An open letter to Indonesian President Susilo Bambang Yudhoyono
Scott McPherson
in Politics and government, influenza and infectious diseases
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8 Comments
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.
Reader Comments (8)
Scott,
You are a wise and handsome man.
I am, however, surprised that you would pander to the demands of the Indonesians. The Indonesians are holding the world to Ransom. To hell with the rest of the world, Indonesia wants blanket coverage for the duration of the pandemic. I have no doubt that they will get what they want, as governments around the world will pander to their needs. Millions of dollars have been thrown at the situation in Indonesia, it has disappeared with nothing to show for it. The Indonesians now want more. Play with the Devil, and you will get burnt.
Nice letter, you write well. Would be amazing in its self if it got through to the proper channels, and actually had an impact.
Although, taxpayers really have sent them enough money Scott. When is enough - enough?
Scott,
I'm always a sucker for an idealist.
Thank you for taking the time to write the letter. It will be read, it will become part of this whole history in the making.
Tilting at windmills is not always done in vane, and I actually have a certain amount of hope that this letter, in its plain sincerity will wend its way to any number of people who will eventually be meaningful in the resolution of this issue.
Okieman posted this quote on FluWiki earlier today and I found it moving in a personal way. I feel it is apropos to this issue and your efforts with this letter so I will drag it here as well...
It all matters.
SZ
Bye... bye namru
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Everyone,
I am preparing a blog on why I wrote the open letter. Also, I encourage all to read the Wall Street Journal editorial of yesterday. It is most awesome. http://online.wsj.com/article/SB120846038978123721.html?mod=rss_opinion_main
Its so strange to think that its Siti Fadilah Supari that want the cessation of NAMRU. On the contrary, she is one of those who who said that NAMRU is an important lab, and she is more than willing to cooperate as long as there's a MoU for its operation!
You better learn the facts more before writing such an open letter to the President of Indonesia.
Isn't it embarassing?
When you wrote this open letter, the position of Siti Fadilah Supari was to support NAMRU-2 as long as there's an MOU to its operation.
But since last weekend (25-26 April), her stance was indeed changed. She inclined to close it after hearing what other officials/former officials had to say on this issue. And she was encouraged to do so by members of DPR and DPD. You can read it all in the media.