[A2k] US military flu virus collection parallels WHO virus system

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See http://www.geis.fhp.osd.mil/ and
http://www.nmrcd.med.navy.mil/confpres.htm for more information.

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US military flu virus collection parallels WHO virus system
SUNS #6599 Thursday 27 November 2008

Bogota, 26 Nov (Edward Hammond*) -- A large and rapidly growing global US
military virus collection system parallels the World Health Organization's
Global Influenza Surveillance Network (WHO GISN) but does not entirely share
its public health purposes.

The US military system is a source of viruses for the WHO GISN; but it does
not give most of its virus collections to WHO. It does keep all the lab
specimens and viruses it collects for its own use.

Wider knowledge of the extent of the US military virus collection system and
its ambiguous relationship to the WHO GISN system will raise important
questions for the WHO Pandemic Influenza Preparedness Inter-Governmental
Meeting (PIP IGM), which will convene in Geneva the second week of December.

The extent of the Pentagon's quiet but large virus collecting and its
relationships with the WHO GISN will surprise many. For example, the
Pentagon claims credit for having collected several important influenza
viruses that were subsequently selected by WHO for use in seasonal and H5N1
pre-pandemic vaccines from 2000 through the present, including viruses from
Panama, Peru, Nepal, Malaysia, and Indonesia.

Some developed countries, including the United   States, have insisted that
developing countries only share influenza viruses with the WHO GISN and not
bilaterally with others. Yet, contradictorily, the United   States has a
massive military influenza virus collection program, but only provides a
very small percentage of the materials that it collects to the WHO.

It is unclear if and how viruses collected by the US military in other
countries would be covered by a WHO GISN material transfer agreement because
they are obtained and transferred outside what is now-understood to be the
WHO system.

If one WHO Member  State unilaterally amasses influenza viruses without full
participation in the WHO access and benefit sharing system there is strong
potential for the WHO system to be undermined.

Also undefined is the legal status of a virus received by the WHO system;
but not from an approved lab of its country of origin - a situation that now
frequently occurs due to the activities of the US military virus collection
system.

The US military system is active globally, including at least 56 countries
where it is collecting influenza viruses (as of 2007). The system pulls in
clinical specimens and locally isolated viruses that are shipped to the
United States. It provides some of these viruses to the WHO GISN network,
mainly through the US Centres for Disease Control (CDC), a WHO Collaborating
Centre in Atlanta, Georgia (and part of the US health ministry), but keeps
all specimens and viruses for its own purposes.

The size and capacity of the US military program is dramatically expanding
and has more than doubled in recent years. In 2005, it was active in 30
countries and included three BSL-3 labs and a total sample processing
capacity of 9,000 specimens per year. By 2007, the network was active in 65
countries and included eight BSL-3 labs and the capacity to process 18,000
samples annually.

The network is named the US Department of Defense Global Emerging Infections
Surveillance & Response System ("DoD-GEIS"). A DoD-GEIS program called the
US Department of Defense Worldwide Influenza Surveillance Program focuses
specifically on flu viruses.

The military network has "sentinel" sites around the globe, reported by US
military sources to include 128 or more locations. These are installations
where US military personnel are based, as well as collaborating non-military
sites that collect samples from US personnel and local civilian populations.

In 2006-2007, the system collected influenza viruses from developing
countries including:

-- Americas: Belize, Guatemala, Honduras, El Salvador, Nicaragua, Venezuela,
Colombia, Ecuador, Peru, Bolivia, Paraguay, and Argentina.

-- Africa: Morocco, Libya, Egypt, Eritrea, Djibouti, Sudan, Uganda, Kenya,
Burundi, Gambia, Ghana, Nigeria, and Cameroon.

-- Middle East: Turkey, Jordan, Iraq, and Oman.

-- Central/South Asia: Azerbaijan, Kazakhstan, Uzbekistan, Mongolia,
Afghanistan, Pakistan, India, Nepal, and Bangladesh.

-- Southeast Asia/Oceania: Myanmar, Thailand, Vietnam, Laos, Cambodia,
Philippines, Indonesia, Papua New Guinea, and Solomon Islands.

A US Air Force lab at Brooks City Base in San Antonio,  Texas coordinates
the
system. In 2006 and 2007, its systemwide budget was over $40 million per
year. In the 2006-2007 flu year, the Texas lab alone processed 5,810
specimens from persons across the globe suspected to have respiratory
infections. Of these, 2,444 tested positive for a respiratory virus,
including 1121 positive for influenza virus. According to the US Department
of Defense (DOD), "All original specimens are archived and kept for requests
from [Department of Defense] partners or the CDC."

Another lab at a US Navy facility in San Diego,  California processes an
unknown number of additional samples. Of note, the Navy lab systematically
isolates flu viruses from military personnel who become infected during port
visits. Using this unusual collection method, in 2007, it isolated seasonal
influenza viruses from countries including Indonesia, Papua New Guinea, and
the Solomon Islands after US Navy ships docked there and US sailors became
infected while ashore.

Including the Navy lab and other facilities (see below), the military system
handled an overall total of approximately 8,000 influenza and other viral
cultures in 2007. Of these, only a small percentage are given to CDC. In
2006, this number was 120 viral isolates (about 1.5%), meaning that over 98%
of the viruses collected by the US military program do not enter the WHO
system.

In addition to the CDC, collected viruses (especially H5N1 viruses) are
provided to US Army Medical Research Institute of Infectious Diseases
(USAMRIID) at Fort Detrick in Frederick, Maryland. USAMRIID is the
historical home of the US offensive biological weapons program (terminated
in 1969), and is presently the headquarters of the US military's biological
defense effort. Drawing on viruses collected by the US military and WHO
sources, as of 2007, USAMRIID maintained a collection of thirty different
H5N1 strains plus many other flu types that it uses in research and provides
to other US military labs.

According to the program, the primary purpose of the virus collection system
is to ensure US military readiness: "The principal objective is to enable
the rapid discovery of novel strain mutations that could trigger a pandemic
and to monitor these strains for their ability to transmit and to cause
disease... the priority of the DoD is to maintain readiness and protect the
health of service-members and beneficiaries, the contributions from the [San
Antonio-based] surveillance program also benefit the greater global health
community."

Five overseas laboratories operated by the US Department of Defense act as
regional coordination centres for the collection effort. The five labs are:

-- Naval Medical Research Unit No. 2 (NAMRU-2) in Jakarta,  Indonesia.

-- Naval Medical Research Unit No. 3 (NAMRU-3) in Cairo,  Egypt.

-- Naval Medical Research Centre Detachment (NMRCD) in Lima,  Peru.

-- Armed Forces Research Institute of Medical Sciences (AFRIMS) in Bangkok,
Thailand.

-- United States Army Medical Research Unit-Kenya (USAMRU-K) in Nairobi,
Kenya.

With the exception of NAMRU-2, which was recently closed by the Indonesian
government, each of the above labs works not only in the country in which it
is located; but also in nearby countries, where laboratory and personnel
detachments are sometimes placed.

NMRCD operates a high containment (BSL-3) lab in Peru, and coordinates virus
collections in several South and Central American countries and, for
example, has staff in Guatemala. In 2007, it reported that it is seeking to
expand virus surveillance efforts in Ecuador, Bolivia, Paraguay, and
Uruguay.

AFRIMS in Bangkok operates a BSL-3 lab and, in addition to work in Thailand,
maintains a facility in Nepal and collects samples from other countries in
the region. In total in 2007, AFRIMS collected over 1,000 respiratory
samples from seven countries in Southeast and South Asia.

NAMRU-3 in Cairo has at least BSL-3 capability and collects human and animal
influenza viruses. It is a WHO GISN H5 reference lab, submitting viruses
both to other US government labs as well as WHO labs. NAMRU-3 maintains
activities in many African, Middle Eastern, and Asian countries, from Ghana
eastward all the way to Pakistan.

It states that in 2007, "From Egypt, 141 human specimens were received for
influenza A/H5N1 reference testing, and 26 specimens tested positive for
H5N1. H5 reference testing was performed on 459 animal specimens, with 92
positive for H5N1 from Afghanistan, Egypt, and Ghana." From these H5N1
isolates, MANRU-3 deposited HA gene sequence information for 74 strains in
GenBank.

USAMRU-K in Nairobi collects virus samples from hospitals and Kenyan
military facilities and says that it is developing collection capabilities
through universities in Uganda and Cameroon and the Nigerian defense
ministry. Flu viruses it collects are provided to the CDC and the US
military.

Until the Indonesian government closed it, NAMRU-2 in Jakarta played a
similar role, including coordinating US laboratory detachments in Indonesia,
Cambodia and Laos. In 2007, it says that it collected and tested more than
4,500 respiratory samples in Indonesia alone. It is unclear what will happen
to NAMRU-2's activities outside of Indonesia now that the Jakarta laboratory
has been closed.

Other US military BSL-3 labs in the network are located in Germany and South
Korea. The DoD-GEIS network also collaborates with the US Defense Threat
Reduction Agency (DTRA), although the exact nature of the collaboration has
not been publicly described.

Despite the Pentagon's claims that it has frequently contributed to WHO
vaccine strain selections, none of the negotiating texts or background
documents made available by WHO in the course of the Pandemic Influenza
Preparedness Inter-Governmental Meeting have discussed the large US virus
collection system that parallels the GISN, much less explained the
relationships between the two.

Nevertheless, the purpose of the US military system does not wholly coincide
with WHO's public health ends, and its activities at times do not appear to
be compatible with most proposals for a revised WHO GISN virus and benefit
sharing system.

The massive US military virus collection system, which parallels the WHO
system yet does not currently operate under the same rules, creates an
additional complication for diplomats seeking an agreement on virus and
benefit sharing. Its extent and different purposes than the WHO system may
also be of concern to some countries, particularly because WHO system virus
sharing is for public health and not military purposes.

Efforts should be made to ensure that all virus collection and transfers
take place within the WHO system, using a WHO material transfer agreement,
and that virus collections for purposes other than public health not be
permitted.

(* Edward Hammond is an independent researcher and an expert on patents and
biological resources. He contributed this article to SUNS.) +






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