By Richard Holbrooke and Laurie Garrett
Sunday, August 10, 2008
Here's a concept you've probably never heard of: "viral sovereignty." This extremely 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 peoples of the world. So far "viral sovereignty" has been noted almost exclusively by health experts. Political leaders around the world should take note -- and take very strong action.
The vast majority of repeated avian flu outbreaks 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, the World Health Organization has reported.
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, the Indonesian government is threatening to close down U.S. Naval Medical Research Unit Two (NAMRU-2), a public health laboratory staffed by Indonesians and U.S. military scientists. NAMRU-2 is one of the world's best disease surveillance facilities, and it provides health officials worldwide with vital, transparent information. The Indonesian government has accused NAMRU-2 scientists of everything from profiteering off its "sovereign" viruses to manufacturing the H5N1 bird flu in an alleged biological warfare scheme. There is no evidence to support these outlandish claims.
A year ago, Supari's assertions about "viral sovereignty" seemed to be odd yet individual views. Disturbingly, however, the notion has morphed into a global movement, fueled by self-destructive, anti-Western sentiments. In May, Indian Health Minister A. Ramadoss endorsed the concept in a dispute with Bangladesh. The Non-Aligned Movement -- a 112-nation organization that is a survivor of the Cold War era -- has agreed to consider formally endorsing the concept of "viral sovereignty" 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 U.N. 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 products made from the botanicals. 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 AIDS 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 AIDS virus. 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 open-source 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 risk demands 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 in a few cases 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 make 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 has 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 U.S. ambassador in Indonesia, Cameron Hume, is actively trying to prevent a catastrophe. So far, there has been insufficient support from senior Washington officials. They must get involved. And China, in particular, must use its substantial influence with Jakarta on this issue -- in its own self-interest.
The 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, at any time.
Richard Holbrooke is president of the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria. He writes a monthly column for The Post. Laurie Garrett, a Pulitzer Prize winner for explanatory journalism, is the senior fellow for global health at the Council on Foreign Relations.