Siti Fadilah - Minister of Health - Influenza Debate and Standoff With The WHO

Influenza Debate and Standoff With The WHO

On 3 August 2006, Supari made the unprecedented move by announcing that the Indonesian government will make genomic data on bird flu viruses accessible to anyone. Supari said, opening up global access could be the key to unlocking such important information as the origin of the virus, how it causes disease, how it is mutating, the sources of infection, and how to prevent or cure the virus. "But in future cooperation on bird flu with other countries, the delivery of specimens should be regulated under Material Transfer Agreement documents as is commonly practiced in scientific cooperation," Supari added. The Economist wrote, Supari started a revolution that could yet save the world from the ravages of a pandemic disease. That is because Indonesia's health minister has chosen a weapon that may prove more useful than today's best vaccines in tackling such emerging threats as avian flu: transparency.

It was unclear at the time what prompted Supari to share data, given the widespread reluctance of countries affected by the H5N1 virus to share their data, out of fear such disclosure could trigger economic sanctions. An editorial published in Nature magazine just days before, highlighted this problem with China's practice of belatedly publishing details of a case that tested positive for the virulent H5N1 strain in 2003 — contradicting the government's official line that none had occurred before November 2005. Although not mentioning Supari by name, the editorial also addressed a confirmation by the World Health Organization (WHO) that a cluster of eight cases in an extended family in Northern Sumatra was the first unequivocal occurrence of limited human-to-human transmission of the H5N1 virus.

On 22 August 2006, just two weeks after Supari made her announcement, Nancy Cox, the director of the influenza division at the US Centers for Disease Control and Prevention (CDC) communicated in a press release that following Indonesia's announcement, it too made genomic data on bird flu viruses publicly accessible. The following day a correspondence letter appeared in Nature magazine shedding light on what had triggered the sudden shift in Supari’s stance and that of the CDC. The scientific community had just been introduced to Peter Bogner, the new driving force in the virus sharing debate.

Supari would later describe in her book an affinity for Peter Bogner, his plea to her government to share its bird flu virus data and his concern when she annoyed the US administration at times. Supari wrote, he told me indirectly my speech had been too sharp, or Peter Bogner has the capability to change the world’s opinions. A former broadcast executive at Time Warner, he was not only familiar with intellectual property issues, but more importantly, he was friendly with Supari’s government following his role in the 2004 tsunami relief efforts. He would turn out to be the mastermind behind the GISAID initiative, a mechanism devised and financed almost exclusively by him.

When Supari attended the 61st World Health Assembly on 16 May 2008, the day GISAID’s database was launched, Supari delivered on her promise and made available genetic H5N1 data alongside other countries like China and Russia. Within four months, this publicly accessible resource offered the world’s most comprehensive collection of influenza data.

Claiming Western governments could be developing viruses for dissemination in the developing world with the goal of generating business for pharmaceutical companies, Supari refused World Health Organization (WHO) researchers access to Indonesia's H5N1 bird flu virus samples in 2006. Indonesia resumed sending some H5N1 samples to WHO after a new agreement that developing nations would get access to vaccines.