China's scandalous behavior

After saying yesterday morning that China has not shared any of its human viral isolates, along comes an Associated Press report that two isolates were just sent and will shortly arrive at a WHO reference lab in the US. I'd love to say this demonstrates the power of Effect Measure, but . . . Anyway:

The sample updates of the H5N1 virus from China's Health Ministry are awaiting customs clearance, said Joanna Brent, a spokeswoman for WHO's Beijing office.

They include specimens from a 2006 case in Xinjiang in China's far west, and a case in the southern province of Fujian in 2007, Brent said. (AP)

It's also not everything the Chinese promised, oh so long ago. It doesn't include the isolate, "discovered" three years after the fact, of a 24 year old Chinese soldier who was the nation's first recorded bird flu death in late 2003.

But a sample from a 24-year-old soldier who died in 2003 in Beijing was not part of the batch, she said. The Health Ministry in April had promised one from that case, which was disclosed last year after new tests determined he had succumbed to the disease.

The ministry "says the procedures for sharing the Beijing 2003 samples involve the military and are extremely complex," Brent said.

The Chinese military, a power unto itself in China, and is usually secretive about its operations.

WHO records China as reporting 24 cases of H5N1 in humans. Its own state controlled news sources report that only six isolates have been sent to WHO reference laboratories, two in December 2005 and four in May 2006. The two just sent make eight. That leaves 16 WHO confirmed cases that have not been shared with WHO and the world scientific community. A 25th case has just been announced by China and it, too, is a military case, so the chances of obtaning the virus or even relevant history is not good. Moreover there are many poultry isolates which have also not been shared.

Indonesia has balked at sharing samples because they are unlikely to be able to afford any vaccine prepared from a viral seed they supply. We have discussed this often here (see here and links therein). China has no similar excuse. It has its own vaccine industry and can make its own vaccines.

China's recalcitrance and passive aggressive stance vis-à-vis the world community is a scandal. Somebody has to say it.

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Ah, yes, but they've been doing it for years and assumed it was harmless. (attempt at humor tying into the contaminated chinese ingredients issues)

The reason China won't share isolates is *because* they have a vaccine industry. They want to be the first on the block with a vaccine so that they can profiteer by selling it to a panicked world (and putting who-knows-what contaminants into the formulation to take down their rivals and enemies).

By Lisa the GP (not verified) on 26 May 2007 #permalink

As of July 2007, China's estimated population stands at 1,321,851,888 (data from www.cia.gov). The first official case of human infection with transgenic H5N1 occurred in a 3 year old Hong Kong boy who died from respiratory failure in May 1997 (CDC. Isolation of avian influenza A(H5N1) viruses from humans -- Hong Kong, May-December 1997. MMWR 1997;46:1204-7.). So, the cumulative number of human H5N1 cases reported to WHO (as of 24 May 2007) states, since '03, PRC having a total of 24 cases and 15 deaths. Think 'bout these figures for a moment -- a population of over thirteen hundred million people = a small grouping of official human H5 cases and deaths during 1997 and then a zero infection rate until 2003...

As an OUT gay male, I can see the "closet" analogy as an appropriate explanation: in complicit silence, the city folk follow same-sex ships docking undercover of night. The working day sees the 'crap acting' virus infecting those who fear the status quo -- money is a potent silencer. Irrespective, all know what floats other folks boats... The charade is accepted cos all need to eat, pay bills, and lay weary heads upon safe warm pillows.

PRC's human H5 viral isolate charade has been accepted for much the same reasons...

Revere: "[PRC's human H5 viral isolate] recalcitrance and passive aggressive stance vis-Ã-vis the world community is a scandal. Somebody has to say it."

Revere, thank you for doing so!

By Jon Singleton (not verified) on 26 May 2007 #permalink

As a Chinese and a graduate in biology, I felt, to be blunt, really ashamed of the attitude those big guys decided to take. It's kind of relief that I heard of a recent new case almost simultaneously from local news.

However while I tried to google with something like "China" AND "Bird Flu" AND "Viral Isolate"(in Chinese), no wonder it run into what we call the Great Fire Wall.
Apparently, most of us do not even know what happened when the rest of the world is complaining.

But to Lisa the GP, I say you go too far, especially the assumed conspiracy you parenthesized. I don't think there would be one so panic or so stupid to be a rival.

Sephy-Its not just Lisa's estimation regarding the conspiracy. The countries witholding the isolates and samples are flat doing it to extort, conspire and possibly so that they can make a BF vaccine themselves. Most dont have the resources to do it and without genetic information, this is a squat conversation. Witholding information is complicity in its finest order. Witholding it when you know its going to kill over a billion people is murder. I can tell you that I know what I would do if that happened. I would make the offending parties suffer and bad.

They withold this stuff from the world when the world is the one thats going to take the hit, then they have nothing coming. Vaccine? This is so important that unlike prior sanctions by the US government, this one ought to include food. Yes food. If they start to starve a bit then they'll know we mean business and with China a simple word, "EMBARGO." One week of either and they'll find out that this is as serious as it gets.

I am often accused of doom and gloom here. With a current WHO CFR of 60%+ and the rolling year average of 83% I think that is doom and gloom enough to go around. I would love to just sit back and harass the shit out of Revere about UHC and other matters but urp, not on this one. It is time for several countries to come to a reality check. That is that their countrymen and many others are going to die en masse if BF breaks and it will be in a large part to the efforts of those countries to subjugate the world to their "efforts" and that relates only to money, not vaccine. China is actively trying to develop BF vaccine and its only worth about 1 trillion dollars in a 5% event. Now maybe you understand the game a little bit better.

Harsh? Sephy, you better hope that it doesnt get harsh otherwise BF might be the least of your worries. Attagirl to Jonny and Lisa....

By M.Randolph Kruger (not verified) on 26 May 2007 #permalink

Randy: Isn't this the "market" you tout? They've got the virus and they're going to make the vaccine, just like Big Pharma. It's not the sequences we need. It's the viral isolates themselves. I think China has deposited a lot of sequences and shared others, but not the isolates. If I understand what you are saying, you don't think Big Pharma should have licenses for a vaccine either, because then they can hold the rest of us hostage as you are accusing the Chinese of doing. Or does that logic only work in one direction?

I get a mental picture here Revere of a China that is holding onto the isolates for their own use, the Indons to ensure they get a currently non-existent vaccine and one hell of a lot of it. My thing Revere? Hostage, government of poor standing are all terms. I dont disagree with the supposition only that it will be rendered moot.

Regardless of what we all think and do or say wont make one bit of an argument at all if they were sitting on the sequences, the isolates or anything else if this breaks out. We will have something approaching 300 million at a 5% CFR, and about 3 billion at the 40% rate and more than 3/4ths of the planet will be sick to the point of unable to care for themselves much less anyone else. All of their posturings mean absolutely nothing if it breaks. That includes Big Pharma, the research brain trusts, all of them including me will be responsible for allowing this to happen. Smart guys in smart places know like me that a vaccine that appears six months after the pandemic is underway wouldnt mean squat. These talking heads of which I am one dont get it or they do. If they do and they continue doing what they are which is business as usual, we simply wont be around to enjoy the fruits of their medical labors. No customers because we as a species will have been wiped from the face of the planet to a large degree if its high path. After that as it has in every pandemic, there will be wars of major proportions as the pecking order changes. The US will be no exception and we wont have nearly the power that we had before.

IMO Big Pharma has the best chance at making a vaccine right now and if its the only game in town then you have to play. If isolates and sequences are to become governmental property and pawns in the biggest game in recorded history then it may be time to break things or hold their feet to the fire until it blisters their hair.

Do you think that the Chinese have a valid chance of making a vaccine in time, the Indons? I really want to know your opinion because I do respect it and I value what you say in just about every case on this. My drinking budddy immunoguy reads EM and he agrees as well that we are in a deep well and sinking. Even when I dont agree its only on the most minor of stuff and generally because the information is very ambiguous to begin with. THIS IMO is coming like a freight train because I have been involved with the inter-governmental two-step before and they are lying like its just been invented. Add in the subterfuge and history of the governments involved which includes the US and it equates to one thing in major proportions....Death. History will judge the offenders harshly and we all will bear the brunt of it.

As I said to Sephy, "BF might become the least our worries."

By M. Randolph Kruger (not verified) on 26 May 2007 #permalink

To Kruger: you've wrote a reasonable scenario and in part I agree with you that the other countries should response more actively in order to force China into collaboration. However, it seems to me that you somehow over-intensified the overall situation, and I guess, as a Chinese, I could read more delicacies from our government's stance.

Obviously, China's attemping to grab more benefits in terms of geostrategy, or else it could rub the case from the very begining. But, unlike those sci-fi stories where evil scientist could hijack the whole world with his SUPER virus and exclusive vaccine, the jetons in pocket are not as many as what you seemed to guess. As we know BF breaks out in Southeast Asia and some European countries, the dispersed incidence within China is unlikely to indicate a critical, namely, human-to-human transmitted strain. So the point is, the isolates China witholds are undoubtedly important, but not so priceless,with which one might dream to subjugate the whole world. In a sense, if China gov somehow dreams of it, we could stop our discussions to sleep-no one needs to fear a country following such a bad-B-movie logic.

China gov is stupid, however, not paranoiac. As a country with more than 1.3 billion people, it will at least pose as the so-called "responsible superpower". The top knows perfectly the time for a trade-off and would hardly miss it before substantial boycott taken into action.

As you described, China might develop BF vaccine for the trillions of dollars, but the paradox is, if the vaccine is developed to antagonize a specific strain of virus found in China, which is transmittable among humans, then China will have to produce it exhaustively to meet its own immediate need while other countries may justifiably isolate China in case of pandemic; if the vaccine is not developed with such a upheld strain, what is the profit then? Considering the high mutation rate of virus, efficacy of the vaccine itself would be increditable. In my opinion, the most efficient strategy for China is to make the isolates public to those Big Pharma. When the vaccine is done, China could follow it almost for free via compulsory licence.

Conspiracy always sounds intriguing, but not always reasonable. Decision-makers are, stupid or not, H. sapien instead of aliens. Savored vaccine and alike might serve a WMD when sold to other countries, as Lisa depicted, provided that those countries are so credulous to China, a countries hold them hostages. This nasty trick will become nothing but an unprotected bull's eye for enemies. Therefore I consider it only a joke.

Sephy,

Well said. I'm also ethnic Chinese. I completely agree with you, and revere, that this ongoing recalcitrance is scandalous, and bodes ill for China wanting to be taken seriously as a 'responsible' member of international society. It wants to pull its weight in world affairs. Well, there's a price to pay, and a standard of behavior, for joining the club.

However, I also agree that it's a mistake to see this as a conspiracy. Rather, this is only part of a bigger and ongoing issue of non-transparency in governance.

Institutionally enshrined standards of behavior are very hard to change, and need a tremendous amount of persuasion. Often these changes only happen when a new generation of leaders emerge. The West's perceptions of conspiracy, with all respect, are often based more on their perceived importance of their influence on the domestic policies of China than actual reality.

They will do what they want to do when it suits them. Of course international pressure needs to be maintained, otherwise they will never learn or evolve towards the standards of behavior expected of them. Just don't hold your breath.

Deng Xiao-ping "Keep a cool head and maintain a low profile. Never take the lead - but aim to do something big."

Sun Tzu-"The quality of decision is like the well-timed swoop of a falcon which enables it to strike and destroy its victim"

Yes, we military types read the oppositions mail all the time along with everything else they write. Point taken Sephy but it still doesnt change anything. If it comes and they are still sitting on isolates, information it will be China that bears the brunt of the deaths on this planet. They will be isolated for due cause by the rest of the world. Indonesia will still be wagging their tongue's about vaccine that no one has or will have until whatever the going percentage is of people are gone from the face of this earth. When your neighbor has a fire, you dont ask how big nor do you ask how much you'll charge to put it out. That applies both ways here and the distrust comes from the money. I wouldnt be surprised if they came out with a vaccine just about the time that it breaks...coincidentally and that vaccine will come from all quadrants. It will of course be worth dog doo, it will save a couple because it will be close enough for some but not for most and it will be very expensive. Scandolous----?

By M. Randolph Kruger (not verified) on 26 May 2007 #permalink

And if it comes and only the West gets the vaccine (and only those in the west able to pay)? What's the difference?

Well said Revere...

While I have some previously expressed my sympathy for the Indonesians (who, after all are making an ill-conceived gambit to try and protect their people) the PRC gets no such grace. For the PRC, it's the 'state' that is being protected, not its population.

While international co-operation and largesse are scarce, there has always been the expectation that the state would look after its OWN citizens.

And for me, the fact that China is abdicating that responsibility in the most grievous way possible...that is the most scandalous thing of all.

By Jon Herington (not verified) on 26 May 2007 #permalink

Exactly my point Revere. Whats the difference? The difference for the whole thing is tied to the money. The West will be able to afford it, the Chinese and Indons will sit on it until it breaks high path somewhere outside of those countries and then their bargaining chip and their people are both lost. Nothing ever changes. Even if they did pony all the stuff up, it would still go to the PRC's inner circle first. With Indon it will be elected officials women and children first, then the men and IF there is any left over it will go to the public.

We on the other hand can pay more than some slob in Indon or China and as a result those same vaccine makers if you want to use China as an example, will sell it to the highest bidder after they vaccinate their own ruling party. It comes full circle and I am not combating the issue, only laying it out the way it will go. The Indons are fools and the Chinese bandy about with at least 15% for sure of their population if its 5% here. I still dont know where all of this vaccine is going to come from anyway.

Hi Jonny. Good call by you and Revere. I cant disagree with anything either of you says, only that its the difference between a moral issue, a political one and a financial one. Morality goes at the bottom of all conversations whenever a politician is involved and unfortunately they are making the decisions.

By M. Randolph Kruger (not verified) on 26 May 2007 #permalink