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| Brazil's Health Minister Marcelo Castro speaks to the press before attending the Mercosur Health Ministers summit to address the spread of Zika virus in the region, at the Mercosur building in Montevideo, Uruguay, Wednesday, Feb. 3, 2016. The ministers of 13 countries are meeting to coordinate actions to try and fight the spread of the mosquito born virus. Castro said that efforts are being made to create a vaccine against it. |
RIO DE
JANEIRO (AP) -- U.N. and U.S. health officials tell The
Associated Press that Brazil has yet to share enough samples and disease
data needed to answer the most worrying question about the Zika
outbreak: whether the virus is actually responsible for the increase in
the number of babies born with abnormally small heads in Brazil.
The
lack of data is frustrating efforts to develop diagnostic tests, drugs
and vaccines. Laboratories in the United States and Europe are relying
on samples from previous outbreaks. Scientists say having so little to
work with is hampering their ability to track the virus' evolution.
One
major problem appears to be Brazilian law. At the moment, it is
technically illegal for Brazilian researchers and institutes to share
genetic material, including blood samples containing Zika and other
viruses.
"It's a very delicate issue, this
sharing of samples. Lawyers have to be involved," said Dr. Marcos
Espinal, director of communicable diseases in the World Health
Organization's regional office in Washington.
Espinal
said he hoped the issue might be resolved after discussions between the
U.S. and Brazilian presidents. He said WHO's role was mainly to be a
broker to encourage countries to share. When asked whether the estimate
of other scientists that Brazil had provided fewer than 20 samples was
true, he agreed it probably was.
"There is no way this should not be solved in the foreseeable future," he said. "Waiting is always risky during an emergency."
Last
May, as the first cases of Zika in Brazil were emerging, President
Dilma Rousseff signed a new law to regulate how researchers use the
country's genetic resources. But the regulatory framework hasn't yet
been drafted, leaving scientists in legal limbo.
"Until
the law is implemented, we're legally prohibited from sending samples
abroad," said Paulo Gadelha, president of the Oswaldo Cruz Foundation,
Brazil's premier state-run research institute for tropical diseases.
"Even if we wanted to send this material abroad, we can't because it's
considered a crime."
The ban does not
necessarily mean foreign researchers can't access samples. Some were
shared with the
United States, including tissue samples from two
newborns who died and two fetuses recently examined by the Centers for
Disease Control and Prevention. But a U.S. official said that wasn't
enough to develop accurate tests for the virus or help determine whether
Zika is in fact behind the recent jump in the number of congenital
defects. The spike in cases prompted WHO to declare an international
emergency Monday.
Given the drought of
Brazilian samples, public health officials across the world are falling
back on older viruses - or discreetly taking them from private patients.
The
U.S. official, who shared the information on condition of anonymity as
he was not authorized to speak publicly, said the CDC was relying on a
strain taken from a 2013 outbreak in French Polynesia to perfect its
Zika tests. U.S. researchers trying to sequence Zika's genetic code have
been forced to rely on virus samples from Puerto Rico for the same
reason, he said.
In England, researchers are
using samples drawn from Micronesia, the site of an outbreak in 2007.
The French are relying on samples from Polynesia and Martinique. In
Spain, scientists have a Ugandan strain of Zika supplied by the United
States. Even Portugal, Brazil's former colonial master, doesn't have the
Brazilian strain; the National Health Institute in Lisbon said its
tests relied on a U.S. sample from the 1980s, among others.
Some
researchers are bypassing Brazil's bureaucracy by getting samples sent
to them for testing by a private lab, said Dr. Jonas Schmidt-Chanasit,
an expert on mosquito-borne diseases at the Bernhard Nocht Institute for
Tropical Medicine in Hamburg.
"It's almost
impossible to get samples from the country," Schmidt-Chanasit told AP,
referring to Brazil. "It's not going via official government channels.
Our source is simply the rich people who want a diagnosis."
In
public, health leaders have been eager to boast about their excellent
collaboration. WHO's chief, Dr. Margaret Chan, said after Monday's
meeting that Brazil and the United States were working "very closely" on
studies. When asked about sample sharing, Dr. Anthony Fauci, the
director of the U.S. National Institute of Allergy and Infectious
Diseases, told AP: "I don't think it's an issue."
Behind-the-scenes, it was another story.
Four
officials at the World Health Organization told AP the Brazilians were
starving international partners of up-to-date information.
"WHO has gotten zero from them, no clinical or lab findings," one of the officials said.
All four spoke on condition of anonymity because they were talking without authorization.
Ben
Neuman, a virologist at Reading University in England, said thousands
of samples - or hundreds at a minimum - were needed to track the virus
and determine how it's changing. "Science only works when we share," he
said.
The virus sharing problems aren't limited to Brazil, said Gadelha of the Oswaldo Cruz Foundation.
"This
isn't a unilateral issue; it's a global problem," he said, adding he
hoped the current crisis would speed efforts at international
cooperation, which has long been an issue in outbreak response efforts.
More
than a decade ago, WHO faced a similar problem when Indonesia refused
to hand over bird flu samples, arguing that Western scientists would use
them to make drugs and vaccines the country couldn't afford. At the
time, Brazil had a leading role in ending the impasse, helping to broker
an agreement ensuring developing countries were guaranteed access to
products developed from shared viruses.
Lawrence
Gostin, director of WHO's Collaborating Center on Public Health Law and
Human Rights at Georgetown University, said there are no rules that
force governments to hand over viruses, tissue samples or other
information.
"If countries don't share, the only repercussions they face are public condemnation," he said.
