Special blog: Assistant DG of WHO Fukuda Tries to Clarify Flu Decisions

Posted on by Laurie Garrett

On February 16 & 17th a group of 21 scientists (mostly influenza experts) and 1 ethicist gathered at World Health Organization headquarters in Geneva to decide the fate of the manmade H5N1 viruses, generally described as potentially the most dangerous microorganisms humanity has ever faced. We concede that there is controversy on that statement: Though the viruses made at Erasmus University in Rotterdam readily spread in airborne fashion among laboratory ferrets, killing 60% of the animals, skeptics downplay the findings. Ferrets do not equal humans, they say, and even in nature the lethality to humans of the H5N1 bird flu is overstated.

It was not the duty of the assembled scientists to decide if the phrase “potentially the most dangerous microorganisms humanity has ever faced” is accurate. WHO Assistant Director-General Dr. Keiji Fukuda gave the meeting a narrower charge, and after what he described repeatedly as a “hot” and “heated” discussion a series of recommendations were agreed upon, in a process initially described as “unanimous” but later amended to “consensus” with dissent. Six decisions were reached.

Fukuda held a press briefing on February 17, but confusion and contradictory reporting followed. He then distributedto scientists and reporters the e-mail that I have provided (edited only to correct spelling and clean the format) below.

Sent: February 17, 2012

Dear All,

Given this rather extraordinary email list from [NAME REMOVED by me], I would like to take advantage and provide perspective and insight on the recent H5N1 research meeting held at WHO 16-17 February 2012 in Geneva at WHO.

1. The meeting was held under confidential conditions because it included a review of unpublished data that was considered sensitive and at the heart of the controversy. The premise was that holding a discussion based on facts -- including the manuscripts and information at the heart of the controversy -- was best. Although there have been a number of informed editorials and opinion pieces, we wanted to base the discussion on more than just opinion and concerns.

2. The participants -- whose names were posted on the first day of the meeting -- largely were asked to participate largely because they had a role in some aspects of the research (conduct, review, funding, oversight, publication etc), or in sending the viruses to WHO or were considered to have a potential role in implementing solutions.

3. The purpose of the meeting was not hold broad debate on the relative merits of research and publication versus security or safety as many seem to have assumed. Instead, it was based on the idea that there are a very large number of extremely complex considerations, and focusing discussions on the most acute issues related to the specific situation would be most useful and productive. These issues were largely:

1) what can be said about the manuscripts / information and

2) what can be agreed upon related to the new lab modified H5N1 viruses held at the two universities and research on them.

Moreover, the starting premise was that research and availability of information is essential but that research takes place in a social context and that social safety and security concerns are of equal importance. Therefore, we did not enter into a debate over the respective perspectives but said the real issue is find ways in which both concerns can be balanced and accommodated. Importantly, the meeting was not set up to discuss or second guess and other previously held discussions or meetings.

4. Every participant was asked to partake in the discussions from this perspective, and in this spirit. Despite the widely varying backgrounds of the participants, they did so which is why several agreements were reached.

5. The results and agreements among the participants have been posted and I will not comment further on those points.

6. The related issues which are being debated in various fora are part of a historical continuum. Some aspects are similar to what was discussed back in the 1970's with recombinant DNA technology and later events such as the anthrax attacks. But other considerations are new, including the fact that the world now has a Pandemic Influenza Preparedness Framework whose existence and implementation are important.

In ending this note, this meeting was not intended to answer all questions and did not do so. But it showed that participants with widely varying opinions, priorities and backgrounds could come together and find common ground when the discussions were based on facts and mutual good will. Since I am overloaded with emails, many related to this meeting, I most likely will not respond to individual comments generated by these comments so my apologies in advance.

Thank you,

Keiji Fukuda

Keiji Fukuda copy.jpg