NGOs call World Health Assembly to take measures on smallpox stocks

Lim Li Ching - South-North Development Monitor (SUNS)

25 May 2006
As the 59th World Health Assembly (WHA) meets in Geneva from 22-27 May, an issue expected to generate some heated discussion is the destruction of remaining smallpox (variola) virus stocks.

In particular, the WHA is expected to discuss whether it will keep the door open to smallpox research (including genetic engineering experiments which many experts believe to be hazardous) or set the path for destruction of the virus stocks.
These issues will be discussed in a draft resolution, the result of a request from African countries that the WHA consider a formal resolution on smallpox at its 2006 meeting. The resolution provided an opportunity to narrow the research agenda and strengthen international oversight, with a view to final destruction of the virus stocks.
However, opposition to this line of action could come from the two holders of the remaining smallpox virus stocks - the United States and Russia.
The smallpox discussion will take place in Committee A at the WHA, under the agenda item "Smallpox eradication: destruction of variola virus stocks".
Although smallpox was eradicated in the wild in 1977, the US and Russia currently hold stocks of the live virus, with the agreement of the WHA members. However, health and biosafety experts believe the continued retention of smallpox virus poses serious public health, biosafety and bio-weapons risks.
Even if undisclosed stocks exist, and there is no evidence that they do, it would serve no security purpose to retain the existing stocks, according to experts and delegations that are in favour of destroying the stocks. The world already has vaccines and diagnostic tools to deal with a potential smallpox outbreak.
Retaining the virus stocks would serve no extra purpose for dealing with an outbreak, but would instead create more insecurity. The possibility of an accidental or even deliberate release of the virus is too high to continue supporting the retention of the live virus.
Many previous WHA resolutions have called for, and set a date for, the destruction of the virus stocks, but the US and Russia have refused to do so. In 2002, the WHA slid backwards in its determination to see the stocks destroyed, most notably in its Resolution 55.15, wherein it approved a broad research agenda and simultaneously ceased to insist on a date for destruction.
As a result, in 2004, the WHO Advisory Committee on Variola Virus Research recommended approval for more research, which included genetic engineering of smallpox, insertion of smallpox genes in other orthopoxviruses, and unlimited distribution of smallpox DNA segments. These recommendations could collectively result in the creation of viruses even more dangerous than smallpox and are potentially tantamount to permitting distribution of smallpox virus itself, according to biosafety experts.
The recommendations have been publicly opposed by several medical experts, including former senior WHO staff involved in smallpox control and renowned academics who serve on WHO advisory groups.
The recommendation to insert smallpox genes in other orthopoxviruses has now been withdrawn by the Committee, at the urging of the WHO Director-General, but the status of the other recommendations is unclear.
Several NGOs, including the Third World Network and The Sunshine Project, are calling on the 2006 WHA to decide, in its smallpox resolution, to take the following measures:
* That the WHO Advisory Committee be asked to prohibit research involving genetic engineering of the smallpox virus and the distribution of smallpox DNA for non-diagnostic purposes. These two activities had been recommended by the Committee. At the 2005 WHA, many delegations had raised objections to these recommendations. Yet, the Advisory Committee has not reconsidered these recommendations and their status is ill-defined.
The NGOs are urging the 59th WHA to remedy this situation by specifically directing the Director-General, in a resolution, to reject (a) any smallpox genetic engineering experiment and (b) any distribution of smallpox DNA for non-diagnostic purposes. Consequently, the Committee should be asked to withdraw these recommendations.
* Withdrawal of WHA authorization for the retention of virus stocks for sequencing and development of diagnostics and vaccines. According to the NGOs, there is broad agreement among experts that sufficient sequences of smallpox strains have been obtained, rapid and accurate diagnostics have been developed, and that effective vaccines exist that do not require the smallpox virus.
Therefore, the NGOs are asking the WHA to bring to an end research involving live smallpox virus on these items. It could do so by explicitly withdrawing its temporary authorization for the retention of smallpox virus stocks for these three purposes in its resolution.
* Establishment of a new destruction date for smallpox virus: The remaining smallpox virus stocks will be destroyed only if a new date is fixed. For four years, the two smallpox virus research programmes have operated without a destruction date and, in that time they have sought to still further expand permitted smallpox virus research, rather than moving toward consensus on a destruction date. The NGOs suggest that a new date of destruction should be set: preferably by 30 June 2008 but no later than 30 June 2010.
* Reform of the Advisory Committee on Variola Virus Research. The NGOs say that the Committee has failed in its task of implementing the WHA's mandate to control variola virus research and to determine what research, if any, is essential.
Only at its seventh meeting did the Committee take steps to oversee a research program (such as a format and presentation and review of proposals). Surprisingly, it had to request that the repositories submit descriptions of ongoing research. The Committee and its advisors are not geographically and scientifically balanced, it lacks transparency, and it is principally funded by a single Member State.
The NGOs are calling for the WHA to open the Committee's meetings to non-governmental observers, improve its geographic balance with more representation from developing countries, and better balance the committee by increasing the representation of public health fields.
It should also be required to report all new recommendations and the implementation of prior recommendations to the WHA, including all approved research proposals, safety documentation and research results, conclude the NGOs.

Lim Li Ching - South-North Development Monitor (SUNS)
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