But many are skeptical the meeting can resolve the lingering stalemate, triggered early this year when Indonesia announced it would no longer supply viruses to the WHO's Global Influenza Surveillance Network without guaranteed access to vaccines created from them.
The Third World Network, a non-governmental organization that advocates for the rights of developing countries, has been advising Indonesia in this dispute. Its legal expert says it is unlikely the four-day meeting, beginning Tuesday, will resolve all outstanding issues.
"But I think member states understand the urgency of the matter. And so I'm sure countries are going try their best to actually try and resolve it," Sangeeta Shashikant says from Geneva.
Many involved are unwilling to speak on the record about the politically charged situation, fearful of saying anything that might deepen the divide. For instance, Dr. Arlene King, the Public Health Agency of Canada's point person for pandemic influenza, declined to be interviewed before the talks take place.
Framing the discussions are difficult questions about the ownership of viruses, intellectual property, the scope of the Convention on Biodiversity and how the world will divvy up scarce vaccine during a global medical emergency.
Adding to the pressure to break the logjam is the fact that the longer it goes on, the less the global influenza community knows about H5N1 viruses circulating in Indonesia. Are dangerous mutations occurring there? Are the viruses susceptible or resistant to antiviral drugs at this point? Without a steady stream of sample viruses, those questions can't be answered reliably.
"By not having viruses from Indonesia, it gives an incomplete picture of what's going on in the world in terms of human avian influenza infections," says Dr. David Heymann, the veteran WHO official who heads avian and pandemic influenza operations.
"And it decreases the possibility of preparing vaccines from those strains should those strains, in the risk analysis, be shown to be strains that should be considered for vaccine development."
Indonesia is the country worst afflicted by the H5N1 virus, which has infected at least 335 people worldwide and killed 206. Indonesia accounts for 113 cases and 91 deaths.
The country is seeking a quid pro quo for supplying virus samples to the WHO surveillance network in the form of guaranteed access to affordable pandemic vaccine. It claims it has sovereign rights to influenza viruses circulating within its borders under the Convention on Biodiversity.
But the top official heading the U.S. delegation to the meeting says that country would be "very opposed" to anything that smacked of royalties.
"Clearly in our minds there should not be a one-to-one relationship between sharing a particular sample and accruing a specific benefit," says Ambassador John Lange, the U.S. special representative for avian and pandemic influenza.
"Countries that do their duty and share the information and samples should not expect to receive something concrete each and every time they share."
Lange said the U.S. would also object to a system that gave a contributing country a veto over which research institutes or vaccine manufacturers can work with its viruses, or one which required a special document, known as a "material transfer agreement," for every virus or specimen donated.
Laboratories in the WHO network have said they would not handle the crush of paperwork that would entail.
"We really need to be understanding that this is a process, whether it's the seasonal flu vaccines or a possible pandemic, where time is of the essence," he says.
Others dispute the claim that viruses can be considered part of a country's biological resources under the Convention on Biodiversity.
David Fidler, an international law professor at Indiana University, argues the convention is meant to prevent outside exploitation of a country's biologic and genetic resources. That protection doesn't extend to viruses, entities affected countries are actually trying to eradicate, he writes in an article that will appear in the January issue of the journal Emerging Infectious Diseases.
But Shashikant sees things through a different prism. She insists the convention does cover viruses and in the current climate, H5N1 viruses are clearly a resource. "Without the virus you cannot have the vaccine. You could say it's a resource because it's what everybody wants now."
Options for resolving the problem could include a royalty schedule, she says, though the Third World Network prefers the notion of pooling gains to be shared among developing countries that would need help obtaining vaccine during a pandemic.
It's not clear whether Indonesia supports this pooled benefits approach. Its statements to date suggest it may envisage a system where it directly benefits from any commercialization of viruses it contributes to the network.
Shashikant outlines a scheme that would require vaccine manufacturers who want viruses for production purposes to contribute to a global pot for developing countries. Benefits would include contributions to the WHO's pandemic vaccine stockpile, affordably priced vaccine in a pandemic, and possibly agreements to transfer technological know-how to developing countries so they could build their own flu vaccine plants.
This system, she suggests, should apply to both seasonal and pandemic flu vaccine.
"We have to see how the system can actually help us to be prepared (for a pandemic)," Shashikant says. "And the only way that I think we can actually be more prepared is if we have a more equitable system. You know, benefits have to come back to countries, in some form or other."
The WHO, with the assistance of developed countries and pharmaceutical countries, has been trying for some time to put together a package to help developing countries cope during a pandemic.
Hoffman-La Roche donated millions of treatment courses of the antiviral drug Tamiflu to the WHO for an effort to contain a pandemic at source. GlaxoSmithKline announced it will contribute enough H5N1 vaccine to a WHO stockpile to vaccinate 25 million people. Other vaccine manufacturers have said they too will donate, though they haven't yet announced how much.
The WHO is expected to outline the recommended size of the vaccine stockpile at this week's meeting.
