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WHO hopes controversial bird flu studies will be published by summer

03/16/2012 03:54 EDT | Updated 05/16/2012 05:12 EDT
The top influenza official at the World Health Organization is hoping bird flu studies currently in publishing limbo will be released by the time the agency hosts a second meeting on the controversy this summer.

The date for the meeting hasn't yet been set, but the Geneva-based global health agency is looking at mid-summer, Dr. Keiji Fukuda says.

A major break in the impasse would be needed for that to happen. As things currently stand, revised versions of the two studies are due to be presented late this month to the U.S. biosecurity panel that earlier recommended against their full publication.

The meeting of the National Science Advisory Board for Biosecurity is scheduled for March 29 and 30, sources say. The board has been asked by the U.S. Department of Health and Human Services to review the reworked manuscripts to see if the changes elicit a different opinion on whether the full studies should be published.

Fukuda, who is assistant director-general for health security and environment, says the WHO's second meeting on the studies and the challenging related issues they pose will take place regardless of the publication status of the papers at the time.

"The timing of the second meeting is not predicated on the moratorium being ended or the papers being out. But we would like to move as quickly as possible,'' he says.

The moratorium Fukuda refers to is a promise, made by the world's leading influenza scientists, not to conduct further study for the time being into what might make H5N1 avian flu viruses transmit among mammals — including maybe humans. Originally a 60-day research pause which would have expired in late March, there is currently no fixed date for the moratorium to end.

The ongoing controversy was triggered by work, conducted at Erasmus Medical Centre in Rotterdam, the Netherlands, and the University of Wisconsin-Madison, that created versions of — or in the American case, a hybrid of — H5N1 viruses that spread easily among ferrets.

It's impossible to test the virus in humans, so an animal model must be used. Ferrets are generally considered to be the best model for predicting how a flu virus might behave in humans.

The studies, done with funding from the U.S. National Institute of Allergy and Infectious Diseases, were accepted for publication in the journals Science and Nature.

But the NSABB was asked first to review them to see if they constituted so-called dual-use research — legitimate research which could be used for nefarious ends. And in November, the NSABB recommended that the studies be published in abbreviated form only, to prevent others from trying to repeat the work.

The WHO, which was asked to help broker a solution, hosted a meeting in mid-February where participants concluded redacting the papers would be unworkable and they should be published in their entirety.

It also agreed to host another or other meetings to look at related issues raised by the controversy.

Fukuda says the agency is still trying to figure out which and how many topics should be discussed at the summer meeting, and is considering opening that process up to outsiders. The planners are mulling over the idea of soliciting suggestions of top priorities via a website.

Fukuda does not expect the meeting to address the question of whether researchers should continue to try to puzzle out why H5N1 doesn't currently spread among people and what changes the viruses would need to make to acquire that ability.

"If you ask the question 'Should we continue to try to understand the basis of transmissibility of these viruses,' then I think the answer is a clear 'Yes,'" he says.

"In the same way that if you were to say 'Do we need to understand what makes these viruses so peculiarly dangerous and lethal,' the answer would be 'Yes.'"

Fukuda suggests the pertinent issue is how to do the work while taking full account of concerns over safety.

"I think technically speaking there's an awful lot of really smart scientists out there. And if the question is 'How do we understand transmissibility and get the information and do it in a way which is relatively safer?' my guess is that there will probably be a number of different answers."

He says the hope is that the meeting won't simply explore questions, but get to answers as well. "Those are some of the things we really will want to try to get out of the meeting. Not just discussion, but also ways for going forward to begin to actually resolve some of the dilemmas."

As it plans for the meeting, the WHO has been focusing on the challenge of communications, trying to figure out how to frame the discussions for different groups in the dispute.

"The reasons why we want to do that is that . . . an endless back and forth discussion which is just simply 'We are right and you are wrong' doesn't get us anywhere," Fukuda says.

"The high-level scientists who deal with influenza don't necessarily need to understand about the research better, but perhaps to understand that research takes place in a social context is important to understand.... But non-scientists — people in the biosecurity world or the political sphere — may need to know research like this isn't cooked up overnight."

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