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the research' (WMA 2008 ). It is clear that this article is relevant to the Indonesian
sample donors, particularly in relation to demands for research benefits for the
community. However, Indonesia chose the CBD as its point of reference. Although
the CBD excludes human biological resources from its remit, it is part of the
framework of international law and has led to some benefit-sharing agreements.
The point Indonesia has made through its actions is that when developing coun-
tries share virus samples that are critical to the development and production of
vaccines and/or antivirals, these donor countries are mostly excluded from result-
ing benefits. As noted earlier by Sedyaningsih et al. ( 2008 ), any resulting vaccines
are sold at a high price and so are largely unavailable to those living in developing
countries such as Indonesia. Furthermore, in contrast to many developing coun-
tries, developed countries have the funds necessary to obtain supplies of limited
vaccines through pre-purchase agreements with manufacturers. As Caplan and
Curry ( 2007 ) have noted:
Indonesia is basically correct: pandemic vaccines that are in development and early test-
ing … are largely already obligated by contract to a limited group of national govern-
ments. That list does not include Indonesia or developing nations in general.
These sorts of benefit-sharing issues are highly relevant to global public health.
In practice, the timely delivery of samples to the WHO, which is necessary to
protect global public health, cannot be separated from the development of mean-
ingful benefit-sharing measures, particularly when vulnerable populations are
involved. As the Indonesian case illustrates, as long as sample donors continue
to lack access to the benefits that result from their participation in research, their
continued participation in such research is precarious. The governments of devel-
oping countries may withhold samples when the research process is regarded as
exploitive or unfair to their citizens. At the same time, it would have been diffi-
cult, without the Indonesian virus samples, to monitor avian flu properly and to
develop an effective vaccine. Global public health would have been at significant
risk (Tables 5.6 and 5.7 ):
Virus sharing is a critical part in the global effort for pandemic preparedness and global health
security. Hence, the global community should continue the efforts to create a mechanism for
virus access and benefit sharing that is accepted by all nations (Sedyaningsih et al.: 484).
Table 5.6 Time L ine and Details of Avian Flu Case (WHO 2011b )
IHR adopted by WHO regarding international sharing of biological samples in
a health emergency
Mar 2005
Indonesia reports its first human H5N1 case, and begins to send virus samples
to WHO laboratories in Jakarta and Hong Kong
Jul 2005
H5N1 cluster erupts in Indonesia
Late 2006
Indonesia learns from a journalist that an Australian pharmaceutical company
is developing a vaccine based on samples shared with them by the WHO
and subsequently stops virus sharing
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