The threat to global health and security posed by Indonesia's refusal to share samples of H5N1 virus with the WHO could be countered by establishing a strategic vaccine stockpile by member countries of the Asia-Pacific Economic Cooperation Forum, say Laurie Garrett and David P. Fidler in PLoS Medicine.

Indonesia's stand is based on a lack of reciprocity: the country wants greater access to vaccine derived from samples shared with the WHO.

Failure to settle the dispute, say the authors, could threaten international cooperation against infectious diseases and splinter global health governance, pitting industrialised and developing countries against each other on issues ranging from surveillance to intellectual property rights for pharmaceutical products.

Countries threatened by the withholding of virus samples might also pursue high-stakes strategies to break the deadlock, including seeking United Nations Security Council intervention.

Garrett and Fidler say establishing a strategic stockpile in Hong Kong, composed of annually-updated supplies of 500 million doses of highly specific influenza vaccine plus antiviral medicines, is one way to construct a "valid and politically sensible path" for ensuring that preparedness for pandemic influenza — and the next emerging virus — does not disintegrate, leaving everyone at risk.

Link to full article in PLoS Medicine