Indonesia has gone back on its pledge to resume sending bird flu samples to the World Health Organization (WHO), while upping the rhetoric in a standoff that has pitted poor countries against the rich.
Health officials from the nation hardest hit by bird flu say it's unfair for WHO to simply hand over their H5N1 viruses to drug companies, arguing any vaccine produced from their specimens would likely be out of reach for many cash-strapped countries.
Some international scientists have accused the government of holding the virus hostage, keeping experts from monitoring whether it is mutating into a dangerous form that could spread easily among people.
"We don't care," Triono Soendoro, head of the National Institute for Health Research and Development, said to the mounting criticism, maintaining that his country was fighting for a bigger cause.
The government has reported 74 human deaths from bird flu since its first outbreak two years ago -- more than a third of the world's total. They stopped sending viruses in January, using the samples as leverage against a system they say caters to the developed world.
But one month ago, Health Minister Siti Fadiliah Supari surprised all by announcing at a high-level meeting with WHO in Jakarta that she was ready to end the standoff. The WHO, in turn, promised not to share virus samples with vaccine companies without Indonesia's permission.
"We will start sending bird flu samples to the World Health Organization immediately," Supari told reporters at the time, saying she was satisfied with assurances offered by the global body.
But four weeks later no samples have been sent, Health Ministry spokeswoman Lily Sulistyowati said on Wednesday, and Supari's criticism of WHO's virus sharing system remains as harsh as ever.
"Exploitation by industrialized countries toward poor countries is not something new," she wrote recently in an editorial. "This situation brings poverty, suffering and stupidity."
It's not clear what triggered the reversal.
But some experts say she has a point, and that Western governments should realize a pandemic that starts in Asia would not only kill indiscriminately but also cripple economies everywhere. There is capacity to produce up to 500 million doses of flu vaccine a year -- far short of what would be needed in a pandemic.
"It's not just about altruistic public health," said Michael Osterholm, a University of Minnesota infectious disease specialist. "When we realize Southeast Asia and China are shut down economically from a pandemic perspective, so goes our economy. So goes many critical products and services that we count on every day."
The WHO hasn't counted any Indonesian bird flu cases since the country stopped sending samples, keeping its official count at 63. Indonesian officials have recorded 11 deaths since then.
The UN health agency has been careful not to criticize the government. Last month's meeting in Jakarta, also attended by health officials from dozens of developing countries, was intended to assure that the poor will not be left out. Historically, they have had little access to everything from expensive AIDS drugs to seasonal flu vaccines.
WHO's concession -- that drug companies be required to seek permission before using Indonesia's viruses to make vaccines -- was a major departure from the global body's free sharing system used to develop seasonal flu vaccines for the past 50 years.The temporary deal applies only to Jakarta, and all other governments are expected to continue providing samples unrestricted, said David Heymann, WHO's top flu official.
Vietnam and Thailand have also resisted sending bird flu specimens in the past, and China has not shared any human samples since spring of last year, said WHO spokeswoman Joanna Brent in Beijing. State-run Chinese media reported last week that the government would resume sending samples soon.
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