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The business
of $AR$
By Rahul Goswami
SINGAPORE - For Southeast Asians who have had to
live uneasily from one mask to the next, the waning of
the SARS outbreak is a relief. Piles of used masks no
longer clog public rubbish bins, and health workers are
breathing easier.
But the region's defense
against severe acute respiratory syndrome has entered a
new stage, after the removal by the World Health
Organization (WHO), effective Tuesday, June 24, of the
recommendation that all but essential travel to Beijing
- the last area in the world still covered by this
warning - be postponed.
Now, as anti-SARS
measures focus on vigilance and containment, two areas
of interest remain: the race to find a cure for SARS -
as well the attendant commercial spinoffs - and the
validity of the definition of SARS.
The hectic
activity in Singapore surrounding last Friday's
scientific conference on SARS research held here
provided an indication of the first concern regarding
the commercial potential of a cure to
SARS.
Research institutes, hospitals,
universities and the private sector have submitted 77
research proposals with a view to securing fund grants
through Singapore's Agency for Science, Technology and
Research.
The conference, which immediately
followed the June 18-19 global conference on SARS in
Kuala Lumpur organized by the WHO, also revealed the
scale of efforts related to SARS research in this
city-state that is building itself into a biotechnology
hub.
Research groups here are likely to
collaborate with those elsewhere, said a spokesperson
for the Agency for Science, Technology and Research.
Yet the US Centers for Disease Control and
Prevention (CDC) and the British Columbia Cancer Agency
(BCCA) in Canada have already applied for patents on the
SARS genome, thereby inviting criticism.
"As an
alternative, these agencies could have published the
genome, thus preventing others from being able to patent
it," wrote Dr E Richard Gold, of the faculty of law at
Canada's McGill University, in a recent issue of the
medical journal The Lancet.
The two
organizations aim not only to prevent others from
patenting the genome but also to obtain the exclusive
right to use and sell molecular forms of the genome.
But there is competitive maneuvering too. The
patent option provides the US and Canadian organizations
more leverage in dealing with the University of Hong
Kong's Versitech Ltd - which has also applied for a
patent - and indeed others that could patent various
uses of and products that interact with the SARS genome.
One such organization is the US-based
health-care company Abbott Laboratories, which announced
in June plans to market and distribute a new SARS
diagnostic test kit to assist government laboratories in
Asia within weeks.
The company claims that the
kit - developed by German biotechnology firm Artus GmbH
- can detect at early stages of the disease the
coronavirus suspected of causing SARS.
However,
the feverish moves to and from the patent office by
research groups are not defensive patenting, according
to Chee-khoon Chan, coordinator of the Citizens' Health
Initiative and associate professor at the School of
Social Sciences, Universiti Sains Malaysia, in Penang.
"The US biotech industry really got going when
the US National Institutes of Health [the focal point
for health research in that country] decided to allow
their research grantees to commercially exploit
NIH-funded research findings," he said. Until that time,
he said, these findings had been the intellectual
property of NIH as "public trustee".
Dr Kalyan
Banerjee, virologist and former director of the Indian
National Institute of Virology, agreed: "Patenting is
bound to happen as there is huge commercial value."
Of more immediate concern to the WHO and health
authorities in China is an outbreak of Japanese
encephalitis in Guangdong province, where the
coronavirus that causes SARS originated. The disease is
mosquito-borne, attacks the brain and the spinal cord,
and is endemic to many parts of Asia. China reports
thousands of cases a year.
That it has
immediately followed the SARS outbreak, rapidly killed
18 children and infected over 200, and emerged in the
same region where SARS began, has prompted WHO to
closely monitor its progress.
Japanese
encephalitis is a seasonal disease, and medical
researchers are questioning whether SARS too will be
seasonal, and whether it may reappear in October or
November.
Much will depend on an improved
diagnostic test, which Dr David Heymann, WHO's executive
director for communicable diseases, regards as a "top
priority".
At the Kuala Lumpur meeting, Heymann
warned: "The next influenza season will result in a
large number of patients with symptoms easily confused
with SARS ... a more precise and sensitive case
definition is absolutely essential to keep health
services from being overwhelmed."
The WHO case
definition is aimed at prompt isolation of any person
who might have been exposed to the SARS virus. WHO
continues to recommend that suspect cases be immediately
isolated and remain so until either a probable diagnosis
is made or another agent is determined to be the cause.
It is a definition that has worked well to
contain the outbreak in this initial emergency response
to the SARS outbreak, but health workers and medical
researchers in the frontlines of the battle against SARS
have called for a more precise definition for longer
term surveillance.
Among them is a group from
the Chinese University of Hong Kong. Following their
study of patients in a SARS screening clinic in Hong
Kong, the group concluded: "Current WHO guidelines for
diagnosing suspected SARS may not be sufficiently
sensitive in assessing patients before admission to
hospital."
Whether WHO guidelines and
definitions change with a virus that has already shown
its ability to mutate is unclear. Indeed, some of the
criticism of the WHO from within Asia has long been that
it is inflexible, not recognizing differences in
cultural and social perceptions of health and disease.
Dr N S Deodhar, a former additional director of
General Health Services in India and member of the
International Epidemiological Association, said that
"the WHO has served to mystify" matters. This approach,
he added, undervalues epidemiological investigation to
determine transmission routes and the social and
economic contexts of the disease.
(Inter Press
Service)
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