A New Flu Fight

As the world health organization (WHO) representative on pandemic influenza, Dr. David Heymann has one of the most important jobs in medicine: coordinating international preparations for a possible virus outbreak that could threaten millions of lives. That job got much harder on Feb. 7, when Indonesia announced it had stopped sharing with the WHO the samples of H5N1 avian-flu virus it had isolated. Simultaneously, Jakarta announced an agreement with U.S. drug company Baxter International, which will develop a vaccine from the strains and give Indonesia technical assistance in manufacturing it. For 50 years, the WHO has received free influenza-virus samples from around the world, which it makes available to pharmaceutical firms in order to ensure the production of the best possible vaccine. If Indonesia pulls out, Heymann tells TIME, "there is a danger cooperation could collapse, and that would hurt us all. It puts us at risk of not getting the right vaccine during a pandemic."

Still, Heymann concedes, the Indonesians have a point. This nation of 245 million has suffered more fatalities from bird flu than any other country, with its 63rd victim dying Jan. 19. Yet, if a pandemic does arise, Indonesia might well be one of the last in line to receive a vaccine: most of the world's limited production capacity is already spoken for by wealthier nations. A recent article in the British medical journal the Lancet predicted that if the next pandemic were to be as deadly as the 1918 flu, 96% of its estimated 62 million victims would come from developing countries. But withholding information on H5N1 isn't the answer. Instead, Heymann and the WHO are working to expand vaccine production in the developing world, enlisting companies to transfer medical technology there and encouraging wider use of seasonal flu vaccines, considered a luxury in poorer countries. Says Heymann: "We need to change the way the system works in a way that could benefit the entire world."