important player in the whole bird flu drama. Indonesia, the country most affected by the bird flu virus and the one with the highest death toll, is still considered an important player in the whole bird flu drama.

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arukmantara
7:47pm Jan 25, 2012

I thank you Emmy Fitri to remind us all of one of the most serious public health threats we have here in Indonesia. We are all accountable whenever another pandemic occur in the future. It can only happen because we neglect the fact that we haven't succeed in combatting the virus. We are busy protecting our interests compared to public safety. It is a collective sin to let more and more people die of teh disease we once knew how to prevent.


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The US National Science Advisory Board for Biosecurity on Dec. 20 issued a recommendation to ban detailed publication of recent research on an engineered, highly contagious version of the H5N1 avian influenza virus, citing the threat of bioterrorism copycats.

The news may have come as a surprise, but it somehow sounds familiar.

After the unprecedented recommendation and a moratorium signed last Friday by researchers to halt their lab work, the name of former Indonesian Health Minister Siti Fadilah Supari instantly came to mind.

In late 2006, she did the same thing as the NSABB: ask scientists not to publish their research findings.

At the time, Siti Fadilah, working with officials from other developing countries, was leading an audacious campaign to revoke a World Health Organization rule that mandated the sharing of virus samples.

Her problem with the rule was a restriction attached to it that said the genetic codes of newly discovered virus strains could only be accessed by countries meeting certain security requirements. In practice, those countries would be mainly wealthy and Western. Siti Fadilah wanted the protocol revised so data could be accessed by all WHO member states.

It took more than four years before her wishes were partly granted, but in 2010 but the world did change.

Amid much speculation about her decision in 2006 to withhold samples of the bird flu virus — Indonesia was thought to have one of the most lethal strains — one of her official excuses was the fear that pharmaceutical companies in wealthy countries would use it to produce a vaccine only available to them. Poorer nations like Indonesia, she argued, might have to pay dearly to obtain it.

Her persistence in the face of WHO rules drew widespread criticism, especially from researchers working to find ways to prevent a global bird flu pandemic.

The former minister even published a book, “Saatnya Dunia Berubah! Tangan Tuhan di Balik Virus Flu Burung” (“It’s Time for the World to Change! God’s Hand Behind the Bird Flu Virus”), in which she laid out her case.

In the book, later recalled from bookstores because, allegedly, of inaccurate translations and strong objections from some foreign embassies it mentioned, Siti also cited international conspiracy theories behind the string of bird flu outbreaks, even suggesting the virus may have been man-made.

The US government’s Los Alamos National Laboratory in New Mexico is mentioned in the book. It was widely believed, though, that Siti Fadilah’s accusations were baseless.

Regardless, Indonesia, the country most affected by the bird flu virus and the one with the highest death toll, is still considered an important player in the whole bird flu drama.

With the recent NSABB recommendation, the drive to crack the code of the long-mysterious and deadly virus must stop and be rerouted back to square one.

On Friday, researchers from leading flu labs around the world signed a voluntary moratorium, published on the Web sites of the journals Science and Nature, as a sensible response to the emerging controversy over how to handle research that is high-risk but at the same time has the potential to bring a big payoff for the greater good.

Two labs, one at Erasmus University in the Netherlands and another at the University of Wisconsin-Madison, have successfully created mutant strains of the H5N1. The breakthroughs were products of research into how the bird flu virus might mutate to become a more dangerous threat to people.

The ban recommended by the NSABB, which came only days after the researchers announced their discoveries, received strong support from critics who also worried that a lab accident might allow the virus strains to escape and wreak havoc.

The US government’s efforts to prevent the research results from falling into the wrong hands is something the world should be able to understand. The United States, which largely funded the Erasmus-Wisconsin research, experienced bioterrorism in 2001, when there was a series of anthrax attacks.

At a newspaper called the South Florida Sun Sentinel, an envelope containing anthrax spores was found in a mail bin, killing veteran photographer Robert Stevens. That same month, letters with anthrax dust were received by the secretary of Senator Tom Daschle in Washington, DC, and by the New York City offices of NBC, CBS, ABC and The New York Post.

But the view of one of the leading researchers from the Rotterdam-based Erasmus University team, Ron Fouchier, must also be taken into account. On Saturday, a day after the moratorium was signed, in an interview with ScienceInsider magazine, Fouchier stated: “As researchers, we work very closely with people in Indonesia. It would be very unwise for us not to share our results with our close collaborators.”

He also said: “It’s a pity that it [the research] has to come to this. I would have preferred if this hadn’t caused so much controversy, but it has happened and we can’t change that.”

The moratorium was deemed the most sensible course of action, as it would give NSABB time to work out a solution on what to do with the findings. If the new research can lead to a more potent antiviral drug, the United States should work closely with the WHO to help countries like Indonesia that are most in need of help in stamping out bird flu.

Unlike in the past, when Siti Fadilah accused the WHO of siding with wealthy countries, the organization must stand strong. It has said the research is “super-important,” but also that it is just as important that the findings are shared. If they aren’t, it could mean the end of global cooperation for pandemic preparedness.

But at home, sadly, Indonesian researchers have remained tight-lipped about what they contributed to the research and about their own expectations for it. This attitude has given the impression that Indonesian researchers seem to feel inferior and lack concern about what happens here. None of them issued any statement despite the good possibility that they will be unable to see the results of research they participated in.

Complacency is the easiest way out. It shouldn’t surprise us, then, that despite massive prevention campaigns Indonesians continue to fall victim to bird flu. And the most worrying recent news is that the resistance of virus strains to antiviral drugs could be on the rise.

Since 2005 Indonesia has struggled to contain the spread of the virus and it remains the country with the highest number of victims, with more than 180 cases and 150 deaths. For now, people only get sick from having direct contact with infected birds, but experts fear that a mutation could enable the virus to easily pass from human to human, which would make a deadly global pandemic much more likely.

Borrowing a phrase from Siti Fadilah, the time is more than ripe for the world to (once again) change. Since the United States is the one country that strongly opposed Indonesia’s decision to withhold virus samples in 2006, it should be easy for Washington to understand why it is crucial that the results of the Erasmus-Wisconsin research are shared with the global community of scientists.

Emmy Fitri is features editor at the Jakarta Globe.




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