More than 100 doctors, researchers and health experts from around globe signed an open letter published
Friday urging the United Nation's World Health Organization to either
move the summer games from Rio de Janeiro or to delay them, saying they
are concerned about the virus' potential impact on global health.
Unsurprisingly, as it would reflect badly on the organisations, WHO and the IOC have rejected the call.
Here is the
full text of the letter.
Open Letter to Dr. Margaret Chan, Director-General, WHO
(Copied to the International Olympic Committee)
We
are writing to express our concern about the upcoming Olympic and
Paralympic Games in Rio de Janeiro. WHO’s declaration of Zika as a
“Public Health Emergency of International Concern,” coupled with new
scientific findings that underscore the seriousness of that problem,
call for the Rio 2016 Games to be postponed and/or moved to another
location—but not cancelled—in the name of public health.
We
make this call despite the widespread fatalism that the Rio 2016 Games
are inevitable or “too big to fail”. History teaches this is wrong: the
1916, 1940, and 1944 Olympic Games were not just postponed, but
cancelled, and other sporting events were moved because of disease, as
Major League Baseball did for Zika, and the Africa Cup of Nations did
for Ebola.
Currently, many athletes, delegations, and
journalists are struggling with the decision of whether to participate
in the Rio 2016 Games. We agree with the U.S. Centers for Disease
Control recommendation that workers should “Consider delaying travel to
areas with active Zika virus transmission”.1 If that advice were
followed uniformly, no athlete would have to choose between risking
disease and participating in a competition that many have trained for
their whole lives.
But our greater concern is for global
health. The Brazilian strain of Zika virus harms health in ways that
science has not observed before. An unnecessary risk is posed when
500,000 foreign tourists from all countries attend the Games,
potentially acquire that strain, and return home to places where it can
become endemic. Should that happen to poor, as-yet unaffected places
(e.g., most of South Asia and Africa) the suffering can be great. It is
unethical to run the risk, just for Games that could proceed anyway, if
postponed and/or moved.
In our view, several new
scientific findings require WHO to reconsider its advice on the 2016
Olympic and Paralympic Games. For example:
1. That the
Brazilian viral strain causes microcephaly2 and probably Guillain-BarrƩ
syndrome3. Further, because human4, animal5 and in vitro studies6
demonstrate that the virus is neurotrophic and causes cell death, it is
biologically plausible that there are other as yet undiscovered
neurological injuries, as exist for similar viruses (e.g. dengue).7
2.
That while Zika’s risk to any single individual is low, the risk to a
population is undeniably high. Currently, Brazil’s government reports
120,000 probable Zika cases,8 and 1,300 confirmed cases of microcephaly
(with another 3,300 under investigation)9, which is above the historical
level of microcephaly.10
3. That Rio de Janeiro is
highly affected by Zika. Brazil’s government reports Rio de Janeiro
state has the second-highest number of probable Zika cases in the
country (32,000) and the fourth-highest incidence rate (195 per
100,000), demonstrating active transmission.8
4. That despite Rio’s new mosquito-killing program, the transmission
of mosquito-borne disease has gone up rather than down. While Zika is a
new epidemic and lacks historical data, using dengue fever as a proxy,
cases in Rio from January thru April 2016 are up 320% and 1150% over the
same periods in 2015 and 2014, respectively.11 In the specific
neighborhood of the Olympic Park (Barra da Tijuca) there have been more
dengue cases in just the first quarter of 2016 than in all of 2015.11
5.
That Rio’s health system is so severely weakened as to make a
last-minute push against Zika impossible. Recently Rio’s state
government declared a health sector emergency,12 and Rio’s city
government cut funding against mosquito-borne disease by 20%.13 While
the virus is the infectious agent of Zika, its real cause is Rio’s poor
social conditions and sanitation—factors that lack a quick fix, and that
are not helped when shrinking health resources are diverted to the
Games.
6. That it is possible to eradicate the Aedes
aegypti mosquito, which transmits Zika, from Rio. Actually that
mosquito was totally eradicated from Brazil in the 1950s, but came back
after control efforts lapsed.14 Thus holding the Games, in the presence
of Zika-carrying mosquitoes, is a choice and not necessary.
7.
That one cannot count on nature for defence. While lower mosquito
activity during Rio’s winter months reduces the individual risk to
travelers of infection, that is partly offset when travelers who became
infected return home during the northern hemisphere's summer months and
peak mosquito activity, which increases the public health risk that
local mosquitos acquire and spread the virus—meaning that both seasons
are relevant to the epidemic's course.15 Also, infection can spread
through blood donations and transfusions, particularly in poor countries
that lack screening for Zika.16
In sum, the evidence
shows: (i) that Brazil’s Zika virus strain has more serious medical
consequences than previously known, (ii) that Rio de Janeiro is one of
the most affected parts of Brazil, and (iii) that Rio’s mosquito-killing
efforts are not meeting expectations, but rather mosquito-borne disease
is up this year. It is therefore imperative that WHO conduct a fresh,
evidence-based assessment of Zika and the Games, and its recommendations
for travelers.
Because Zika is a new emergency, its
many uncertainties—of travel flows during the Games, of epidemiology,
and of entomology—currently make it impossible for mathematical models
to predict the epidemic’s course accurately. Therefore, for now, any
decision about Zika and the Games has to be more qualitative than
quantitative. If one considers the following options:
(a) Holding the Games in Rio in 2016 as scheduled;
(b) Holding the Games in Rio at a later date after Zika is controlled, and;
(c) Holding the Games at Zika-free sites having Olympic-standard facilities.
It is indisputable that option (a) of holding the Games as scheduled has a greater risk of
accelerating the spread of the Brazilian viral strain than the
alternatives. Postponing and/or moving the Games also mitigates other
risks brought on by historic turbulence in Brazil’s economy, governance,
and society at large—which are not isolated problems, but context that
makes the Zika problem all but impossible to solve with the Games fast
approaching.
We are concerned that WHO is rejecting
these alternatives because of a conflict of interest. Specifically, WHO
entered into an official partnership with the International Olympic
Committee, in a Memorandum of Understanding that remains secret.17
There is no good reason for WHO not to disclose this Memorandum of
Understanding, as is standard practice for conflicts of interest. Not
doing so casts doubt on WHO’s neutrality, for reasons described further
in the Appendix.
WHO must revisit the question of Zika
and postponing and/or moving the Games. We recommend that WHO convene an
independent group to advise it and the IOC in a transparent,
evidence-based process in which science, public health, and the spirit
of sport come first. Given the public health and ethical consequences,
not doing so is irresponsible.
Don't forget to visit
www.olympicswarehouse.com
www.olympicsdiary.com brought to you by
www.kenfrost.com "
The Living Brand"
