Deadly pathogens: the threat of commoditisation
A new market has recently appeared, dealing in deadly pathogens. Countries, particularly developing nations, to which some of the world’s most deadly diseases are endemic, have suddenly realised that they are sitting on a vast natural resource. This resource, they have discovered, can be parlayed into increased wealth, the development of a new industry, and a diplomatic lever. If a new, virulent, disease arrives on the scene this could create stumbling blocks for the efficient development of a cure.
The traditional model for analysis of a pathogen and development of a vaccine or other medical countermeasure has been for a first-world country with a well developed medical and scientific infrastructure to obtain a sample of the virus, analyse it, and attempt to produce a vaccine. There has been controversy in the past over the price developed nations have charged poorer countries to receive these medicines.
A such, some developing countries have decided to restrict access to the raw material, arguing that they would be better served by using the viruses to advance their own medical and scientific infrastructure. Acknowledging that this will take time, these countries have found they are able to use the viruses to exert influence over their richer counterparts. The trigger for this process was the securitisation of international health threats that came about as a result of SARS and avian influenza (H5N1).
Threat recognition
In November 2002 SARS (Severe Acute Respiratory Syndrome) appeared and
demonstrated how quickly a disease can spread around the globe. Although SARS
turned out to be a naturally occurring disease, there were initial fears that it
was a bio-terror event. This raised the profile of pandemics in the public
consciousness, and diseases began to be thought of much more in security terms
than had previously been the case. When the spectre of avian ‘flu (H5N1)
materialised, the developed world looked to Indonesia
In 2006, amidst grave international concern, in some quarters verging on panic, that the world was on the brink of another flu pandemic like one in 1918 (which lasted for two years and killed between 50m and 100m people, or 3%-6% of the world’s population), the Indonesian government took the controversial decision to stop sharing its H5N1 virus samples with the international community. The anxiety about a possible avian ‘flu pandemic suddenly rendered the viruses circulating in Indonesia very valuable, because they were needed for tracking the evolution of the virus and for developing up-to-date countermeasures against the threat. The Indonesian government realized that it controlled a very precious commodity, which it could deploy as a diplomatic bargaining chip for negotiating greater access to vaccines and other benefits.
A particular annoyance to Indonesia was that it discovered that the virus samples it had been sharing freely with the World Health Organization (WHO) through the long-standing Global Influenza Surveillance Network (GISN) were being passed on to pharmaceutical companies in the West, which in turn used them to develop lucrative new vaccines. The pharmaceutical companies were then selling those vaccines back to the Indonesian government at commercial rates. Indonesia’s government could not continue to engage in a process that exploited, as it saw it, Indonesia’s vulnerable population for the further enrichment of the West. Many western countries and researchers expressed fear and anger at a decision they claimed endangered public health and global health security. Although Indonesia’s position was not without merit, and debate has raged on the subject ever since.
However, an unlooked-for consequence of the debate is that it has been used by Islamist fundamentalists operating in South Asia as a wedge to create greater perceived divisions between the US (and its allies) and the Muslim world. This may no longer be an issue directly related to virus sharing, but it has been connected in such a way that the debate cannot be resolved without addressing it.
Mud-slinging
Further hindering the resolution of the argument is the acrimonious language
that has been used by both sides over the last few years. Siti Fadilah Supari,
the former Indonesian Health Minister, has accused the US government of
siphoning off samples in order to develop biological weapons at Las Alamos
National Laboratories, an accusation she has repeated on a number of occasions,
including in March 2009 when she said “I’m truly afraid the world will use our
viruses or DNAs to create a mass biological weapon that may be used to attack
us.” Western officials have reciprocated with well publicised articles which
question Indonesia’s motives for stopping the supply of viruses, pointing in
particular to internal political turmoil, and the fact that Siti Fadilah Supari
is a strong advocate of Indonesia being ruled by an Islamic regime.
The commoditisation of viruses, in this case H5N1, has made the virus sharing dispute difficult to resolve. It has turned it into a West/Muslim issue, and it has rendered international health co-operation a matter of calculated national interest.
The danger ahead
This article has looked at the situation arising out of Indonesia, as this is
where the battle has most recently been fought. But other developing nations
have taken note and are watching carefully. If Indonesia comes out of the
process better off, with greater wealth, more lucrative and more effective
pharmaceutical infrastructure, and greater influence on the world stage, then
they will certainly follow suit if a new disease appears in their territory. In
the case of avian ‘flu the world has been fortunate (so far). The virus samples
from Indonesia are still very important, but the fear of an immediate pandemic
has abated. The biggest danger at this point is that another disease could
appear, more deadly than H5N1 that really is a serious threat; we saw an
indicator of the panic that can occur with swine ‘flu. The development of a
vaccine takes time, and if extra time is required for negotiations to be
concluded over access to virus samples, there is an increased threat of the
disease taking hold. It is inevitable that developing countries will wish to
build up their own infrastructure. How closely the international community works
with them to achieve common goals may help to decide how serious, future,
pandemic disease threats prove to be.
Points to watch
* Watch for other developing nations refusing to share virus
samples freely.
* Look for international initiatives, sponsored by first world
countries, designed to assist the development of indigenous pharmaceutical
infrastructure in developing countries.
* Expect to see the WHO tightening up its
protocols around who can benefit directly from its programmes such as GISN.
* If the next pandemic threat occurs in an Arab or South Asian country, expect to see
these issues in extremist rhetoric.