WHO Group: H5N1 Papers Should Be Published in Full

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Science  24 Feb 2012:
Vol. 335, Issue 6071, pp. 899-900
DOI: 10.1126/science.335.6071.899

An elite group of 22 influenza scientists, public health officials, and journal editors from 11 countries recommended last week that the details of how a highly pathogenic bird flu virus was rendered capable of being transmitted easily among mammals be published in full. The recommendation, agreed to at a meeting at the World Health Organization (WHO) in Geneva, flies in the face of advice from an influential U.S. committee that key details of the experiments be confined only to those who have a need to know.

H5N1 is highly lethal to humans but does not spread easily from person to person. Two teams working with ferrets, which many researchers consider the best animal model for humans, manipulated H5N1 to introduce genetic changes that made it easily spread through the air between these weasel-like animals. In December, the National Science Advisory Board for Biosecurity (NSABB), a U.S. government committee, recommended that Science and Nature, which have reviewed papers about the work, not publish key details. NSABB feared that in the wrong hands, the information could provide a recipe for triggering a devastating human pandemic. An impassioned international debate ensued, pitting scientific freedom against public safety. The journals, heeding NSABB's advice, had planned to publish manuscripts stripped of critical details in mid-March, provided an as-yet-undetermined mechanism is established to make the entire manuscripts available to flu investigators and public health officials who need to know all the data.

In Geneva, the researchers who led the work—Ron Fouchier of the Erasmus University Medical Center in Rotterdam, the Netherlands, and Yoshiro Kawaoka of the University of Wisconsin, Madison—passed out copies of the papers they submitted to the journals. To demonstrate what the papers would look like if the journals followed NSABB's advice, the researchers also distributed redacted versions at the closed-door meeting. The drafts of each paper were numbered, participants had to sign for them upon receipt and return, and in the end, the authors shredded all the papers in front of everyone in the room. “That certainly was a surreal touch,” says Barbara Jasny, a deputy editor at Science, who represented the journal at the meeting, held 16–17 February.

The group recommended that the journals publish the papers without deleting details. Keiji Fukuda, WHO's assistant director-general for Health Security and Environment, said the complexity of distributing the full manuscripts to a select few, combined with the public health and scientific value of widely sharing the data, led to a “quite strong”—but not unanimous—agreement among the Geneva group to go against NSABB's recommendations. “Who would hold on to the sensitive information?” Fukuda asked at a WHO press conference. “Under what conditions would that information be released? What are the other complicating factors? It was recognized that coming up with such a mechanism would be very difficult to do overnight, if not impossible.”

Peer review.

WHO's Keiji Fukuda led an expert group that said papers on transmissible bird flu viruses should not be redacted.


Paul Keim, the acting chair of NSABB, who attended the Geneva meeting, disagrees with the consensus opinion. Keim, a geneticist and anthrax specialist at the University of Northern Arizona in Flagstaff, praises the international makeup of the WHO group but stresses that it mainly consisted of influenza researchers. “I believe that the redacted versions were so obvious to them that they held them in little value,” Keim said. “This type of policy decision can't be made by the flu research community alone.” The U.S. government's top representative at the meeting, Anthony Fauci, also dissented from the consensus. “I stand by the NSABB recommendations,” says Fauci, who heads the U.S. National Institute of Allergy and Infectious Diseases (NIAID).

In many ways, the WHO meeting gave a stamp of validation to NIAID, which funded both of the studies, and the researchers themselves, whom some have criticized for conducting the work in the first place. Summing up the consensus of the WHO group, Fauci said, “being able to pursue openly this type of research by the public health and scientific community outweighs the issues of a terrorist getting enough information to do something nefarious.”

Fouchier, Kawaoka, and their co-workers say their studies reveal critical factors that lead to transmission of H5N1 in mammals. They contend that their data can also potentially help surveillance efforts detect dangerous mutations in birds or other species before these variants make the jump into humans (Science, 17 February, p. 785).

Albert Osterhaus, a meeting participant who works with Fouchier, says the WHO group received information about recently detected H5N1 variants in nature that underscores the value of their ferret work. “Quite a number of data, which are not yet in the public domain, have been shown that actually indicated that the H5N1 viruses are developing very fast,” says Osterhaus, who did not want to discuss specifics. These new details, which he noted were not available to NSABB, mean their experiments could aid surveillance today. “That's a very important thing to realize,” he says.

Although it endorsed full publication, the WHO group urged the journals to delay publishing the manuscripts and asked the research community to continue a voluntary 60-day moratorium set to expire on 20 March to allow time to increase “public awareness” about the importance of the work. “This was a most important step for making sure anxieties will not be unnecessarily increased,” Fukuda said. The WHO group also hopes that extending the moratorium will allow for a fuller discussion about the safety conditions needed by labs that work with these viruses.

Like NSABB, the WHO group influences but does not control the fate of these papers. Science Editor-in-Chief Bruce Alberts, who was not at the WHO meeting, said he is “not completely clear about what the decision means because it's qualified,” but said Science has scuttled plans to publish the redacted papers next month. Nature Editor-in-Chief Philip Campbell, who attended the Geneva gathering, issued a statement that Nature supports the group's decisions about the benefits of full publication. “Discussions at the WHO meeting made it clear how in effective redaction and restricted distribution would be for the Nature paper,” Campbell's statement said. Neither journal offered a timeline for publication.

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