The 2011 Pandemic Influenza Preparedness Framework: Global Health Secured or a Missed Opportunity?

In early 2007 the Indonesian government announced that it would cease sharing H5N1 influenza virus samples with the World Health Organization's Global Influenza Surveillance Network. At the heart of the government's complaint was the fact that samples were being passed by the WHO to pharmaceutical companies which developed, and patented, influenza vaccines that the Indonesian authorities could not purchase. The decision gained widespread support among advocates of greater equity of access to medicines, and in response the WHO established an intergovernmental process to agree a framework for influenza virus sharing. The process officially concluded in April 2011 and a new Pandemic Influenza Preparedness Framework (PIPF) was agreed at the 64th World Health Assembly in May 2011. This article investigates the events that prompted the re-examination of a technical cooperation system that has provided effective global health security on influenza for 60 years, and evaluates the framework that has now been agreed. Drawing the distinction between functional and moral-political benefits, the article argues that PIPF more accurately represents a diplomatic stand-off - one that has now been effectively sidelined with the passage of the agreement - rather than genuine reform. In fact, the PIPF papers over fundamental disagreements regarding authority in global health governance, the relationship between the WHO and governments, and the role of private industry. The article concludes by examining an alternative mechanism that would arguably better address the inherent tensions between national and collective interests, and accomplish the functional and moral-political benefits that the negotiations set out to achieve.