New Enemy Sparks Repeat of the 2012 Dual Use Research Debate
“Someone doesn’t have to weaponize the bird flu. The birds are doing that.”
– Dr. Ellis Cheever, Contagion, 2011
On Tuesday, August 6, the British Medical Journal published the first report of suspected human to human transmission of the newly emerging H7N9 strain of avian influenza. This represents a potentially game-changing turn in the progression of the illness as the worst case scenario of a global pandemic hinges on the ability of the virus to achieve sustainable transmission between persons. Fortunately, the evidence in this initial case suggests that the transmission is “limited and non-sustainable” and, as such, represents only the ominous tip of an iceberg on the horizon for public health. As this case occurred back in March between family members and no other contacts of the two individuals in question experienced illness, there is little to suggest that the virus promotes an immediate threat, but there is plenty to suggest that human ought work as quickly and safely as possible to understand this virus and develop specific countermeasures to the H7N9 virus.
To that end, Ron Fouchier, a researcher at Erasmus University in the Netherlands, proposed this week a controversial step of trying to actively adapt the H7N9 virus to grow in humans in an effort to study and better characterize the virus before nature does the conversion process itself. Dr. Fouchier made headlines last year when it was revealed that his lab and others had adapted the H5N1 avian influenza to infect humans. A very public debate ensued wherein several scientific journals, the National Institutes of Health (NIH) and an advisory panel of biosecurity experts went back and forth on the risks and benefits of publishing research that became termed as Dual Use Research of Concern (DURC). Ultimately, the work was published in full, but significant policy changes were made to ensure that such research was conducted under greater scrutiny long before the publication stage.
As the National Science Advisory Board for Biosecurity (NSABB) concluded, such research, if well-conducted under appropriate oversight is a necessary risk. Experts still understand very little about how the H7N9 interacts with the human body to cause mortality in nearly a third of all those infected. This reflects a considerably higher case fatality rate that the very famous 1918 Spanish Flu which killed somewhere in the area of 2% of those infected, but still managed to kill more than 50 million people worldwide. One might suppose that if the virus adapts to humans, its case fatality rate is likely to drop considerably, but even a similarly lethal virus to the 1918 strain could result in more than 250 million people worldwide. That number underscores the importance and potential risk of the research proposed by Dr. Fouchier and others.
The US government and global research community need to support extensive study of the H7N9 avian influenza virus through appropriate funding and oversight. Furthermore, the communities in which this research is being conducted need to be appropriately engaged and educated to ensure that the safety and security of the labs and their neighbors are fully and effectively protected. This represents an opportunity for the scientific experts in the Obama Administration to test the effective oversight changes that were implemented in the wake of the 2012 DURC controversy and measure their ability to effectively regulate, while not overtly impeding, critical biosecurity research.