Bird Flu crisis in Indonesia escalates, misinformation reigns supreme
In light of several recent bird flu deaths apparently caused by human-to-human transmission in Indonesia, Jakarta is badly lagging behind in terms of prevention, education and understanding of the virus, and the grave danger to the world that all this poses.
According to the World Health Organization, at least seven family members are believed to have passed the virus on to one another from an original case in the family, “All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness. Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing.” (situation report at www.who.int
for May 23, 2006)
While the seriousness of a global pandemic as a result of human-to-human transmission has been well documented worldwide, there seems to be a huge gap in understanding on the ground in Indonesia, particularly at the main government hospital mandated to deal with it. The head nurse on Wednesday at Sulianti Saroso hospital, Mrs. Sinpi, said that the recent Sumatra cases “definitely were not human-to-human.” Additionally, when asked if the general public had access to Oseltamivir, or Tamiflu, as a prophylaxis, the nurse said, “no we cannot give Tamiflu to people for prevention because it has dangerous side-effects”, while adding that the government’s stockpile was the only source of Tamiflu and only allowed by prescription from one of five hospitals around the country for people confirmed with bird flu symptoms.
According to the manufacturer of the drug, Roche Holding AG of Switzerland, it was developed for both prevention and treatment, and, “TAMIFLU may cause mild-to-moderate nausea or vomiting in one out of 10 people. Taking TAMIFLU with food may reduce the potential for these side effects.” The WHO also recommends it as a prophylaxis and for treatment.
The chief pharmacist, M. Menik, at a highly respected private clinic, SOS International, explained that the government was not allowing pharmacies in the country to import or sell Tamiflu to the public or private hospitals because there “was not enough of the medicine available to be used for prevention”. Her clinic recommends and stocks another medicine called Vaxigrip, which is not on the WHO list or US Centers for Disease Control list of possible avian influenza treatment. WHO said last week that Zanamivir - which is marketed as Relenza by GlaxoSmithKline - was a second choice for both prevention and treatment.
According to Bloomberg.com, Roche has stated it was not a problem for either Kalbe Farma pharmaceuticals or government-owned Kimia Farma to produce the vital drug. The Minister of Health, Siti Fadilah Supari, said in late November that the government was importing the raw materials for the drug, but since then there has been no word on whether it is now being produced by the local pharmaceutical companies and both have remained tight lipped.
Mrs. Giri at the ministry said last Wednesday June 21, “I have no idea if it is being produced here.”
A public relations staff person at Kalbe Farma, would only say that it “was still in process.”
Kimia Farma’s president Gunawan Pranoto was quoted as saying recently "We will speed up the process because it's urgent."