The Alarming Battle Over Who Gets To Study Zika

I have been asking dozens of scientists to describe our response to the global Zika virus outbreak and in my interviews, one unexpected adjective kept cropping up again and again—ad hoc. It’s a description I wasn’t really anticipating because the World Health Organization has been receiving wide praise for its quick and organized response to the outbreak, and we often see the scientific community as a role model of organization, and science just happens. But accounts from individual scientists working on Zika reveal a far messier reality: In the early months of the outbreak, many struggled to do research because they couldn’t get their hands on samples of the virus. “It’s been ad hoc, you know, and some laboratories will get it some will not,” says Harvard global health law expert Lawrence Gostin. The culprits: politics, bureaucracy, and rivalry.

One of the major blockades has been a much-criticized Brazilian law, which makes it illegal for scientists themselves to export samples of any virus from within the country. Robert Tesh, an emerging infectious disease researcher at the University of Texas Medical Branch who is working on Zika says that the way international research is performed has changed notably in recent years. “In the old days you could simply go over to visit your friends, put [biological samples] in your pocket and take them home to study,” he says.

According to João Nunes, a global health policy researcher at the University of York, Brazil’s restrictive laws are in place for a good reason: to protect the country from predatory practices. In 2012, the Brazilian government fined 35 multinational cosmetic and pharmaceutical companies $44 million in total for biopiracy. “Brazil has had problematic experiences in the past with multinational companies coming in and swiping biological materials that turn into drugs and patents,” Nunes says. “[The country] is prepared to fight when it sees that the health of its population is at stake.”

The situation appears eerily similar to a standoff almost a decade ago with Indonesia during the height of the bird flu outbreak, when officials refused to share virus samples because they feared that other countries would produce a commercial vaccine that Indonesia’s citizens could not afford. However, Nunes points out that unlike Indonesia, Brazil has a large infrastructure that is able to do vaccine research and development, and so far its officials have demonstrated a greater commitment to cooperation than the Indonesian government did.

Still, the protection laws have remained unchanged, and made it nearly impossible for most international scientists to quickly obtain the virus from Brazil by themselves. The few labs that did receive Brazilian specimens soon after the outbreak, such as Koen Van Rompay’s lab at the University of California, Davis, were fortunate enough to have collaborations for other projects already in place with Brazilian blood bankers and tropical disease scientists, making the transfer of materials much easier once Zika came around.

But most labs, like those at Harvard, Texas, Vanderbilt and Brock, had to pivot and use older strains of the virus from Asia, Africa, & the Pacific. These strains are genetically similar to the version that’s now weaving its way through the Americas, and were useful in getting basic research off the ground. But Zika virus only sporadically triggered disease in Africa and Asia, so, tackling one of the most pertinent scientific questions—is there anything special about the Brazilian strain that’s causing an unprecedented rise in birth defects—was likely delayed because most scientists only had access to older strains early on in the game.

And even as they turned to using non-Brazilian Zika virus strains, scientists ran into bureaucratic brick walls. When Priscilla Yang, a Harvard researcher who specializes in flaviviruses, requested samples of the French Polynesian strain from the European Virus Archive (EVA) last December, the EVA was happy to send her the samples right away. But months later, no materials had come through.

Paperwork had been responsible for the hold-up. To receive the samples, Yang needed to obtain a stack of authorizations including a material transfer agreement between the sharing institutions, a CDC permit, and a USDA permit.

Having stringent checks seems fair enough—we’d all prefer for a dangerous pathogen not to end up in the hands of an evil supervillain, thank you very much. And at the end of the day, scientists know the drill. Whether it’s the hot new virus on the block, or your garden-variety biological reagent, it’s all the same: to paperwork trail you go!

But on top of all this, Yang was experiencing administrative errors. During her application for a USDA permit Yang had to resubmit her application several times, and at one point her file was even lost from the system entirely. She waited over five weeks for the standard paperwork, preventing her from doing any research while a global health emergency was escalating.

Yang told Popular Science that she thinks that mistakes were made because even though Zika is a research priority in the scientific community, the USDA does not consider it as a special case, so it’s processed just like any other samples that’s stored with an animal product. Since the USDA is bombarded with requests for all kinds of biological reagents every single day, they simply cannot process them accurately or efficiently enough.

Yang’s experience highlights a significant problem that scientists confront when trying to get ahead of emerging diseases. Researchers are already overwhelmed with the day to day rat race of being a scientist, burdened with managing experiments, writing journal papers, preparing grant applications, and teaching. Navigating a complex and inefficient administrative web during a public health crisis only adds to that burden.

Though it seems a little counterintuitive, Zika research has also been bogged down by scientific competition. For example, when Yang requested antibody results from a regular collaborator who also works on flaviviruses, she noticed that one particular virus of interest was missing in the dataset. After following up, she was told by her colleague that the information was left out because Zika was “a sensitive issue at their institution” and they are under pressure to be the first to publish.

Over the past few months, many scientists have raised concerns over this issue. Columbia virologist Vincent Racaniello, who hosts a science podcast called “This Week in Virology,” has encountered similar stories. He recently had two Zika researchers as guests on the show that revealed that they were having great difficulty getting reagents. The scientists they were in touch with also used the old “we can’t share” excuse, claiming that they needed to get ahead of the research themselves before helping anyone else.

Racaniello even wrote a plea on his blog, urging researchers to open up in the spirit of science. “The more people that work on something, the faster it gets cracked,” he wrote. “You never know who’s going to make the breakthrough so let everyone who wants to work on it, work on it.”

Despite all the travails, most researchers I spoke to were very understanding about the reality of the scientific profession and how that makes it difficult to help each other out, even in the midst of a global health emergency. “I wish that there was a better way to work together and share resources, but that’s science… and it’s not unique to the current situation,” says Yang. “You should share research with other scientists, but it all takes time and money, and you’re under pressure to advance your own scientific goals.”

Since the early months of the outbreak things have gotten better. While export laws, administrative paperwork, and rivalry still remain, larger national organizations including Brazil’s Fiocruz, the National Institutes of Health and Centers for Disease Control and Prevention in the U.S., and the National Microbiology Laboratory in Canada have stepped up to help to take the burden off individual scientists. These institutions have set up repositories of the virus that provide a more formal, less ad hoc way for researchers to get their hands on samples, with much less red tape.

“That’s the reason we want to put things in repositories because when it’s in a government repository, we give it to everybody and anybody who needs it,” says National Institute of Allergy and Infectious Diseases director Anthony Fauci (who was interviewed at a previous time, not for this story). Thanks to these efforts, research on Zika as a whole has stayed on track and is flourishing. A quick glance on Pubmed reveals well over 700 papers on Zika published since the start of 2016 alone; before the current outbreak there had only been about 25.

Still, it’s concerning how difficult it was for the research community to obtain the virus in the first place. At the beginning of the outbreak, instead of doing experiments, scientists wasted time scrambling around to find sources and fill out paperwork. And while experts do not believe that Zika poses an extraordinary threat to humanity in general, thanks to increased air travel, a rapidly rising global population, and climate change, it probably won’t be too long until the next big pathogenic threat pops up. When that time comes, can we make science happen fast enough to beat them back again?

Experts believe that a lot more work needs to be done. Repositories set up by national organizations are effective, but ultimately take a while to set up and rely on how quickly and smoothly countries can navigate the diplomatic process.

After the Indonesia debacle, the WHO came up with a framework called “PIP” (which stands for Pandemic Influenza Preparedness). PIP sets some ground rules for doing scientific research during an outbreak: when countries should share their biomaterials, what they need to share, and what protections and compensation they will receive in return. But PIP only covers influenza, for other pathogens like Zika, it’s still pretty much the Wild West.

“You have a global mess,” says Gostin, who believes that we need a “PIP” that covers all infectious diseases. “Not only is it happening with Zika but it will happen going forward with every novel emerging infection unless we can figure this out and come to some kind of international agreement. In the end I believe the WHO is at the driver’s seat to make sure countries share biological materials freely.”

Gostin makes a good point. Death and disease have no national barriers. So when it comes to fighting them, why are borders holding us back?