Life-saving medicines from HIV antiretrovirals to heart disease drugs are often inaccessible to developing countries because of restrictive patent laws and high costs. These same nations now increasingly worry that vaccines and drugs to fight the H5N1 virus would similarly be out of reach in the event of an influenza pandemic.
On Wednesday, Indonesia declared it would only share its H5N1 bird flu samples with those who agreed not to use them for commercial reasons. Its officials insisted it was unfair for foreign vaccine makers to use these samples, design vaccines, patent them and then sell the "discovery" back to the country.
Aid agencies said that, while Jakarta's actions were reprehensible, its concerns and worries were valid and they were not confined to Indonesia alone.
"People (pharmaceutical firms) should be more sympathetic to public health issues," said Loretta Wong, chief executive of Aids Concern, a group dedicated to helping and securing treatment for people living with HIV/AIDS.
"After all, we are talking about human lives. One will not die not being able to watch pirated VCDs but one will die without access to affordable treatment," she said.
Indonesia's move struck a chord with Thailand, which recently voiced similar fears at a World Health Organization (WHO) meeting in Geneva.
"The Indonesian health minister is wise, and sending a strong message that, unless developing countries which are at the epicenter of the pandemic can be assured access to potential pandemic flu vaccines, they should not cooperate by sending out the viruses to WHO," said Suwit Wibulpolprasert, a senior public health official in Thailand's Ministry of Public Health, in a statement emailed to Reuters.
"Developing countries are having some doubts that WHO may be used as a socially credible intermediary organization to steal their viruses for commercial purposes.
"How can a vaccine firm develop a vaccine if it does not receive the virus from these countries? This is a global problem, not a local one, and should not be addressed by blaming the country that decided not to cooperate when they are treated unfairly."
But few others backed Indonesia's decision. Sharing of virus samples is crucial as it allows experts to study their make-up and map its evolution and the geographical spread of any particular strain. Samples are also used to prepare vaccines.
"A virus is not something you can patent, it's not a product. If you use it to do business, it's not ethical. We're not talking business here, but saving lives in different countries affected by a virus," said William Chui, chief of pharmacy service at the Queen Mary Hospital in Hong Kong.
Although H5N1 bird flu remains essentially a bird disease, it has killed at least 166 people since late 2003, mostly in Asia, and experts fear it could trigger a pandemic once it learns to transmit efficiently between people.
It has flared up in recent months, spreading through poultry in Thailand, Japan, Vietnam and South Korea and killing six people in Indonesia. It turned up last weekend in a British turkey farm.
Experts stressed that this was a global matter and not a problem for Jakarta to solve unilaterally.
"The WHO must intervene, allocate vaccines, govern how it is charged and make sure companies don't profiteer. It is not an Indonesia-specific problem, it is a world issue," Chui said.
