Bird flu puts patents and intellectual property rights in the spotlight, with the world's poor once again destined to suffer the worst consequences. Gamal Nkrumah investigates The sensationalist international media scare concerning bird flu belies a far from mortal combat. The biggest beneficiaries of the highly pathogenic H5N1 avian influenza virus are undoubted to be giant multinational pharmaceutical companies. The Swiss pharmaceutical giant Roche Oseltamivir, producer of Tamiflu, currently the antiviral drug of choice for pandemic influenza, is making a killing out of the feared illness. The bird flu outbreak has sickened millions of birds in the past decade. The crucial question today is whether people, too, will suffer the same fate. In order to salvage something of their reputation, or lack of it, pharmaceutical multinational giants are making many goodwill gestures. Roche promptly donated three million courses of Tamiflu to the World Health Organisation (WHO). The Asian Development Bank (ADB) has similarly pledged to provide $5 million in funds for containing the virus. Will such moves wash with the poor? "There are two ways of treating avian influenza -- antivirals and vaccines," Raouf Hamid of the Cairo-based National Organisation for Drug Control and Research explained. "Vaccines are far more effective and hence their manufacture is more vitally important. Antivirals are very expensive and are not readily available in developing countries," he added. Hamid said that even though there are a handful technically advanced centres for the production of vaccines in some developing countries such as Egypt, Cuba, India and Iran, he stressed that the bulk of production is available only to about 10 per cent of the world's population, most of it confined to the rich, industrially advanced countries. The United Nations Food and Agriculture Organisation appealed this week to the international community to help African countries improve efforts to contain a possible outbreak of bird flu. If the disease spreads to Africa it might increase the risk of the virus mutating into a strain that could be transmitted to humans. It will not do to adopt a Pollyanna view of the situation, which seems to be the case in much of Africa and the Arab world. Some experts believe that the infectious pathogens spread more rapidly by the international poultry trade than by migratory waterfowl. Of grave concern is that few African countries have functional and efficient influenza surveillance capacities. Some five billion birds cross the Sahara every autumn and the countries of North Africa are very susceptible to the disease. There are growing fears that the pandemic might wreck havoc in African countries south of the Sahara, too. So far, no cases have been detected. The World Organisation for Animal Health is closely monitoring the situation in Africa and around the world. Avian influenza has conjured up fears of a world pandemic and health experts warn that soon it might have disastrous consequences and that the poor and needy are the most vulnerable. The poorest countries have the least technical capacities to deal with the pandemic. They lack the medical personnel, antivirals and vaccines necessary to combat the illness, which has now appeared in Turkey -- a strategically located country on the path of many different migratory birds. Indeed, avian influenza has already hit Europe's migratory birds. In Egypt, the Nile Delta lagoons are virtual bird sanctuaries and receive thousands of migratory birds from Eastern Europe and Turkey every autumn. There is also the danger of contact between domestic and migratory birds. "There are three prerequisites to start an influenza pandemic: the emergence of a novel virus; the ability of the new virus to replicate and cause disease in humans; and the ability of the new virus to spread efficiently from human to human," Hassan Al-Bushra of the World Heath Organisation Cairo branch told Al-Ahram Weekly. "We don't have a vaccine because the virus is not here yet. It takes six months to produce and another three or four months to mass- produce," Al-Bushra explained. The pathogenic H5NI outbreak in nine neighbouring Asian countries could easily spread to the Middle East and Africa through the brisk poultry trade with Asia. In December 2003 Japanese authorities announced the death of 6,000 chickens at a single farm. According to WHO, to date no confirmed human-to-human transmission of H5N1 is known to have occurred. Roche's patent for Tamiflu gives the Swiss multinational a monopoly over the production of antivirals that combat avian influenza. But, as the international community steps up measures to combat the spread of bird flu, many Asian countries are now considering producing antivirals and vaccines of their own. Fuelled by public fears over bird flu, there is an unprecedented surge in demand. Supplies of antiviral drugs are expected to dry up soon. Giant pharmaceutical companies stand to benefit the most. Bird flu and similar viral diseases such as the pneumonia-like Severe Acute Respiratory Syndrome (SARS) have ravaged East Asia in the past. Health experts urge countries to build stockpiles of necessary antiviral drugs as well as logistical plans for the supply and use of the drugs. In this, poor or developing countries face an uphill struggle. Even rich and industrially advanced countries are embroiled in the crisis. Britain is facing a chronic shortage of flu vaccine. The World Trade Organisation's trade-related aspects of intellectual property rights (TRIPS), allows for the provision of compulsory licences to countries faced with pandemics. Taiwan, which had been seeking licence from Roche for the mass production of Tamiflu said it could mass-produce drugs for one million people within three to five months. Giant multinationals must not have a monopoly over patented antiviral drugs. The death of a South American parrot in Britain shows how geographically widespread the disease has become. The parrot, imported from Suriname, died in quarantine. With fears that the H5N1 strain is moving towards a form that could pass easily among humans, Egypt, along with other countries in the region, is taking precautionary measures. So far there is no immediate danger from diseased poultry, but health experts are not sure how long the avian influenza pandemic can be staved off. Health experts in North Africa and the Middle East have been examining the East Asian experience closely. In Hong Kong, mild cases of avian influenza (H9N2) were found in two cases involving children in 1999 and in another case in December 2003. Millions of birds have been quarantined. In some Asian countries thousands of birds have been slaughtered. The relatively mild H9N2 strain, which resulted in the death of two children in 1999 and another death in December 2003, contrasts with the highly pathogenic H5NI strain detected in Turkey over the past two weeks and which is deadly to humans. The H5N2 strain is less virulent, not considered especially dangerous as far as humans are concerned. The prompt culling of Hong Kong's entire poultry population in 1997 was a watershed experience, but the disease was but temporarily contained. Many countries in Africa and the Middle East have banned poultry from affected East Asian countries. Hamid advocates the founding of emergency centres throughout the world, and especially in the developing countries of the South. If a lethal bird flu pandemic spread, it would not be the first time that flu strains hit human populations with devastating effect. Health experts want to avoid at all costs the 1918-19 Spanish flu pandemic that resulted in the death of 20-40 million people. The 1957-58 Asian flu epidemic resulted in the death of 1-4 million people.
