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How human health depends on biodiversity

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By: Lynda Truong

Image by V Perez from Pixabay 

By many measures, the Earth is facing its sixth mass extinction. The fifth mass extinction, a result of a meteorite approximately 10 km in diameter, wiped out the dinosaurs and an estimated 40-75% of species on Earth. This time around, the natural disaster that is threatening life on Earth is us.

In May, the United Nations released a preliminary report on the drastic risk to biodiversity (not to be confused with the recent report on the drastic consequences of climate change).  The assessment, which was compiled by the Intergovernmental Science-policy Platform on Biodiversity and Ecosystem Services (IPBES), draws on information from 15,000 scientific and government sources with contributions from 145 global experts. It projects that one million species face risk of extinction. Scientists have estimated that the historical base level rate of extinction is one per million species per year, and more recent studies suggest rates as low as 0.1 per million species per year. At the established base level rates, it would take one to ten million years to see the same magnitude of extinction the planet currently faces. This accelerated rate of extinction can be linked to a variety of man-made causes, including changes in land and sea use, direct exploitation of organisms, climate change, pollution, and the introduction of invasive species. 

For some, that may not seem important. If humans are not on the endangered species list, why should it matter? As the IPBES Global Assessment indicates however, healthy ecosystems provide a variety of services, including improving air quality, purifying drinking water, and mitigating floods and erosions. The vast canopies of rainforests worldwide sequester 2.6 billion tons of carbon dioxide a year. Plants and soil microbes found in wetlands can remove toxins from water, including explosive chemicals such as nitroglycerin and trinitrotoluene (TNT). Mangrove forests serve as an important buffer against ocean storm surges for those on land. Nature is a powerful resource, and declines in biodiversity have broad implications for global development and health. 

The importance of biodiversity on global health is immediately apparent in middle- and low-income countries, which rely heavily on natural remedies and seasonal harvests for health and nutrition. The loss of entire species of plants can eliminate valuable sources of traditional medicine for indigenous communities. Genetically diverse crops are more resilient to pest and disease, ensuring a stable food supply and bolstering food security. Beyond this, ecosystem disturbances also have complex implications for infectious disease, which are often endemic to developing nations. 

However, these effects are also seen in first world countries. A well cited example for the impact of biodiversity loss on infectious disease involves Lyme disease, which is endemic to parts of the United States. The white footed mouse is a common carrier of Lyme disease, and in areas with high densities of these mice, ticks are likely to feed on the mice and subsequently transmit the disease to humans. However, the presence of other mammals that the tick can feed on dilutes the disease reservoir, lowering the likelihood of an outbreak (commonly referred to as the “dilution effect”). While biodiversity has complicated effects on the spread of infectious diseases, drastic changes to ecosystems often provide a breeding ground for disease vectors and lead to increases in transmission.

In addition to the direct effects of declines in biodiversity have on global health, an often-neglected aspect of its importance for health is as a resource for biomedical science. The IPBES assessment reports that 70% of cancer drugs are natural or inspired by natural sources such as traditional medicines. This merely scratches the surface of the influence of nature on modern biomedical research. 

Much like the communities that rely on natural products as medicine, many drug compounds produced by pharmaceutical companies are derived from nature. Morphine has been one of the most revolutionary drug compounds in history, effectively treating both acute and chronic pain. The compound was originally isolated from the opium poppy, and its chemical structure has since been modified to reduce negative effects and improve potency. While the current opioid crisis in the United States has highlighted the importance of moderate use, morphine and its analogues are some of the most useful and reliable pain relievers in modern medicine. Similarly, aspirin has been regarded as a wonder drug for its analgesic, anti-inflammatory, and cardioprotective effects. Aspirin is a chemical analogue of salicylic acid, a compound originally isolated from willow tree bark. 

Beyond general pain relief, many naturally derived drugs have also been useful for disease treatment. Quinine, the first effective antimalarial drug, was extracted from the bark of cinchona trees, and quinine and its analogues are still used to treat malaria today. Penicillin, serendipitously discovered in a fungus, has been useful for treating bacterial infections and informing modern antibiotic development. These medicines and many more have been crucial to the advancement of human health, yet could have just as easily been lost to extinction.

On a more fundamental level, scientific research has benefited from many proteins isolated from nature. Thermophilic polymerases, isolated from a bacterium residing in hot springs, are now an essential component of polymerase chain reactions (PCR) – a common laboratory technique that amplifies segments of DNA. This method is critical in molecular biology labs for basic research, and forensic labs for criminal investigations.Fluorescent proteins, which have been isolated from jelly fish and sea anemone, revolutionized the field of molecular biology by allowing scientists to visualize dynamic cellular components in real time. More recently, CRISPR/Cas systems were discovered in bacteria and have been developed as a gene editing tool capable of easily and precisely modifying genetic sequences. These basic tools have vastly improved the scope of biomedical research, and all of them would have been close to impossible to develop without their natural sources.

In addition to medicines and tools, nature has often informed biomedical research. Denning bears are commonly studied for potential solutions to osteoporosis and renal disease. Their ability to enter a reduced metabolic state where they do not eat, drink, or defecate for months at a time provides valuable insight into how these biological processes may be adapted to benefit human disease and physiology. Even more interestingly, there are a few species of frogs that become nearly frozen solid in winter, and thaw fully recovered in spring. In this frozen state, much of the water in their body turns to ice, their heart stops beating, and they stop breathing. When temperatures rise, they thaw from the inside out and continue life as per usual. Crazy cryonics and immortality aside, the freeze/thaw cycles could inform improved preservation for organ transplants.

Nature is a much better experimentalist than any human, having had billions of years to refine its experiments through the process of evolution and natural selection. Depleting these living resources, which provide invaluable benefits to human health and ecosystems, lacks foresight and is dangerously reckless. The techno-optimist approach of ceaseless development in the blind belief that whatever problem humanity encounters can be solved with research and innovation neglects to account for the dependency of research and innovation on nature. Most biomedical scientists, most physicians, and much of the general public have probably devoted a minimal amount of consideration to the importance of biodiversity. But for the one million species currently at risk, and for the hundreds of million more yet to be discovered, it’s worth a thought.

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Written by sciencepolicyforall

June 7, 2019 at 9:51 am

How are we welcoming our next generation-The first 1000 golden days?

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By: Deepika Shrestha , Ph.D.

Source: Wikimedia

The most important period for a child’s development, especially for the brain and immune system, is the first 1000 days of life. The Developmental Origins of Health and Disease (DoHAD) hypothesis suggests that the roots of many complex diseases and behavioral risks originate very early – between the time window of pre-conception to early postnatal periods. Indeed, genetic, epigenetic and environmental evidence indicate that most adulthood health and disease risk have been coded during fetal development in the intrauterine environment, lending support for the DoHAD hypothesis

The increased prevalence of an obesogenic environment and rate of chronic diseases in mothers increases the risk of childhood obesity and future cardiometabolic risk in the offspring. Moreover, increased risks can be transgenerational within families. This is also the case for Autism, Attention Deficit Hyperactive Disorder (ADHD), and other mental and psychological disorders. Given that over 50% of all mothers are overweight or obese, there is a growing cause of concern about the quality of fetal growth and development. Further, recent statistics revealed a sobering picture of increased incidence of various maternity-related illnesses such as postpartum depression (CDC Reports: as high as 1 in 5 women) and maternal mortality (CDC MMR 2019 report: 700 deaths per year- out of which relatively 3 in 5 deaths preventable, 31.3% deaths occurred during pregnancy, 16.9% on the day of delivery, and 51.8% over 1 year of post-partum days) in the US. These numbers show that many women in the US are among the most vulnerable and need sufficient support from family, society and governmental policy. There have been successful campaigns to institute policies raising awareness of issues concerning fetus growth, development and maternal/infant nutrition in developing countries, such as Golden 1000 Days. The United States needs similar programs special focusing on maternal care, especially on the nutritional, psychological, mental and financial needs of pregnant mothers and women in reproductive age groups. 

Another program has also been put in place to improve nutrition in mothers and children. The Women, Infant and Child (WIC) program provides supplemental nutritional support to roughly 8 million low-income mothers and young children under 5 years of age. With approximately 6 billion USD of funding in 2016, the current WIC program is the result of an update in 2009 after rigorous review by the Institute of Medicine (IoM) to reflect the latest nutritional science as well as public health concerns. However, recent evidence indicates that food and nutrients supplements through the WIC program might not match the nutritional need of the participants as it fails to account for women’s prepregnancy obesity status, gestational weight gain, and gestational diabetes.  For instance, concentrated fruit juice may increase the risk of gestational diabetes risk and is not a healthy food option. This important policy needs fair re-evaluation based on the updated scientific evidence for nutritional needs.

Another point of concern for expecting mothers is the lack of psychological care. Mothers-to-be undergo extensive physiological and psychological changes during pregnancy. Therefore, this 1000-day window is a sensitive time period —a time where pregnant women require support and potential intervention. Recent data highlight increasing trends of maternity related illnesses, be it postpartum depression or maternal mortality. More importantly, in the US these issues disproportionately affect women of color or low socioeconomic status.  Alarmingly, 42% of mothers  are sole or primary earners and may lack adequate financial support from their spouse and family. The Pregnancy Discrimination Act and Family and Medical Leave (FMLA) act was put in place to protect pregnant women in the job place for 12 weeks after childbirth. However, the United States is one of the few countries in the world with almost no access to paid parental leave—only 14% of civilian workers have access to any amount of paid parental leave in 2016, a slight increase from 11% in 2010

Access to paid parental leave currently serves as elite benefits and is dependent upon company policy. The most generous policies afford 16 weeks for birth mother, 8 weeks for birth father, 8–16 weeks for adoptive parents (16 for primary, 8 for secondary) according to PL+US’s report. About 23% of mothers go to work within 10 days of giving birth and are disproportionately from low-income families.In addition to maternal paid leave, recent mothers often require considerable sick leave for the first year, and providing a flexible policy could be a steppingstone towards helping the psychological as well as physiological health of a child. Furthermore, it is no secret that inspected and reputable day care facilities takes a major chunk of the family income, and are unaffordable to many families.

In addition, there is also a need for Newborn Rights. Irrespective of socioeconomic status, each baby has inborn rights and deserve equal family bonding time and breast-feeding needs. Children born to poor maternal care during pregnancy and lactating period are at increased risk of having neurological problems, poor school achievement, early school dropout, low-skilled employment, and providing poor care to their own children, thus contributing to the intergenerational transmission of poverty and malnutrition. On the contrary, children who get good nutrition and care in their first 1000 days are ten times more likely to overcome life threatening childhood disease, have higher educational retention in schools and are likely to earn more than 21% in wages as adults and also to have healthier families on their own. Therefore, there is an unmet need for a stronger policy that invests in children and their families from the very beginning and helps each child to be a healthy and contributing member of the society in their adulthood. It takes a major process and significant effort to raise a child into a healthy adult who is mentally, spiritually and physically fit to keep going in a productive society.

Paid maternity leave and insurance coverage needs support from Government/Congress to mothers or family unit regardless of the beneficiary’s work status. Investing in this policy may cost taxpayer a small percent of GDP (Gross Domestic Products) but will have a huge return in the long run when Health is valued as development index. There is ample evidence to show that countries that fail to invest in the well-being of women and children in the first 1,000 days lose billions of dollars to lower economic productivity, health issues, societal inequality and higher health costs. This is a main point of concern given that the US is lagging far behind other developed nations in this human development index (HDI). Currently, there is a huge disparity of investment in the first 1000 days based on socioeconomic status, and there is a clear and unmet need for structural and policy intervention. Issues related to the maternity period such as nutritional aspect, mental health, and paid maternity (or paternity) leave should not be considered only a women’s issue. Therefore, more than ever, there is a heightened need for research resources to understand maternity health issues and also concrete plans to address these issues.

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Written by sciencepolicyforall

May 24, 2019 at 2:21 pm

Science Policy Around the Web – April 16, 2019

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By: Mary Weston, PhD

Source: Wikimedia

Astronaut twins study spots subtle genetic changes caused by space travel

In 2015, NASA began their Twins Study, where they evaluated the biological effects of one year of spaceflight on an astronaut by comparing him to his earthbound identical twin. One year after returning to earth, the majority of observed physiological changes from space reverted back to the astronaut’s original state, with only subtle genetic changes remaining. 

Spaceflight exposes the body to ionizing radiation and near-zero gravity, and the consequences of long-term exposure to these conditions are not known. On this mission, Scott Kelly spent 340 days in space from 2015-2016 (he has a lifetime total of 520 space days). His brother Mark, a retired astronaut who had previously spent 54 days in space over four space-shuttle missions, remained on earth and acted as a near identical biological control. The study involved only two people, so not all findings may be applicable to other astronauts, but NASA hopes to use the information to direct future astronaut health studies.

Teams of researchers gathered a wide array of genomic, molecular, physiological, and other data on the men before, during, and after the mission. They reported that Scott Kelly did display signs of stress from space travel, with changes seen in most areas measured. 

However, now researchers are finding that most of the changes Scott Kelly experienced from spaceflight have reverted back to their original state after 6 months of being back on earth. NASA argues that “the Twins Study demonstrated the resilience and robustness of how a human body can adapt to a multitude of changes induced by the spaceflight environment”.

One genetic change that did persist six months after Scott’s return was to his chromosomes. Parts of them inverted (flipped), which could lead to DNA damage, and is possibly due to the large amounts of space radiation. Further, researchers hypothesized that space flight would shorten telomers, important caps at the end of chromosomes, since they decrease with age and spaceflight is expected to stress the body similar to aging. However, a majority of his telomers lengthened while Scott Kelly was in space, while only few shortened. Those that lengthened returned to their normal state after about 48hrs on earth, but the shortened ones remained. 

Given the space community’s interest in increasingly ambitious space missions and plans to explore Mars, studies exploring the long-term health impacts of spaceflight will be extremely important for the future.

(Alexandra Witze, Nature


Abnormal Levels of a Protein Linked to C.T.E. Found in N.F.L. Players’ Brains, Study Shows

Last week, the New England Journal of Medicine published a study that used experimental brain scans to compare the levels and distribution of tau, a protein linked to chronic traumatic encephalopathy (CTE), in retired NFL players and male controls who had never played football. They found that the NFL players had elevated levels of tau in areas where the protein had previously been detected postmortem. 

CTE is associated with repetitive hits to the head, like those encountered during contact/collision sports. Currently, pathologists can only posthumously diagnose CTE. This new study is the first to evaluate tau averages and overall patterns from a group of living former football players (26 men) with a control group (31 men). The project, led by Dr. Robert Stern of Boston University, used Positron Emission Tomography (PET) scans to image the brain after exposure to a radiolabeled substrate that specifically binds tau. 

Both the study’s authors and outside experts emphasize that a CTE diagnostic test is still far from ready and would likely include other markers from blood and spinal fluid as well.  However, this study represents a preliminary, first step towards developing a clinical test to detect CTE in living players, which may also ultimately assist in identifying early disease signs and those with potential risk of developing CTE. 

The relationship between CTE symptoms and the role of tau, which occurs naturally in the brain, is not clear. The study found no correlation between the amount of abnormal tau and the severity of cognitive and mood problems in the players. However, these results are preliminary and the player sample size was small. Evaluation of larger sample size of football players is needed to continue to explore the role of tau and replicate the observed elevated levels found in this paper. 

(Ken Belson and Benedict Carey, New York Times


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Written by sciencepolicyforall

April 17, 2019 at 9:34 am

Intellectual property theft and its effects on US-China trade relations

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By: Neetu Gulati, Ph.D.

Source:Wikimedia

China and the US are currently in the midst of a trade war that, if not resolved my March 1, 2019, will lead to another increase in tariffs by the US. This trade war, which started over the US accusing China of stealing intellectual property from American companies, has already affected the economy of the two countries and could have global effects. The US has evidence that information including biomedical research breakthroughs, technological advances, and food product formulations have been stolen. In response to these illicit trade practices, the US imposed tariffs on Chinese imports, leading to the beginning of the trade war.

So how did we get here? 2019 marks forty years of diplomatic relations between the United States and China, which officially began on January 1, 1979. Since relations began, the two countries have benefited from ongoing trade, and China has become the largest goods trading partner with the US. Bilateral economic relations have increased from $33 billion in 1992 to over $772 billion in goods and services in 2017.  Despite strong economic ties, relations between the two countries have come under strain in recent years. The US State Department has identified concerns over military conflict in the South China Sea, counter-intelligence and security issues, and the trade deficit, among other issues. These issues came to a head in April 2018 when President Donald J. Trump issued a statement that China had stolen America’s intellectual property and engaged in illegal trade practices. In response, the US imposed additional tariffs on approximately $50 billion worth of Chinese imports. China then countered with tariffs on US imports, and thus a trade war between the two countries began.

To understand how intellectual property, or IP, fits into the trade war, it is important to first understand what it is. According to the World Intellectual Property Organization, IP “refers to creations of the mind, such as inventions; literary and artistic works; designs; and symbols, names and images used in commerce.” More simply, IP is something created or invented through human intellect, but not necessarily a tangible product. These products often have important scientific implications, as the umbrella of IP can cover genetically engineered crops, newly developed technologies and software, and new therapeutics, just to name a few. IP is legally protected through means such as patents, trademarks, and copyright, which allow people to gain recognition and financial benefits from their creations. These protections are country-specific, and the US Patent and Trademark Office gives guidance about protecting IP overseas, including in China. The process of transferring IP from the creator to another entity, often for distribution purposes, is known as technology transfer. This process is at the heart of the accusation of theft of American IP.

According to a seven-month long investigation done by the United States Trade Representative (USTR), China’s unreasonable technology transfer policies meant they did not live up to the commitments made when joining the World Trade Organization. The report found that Chinese laws require foreign companies to create joint ventures with domestic Chinese companies in order to sell goods within the country. The investigation by USTR found that “China’s regulatory authorities do not allow U.S. companies to make their own decisions about technology transfer and the assignment or licensing of intellectual property rights.  Instead, they continue to require or pressure foreign companies to transfer technology as a condition for securing investment or other approvals.” By pushing for technology transfer, these laws opened up American companies to theft of their IP. Stolen IP has included things like software code for a wind turbine, genetically modified corn seeds, the idea behind a robot named Tappy, and even the formulation for the chemical that makes Oreo filling white.

Beyond stealing information for goods entering China, it is also possible that Chinese workers in the United States may be stealing IP and sending it back to their home country. For example, a Chinese scientist known as ‘China’s Elon Musk’ was accused by his former research advisor of stealing research done at Duke University and replicating it in China for his own gain. A former assistant director of counterintelligence at the FBI suspects that the Chinese scientist was sent by the Chinese government intentionally to steal IP. This was not an isolated incident, either. According to a report from an advisory committee to the National Institutes of Health (NIH), research institutions in the US may have fallen victim to a small number of foreign researchers associated with China’s “Talents Recruitment Program,” which the National Intelligence Council identified as an effort to “to facilitate the legal and illicit transfer of US technology, intellectual property and know-how.” This comes mere months after the NIH announced that it had identified undisclosed financial conflicts between US researchers and foreign governments. Without giving details of specific countries, NIH Director Francis Collins reported to a Senate Committee hearing that “the robustness of the biomedical research enterprise is under constant threat.” Nevertheless, these threats should not hinder the research enterprise. During a hearing in April 2018, House Science Committee Chair Lamar Smith remarked, “on the one hand, we must maintain the open and collaborative nature of academic research and development. On the other, we must protect our research and development from actors who seek to do us harm.”

The balance between research collaboration and theft is delicate. Information sharing is increasingly necessary as scientific pursuits become more interdisciplinary in nature, and can lead to more productivity in research. However, voluntary collaboration is different from unwilling or coerced transfer of ideas. The ability of US scientists and entrepreneurs to innovate and create new IP is an important driver of the American economy, and further allows for the ability to research new scientific pursuits. Not only does IP theft undermine the incentive and ability for Americans to innovate, it has had drastic negative effects on the American economy, with annual losses estimated to be between $225 billion and $600 billion according to a report put out by the IP Commission. These losses directly affect those who own and/or license IP, as well as those who are associated with these companies or individuals. This can then lead to downsizing or cutting jobs, further harming American science and technology industries. It is for this reason that the US responded so strongly against the evidence of IP theft.

In response to the accusations from the US, Chinese President Xi Jinping promised to resolve the “reasonable concerns” of the US regarding IP practices. The Chinese government announced punishments that could restrict Chinese companies from state funding support due to IP theft and at the G20 Summit in December 2018, the Presidents of the two nations agreed to a 90-day financial truce, which will end March 1, 2019. 

The two countries are currently working on a trade deal to end the escalating tariffs, which would lessen tensions between the world’s two largest economies. The US wants China to commit to buying more American goods and services, and to agree to end the practice of requiring American companies to give technology transfers in order to do business in China. Without hashing out details, China has agreed to increase imports of U.S. agriculture, energy, industrial products and services. Delegations from the two countries will meet again in mid-February in China to continue negotiating. Trump was optimistic that the two nations would be able to make a deal before the deadline, saying, “I believe that a lot of the biggest points are going to be agreed to by me and him.”  

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Written by sciencepolicyforall

February 7, 2019 at 9:39 pm

Science Policy Around the Web – January 25, 2019

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By: Allison Dennis B.S.

Source: Pixabay

A safe prenatal genetic test is gaining popularity with young moms-to-be and their doctors

The DNA sequencing revolution is giving pregnant women and their doctors an earlier-than-ever-before glimpse into the health of the fetus as it develops. Marketed as the “noninvasive prenatal test” (NIPT), the diagnostic examines small fragments of fetal DNA derived from a blood sample provided by the mother for genetic abnormalities. Small amounts of fetal DNA are released as cells making up the placenta are turned over. This cell-free DNA enters the mother’s blood stream, where it can be accurately detected by NIPT in as early as 10 weeks. By measuring the amounts of DNA derived from each chromosome, the tests can screenfor Down syndrome and other chromosomal abnormalities including Edwards Syndrome and Patau syndrome. The test poses no risk to the fetus, and is highly regarded by OB/GYNs as a highly effective diagnostic tool. It is much less risky and invasive while being more accurate compared to amniocentesis and chorionic villus sampling, which was the previous standard of care for high-risk pregnancies. 

Most U.S. insurance plans only cover the test for mothers older than 35, whose pregnancies are at elevated risk for genetic abnormalities. Yet many younger mothers and their doctors are embracing the diagnostic. Because NIPT also offers the earliest chance for parents to determine the sex of their baby, some OB/GYNs are worried that parents may pursue the test without wanting or understanding the full implications of the results provided. Following a NIPT result indicating an abnormality a more invasive method will be recommended to confirm the diagnosis. Medical professionals and genetic counselors are working together to learn how to best help patients understand complex genetic information so they can make informed decisions regarding their care and not be blindsided by unexpected results.

(Sarah Elizabeth Richards, The Washington Post)

Science with borders: A debate over genetic sequences and national rights threatens to inhibit research

The Nagoya Protocol was adopted in 2010 as part of the United Nations Convention on Biodiversity to undercut the threat of biopiracy by giving countries an express right to any assets derived from the use of biological and genetic materials naturally occurring within their borders. The U.S. did not attend the Convention, but it is subject to following the established standards when interacting with countries who have ratified the protocol. Currently under the protocol, a donor country must certify their permission for an international researcher to take possession of a genetic resource. Prior to the outside party gaining access, both parties agree to the extent of benefit-sharing arising from genetic resource. 

Debate has arisen over the interpretation of the the agreement, specifically whether the sharing the genetic sequences derived from pathogens, the strings of letters that represent their genomes, require the same burden of documentation as the pathogens themselves. Researchers have expressed concern that including sequences under the regulations of this international treaty may hinder disease surveillance and international collaborations. Yet many understand that proteins can be synthesized following the instructions held in the genetic sequences, narrowing the gap between knowing a pathogen’s sequence and producing the physical components characteristic of that pathogen. As it stands, whether genetic sequences must be certified before they are shared is up to the donor country. 

Concern arising from the ambiguity surrounding digital genetic sequences sparked the WHO to draft of a Code of Conduct to guarantee the “open and timely sharing of pathogen genetic sequence data during outbreaks of infectious disease.” As pathogens emerge, it is often necessary to rapidly disseminate genetic data to characterize and track the spread of a particular disease strain. Experts must often work across borders to develop vaccines that match the relevant threat. In the spirit of benefit-sharing, the code requires scientists who obtain sequence data during outbreak situations to collaborate with the scientists who generated the sequence data when possible and acknowledge their contributions upon publication.

At the United Nations Biodiversity Conference held in November 2018, it was agreed that an Ad HocTechnical Expert Group would continue to consider the implications of the protocol on digital sequence information. Hopefully, clarity will be offered on the subject and any changes be adopted at the 2020 United Nations Biodiversity Conference. 

(Helen Branswell, STATNews)

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January 25, 2019 at 5:00 pm

Saving the Chesapeake Bay – Home to 18 million people

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By: Hsiao Yu Fang, Ph.D.

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Source: Flickr

The Chesapeake Bay is the largest U.S. estuary, where freshwater from rivers and streams flows into the ocean and mixes with seawater, making it a rich environment with abundant wildlife. Every year, the Bay produces 500 million pounds of seafood. The entire Chesapeake Bay watershed, which includes six states (New York, Pennsylvania, Maryland, Virginia, West Virginia, and Delaware) and the District of Columbia, is home to 3,600 species of plants and animals and more than 18 million people. Importantly, the actions of these 18 million people directly affect the health of the Bay. To quote the movie Finding Nemo, “All drains lead to the ocean.” Due to the combination of water-born nutrient pollution that comes from human-produced waste and runoff from cities and farms, the Bay has been listed on the country’s “impaired waters” list for decades. Thankfully, recent policy measures to regulate the environmental impact of human activity on the Bay have shown profoundly promising results that with further efforts could fully restore the health of the Bay.

At one point, the conditions of the Chesapeake Bay seemed almost irreversible. Years of population growth and pollution led to a significant decline in animal species, affecting commercial and recreational fishing as well as tourism. Scientists have shown that about one-third of the nitrogen in the Chesapeake comes from air pollution. Pollution in the air emitted from power plants and vehicles is carried over long distances via weather conditions and eventually deposits into the Bay’s waters. As air pollution can travel thousands of miles, the region over which air pollutants are capable of impacting the Bay is known as the airshed; this area is about nine times as large as the Bay watershed. Excess nitrogen and phosphorus pollution in the Chesapeake cause a biological chain reaction that results in “dead zones” – areas with minimal amounts of oxygen. This phenomenon worsens in the summer, when heat and pollution fuel algae blooms, blocking sunlight and depleting life-sustaining oxygen underwater. Aquatic life including fish, crabs, and oysters suffocate in these areas of the Bay affected by dead zones. The Bay used to yield tens of millions of bushels of oysters. Today the annual catch has fallen to less than one percent of historic records.

There have been several attempts through the years to restore the Bay. The Clean Water Act of 1972 reduced industrial pollution to the Bay, though it fell short of its promises of transforming the Bay into “fishable, swimmable” waters. In 1984, the six states within the Bay watershed embarked on another cleanup plan, which again failed to show lasting improvements. In 2010, the Chesapeake Clean Water Blueprint was established, which is the largest water cleanup plan ever managed by the US government. Using the powers granted by the Clean Water Act, the Environmental Protection Agency (EPA) issued new pollution limits for nitrogen, phosphorus, and sediment feeding into the Bay. Subsequently, the six Bay states and the District of Columbia announced formal plans to meet the EPA limits by 2025. What makes the Blueprint unique compared to previous failed attempts is that it will impose penalties on states that fail to act.  Each state is required to reach two-year incremental milestones of pollution reduction. Ideally, once the Blueprint fully achieves its goals, the Bay should no longer be on the impaired waters list.

Almost a decade has passed since the restoration efforts of the Chesapeake Clean Water Blueprint began, and already the Bay shows the potential for becoming a transformative environmental success story. Today, the Bay appears more resilient and capable of adapting to excess pollution loads. Recent studies have shown that the Bay is beginning to replenish oxygen in its waters; repairing what were once underwater dead zones. The Chesapeake Bay Foundation’s (CBF) 2018 State of the Bay Report’s Habitat Indicator Scores show that the resilience of the Bay, quantified as the growth of underwater grasses and resource lands, is slowly increasing from their 2016 levels, despite the record-breaking summer storms of 2018.

While progress has been made in restoring the Bay, more is needed. Bipartisan support from the federal government and from federal-state collaborations is essential to the Bay’s further recovery. The Bay’s overall health remains fragile and additional improvement is not assured. In fact, CBF’s2018 State of the Bay Report released this month showed a decline in the Bay’s health for the first time in a decade. This was due to extreme storm-related weather conditions in 2018 that carried high concentrations of nitrogen, phosphorus, and debris into the Bay.

The Chesapeake Bay’s health has vital impacts on people’s health, jobs, and access to clean drinking water. The forests in the Bay watershed produce safe, filtered drinking water for 75 percent of the watershed’s residents, which is nearly 13 million people. If more action is not taken now, the future cost of inaction will be more dire and expensive than current restoration efforts. The Chesapeake Clean Water Blueprint might be the best and last chance to restore the Bay. Simple, individual actions like conserving water and energy in our daily activities, volunteering in stream and river cleanups, and contacting local representatives and advocating for the importance of protecting the Bay can also go a long way towards contributing to the well-being of the Bay. “Treasure the Chesapeake” is not just a slogan on a license plate – these words underlie a great environmental recovery project, as well as a potential model for water pollution clean-up projects around the world.

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January 23, 2019 at 3:54 pm

Conspiracy Theories and Ebola: How a US Federally Funded Research Facility in the Heart of Sierra Leone’s Ebola Outbreak Acerbated Local Misconceptions about Ebola

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By: Caroline Duncombe

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An inherent distrust follows what one does not understand; scientific endeavors if not explained properly are easily misunderstood. From climate skeptics to CERN’s 666 logo, the world is wrought with conspiracy theories surrounding science. The role of conspiracies should not be underestimated or neglected, especially since such theories are interspersed with layers of truth. Usually conspiracies reside harmlessly on the edge of the web, but during the Ebola outbreak in Sierra Leone an unaddressed rumor resulted in fatal consequences. Rumors revolving around a Tulane University research facility located in Kenema Government Hospital prompted a breakdown in relations between the local populations and international health care workers. This mistrust led to the refusal to permit blood draws for diagnostic purposes during the critical initial stages of the Ebola outbreak. By underestimating the importance of cultural and religious symbolism surrounding scientific research U.S. federal funding agencies, laboratory researchers, and private companies made a crucial mistake. By analyzing this curious conspiracy theory, scientists, funding agencies, and health practitioners can learn from past mistakes and become more aware of the impact of research beyond pure scientific pursuit.

Background

            On May 24th, 2014,a young woman miscarried in Kenema Government Hospital. Given the recent outbreak in nearby Gueckedou, Guinea, Ebola was suspected. A day later, the same hospital reported the first confirmed case of Ebola in Sierra Leone. Soon after, Kenema became a hot zone – the entry point for the Ebola virus to spread throughout Sierra Leone and eventually the world. The repercussions of the Ebola outbreak extend well beyond the 11,310 death count in West Africa to economic, social, medical, and cultural spheres.

The Kenema Government Hospital was not a typical Sierra Leonian public hospital. In fact, the hospital was well-equipped, with the only Lassa fever isolation ward anywhere in the world. The lab dated to 2005, when Tulane University received a $10 million grant from the U.S. National Institutes of Health to study “Diagnostics for Biodefense against Lassa fever”. Since previous investigations of sporadic Lassa fever outbreaks were based out of Kenema, the natural choice for the establishment of first-rate laboratory infrastructure was Kenema Government Hospital.

As the years passed, the Tulane research laboratory acquired more grants and partnerships. One of the principal collaborators was the private for-profit company, Metabiota, which received grants from two U.S. Department of Defense (DoD) agencies – Defense Threat Reduction Agency and Biological Engagement Program – to primarily study the pathogenesis of Lassa fever, a ‘US bioterror threat’. Due to stipulations in NIH grant funding, the substantial amount of money flowing into this “shiny new” research laboratory could not be applied to assisting patients in the “dilapidated, cramped, and poorly resourced Lassa ward only some 50m away” (Bausch). During the Ebola outbreak, the Lassa laboratory’s focus shifted to Ebola, continuing research until the NIH did not renew funding in 2014, primarily due to safety reasons.

The Conspiracy Theory

Following the 2014 outbreak, a conspiracy theory circulating throughout Sierra Leone, essentially claiming that the U.S. created Ebola, or a Lassa-Ebola hybrid, and either intentionally or accidentally released this bioterror weapon from the U.S. NIH and DoD-funded research facility at Kenema Government Hospital. While such a rumor lacked credible evidence, there were specific circumstances surrounding the policies of the research outpost that fed into the narrative – truths that should have been addressed through culturally sensitive policies.

Four main factors converged into a superstitious and suspicious narrative about the Lassa research laboratory. First, by branding the Lassa research facility with a bioterrorism component, the project assisted in drawing out a natural conclusion that bioterror weapons were also present in the laboratory. Tulane University’s initial grant application in 2005 framed Lassa virus as a US biosecurity threat through key words such as “Diagnostics for Biodefense” and “LASV as a biological weapon directed against civilian or military targets necessitates development of… diagnostics.” The framing of the diagnostic development laboratory in terms of a biodefense strategy against the NIAID Category A classification was not an accident, but rather a necessity to gain funding. As Annie Wilkins puts it “whether the prospect of weaponization is regarded as sensationalism or a real concern, all researchers are aware of the utility the bioweapons threat has in obtaining funding.” By emphasizing biodefense and collaborating with the U.S. DoD via Metabiota’s funding stream, a natural linkage between the work of the research outpost and bioweapons developed.

The second factor was out of the control of Tulane University: A suspicious coincidence. Due to its proximity to Guinea, laboratory capacity, and fluidity in movement across the Sierra Leone-Guinea border, the first confirmed case of Ebola in Sierra Leone occurred in Kenema Government Hospital. Although there potentially were other cases of Ebola in Sierra Leone, none of the primary health care clinics in the area had the laboratory capacity to officially diagnose Ebola. A natural speculation ensued: what are the chances that the one Biodefense laboratory in Sierra Leone, where the hemorrhagic Lassa fever virus was located, was also the site of the first confirmed case of a “new” bioterror threat that also causes hemorrhagic fever, Ebola? Money draws attention, and the money flowing into this singular laboratory was substantial when compared with other public hospitals in Sierra Leone. For reference, the Sierra Leone Ministry of Health and Sanitation allocated U.S. $20 million budget to run the entire national health system in 2009.

Third, a nurse from Kenema Government Hospital claimed to an audience at a fish market that “the deadly [Ebola] virus was invented to conceal “cannibalistic rituals”. The statement and an already distrustful community culminated into a riot at the hospital on July 25th, 2014. Such a case further cemented the people’s suspicions that the laboratory was “stealing” the blood of Sierra Leonians. Even though collecting blood is necessary for diagnostic tests, there are many deeply held cultural beliefs about blood in Sierra Leone, and many people are reluctant to participate in blood test as a result.

Fourth, the research facility suspiciously and suddenly shut down right at the beginning of the outbreak without much explanation to the community. Additionally, many of the Sierra Leonian staff who could have addressed the suspicions about the facility pre-outbreak have since died while bravely combatting Ebola. All of these factors accumulated into the conspiracy theory that actors involved with the bio-defense grant and the US government created a bioterror weapon and unleashed it on West Africa.

Policy Considerations

The accumulation of these factors demonstrate the importance of cultural sensitivity and awareness when implementing scientific research policies. In 2018, Tulane University and a variety of partners received a new $15 million federally funded grant to study how Ebola and Lassa survivors fought off the diseases. Hopefully, the researchers are opening this facility with a new awareness and increased precautions on the spiritual and social baggage they bring to Kenema. This is especially important when considering the potential for further stigmatization of Ebola survivors if called to Kenema Government Hospital for research or treatment purposes.

There are several policy considerations that could alter the course of this conspiracy and help acclimate the community to both the presence of a well-equipped laboratory and blood draws for diagnostic purposes. Research institutions should refrain from using vocabulary such as “biodefense” and “bioweapon” to describe the purpose of research. A clinician in the Lassa ward pointed out that “The average Sierra Leonian won’t see Lassa Fever as a bioweapon threat. Only in the Western world do they see it like that.” Since the potential for contracting Lassa and Ebola is an everyday reality for Sierra Leonians, research initiatives on such diseases should be spoken about in terms of their potential for public health. Additionally, universities seeking to do medical research should consider the cultural significance of their location, and contemplate ways, including shifting location, that might reduce any negative connotations. Engaging influential spiritual leaders in productive information partnerships could also assist in assuaging local concerns.

Policy considerations should also be contemplated by grant funding institutions like the NIH and DoD. First, grant stipulations should integrate a layer of flexibility for distributing certain supplies and resources for patient care. Second, the NIH and DoD should be cognizant of their bias in funding grants that are written in terms of biodefense interests of the US, especially when related to countries where such a ‘bioweapon’ is an everyday reality. This is especially important because such bias incentivizes deleterious narratives that invokes cultural, social, and medical consequences.  Lack of funding for neglected infectious diseases that only burden developing countries by the US is a complex and important issue that will require deep structural changes – and would require another blog post to contemplate. Yet, a simple solution would be to require scientific grant applications to contain a section in which the applicant considers the cultural and social impact of the work within the community of interest. In addition, community outreach with intentional dialogue on assuaging concerns about sensitive research activities should made be mandatory.

The conspiracy theory exacerbated the already high level of mistrust in Western interventions during the outbreak. As the Washington Post emphasizes, the lesson from this case study is “that winning the trust of communities at risk is absolutely indispensable to limiting the impact of the inevitable next Ebola epidemic in West Africa.” Hopefully, the Tulane University research center in Kenema Government Hospital has learned from past mistakes, and seeks to engage the community and douse suspicions against their research upon re-opening the laboratory this year. Conspiracy theories usually integrate truth with speculation. The traditional method of ignoring such theories or flat out denying (as was the case with Tulane University) may have detrimental consequences as seen during the Ebola outbreak in Sierra Leone. The power in a conspiracy theory is not necessarily its truth, but it’s power to persuade people that it is true. And as scientists who are often focused on the facts, we often have a hard time understanding that concept. When doing research, it is crucial to be cognizant of the social perception of science and attempt to build bridges between gaps of understanding on cultural practices and scientific endeavors.

 

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Written by sciencepolicyforall

January 17, 2019 at 6:34 pm