February 11, 2016

The Zika Outbreak: Can We Find a Silver Lining?

Late last week, reports surfaced that the Brazilian government was considering amending its 2005 biosecurity law which restricts international sample sharing amid complaints that international researchers were having difficulty obtaining a sufficient quantity of Zika virus to design effective diagnostic tests and countermeasures (Source: CBC News). If such an amendment is made, it would significantly improve the global response capability by giving researchers around the world access to the most current viral and tissue samples. The controversy, however, highlights an important area of “health security diplomacy” that requires additional attention: the balance between a country’s genetic property rights and the need to accelerate sample sharing in cases of a public health emergency. While it is unfortunate that the recent Ebola and Zika outbreaks have caused such great morbidity and mortality, the international health security community should use these crises to focus on this issue that has gone inadequately addressed for too long.

From the perspective of advanced biotechnology companies, the primary motivation for designing diagnostics and countermeasures is rooted both in a desire to not only do social good, but also for economic gain—from a business standpoint, vaccine production is often a money-losing venture. Without sufficient compensation, many companies have noted that they would leave the vaccine marketplace. Unfortunately, this at times has run counter to the interests of the material’s source—financial gains from vaccines and drugs developed have often not been shared with the developing nations from which the original samples were obtained. As a result, and citing the Convention on Biological Diversity (signed in 1992, entered into force in 1993) which guarantees fair and equitable sharing of benefits arising from genetic resources, many nations have developed legislation that restricts the sharing of genetic resources until a compensation scheme is adequately negotiated. However, regrettably, contract negotiations often fail to keep pace with a disease outbreak. Consequently, the world ends up with a situation that repeats itself: Indonesia refused to share H5N1 bird flu samples in 2006 and sharing of both Ebola and Zika samples has been described as limited and tenuous at best in the most recent outbreaks. Meanwhile, public panic is accelerated in the absence of information that cannot be obtained quickly enough, in part, because of these legal disputes.

Solving this issue represents an incredible diplomatic challenge that can pit the global social good against the rights and benefits arising from resource development. Finding a solution will take time. But, there is a second track that should be pursued concurrent with high level international negotiations: preparedness through meaningful partnership. Negotiations that take place in the absence of context or a longstanding relationship are often clouded by mistrust and lack of understanding. Clearly, these are not the ideal conditions to achieve success. Instead, we should be building and developing long-term, sustained relationships that not only place technical resources in country, but also build trust before a crisis occurs. Although some programs, such as the White House-led Global Health Security Agenda, CDC Field Epidemiology and Training Program, and NIH Fogarty International Center, aim to develop these relationships, these programs must continue to receive sustained funding to be effective. By doing so, we can move away from the notion of “cherry picking” where less developed nations provide key data without recognition or benefit, and replace it with a sense of collective responsibility for global health security. Through these relationships, we can develop the foundations for the legal frameworks that shape sample sharing and mutually beneficial research and development. True, grassroots-level diplomacy takes hard work and time—but it’s exactly the kind of effort that is needed to overcome shared challenges and build effective response despite the legal and political hurdles that exist.

If there’s anything that the last decade has shown, it is that the world is becoming increasingly flat and that global travel, climate change, and economic interdependence are going to make disease outbreaks like Zika more common. Rather than simply chasing each “next emergency,” we should be building meaningful partnerships around the world that will make each response more effective.