US Ambassador In Geneva Defends Secrecy In UN Pandemics Negotiations

The United States Ambassador to the United Nations in Geneva this week offered a frank assessment of the UN system of dealing with pandemic diseases, and defended the need for governments to negotiate in secret to work out remaining differences.

In her end of year press gathering at the US mission, US Ambassador Betty King devoted significant attention to pandemics. She said she spent “most” of her time in the past year – her first in the position – working on pandemic influenza preparedness, an international effort being led by the World Health Organization to ensure all countries are ready for the next pandemic flu, like H1N1. She said was pleased with the progress – meetings on the subject continued this week (IPW, Public Health, 6 December 2010) – calling it “one of the most productive set of meetings that we have had in the UN system.”

But King raised alarm over the heavy concentration of vaccine production occurring in one country – India. “One of the things that stunned me through this process was to learn that more than 70 percent of the world’s vaccines are now produced in India,” she said. “So if you have that concentration of production in one part of the world and you’ve got an outbreak somewhere else, it is very difficult to get the supply quickly to where it needs to be.”

Therefore, policy work has been focussed on logistics of delivery, and on increasing the capacity of developing countries to produce the vaccines themselves. The US is leading efforts at the WHO to find alternatives to traditional egg-based vaccines, such as plant-based vaccines, King said.

India for its part has been working through the World Trade Organization dispute settlement system to ensure that delivery of its generic medicines is not impeded by European countries that might have brand-name competing interests. And a component of the pandemic discussions has been the fear among developing countries that if they share their strains of viruses to help with vaccine development, the resulting vaccines may be patented in a developed country and sold back expensively to the origin country. In the last pandemic, developed countries had excess medicine for their populations while many developing countries did not have enough.

King said Mexico felt it shared its virus strain of H1N1 and then did not get back the vaccine it needed from drug companies with whom they shared the virus. “It was not until President Obama opened up our supplies to Mexico that they got their first set,” she said.

So now all sides are negotiating to create mechanisms for sharing the viruses and the benefits of the shared viruses, she said.

King said this week’s meeting at WHO had to be held behind closed doors because “if you put these negotiations out into the public there would be so much grandstanding that we’ll never get to where we want to go.” Last year, the WHO membership raised concerns about the lack of transparency related to pandemic policy, but she said the time for going public is after differences are worked out, which hasn’t happened yet.

“You do not want to be in a situation where you are discussing these things,” she said. “As interested as you are, you can imagine the drug companies are even more interested in this conversation.”

When this reference was challenged by a reporter who said drug companies have an inside track in Geneva policymaking circles, King said it should not be that way and that if governments cannot converse in private “then the whole effort is flawed.” She went so far as to link it indirectly to the US philosophy on Wikileaks, saying, “we shouldn’t have the diplomatic conversations being read on people’s email.”

Separately, in the question and answer period, King declined to provide detailed answers to questions on the Wikileaks controversy. She did say some privacy should be allowed in diplomacy and said definitively that since her arrival, no one on her staff is collecting data on UN officials. She could not speak for her predecessors in the Bush administration, however.

The official transcript of King’s remarks is here.