British Medical Journal | June 2, 2007
Tension between developed and developing countries over access to any vaccine for bird flu was much in evidence at the World Health Organization’s World Health Assembly in Geneva last week.
Indonesia had stopping sharing virus samples in December 2006, alleging that a WHO collaborating centre had violated an agreement by turning over samples to third parties.
Battle lines were drawn between rich and poor countries during discussions at the assembly of preferential pricing, access to technology, and distribution on the basis of need. Some developing countries contend that viruses can be patented, a position with broad implications for the drug industry, which says that it must have access to reference strains to be able to proceed with research and development.
WHO’s director general, Margaret Chan, referred to countries that hesitate to share samples of the highly unpredictable bird flu virus: “It is mutating at a pace we cannot keep up with. If you do not share the virus with us, I want to be absolutely honest with you: I would fail you because you are tying my hands, you are muffling my ears, you are blinding my eyes.”
Indonesia announced at the assembly that it had resumed sharing of virus samples, and a resolution addressing the contentious issue was passed. But it is clear that the thorny problem of intellectual property is here to stay at WHO, although many within the organisation would prefer that questions of intellectual property were taken up by other UN agencies. One senior WHO official said, “We are not responsible for international law for IP [intellectual property]—that’s for the WTO [World Trade Organization] and WIPO [World Intellectual Property Organization].”
Another debate was triggered by a resolution on dealing with the harmful effects of alcohol. The resolution was introduced by Sweden and was supported by other Nordic countries, where alcohol consumption is a major public health issue. The liquor industry sent several representatives to the assembly, an indication of how seriously it views the question of possible interventions by WHO.
But the resolution was derailed by determined opposition from several Caribbean countries with a strong liquor industry presence, with Cuba leading the charge.
Other perennial topics that the assembly discussed were the migration of health workers from the developing world to the developed world and the admission of Taiwan to WHO. Although UN membership is a prerequisite for WHO membership, and Taiwan does not have this, it has unsuccessfully tried for many years to gain observer status. It failed again this year.