Monday, February 13, 2012

You really cannot make this up if you tried. They (HHS, DoC, White House) have finally decided that we all need export control licenses to go to Geneva. The DoC and HHS are working feverishly to get them on time before we all (me, Nancy Cox, Paul Keim – representing NSABB) leave for Geneva. The entire process has been ludicrous with regard to the concern over security as well as the craziness of the laws related to export control licenses. Export control was originally designed as a multinational agreement to protect against the shipment of sensitive products such as computer chips, weapons, etc. to countries with whom we (USG) or other countries have a problem with. In this case (uniquely), the export control applies to shipping of information or even being in a room where information (sensitive) is shared. In this case, the information is the H5N1 unredacted manuscripts. I need an export control license (even though I am not taking anything with me) to go to Geneva and I must name on the license everyone who will be at the meeting. I cannot do this since the WHO will not release the names of the attendees until the day of the meeting and so DoC cannot put in for a license for me. OK, we get the names and then Tom Countryman from State has deep concern that we are even going to such a meeting to discuss potentially sensitive information. We calm him down and then the White House (John Brennan and Heidi Avery) do not want Fouchier to discuss the 9 mutations that are capable of giving the ferrets transmission/lethality without the requirement for passage among ferrets (more below on that). They only want him to discuss what is in the unredacted paper (5 mutations + passage). They (through Sally Howard of HHS) want me to call Ron Fouchier to ask him to not mention the 9 mutations and to restrict his discussion to the paper. The discovery of the non-passaged virus’s ability with 9 mutations by reverse genetics to allow transmission/lethality is not contained in the paper. Now here I am (very uncomfortably) asking Ron to voluntarily withhold any information both during the question period and the discussion about the other 4 mutations that together with the original 5 make a wild type H5N1 transmissible/lethal in ferrets without the requirement of passage. Ron reluctantly agreed because he wants the meeting to occur and the White House said that the meeting will be nixed if we discuss the 9 mutations. Here is the irony of this all. The meeting was called by WHO to add “transparency” to the process and to preserve the PIP agreement so that the Indonesians and Vietnamese do not feel that we are withholding information from them and a White House condition for supporting the meeting and allowing me to go is that Ron “withholds” information if asked about the obvious questions that any virologist would ask, i.e. if you took a wild-type H5N1 (cloned) and only inserted the 5 mutations, would it transmit in ferrets – answer = no. Then what did you do? Ron would answer that the virus after 5 mutations (commonly known in the literature) + 12 passages obviously also accumulated other mutations besides the original 5 (3 + 2). Ron then did deep sequencing of the transmissible virus and by reverse genetics figured out that you needed the 5 + an additional 4 (now he says less than 4). This was not in the original manuscript (unredacted). White House does not understand that the 5 mutations + Passage = the unpassaged 9 mutations. They fixate about not mentioning the precise 9 mutations when anyone can just take any quasispecies and get a transmissible virus after many passages. You just need a virus and some ferrets. I again am very uncomfortable in asking Ron to hold back this information and told him that this would be his choice and he would have to play it by ear at the meeting, but he will try his best to be vague about the 9. Another ludicrous happening is that this export control issue must also get input from the iPC (interagency Policy Committee) which includes DoD. The night before I am leaving for Geneva (tomorrow on 5:47 PM flight) DoD says that they want to know when I am leaving since they are not sure that I can go since they want the WHO to disinvite the Chinese (where the disease is occurring) since we (USG) do not share restricted information with them. They fail to realize that Margaret Chan (Director General of WHO) is Chinese!!!!! You cannot make this up. DoD is examining this issue tonight and will let me know tomorrow if I can go to Geneva.