Indonesian virus samples were going to contribute to the development of a vaccine,
yet Indonesians would not be able to afford the resulting product. As it happened,
the Indonesian government made reference to the CBD rather than the post-study
obligations of the Declaration of Helsinki when justifying their actions. This sug-
gests that expanding the CBD to include human biological resources could be one
way forward towards achieving benefit sharing. We shall return to this below.
However, the Indonesian case also shows that arguments about justice get very
complicated if one moves from specific justice in exchange between researchers
and their research participants or sample donors to generalized questions of dis-
tributive justice between North and South. The Indonesian government did not
demand access to the avian flu vaccine for individual donors of biological sam-
ples, as they were already affected by the disease, 2 but instead insisted on afforda-
ble access to the vaccine for the entire population.
This is a perfectly legitimate demand, especially since all human beings have
a right to the enjoyment of the highest attainable standard of physical and mental
health (ICESCR 1966 ). But it is not a narrow justice-in-exchange demand, as we
have discussed it in this topic. All human beings deserve access to health care, but
justice in exchange for the donors of biological materials is an additional issue in
the context of exploitation. This has an important implication, namely that benefit
sharing for individual research participants should not be conflated with efforts to
secure the human right to health for all.
Discussions of benefit sharing should never act as window dressing, or dis-
tract from broader, more visionary attempts to secure access to health care for
all. Benefit sharing is a tool to prevent the exploitation of resource providers,
not a tool to realize the human right to health. This topic has introduced the pro-
posed Health Impact Fund as an example of a reform plan that aims to improve
the availability of and affordable access to life-saving medicines. It is important
that reform plans aimed at improving access to health care for all globally
be pursued and supported alongside efforts to secure case-by-case justice for
resource providers through benefit sharing .
10.4 What Benefits?
If benefit sharing for the donors of human biological resources is meant to focus
on 'alternative benefits', as we have suggested above, what should these alterna-
tive benefits look like? What benefits will ensure that the exploitation of donors
is avoided? Unsurprisingly, there is no easy answer. The issues are not only about
process (e.g. whose voices need to be heard when decisions about benefit sharing
are made) but also about substance (e.g. whether royalties from product sales are
2 The Indonesian case demonstrates that access to successfully tested interventions is a very
crude tool for sharing benefits with the donors of biological resources. For the individual donors
of avian flu samples in Indonesia, access to the vaccine would have come too late.