Tuesday, 20 December 2011

To publish or not publish man-made 'super flu' articles

From Laurie Garrett, Council on Foreign Relations

December 20, 2011

Dear Friends and Colleagues,

Today, December 20, 2011, the National Science Advisory Board for Biosecurity (NSABB) released its decision regarding publication of two scientific papers claiming to have made a “super-flu” variant of the H5N1 avian virus. Two research teams, from the Netherlands and Wisconsin, separately claimed in September to have man-made genetic variants of the widely circulating H5N1 virus, rendering the flu not only transmissible man-to-man, but also more than 50 percent lethal.

As I described last week, the research sparked a range of fears, including concern that what amounts to the most dangerous human pathogen ever known to have existed could escape its laboratory confines, with disastrous repercussions; that publication of the “how-to” aspects of the experiments could constitute handing a catastrophe cookbook to terrorists or malevolent individuals; and that recent proliferation in high security biology labs worldwide has increased the risk of both lab accidents and untraceable bioterrorism research.

The NSABB faced three basic options regarding publication of papers by Ron Fouchier of Erasmus University in Rotterdam and Yoshi Kawaoke of the University of Wisconsin in Madison:
1)      Advise all credible scientific publications to decline release of the papers, essentially censoring the work;
2)      Allow full and free publication of both papers;
3)      Advise publication, but with key passages related to how the feats were performed, deleted.

The NSABB essentially opted for number three, suggesting to ScienceNature, and other major journals that they agree to publish the two studies, but omit some of the materials and methods sections, allowing scientists to know what was done, but not how:

Due to the importance of the findings to the public health and research communities, the NSABB recommended that the general conclusions highlighting the novel outcome be published, but that the manuscripts not include the methodological and other details that could enable replication of the experiments by those who would seek to do harm. The NSABB also recommended that language be added to the manuscripts to explain better the goals and potential public health benefits of the research, and to detail the extensive safety and security measures taken to protect laboratory workers and the public.

The U.S. Department of Health and Human Services released a statement today, responding to the NSABB (which technically is an advisory board to the HHS):

The NSABB recommended that the general conclusions highlighting the novel outcome be published, but that the manuscripts not include the methodological and other details that could enable replication of the experiments by those who would seek to do harm.
The NSABB also recommended that language be added to the manuscripts to explain better the goals and potential public health benefits of the research, and to detail the extensive safety and security measures taken to protect laboratory workers and the public.
HHS agreed with this assessment and provided these non-binding recommendations to the authors and journal editors.
One of the journals likely to publish the research is Science magazine. Science Editor-in-Chief Dr. Bruce Alberts issued a statement today:

Science editors will be evaluating how best to proceed. Our response will be heavily dependent upon the further steps taken by the U.S. government to set forth a written, transparent plan to ensure that any  information that is omitted from the publication will be provided to all those responsible scientists who request it, as part of their legitimate efforts to improve public health and safety.
The British journal Nature is also likely to publish one or both papers, and today its Editor-in-Chief Philip Campbell said:
We have noted the unprecedented NSABB recommendations that would restrict public access to data and methods and recognize the motivation behind them. It is essential for public health that the full details of any scientific analysis of flu viruses be available to researchers. We are discussing with interested parties how, within the scenario recommended by NSABB, appropriate access to the scientific methods and data could be enabled.
Where does this leave us? The papers will be published, and smart scientists working in virology or allied professions will read between the lines, reckoning exactly how the super-flus were created. The University of Wisconsin released a statement this week insisting that Kawaoke has not made a “super-flu” and welcoming the opportunity to clear the air on his research. Rotterdam’s Fouchier, however, has made a form of bird flu that is readily transmitted airborne between mammals (presumably including humans) with a lethality of about 60 percent: the work will be eagerly digested by scientists all over the world.
The NSABB decision will satisfy almost nobody. Advocates for scientific openness will bristle at any censorship, whether it involve a few sentences or an entire article. Conversely, those that fear bioterrorist use of such information will scoff at the notion that deleting a few paragraphs of methodology will in any way deter dedicated miscreants.
In the end the most important, and alarming aspect of this tale is that human beings were able to turn a fairly harmless (to mammals) virus into possibly the worst microbe to have ever co-existed with our species, and did so inside academic facilities. There was considerable debate inside the NSABB regarding whether it should recommend that all future work on the virus be conducted exclusively inside BioSafety-Level 4 (BSL-4) labs, the highest security facilities – significantly more stringent environs than those in which Fouchier and Kawaoke’s teams toil. It seems the Board punted, avoiding the question.
It is now up to federal authorities in the U.S., Netherlands, and elsewhere to decide whether to sequester the deadly microbes, and experiments conducted on them, inside BSL-4 confines.
Laurie Garrett
Senior Fellow for Global Health

Thursday, 15 December 2011



ESRC Studentships for September 2012 are available at King’s College London, in the thematic area of health policy, effectiveness and evaluation (HPE) (http://www.kcl.ac.uk/study/pg/school/DoctoralTrainingCentres/KISS-DTC/KISS-DTCHealth.aspx) .

HPE is part of the King’s Interdisciplinary Social Science Doctoral Training Centre (KISS-DTC), and it encompasses three broad pathways:

 *   Health care effectiveness
 *   Health policy
 *   Health economics

You can either apply to one or other of these areas, or you can apply with a project that works across them. You should have very good qualifications and a clear research idea, and to apply, there are a number of steps to follow:

1) Identify a potential supervisor (discuss your project with admissions tutors, academic staff etc. in the relevant school/department if don't already have a specific person in mind).

2)  Email the person you have identified, providing detailed information about your background, your qualifications, prior research methods training, and a research proposal.  If after a very careful look, you are unsure about who to contact, please send the material to me at anita.patel@kcl.ac.uk writing ‘ESRC Studentship’ in the Subject.

3)  If the person you have contacted encourages you, follow the application procedures outlined at www.kcl.ac.uk/study/pg/funding/sources/esrc.aspx.  Check your eligibility very carefully, and confer with your potential supervisor if you’re unclear whether your project qualifies for funding from the ESRC.

4)  As well as writing your studentship application – the ‘Case for Support’ – you need to apply for an ordinary/non-funded doctoral place through the online admissions portal: https://myapplication.kcl.ac.uk/.  You’ll need to include a research proposal in the ordinary application, but do note the difference between this and the Studentship Case for Support.  The CfS form asks specific questions and you can’t use more than 2 sides of A4.

5)  The closing date for the ESRC Studentship applications is Wednesday 1 February 2012, 17.00hrs.  If you’re encouraged to apply, start working on the forms well before this deadline. You will also need to contact your referees well in advance, to ensure that they have submitted their references by the deadline.

For general queries related to studentships and doctoral places, please see the KCL graduate school website: http://www.kcl.ac.uk/study/pg/school/index.aspx.

Best wishes
Anita Patel
HPE Theme Leader, KISS-DTC

Thursday, 8 December 2011

King's College London more than 6 fully funded PhD positions in philosophy

SIX fully-funded PhD positions in Philosophy at King's College London

- The Department of Philosophy at King's College London is delighted to
announce SIX KCL - AHRC studentships for UK/EU students in philosophy for

- Candidates may also apply for the following:
* Medieval Studies KCL Graduate School studentship (to include Medieval
philosophy) UK/EU only.
* International PhD doctoral award - for applicants applying to study
jointly with a King's partner institution (National University of Singapore,
Hong Kong University, Humboldt University (Berlin) or Stuttgart University,
or where they have an agreed secondary supervisor at our other strategic
partner institution, the University of North Carolina (Chapel Hill).)
       > http://www.kcl.ac.uk/artshums/study/Funding/gradfund.aspx

* Further studentships are available (UK, EU and international/overseas) via
the KCL Graduate School:
    > http://www.kcl.ac.uk/study/pg/funding/sources/pgr.aspx

The deadline for applications for these awards -for both, programmes and
funding-  is February 1st 2012: all application materials must be received
by this date.

*  In addition, the Department of Philosophy has funds available, up to
£12,000 annually, to assist graduate students in the Department:

How to apply
Full details of how to apply can be found via the above links, and the
Department of Philosophy website:
       > http://www.kcl.ac.uk/artshums/depts/philosophy/study/pgr/index.aspx

* Contact the Centre for Arts & Sciences Admissions at King's:
* Contact the Department of Philosophy via: philosophy@kcl.ac.uk

Messages to the list are archived at http://listserv.liv.ac.uk/archives/philos-l.html.

Discussions should be moved to chora: enrol via

Other philosophical resources on the Web can be found at http://www.liv.ac.uk/pal.

OECD Report: Divided We Stand: Why Inequality Keeps Rising

For full report, link below.

In the three decades prior to the recent economic downturn, wage gaps widened and household income inequality increased in a large majority of OECD countries. This occurred even when countries were going through a period of sustained economic and employment growth. This report analyses the major underlying forces behind these developments:
- An Overview of Growing Income Inequalities in OECD Countries (free .pdf)
- Special Focus: Inequality in Emerging Economies (free .pdf)
- Part I. How Globalisation, Technological Change and Policies Affect Wage and Earnings Inequalities
- Part II. How Inequalities in Labour Earnings Lead to Inequalities in Household Disposable Income
- Part III. How the Roles of Tax and Transfer Systems Have Changed

Saturday, 3 December 2011

Global Fund cancels next round of grants..



November 30, 2011 4:42 pm

Global Fund: reform needed to regain credibility

The Global Fund to Fight Aids, Tuberculosis and Malaria, one of the major funders for HIV/Aids programmes around the world, is facing an unprecedented moment of crisis as it announced last week that it has run out of funding to pay for new grant programmes for the next two years.
Tight economic conditions and recent reports of fraud, theft and corruption among its grantees set the stage for this dramatic decision by its board on November 23 – a decision that is likely to impact poor Aids patients around the world. Recovering from this setback and continuing to pursue its ambitious mission will require bold action by the Fund and significant shifts in what it requires from grant recipients, how it tracks progress and how it ensures accountability for results.

A decade after its founding, the Fund is the largest financier in the fight against these three killer epidemics and has not only saved millions of lives directly through its grants but has shifted market dynamics for antiretroviral medications (ARVs) in ways that make treatment more affordable in the long run. As it now seeks to right its course, it has already taken important steps to chart a new course with an emphasis on accountability, efficiency and additionality – i.e., ensuring that its funding doesn’t displace existing financial resources.
Earlier in October a high-level independent review panel on fiduciary controls and oversight mechanism (HLP) had recommended major changes to the accountability structures at the Fund. The panel’s recommendations, most of which have been adopted by the Fund, were centred on shifting it to focus on outcomes instead of inputs, instituting tiers of grant requirements, and creating better accountability structures within the Fund by repurposing committees, empowering middle managers, and adding positions with an explicit focus on risk management. These recommendations are likely only to create a slow, costly and rigid bureaucracy that delivers only marginal benefits to accountability and effectiveness.
The challenges faced by the Fund today present an important window of opportunity for it to drive reform while preserving its lean design principles that will make it not only more transparent and accountable, but also more agile, responsive and efficient. This can be achieved by driving data-based accountability from the bottom-up, empowering the Fund’s ultimate recipients and partners to provide real time feedback on the performance of the programmes it supports.
One of the most obvious places to achieve this change is in the supply chains its recipients use for delivering medicines and other health products. Through better information collection, particularly using mobile telephony, and enabling a multiplicity of players to participate in those supply chains, efficiency and transparency could be radically improved.
The inclusion of recipient feedback could be part of a lean multi-channel platform which would allow the Fund to make better use of information, create greater transparency, and have more effective tools to manage performance. Previously, incorporating feedback from end-recipients, village councils, professional bodies, fragmented civil society organisations and so forth was prohibitively expensive. But with the spread of mobile and broadband networks within developing countries there is now an unprecedented opportunity to improve the transparency, tracking and evaluation of the Fund’s programmes by collecting data and opening channels of communication between it, its suppliers, the end-users of its products and services, and the intermediaries.
Creating this multi-platform system would require the Fund to rethink its overall accountability architecture, creating new channels for communication not only with end recipients, but also with actors and stakeholders throughout supply and distribution chains.
There are several examples which demonstrate the potential of this bottom-up accountability. For example, years of investment and top-down planning and accountability structures have not been able to address stock-outs at the health facility level. A new programme, SMS for Life, has cut stock-outs of malaria medicines in regions of Tanzania to extremely low levels by linking health facilities to district medical offices through mobile phone-based communication. Using the data collected from health facilities and internet mapping software, the district offices have been able to redistribute stock in the most efficient way possible, saving time and transport costs.
Similarly, the Stop Stock-Outs Campaign, which covered four countries in southern and eastern Africa, used a combination of Ushahidi crowdsourcing software and the FrontlineSMS communication platform to collect reports of stock-outs of essential medicines for six months in 2009 and 2010. It received hundreds of reports, providing a template for consumer monitoring of health services. Admittedly, these examples may not be usable in their current form and structure for the scale required by the Fund. However, they do demonstrate that citizens and end-beneficiaries can be fertile sources of rich and highly granular information about medicine availability and that efficient mechanisms can be created for incorporating end-beneficiary feedback to drive bottom-up accountability.
Similarly, drug regulation is another area that is traditionally governed by top down accountability with national drug regulatory authorities having the responsibility of ensuring safety, efficacy and quality of medicines. The birth of applications such as Sproxil, Pharmasecure, and mPedigree, which allow consumers and pharmacists to send codes marked on products to central databases via text messages to check the products’ authenticity, demonstrates the power of bottom-up accountability in combating counterfeits. They also show how bottom-up mechanisms can work in concert with top-down accountability structures, linking consumer actions and input to governance and oversight bodies. The same kind of communication would allow the Fund to verify the delivery of commodities purchased by grantees.
These kinds of bottom-up accountability mechanisms will need to be institutionalised – covering all suppliers and grantees – if they are to realise their potential. In the private sector, large corporations with the most sophisticated monitoring and control systems that measure multiple metrics at all levels in a system, invest heavily in tools which allow them to tap into the voice of the customer, as this creates a direct link for feedback. This process need not be burdensome, though; the appropriate system would be one that is focused on lean structures, savvy uses of technology, and has a relentless focus on incorporating the voice of recipients – the Fund’s “customers” – to drive accountability and to improve overall performance.
Similarly, there will need to be a move away from exclusively government-run medicine distribution systems. Inefficiency and corruption is inevitable in a system where the government has near monopoly over delivery of drugs and health services, government employees who run the programmes are lowly and irregularly paid, and there is lack of granular data to hold anyone accountable. Transport, warehousing and distribution of drugs, and the data systems that enable supply chains to operate efficiently, are not core strengths of any government. Even the most publicly funded health systems in OECD countries use private sector entities to manage their supply chains.
To ensure that products procured from the Fund’s grants reach the end-beneficiaries effectively and efficiently, the locus of accountability has to become more dispersed; it has to shift from government offices alone to end-beneficiaries and private sector entities. Creating accountability “pressure points” outside the government and removing the government’s monopoly on distribution to the extent possible, will be vital in making delivery systems more responsive, efficient and accountable.
New accountability mechanisms will require new sanctions, too, otherwise they will be short-lived. Bottom-up accountability without top down enforcement is futile. The availability of data collected from bottom-up mechanisms, especially, will increase the accessibility of performance metrics and may strengthen the feasibility of bold performance-based funding. Equally important, it will allow the Fund to focus more on the needs of its intended beneficiaries, with whom it has had limited direct communication to date.
The Fund was formed with the recognition that the old ways of development aid – top-down, tightly controlled efforts, steeped in bureaucratic controls and dependent on large numbers of international staff – didn’t work, and too often built programmes that were poorly matched to local needs, lacked local leadership and were ultimately unsustainable. The Fund risks going down that path in the name of accountability. With more timely, robust and better-utilised bottom-up information on its supply chain and ultimate recipients, it doesn’t have to.
Vicky Hausman is an associate partner at Dalberg Global Development Advisors in New York and leads the firm’s global health practice.
Prashant Yadav is the director of healthcare research at the William Davidson Institute at the University of Michigan (Corresponding author).
Daniella Ballou-Aares is a partner at Dalberg Global Development Advisors in New York and is director of its North American Business.
Brad Herbert is an independent consultant and was formerly the chief of operations at the Global Fund to Fight Aids, TB and Malaria.