Threat from new infections

Dinesh C Sharma

Science Commentator

THE world is witnessing a global health emergency, as declared by the WHO, with cases of coronavirus being reported from over two dozen countries, including India. Most of the people testing positive have had a history of travel to China, which is the epicentre of the outbreak. Some cases where the transmission may have occurred outside China have been reported from Singapore, Thailand, Korea, Japan and Malaysia. Given the high mortality rates, the concern is very high.

Past couple of decades have seen outbreaks of many new and re-emerging infections like SARS, MERS, Zika, Nipah, avian influenza, swine flu, anthrax and chikungunya. Carriers and reservoirs of such pathogens are bats, pigs, birds, mosquitoes etc. On top of this, we live in a hyper-globalised world. This means new viruses can travel from their places of emergence to faraway locations quite swiftly.

In addition to immediate steps such as travel restrictions, quarantine and other public health measures to break the transmission chain, the WHO has initiated studies to understand the disease, its animal reservoirs, transmission methods and clinical severity. This can help in mounting countermeasures for controlling the outbreak and for developing diagnostics, drugs and vaccines. Since such outbreaks can easily become global pandemics, it is necessary for countries to be prepared not just for the immediate crisis, but also for long-term measures like developing vaccines. This can happen only through scientific collaboration among counties and national regulatory frameworks that facilitate this.

India, which has witnessed outbreaks of Nipah in Kerala in recent past and is vulnerable to similar ones, needs to be ready for collaborative research to develop new medical products to address emerging infections. Given the very regional and international nature of such outbreaks, as well as the need for speedy response, it is critical for national governments and agencies to allow information sharing, data exchange and collaboration among laboratories.

Development of vaccines and diagnostics requires access to virus samples and decoding of their genomic information. Sophisticated facilities are needed for culturing the virus and multiplying the same for vaccine production. Depending on the technical capability of virus laboratories of a country, it may also be necessary sometimes to exchange or share samples. This is a tricky issue because sharing of biological samples is governed by plethora of rules and regulations, and has been a subject of many controversies in the past. At times, security and biosafety concerns also arise because viral material can potentially be misused for bioterrorism purposes.

The issue of research into new viruses has come into focus in the past few days, with the reported disqualification of a university-based virus research centre in Manipal which was handling the Nipah virus for research purposes. Another institute in Bengaluru working with filoviruses (like Ebola) in bats in Nagaland has also been reportedly probed by the Indian Council of Medical Research (ICMR). In both cases, collaborating researchers from top international bodies were involved. The foreign angle seemed to have triggered such action, despite the centres making it clear that all permissions were taken and that no sample went out of the country. Study results have been published in reputed scientific journals, and in one case, the list of authors includes the ICMR Director General and top technical officials of the Ministry of Health and the government’s National Centre for Disease Control.

The national regulatory and security authorities must strike a balance between public health imperatives and biosafety concerns. Paranoia about foreign collaboration should not be allowed to block collaborative research. The advice of technical agencies like the Department of Health Research (DHR), Department of Biotechnology and the ICMR should not be shrugged off by the Ministry of Home Affairs and the security establishment. The Principal Scientific Adviser to the Government of India has said national and international collaboration was necessary for scientific research and aberrations, if any, should be corrected to improve the processes.

If the government feels that India should close itself to international collaboration in disease research, it is committing a grave mistake. Such approach will not only deny research opportunities to Indian scientists, but also affect India’s preparedness to meet public health emergencies. Only a few months back, the ICMR committed itself to the formation of a regional research platform on emerging infectious diseases under the aegis of the WHO. It was specifically to address challenges of conducting research in times of infectious disease outbreaks. Potential drugs and vaccines developed in one country may have to be tested in another, and results of such testing could benefit many countries. Vaccine manufacturers in the private sector, too, have to be involved in such studies.

For instance, a potential therapeutic agent against Nipah and Hendra viruses has been found effective in early phase trials elsewhere. Its samples have been made available to India since India has had outbreaks of Nipah. Should India reject this just because it involves foreign collaboration? Such issues are best handled by the DHR and the ICMR, along with the Drug Controller General of India, and not the MHA. Of course, all ground rules in the form of regulatory procedures, testing protocols, data sharing and patent processes should be enforced, but without delays and bureaucratic hurdles. India also needs to develop urgently a roadmap for research into new and emerging infections, and commit necessary funding for its implementation. Securing humans from new infections is as important as securing our borders.

Join Whatsapp Channel of The Tribune for latest updates.