The Zika Outbreak: A Call for Greater International Collaboration
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Global concerns about spread of the Zika virus continue to grow. More than 20 countries in Latin America–especially Brazil–as well as Caribbean locations and several states in the U.S. have reported confirmed or suspected cases. Yet, more remains unknown than known about the consequences of being infected with the virus. Although it is well-established that the virus is transmitted by the Aedes mosquito, it is unclear whether people can become infected through sexual contact with an infected person (one case in which the woman’s male partner had traveled abroad was reported in Texas), or by blood transfusions, even though the virus has been detected in blood, urine, semen, and saliva. The most devastating effect appears to be microcephaly (abnormally small head size) and accompanying brain damage of infants born to mothers infected with the virus, with thousands of cases in Brazil alone. Most recently, the virus has also been associated with eye abnormalities in affected infants. But even in those cases, scientists maintain that a causal connection has not been established. Another possible connection is Guillain-Barré syndrome, a condition that causes weakness and can develop into temporary paralysis.

The World Health Organization (WHO) has declared the situation “a public health emergency of international concern.” This places WHO in the position of a global health coordinator in efforts to halt the spread of the disease, and also gives the organization’s decisions the force of international law. Even at this early stage, however, scientific research has been hampered by national laws such as one in Brazil that prohibits the transfer of human biological specimens to other countries.

So, what do public health officials recommend for people who may be exposed to the Zika virus? Despite the lingering uncertainty regarding a causal connection between infection in pregnant women and resulting microcephaly and brain damage in their infants, some ministries of health are recommending that women delay pregnancy. One such country is El Salvador, which has advised women to delay pregnancy until 2018. Men who have traveled to places where cases of the disease have been reported are urged to use condoms with their sexual partners. And, of course, all the obvious ways of preventing mosquitos from breeding are being recommended. Possibly the most hopeful approach is the release of genetically modified mosquitos that are altered to pass a lethal gene to their offspring, which die before they can reach adulthood.

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One of the most critical needs during a disease outbreak like Zika infection is international collaboration among scientists, including sharing of human biological materials and data. Without recently acquired blood and tissue samples, scientists are hampered in their search for effective preventive and therapeutic interventions. Brazil–the country with the largest number of Zika infections–has a strict biosecurity law that prohibits sending samples to other countries. According to one report, “Brazil has so far probably shared fewer than 20 samples when experts say hundreds or thousands of samples are needed to track the virus’ evolution and develop accurate diagnostics and effective drugs and vaccines. Many countries’ national laboratories are relying on older strains from outbreaks in the Pacific and Africa.” However, the most recent news suggests that the Brazilian government is considering a decree that would reform the current biosecurity law.

One reason countries like Brazil have enacted laws that prohibit sharing of biological materials is that commercial products later derived from such samples are costly and often become available in wealthy countries, but not in developing countries where the samples originated. Clearly, what is needed are enforceable international agreements for benefit sharing. One can only hope that in its role as global health coordinator in the Zika epidemic, WHO will have the foresight and authority to urge reforms in the current barriers to cross-border sharing of biological materials and any resulting commercial benefits.

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The Zika Outbreak: A Call for Greater International Collaboration — 2 Comments

  1. I think you make a very interesting point that is not widely being discussed. Thank you for this article.

    I read the article that you linked to by the Brazilian bioethecist. I thought she also made an excellent point that is also being overlooked, which is that the main populations being affected by Zika and thus at risk for the birth defects (if indeed these are caused by Zika, a point still very much up for debate and study) are the poor, who do not have access to good water infrastructure and thus live in areas where there are, to put it simply, WAY too many mosquitoes. As the author of that article states, no wealthy Brazilian women’s children have been affected. Why? Because they live in areas where mosquito breeding grounds are uncommon. This should be the case everywhere. Rather than focusing on pregnancy or even reproductive rights, I would argue that this crisis would be a moment in which the world and the governments in question focus on putting resources into public health engineering.

  2. Thanks for your kind words, Rachel. I agree with the other points you raise. Ultimately, the best hope for Zika–and Dengue, malaria, Ebola and, of course, HIV–is a preventive vaccine. Meanwhile, scientists are focusing on other approaches such as genetically modified mosquitoes that render their offspring sterile. But then we have to contend with all the anti-vaccine hardliners.

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