Scott McPherson's Web Presence

Sorry for the dearth of posts since my open letter to the Indonesian president.  Been very busy!  But I also had the bad fortune of missing last night's South Park.  You can't get any better, dead-on social commentary than this cartoon show for grown-ups.  That's grown-ups, don't let kids under 16 watch!  Because they probably won't get it, anyway.

But I digress.  Last night's episode is titled "The Day the Internet Stood Still," and it is a sci-fi spoof of the day the Internet just isn't there.  Television stations cannot broadcast any news, Dad can't watch porn, and Mom can't read endless emails.  The town's hysteria grows, until -- well, I didn;t see the dang show, so I don't know!

But I can give you this clip, courtesy of Website Gawker.com, and props to the Drudge Report for the heads-up.  The link is:

http://gawker.com/380877/south-park-the-day-the-internet-stood-still?autoplay=true

I don't think this is too far from the truth!

Dear President Yudhoyono:

Thank you for meeting with our HHS Secretary Michael Leavitt.  As you probably sensed, Secretary Leavitt is an unassuming, kind person.  He is a man of the finest personal character and he genuinely wants to work with your government to try to end an influenza pandemic before it starts.

In order for our two nations to acomplish this goal, however, we need to trust each other more.  And we need to make sure that we can put measures in place that do not rely upon vaccine alone to stop a flu pandemic from striking your nation.

Your nation's location within the "ring of fire" is just as symbolic as it is volcanic.  You have many, many things to worry about.  And bird flu necessarily takes an occasional back seat to the other risks you encounter every day: Insect-borne viruses and bacterial infections, militant Islamic fervor, and geological disasters.

The United States can help you with overcoming bird flu.  NAMRU-2 is a world-class facility, and complements your own university and government labs.  The scientists at NAMRU-2 want to help you and your nation combat this deadly foe. 

The people of the United States are also willing to help you.  The American people have shown their generosity time and time and time again, helping the displaced residents of your nation and others around the planet.  They do not want to see suffering, especially if that suffering can be stopped within your own borders.  I do not know how much Tamiflu the American taxpayers have contributed toward Indonesian stockpiles, but I do not think any thinking American would be upset if their tax dollars went to such interventions in order to stave off a possible pandemic if it broke out on Indonesian soil. 

That is because pandemics know no borders, respect no territorial soverignty, and skirt all known defenses.  This realization has caused the strangest of global "bedfellows."  Look at the cooperation between Israel and the Palestinian Authority.  Israel and the PA meet regularly -- sometimes daily -- to discuss H5N1 and ways to overcome its spread.

Look at the cooperation emerging between India and Bangladesh on the same issue.  Both nations' borders are raging with avian influenza.  Yet these two adversaries are collaborating to try and stave off this common threat.

Israel and the Palestinian Authority. India and Bangledesh.  These nations have put their differences aside, at least on this issue.  It is understandable that you would want to try and buy some leverage for your people.  Whether we agree or disagree with your government's decision, we see the reasons behind the move to withhold viral samples from the rest of the world.  I personally feel that the Australians may have acted and spoken improperly regarding their use of Indonesian samples for native Australian human H5N1 vaccine, and we empathize with your struggle. 

You must also understand that your nation's Health Ministry has risked the health and safety of the entire planet with its decision not just to withhold viral samples, but to require the cessation of activities at NAMRU-2.  This puts the entire world in jeopardy.  If indeed a pandemic strain of H5N1 originates in Indonesia, you will need the scientific and medical resources of the entire world to develop that vaccine and to help your sick.

The Chinese may have beaten everyone to it.  They are formulating a trivalent H5N1 human vaccine that many speculate actually uses the three most common "clades" in its composition.  Their labs, freed from many of the regulatory hurdles that slow down Western vaccine manufacturers, might be able to turn out a specific strain's vaccine much more quickly than anyone else.  

Let me return to the issue of affordable vaccine:  If Indonesian H5N1 acquires easy human transmission, Indonesian samples will be in great demand.  I suggest you consider the following courses of action:

1.  Try to reach an agreement with Western (and Chinese) manufacturers to pay royalties to your government if the eventual pandemic flu strain is Indonesian.  This formalizes any intellectual property claims you feel you might have.  Western governments can agree to underwrite these royalties, and you can require that the royalties be paid in the form of vaccine for your people.  But please, do not link this to the sharing of samples. 

2.  You have a gentleman coming to your nation next month.  His name is Bill Gates, and you know who he is.  Speak to him about your nation's problems and ask his foundation, which already does so much around the planet to stave off disease, to help you resolve this problem.  Mr. Gates would be a formidable ally and intermediary in your fight to guarantee vaccine for your people.  His foundation may even be able to broker the financial part of the deal, negotiating with foreign governments to guarantee royalties while guaranteeing you the funds to purchase the vaccine.

If I could suggest one thing to Mr. Gates, it would be to suggest his foundation and others shoud handle all vaccine production and distribution worldwide.  Let's take the profit motive out of vaccine production entirely. 

3.  Work with the West to formulate a prepandemic vaccine using the newest, latest viral samples.  Be their partner.

4.  Request more help with surveillance for your remote areas.

5.  Request help with the payment of money to compensate farmers for their culled poultry.

I am confident that a "deal" can be reached.  In the meantime, however, please give the rest of the world a display of good faith.  Trust us to help you by restarting NAMRU-2 and resuming the delivery of new human H5N1 samples to the WHO.  You can't claim intellectual property if no one can verify your viral strain is of Indonesian origin.  Let's work together, instead of against each other.

Thank you, President Yudhoyono, for your time.

Scott McPherson

It is my hope that the blggers of the world -- especially those within Indonesia -- can get this message to the Indonesian president. 

Indonesia's Health Minister dashes the dream of Yi Guan upon the rocks of national insanity.

Recently, I wanted to write a blog titled "Found: One same Indonesian."  It was to be a profile of the Indonesian bird flu researcher (I think he is on Bali) and his belief that the Health Minister has gone the way of the rabbithole in Alice's adventures in Wonderland. 

That was a few weeks ago, and the story went stale.  But I have fused the events of the past week and a half into one crystalline structure -- a looking glass, if you will -- for you to peer into and see its many facets.

Two weeks ago, world-renowned Chinese infectious disease expert Yi Guan postulated that we could end pandemics forever if only we had the appropriate amount of surveillance.  The Reuters story included this quote:

"If proper surveillance is in place for animals and humans, yes, we can stop pandemic influenza forever. Not just for H5N1, it may also work for other subtypes of viruses," he said in an interview over the weekend.

"We have the ability to remove pandemics if we have a long-term strategy."

http://uk.reuters.com/article/homepageCrisis/idUKT16178._CH_.242020080330

An audacious dream, indeed.  And it is not outside the realm of possibility.  It is always good to hope.

But apparently the government of Indonesia believes in the words of the German philosopher Nietzsche, who is infamously quoted as writing:

In On the Genealogy of Morals, Nietzsche writes: “Hope is the worst of all evils, for it prolongs the torments of Man.”

Yi Guan speaks of a perfect world, and the global press seized upon his message with the same zeal as if we had stumbled onto a cure for cancer.  The headline trumpeted:

Proper surveillance can stop flu pandemic: expert

The headlines might have also said:  Asteroid can be stopped if we invent spaceship capable of blasting it to smithereens (not the superb band The Smithereens, of which I am obviously fond).  Or "Baldness can be cured if we ever figure out how to change the baldness gene."  Of course, I am personally counting on that one, and soon!  I have work to do in my yard and I hate wearing hats!

But I sadly digress. Yi Guan's point, I believe, is that in a perfect world, all nations would gleefully set up avian surveillance programs in every remote village and hamlet on the planet.  Poor farmers would be trained to look for avian influenza.  Payments for culling sick poultry would skyrocket.  Farmers might actually be persuaded to turn in their flocks for proper compensation at that point!

Yes, and a few poor farmers with bad luck and a bit of larceny in their minds might also try to sicken their own flocks to resemble H5N1, in order to profit monetarily.  That's the Nietzsche in me, I suppose.

Counting on surveillance to help eradicate pandemics forever is a just and righteous cause.  But at this point, it is no more than an audacious hope.  And while surveillance may very well have prevented an H5N1 pandemic from occurring, and maybe more than once, it cannot be counted upon to be infallible.  Just look at all the territory, all the customs of the villagers, all the chickens and ducks being hidden from government authorities, the huge disparity in compensation for farmers worldwide, and the endgame by large corporate farmers who are more than happy to take up the slack and provide protein when backyard farmers are cleaned out.

Now entire governments, driven by their own selfish desires, may even try to stymie the ability of scientists and public health experts to do their good work.  For confirmation of this, look no further than today's story on Indonesia's decision to shut down NAMRU-2.  Shutting down NAMRU is madness, the height of insanity.  It is the scientific equivalent of cutting off one's nose to spite one's face.  And it puts a massive dent in the ability of Indonesian and American scientists to test H5N1 samples -- and those of other viruses such as chikungunya, malaria and dengue.

Surveillance without samples accomplishes nothing, except to cause us to look on in horror as poultry writhes and dies.  Surveillance without samples is empty.  And the Indonesian government, via its decision to shut down NAMRU-2, is making it almost impossible to get quick, independent laboratory confirmation of viral changes at just the time when Indonesia needs all the help -- and all the real friends -- it can get.

Yi Guan is a great scientist and, I am sure, a great person.  He is right to hope.  But one singluar action by a national government has the effect of walking Yi's dream deep into the woods and shooting it in the head.

Call me a pessimist, which I am normally not.  I am the eternal optimist.  But on this topic, my money's on Friedrich.

Over the last fifteen months, we have seen an entire national governmental health establishment's slow roll and spiraling descent into madness.  The nation I am referring to is Indonesia.  Granted, that nation has a lot on its plate, which I have covered ample times (just use search keyword Indonesia on my blogsite and settle back for a few hours' worth of reading).

But that descent into madness at the Health Ministry has accelerated.  First came the January, 2007 decision to withhold H5N1 human virus samples from the WHO and CDC.  Then came Health Minister Supari's book, in which she claimed that the United States government was making a WMD out of bird flu.  Clearly she must have been watching The Stand and thought it was a documentary!  Slowly but boldly, some of her own scientists have been criticizing her utter stupidity.  Even the Indonesian president, who wrote the forward to her book, has expressed profound regret.

Today, the Navy Times is reporting that the Indonesian Health Ministry has banned NAMRU-2 from operating in their country.  Here is the story:

Indonesia bans Navy medical research unit

 Kyodo News Agency
Posted : Thursday Apr 10, 2008 7:10:53 EDT

JAKARTA, Indonesia — The Indonesian government has banned the U.S. Naval Medical Research Unit No. 2, or NAMRU-2 — which is studying infectious diseases in Southeast Asia, including bird flu — from operating in the country, an evening newspaper said Thursday. The reason behind the ban was not immediately clear.

Sinar Harapan daily reported that a note on the ban, signed by Triono Soendoro, director of the Health Research and Development Agency of the Health Ministry, had been circulated among several ministries.

“It [NAMRU-2] has been banned to operate here. Sorry, but I can’t comment further,” the newspaper quoted Soendoro as saying.

Health Ministry spokesman Soemardi also refused to confirm the report.

“I haven’t received any information about that,” he told Kyodo News.

The ban follows the publication of a book by Health Minister Siti Rahil Fadilah Supari, in which she accused the World Health Organization and the U.S. government of trying to profit from the spread of bird flu. NAMRU-2 began investigating the disease after initial cases were identified in Indonesia in 2004.

In the book, “It’s Time for the World to Change,” Supari claimed WHO laboratories forward avian influenza specimens to western countries that make vaccines and then profit from their sale back to the affected countries.

As of Tuesday, bird flu had infected at least 379 people in 14 countries since its re-emergence in December 2003. According to WHO data, 239 of them have died.

Indonesia leads the table with 107 deaths, followed by Vietnam with 52 and Egypt with 21.

The other affected countries are Azerbaijan, Cambodia, China, Djibouti, Iraq, Laos, Myanmar, Nigeria, Pakistan, Thailand and Turkey.

The NAMRU-2 Detachment was established in Indonesia in 1970 and is one of the most advanced facilities of its kind in Southeast Asia. Its work was done in cooperation with and under the auspices of the Indonesian Health Research and Development Agency.

http://www.navytimes.com/news/2008/04/kyo_indonesia_041008/

NAMRU is, of course, the network of US Navy research labs around the world.  In a blog from last July, I spent a couple of paragraphs talking about NAMRU-3, which technically did not even close during the various Arab-Israeli wars!  Although US personnel were asked to leave for awhile, the lab stayed open using its Egyptian staff. 

Now imagine this:  Even when it looked like the world was going to go down in the nuclear flames of Hell itself, NAMRU-3 stayed open.  We were at the highest DEFCON state the nation has ever seen.  Conditions were worse, and military and government sphincters were tighter, then during the Cuban Missle Crisis.  And even then, the Egyptians themselves kept a US Navy research facility open!

Now look at the events of today.  The Indonesian health ministry has banned NAMRU-2 from doing any work.  No virus research.  No work on other infectious diseases such as chikungunya, malaria or dengue.  None whatsoever.

Psychologists would do well to study this latest exercise in Indonesian governmental insanity.  I don't know if this is some sort of suicidal gesture, or maybe more akin to the ritual disfigurement that addicts of methamphetamine do to themselves.  Whatever it is, it is time the rest of the world really took notice.

This action must be protested to the Indonesian ambassador.  It must be protested to the United Nations.  It is time the world understood esactly what the consequences are if this nation continues to behave as if it were alone in this fight. 

And chief among Indonesia's governmental sins is the sin of ingratitude.  We just gave the Tangerang government over a million and a half US dollars to help eradicate bird flu and teach people about personal responsibility in the fight.  American goodwill translated into millions and millions of private dollars -- and billions in worldwide government and corporate aid -- to help the tsunami victims back in December, 2004. 

The British government just announced that above all threats, a flu pandemic sits at Number One.  The United States has a policy of pursuing any and all diplomatic actions against nations that harbor terrorists.  Maybe it's time we thought of terrorism in viral terms, and took action against those nations that, via their incompetence and insanity, allow such things as H5N1 to foment within its human and avian populations.

Thanks and props to Crof and FLA_MEDIC for posting the news on their blogsites.

A few weeks ago, the trade publication Computerworld asked me to start blogging on their Website.  I blog over there for IT professionals who get the print magazine as well as those who surf the Website, and I focus mainly on IT and disaster recovery matters.  In fact, it was my frequent quotes regarding IT pandemic planning that got me the gig over there, although there is no compensation and there is a considerable draw on my time.

I wanted to vector you to that blog, titled "For hurricanes and pandemics, plan one category higher".  Just click on the link.