WHO will help resolve bird flu studies controversy

The World Health Organization says it will take a role in helping sort through an international scientific controversy over two bird flu studies that the U.S. government deemed too dangerous to publish in full.

The scientific and biosecurity communities have been mired in heated debate over the issue for weeks. Voices from both sides have been calling on the WHO to take a lead role in the discussions, saying any solution must be international in scope.

In an interview Sunday, a senior WHO official said the agency will pull together international talks aimed at fleshing out the issues that need to be addressed and then work to resolve them.

"It's the right organization to bring ... balance to the discussion to make sure that the technical and scientific and the political and the public health concerns are all brought together," Dr. Keiji Fukuda, the WHO's assistant director-general for health security and environment, told The Canadian Press.

The issues are thorny, raising among others concerns about the free flow of science, global biosecurity and the future of a fragile new international agreement on sharing flu viruses for disease surveillance and vaccine manufacture.

"It's genuinely a set of difficult and very important questions," said Fukuda, a leading influenza epidemiologist.

"And I just very, very much want to make sure that we don't go off on one tangent or another, pulled by one loud voice saying 'this is the issue' when in fact there are several different issues. And that we do a good job about addressing them all."

Some of the issues need answering in the immediate term -- what to do, for instance, with the viruses in question and how broadly to share details of the work that led to their creation. But there are longer-term concerns too, such as how to set up systems or structures that will work over time -- not just for these influenza viruses, but potentially other lab-made pathogens as well.

"It may be that the short-term solutions are not the long-term solutions, that there's something that has to be done for this particular situation which is ad hoc," Fukuda said.

"But if that's true, at least we can go into it saying 'OK, this is clearly an ad hoc solution. Please, everybody, don't mistake this for a long-term solution."'

Weeks of behind-the-scenes wrangling and debates erupted into public view just before Christmas when the U.S. government announced its National Science Advisory Board on Biosecurity (NSABB) had recommended two studies on H5N1 virus transmission should not be published in full.

The papers are slated to be published in the leading journals Science and Nature. The board's recommendation is not binding, but the journals have grudgingly agreed to abbreviate the papers, leaving out the details of how the work was done.

The research, led by virologists Ron Fouchier at Erasmus Medical Centre in Rotterdam, the Netherlands, and Yoshihiro Kawaoka, at the University of Wisconsin-Madison, reports on how the dangerous virus could be pushed to evolve to the point where it is easily transmissible among ferrets.

Ferrets are considered the best animal model for predicting how influenza viruses will act in people. Many involved in this debate caution that a virus that spreads among sneezing ferrets still might not transmit easily among people.

But it is simply impossible to test the viruses in humans -- the work would be far too dangerous and completely unethical. So the scientific community has to assume the lab-made viruses may be capable of what H5N1 viruses in nature have so far failed to do -- spreading as easily among people as seasonal flu.

Many researchers have denounced the U.S. move as censorship that will hinder science's ability to counter the threat from H5N1 viruses. And in commentaries published Sunday in the journal Nature, several called on the WHO for leadership in finding a way through the quagmire.

Fouchier, and Ab Osterhaus, head of the department of virology at the Erasmus Medical Centre, argued in one of the commentaries that it isn't up to the United States to dictate to the rest of the world on this issue.

"We don't know the worldwide opinion until a group of experts from all parts of the globe is formed," they wrote. "An issue this big should not be decided by one country, but by all of us."

Ironically, this is something on which the scientists and the biosecurity experts agree.

"This has got to be a global discussion. It can't be a U.S.-oriented discussion," said Michael Osterholm, an infectious diseases expert and member of the NSABB.

He welcomed the news the WHO will become involved. "The very major contribution they can make is being the international venue where this thoughtful and international discussion occurs."

He also agreed with Fukuda's assessment that the situation raises a number of issues that need to be addressed.

"Doing it right is clearly more important than doing it quickly. Involving the world is really important, not just those who right now are the prominent players in the discussion," added Osterholm, who heads the Center for Infectious Diseases Research and Policy at the University of Minnesota.

One of the issues that will likely come up is whether future work on the viruses produced by the two research teams should be restricted to laboratories with the highest designation of biosafety and biosecurity, BSL4 labs.

H5N1 work is typically done in BSL3 or BSL3-enhanced laboratories. Neither Fouchier nor Kawaoka have BSL4 labs at their institutions.

Osterholm said he supports those who call for the viruses to be designated as BSL4 pathogens. "I don't know why you wouldn't put this in a BSL4 for the time being," he said, insisting he was speaking as an individual, not as a spokesperson for the NSABB.

When the journals agreed not to publish the papers in full, they did so on the proviso that a system be set up that allows the technical details of the work to be shared with other scientists and perhaps public health authorities on a need-to-know basis.

Asked if the WHO would be taking on the responsibility for running such a system, which would involve vetting applications to see the work, Fukuda suggested that would be outside the agency's scope.

"I think that the issues are too big to say that any organization will simply take it on. That any organization will just as a matter of course police the release of information or monitor all potentially sensitive research. This is not something that I think WHO or any organization will be able to do. I think it is simply infeasible," he said.

It is believed the journals may publish the papers later this month. But putting together the system to decide who can see the full works and how the details can be safely shared may take several months.