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The politics and transboundary spread of pandemics

Updated On: May 11, 2007

The combat against pandemics of global proportions is never simple, as ameliorative efforts are always politicised, and its spread renders national borders irrelevant.

Myanmar recently reported the second polio outbreak in one year near the border with Bangladesh, in western Rakhine state. The New Light of Myanmar blamed the reemergence of the disease on 'certain neighbouring countries which still have the virus'.

According to the World Health Organisation (WHO), although worldwide cases have been dropping from 350,000 in 1988 to 1,912 in 2006, polio remains endemic in IndiaNigeriaPakistan and Afghanistan. The disease also recently affected Indonesia in March 2005 after a decade of zero polio cases.

WHO’s analysis of Indonesia’s viral strain revealed a genetic structure that was almost totally similar to the Nigerian strain. WHO experts also predicted that the virus had originated from Saudi Arabia or Ethiopia, and the disease might spread further across Asian countries, such as the Philippines, Malaysia and China.

Myanmar was officially declared polio-free in 2000, but in June last year, an 18-month-old boy was diagnosed with the virus near the central city of Mandalay. Currently, WHO and UNICEF officials are conducting meetings with Health Minister Kyaw Myint to discuss how to curb the spread of polio, and the government would work with Bangladesh on containing the virus.

On the issue of virus sample-sharing, Indonesia’s ongoing tussle with WHO has reached a head, after the former had agreed to resume the sharing of bird flu samples after the latter agreed to change the existing mechanism to allow developing countries to benefit from any vaccine that is produced from the sample sharing. 

In the follow-up meeting in Geneva last month, no mechanism was agreed on, and Indonesia expects WHO’s 193 members to first agree to a proposal to adopt a system of fair distribution of influenza vaccines to developing countries, especially at the general assembly from May 14 to 23 in Geneva.

According to Dr Triono Soendoro, director-general of the National Institute of Health Research and Development, Indonesia could not resume sharing of the virussamples when the system still worked in favour of pharmaceutical companies while developing countries, where most of the virus samples come from, have no access to affordable vaccines.

Apart from the politics of sample-sharing, many countries are also grappling with the issue of politics of drug patents and production. Former US president Bill Clinton had recently unveiled an ambitious programme to provide generic versions of Aids drugs for patients in developing countries at greatly reduced prices.

Clinton’s initiative is a direct challenge to many US-based manufacturers who have balked at relaxing patent protections and cutting prices for poorer countries. In response, Brazil and Thailand had sought – with Clinton’s endorsement – to override patents on the drugs and to pursue the manufacture of generic versions after negotiations with the manufacturers failed.

Finally, in the current global battle against pandemics, health experts are also warning that too much attention has been paid to the current spotlights on H5N1 or polio.

Mr Anthony Fauci, head of the US National Institute of Allergy and Infectious Diseases, said that 'you can not accurately predict if and when a given virus will become a pandemic virus.' 'We should not...forget the fact that historically pandemics have evolved. We should be building up the knowledge base and expanding the capabilities of making vaccines,' he added.

Writing in the Journal of the American Medical Association, Fauci and his co-authors argued that pandemic prevention strategies must be based on 'expecting the unexpected and being capable of reacting accordingly'. They recommend companies to expand their research on vaccine design, develop new classes of drugs and improve tests to diagnose influenza.

The unpredictable nature of pandemics should also prompt nations to cooperate at the regional and global levels.

A promising step forward is the agreement between Singapore and Indonesia to carry out a pilot project in Tangerang municipality aimed at boosting Jakarta’s bird flu eradication efforts, as the country recorded its 75th death toll on Monday.

The project will also involve the US, WHO, the United Nations' Food and Agriculture Organisation and the World Organisation for Animal Health, and will run for three years at a cost of US$4.5 million ($6.8 million).

According to Health Minister Khaw Boon Wan, Singapore will provide manpower and technical expertise and US$1.5 million.

Minister Khaw added that the project involves surveillance strategies of the disease in animals and humans, and will include the management of infected patients, controlling the disease in animals, as well as restructuring the poultry farming system, communicating the risks and boosting local capacity to deal with the problem. (10 May 2007)

Sources:

WHO intends to certify Indonesia polio-free (Organisation of Asia-Pacific News Agencies, 31 January 2007)

Bird flu kills Indonesian woman (Channel News Asia, 7 May 2007)

Polio virus detected in Myanmar (AFP/Straits Times, 9 May 2007)

Jakarta demands fair vaccine distribution (Straits Times, 9 May 2007)

Bird flu not world's only pandemic risk (Reuters/Straits Times, 9 May 2007)

S'pore, Indon battle avian flu together (AFP/Straits Times, 9 May 2007)  

Clinton challenges US control over Aids drug patents (The Independent, 10 May 2007)