By DONALD G. McNEIL Jr. <http://topics.nytimes.com/top/reference/timestopics/people/m/donald_g_j r_mcneil/index.html?inline=nyt-per> <http://topics.nytimes.com/top/reference/timestopics/people/m/donald_g_j r_mcneil/index.html?inline=nyt-per> Published: February 7, 2007 <http://topics.nytimes.com/top/reference/timestopics/people/m/donald_g_j r_mcneil/index.html?inline=nyt-per> Indonesia, which has had more human cases of avian flu than any other country, has stopped sending samples of the virus to the World Health Organization, apparently because it is negotiating a contract to sell the samples to an American vaccine company, a W.H.O. official said yesterday. <http://topics.nytimes.com/top/reference/timestopics/organizations/w/wor ld_health_organization/index.html?inline=nyt-org> The strains of the H5N1 virus circulating in Indonesia are considered crucial to developing up-to-date vaccines and following mutations in the virus. The official, Dr. David L. Heymann, said the agency was "clearly concerned" about the development and was in talks with Indonesia. <http://topics.nytimes.com/top/reference/timestopics/organizations/w/wor ld_health_organization/index.html?inline=nyt-org> Dr. Heymann, the agency's chief of communicable diseases, said he was not blaming the company involved, Baxter Healthcare of Deerfield, Ill. "But now that this has happened," he said, "we have to sit down and figure out how to rectify it." <http://topics.nytimes.com/top/reference/timestopics/organizations/w/wor ld_health_organization/index.html?inline=nyt-org> Indonesia signed a memorandum of agreement with Baxter today. <http://topics.nytimes.com/top/reference/timestopics/organizations/w/wor ld_health_organization/index.html?inline=nyt-org> A Baxter spokeswoman said the company had not asked Indonesia to stop cooperating with the W.H.O. She added that the agreement under negotiation would not give it exclusive access to Indonesian strains. <http://topics.nytimes.com/top/reference/timestopics/organizations/w/wor ld_health_organization/index.html?inline=nyt-org> The virus has not yet mutated into a strain easily transmitted among humans. But it has infected 81 people in Indonesia, 63 of them fatally. It killed more people in 2006 than in any previous year and is out of control in poultry in Indonesia, Egypt and West Africa, so experts fear it as much as ever. <http://topics.nytimes.com/top/reference/timestopics/organizations/w/wor ld_health_organization/index.html?inline=nyt-org> In addition, Indonesia's decision upsets the pattern for making seasonal flu vaccines - by choosing among hundreds of samples sent in voluntarily from all over the world - and could set a dangerous example for other countries. Indonesia and other poor countries feel slighted by the system - justifiably so, some experts say - because the samples they send in are used to produce vaccines that they often cannot afford. <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/influenza/index.html?inline=nyt-classifier> "Their concern," Dr. Heymann said, "is that their strains have been used by several manufacturers to produce vaccines, and that Indonesia should get some compensation. From their point of view, it's understandable." <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/influenza/index.html?inline=nyt-classifier> A spokeswoman for Indonesia's Health Ministry told Reuters yesterday that the country "cannot share samples for free." <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/influenza/index.html?inline=nyt-classifier> "There should be rules of the game for it," said the spokeswoman, Lily Sulistyowati. "Just imagine, they could research, use and patent the Indonesia strain." <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/influenza/index.html?inline=nyt-classifier> The Financial Times reported the move by Indonesia yesterday; the country has not released a flu sample since late last year. <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/influenza/index.html?inline=nyt-classifier> Getting affordable flu vaccines has not been a high priority for poor countries, because they are worried about greater threats that can be prevented by vaccines - including measles, polio, rotavirus and other killers of children - and about medicine for AIDS. <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/aids/index.html?inline=nyt-classifier> But with the threat of a lethal flu looming and with Western companies able to produce enough vaccine each year for less than a quarter of the world, Indonesia is trying to secure an affordable supply for its people. <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/aids/index.html?inline=nyt-classifier> The Baxter spokeswoman, Deborah Spak, said the company had done nothing to encourage Indonesia to cut off the W.H.O. <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/aids/index.html?inline=nyt-classifier> "Baxter has nothing to do with this," she said. "Our role is in developing vaccines. We're not involved in ownership decisions." <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/aids/index.html?inline=nyt-classifier> Some leading flu experts said they believed that Indonesia was acting on its own, not understanding the ramifications. <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto pics/aids/index.html?inline=nyt-classifier> "This is counterproductive - it will hurt Indonesia more than it hurts other countries," said Dr. Arnold S. Monto, an epidemiologist at the University of Michigan. "The W.H.O. should be their biggest friend. Indonesia has a virus with a 70 percent case fatality, and we don't know why. If they want to work with the best laboratories in the world, they should make sure that virus samples can get out." <http://topics.nytimes.com/top/reference/timestopics/organizations/u/uni versity_of_michigan/index.html?inline=nyt-org> With human cases breaking out in Egypt, Nigeria and elsewhere, new pandemic flu vaccines could be produced from other strains, Dr. Monto added. Indonesia's Asian neighbors are the most threatened by its outbreak and may press it to back down, he said. <http://topics.nytimes.com/top/reference/timestopics/organizations/u/uni versity_of_michigan/index.html?inline=nyt-org> In the United States, Thomas W. Skinner, a spokesman for the Centers for Disease Control and Prevention, declined to comment specifically on Indonesia or Baxter, but said his agency "takes this very seriously and supports the notion of the W.H.O. that this type of information should be shared in a timely manner." <http://topics.nytimes.com/top/reference/timestopics/organizations/c/cen ters_for_disease_control_and_prevention/index.html?inline=nyt-org> Because flu mutates so rapidly, samples are normally gathered from all over the world. For seasonal flus, an expert committee meets each February to try to predict which three are the most likely to be a problem by October, when the Northern Hemisphere's flu season begins. <http://topics.nytimes.com/top/reference/timestopics/organizations/c/cen ters_for_disease_control_and_prevention/index.html?inline=nyt-org> The strains are usually rendered harmless by laboratories that consult with the W.H.O., and the genes responsible for the ability of the virus's outer coat to invade cells are spliced to older, well-known strains. Then this "seed virus" is given free to private companies that produce millions of doses. <http://topics.nytimes.com/top/reference/timestopics/organizations/c/cen ters_for_disease_control_and_prevention/index.html?inline=nyt-org> The arrangement was informal until the W.H.O. started writing rules for it last fall. To assure countries like Indonesia a supply of vaccine, Dr. Heymann favors helping them get plants where they can produce it themselves at low cost. <http://topics.nytimes.com/top/reference/timestopics/organizations/c/cen ters_for_disease_control_and_prevention/index.html?inline=nyt-org> Until recently, Indonesia had been very cooperative about releasing genetic information about H5N1 flu found in animals and humans there, said Henry L. Niman, a Pittsburgh biochemist who runs a Web site tracking the genetics of flu cases, recombinomics.com. <http://recombinomics.com> The release of sequences - not the virus itself, but the pattern of amino acids in its genes, which shows what mutations it has made - is a touchy subject because some scientists try to keep the data secret until they can publish scientific papers. <http://recombinomics.com> A spokeswoman for the Indonesian Health Ministry suggested it might return to releasing sequences soon. <http://recombinomics.com> It is not uncommon for universities, for example, to release genetic information but require companies wanting to profit from it to pay royalties, Dr. Niman said. <http://recombinomics.com>
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