U.S. Apologizes for Syphilis Tests in Guatemala

By DONALD G. McNEIL Jr.



From 1946 to 1948, American public health doctors deliberately infected nearly 700 Guatemalans — prison inmates, mental patients and soldiers — with venereal diseases in what was meant as an effort to test the effectiveness of penicillin.

American tax dollars, through the National Institutes of Health, even paid for syphilis-infected prostitutes to sleep with prisoners, since Guatemalan prisons allowed such visits. When the prostitutes did not succeed in infecting the men, some prisoners had the bacteria poured onto scrapes made on their penises, faces or arms, and in some cases it was injected by spinal puncture.

If the subjects contracted the disease, they were given antibiotics.
“However, whether everyone was then cured is not clear,” said Susan M. Reverby, the professor at Wellesley College who brought the experiments to light in a research paper that prompted American health officials to investigate.

The revelations were made public on Friday, when Secretary of State Hillary Rodham Clinton and Health and Human Services Secretary Kathleen Sebelius apologized to the government of Guatemala and the survivors and descendants of those infected. They called the experiments “clearly unethical.”

“Although these events occurred more than 64 years ago, we are outraged that such reprehensible research could have occurred under the guise of public health,” the secretaries said in a statement. “We deeply regret that it happened, and we apologize to all the individuals who were affected by such abhorrent research practices.”

In a twist to the revelation, the public health doctor who led the experiment, John C. Cutler, would later have an important role in the Tuskegee study in which black American men with syphilis were deliberately left untreated for decades. Late in his own life, Dr. Cutler continued to defend the Tuskegee work.

His unpublished Guatemala work was unearthed recently in the archives of the University of Pittsburgh by Professor Reverby, a medical historian who has written two books about Tuskegee.

President Álvaro Colom of Guatemala, who first learned of the experiments on Thursday in a phone call from Mrs. Clinton, called them “hair-raising” and “crimes against humanity.” His government said it would cooperate with the American investigation and do its own.

The experiments are “a dark chapter in the history of medicine,” said Dr. Francis S. Collins, director of the National Institutes of Health. Modern rules for federally financed research “absolutely prohibit” infecting people without their informed consent, Dr. Collins said.

Professor Reverby presented her findings about the Guatemalan experiments at a conference in January, but nobody took notice, she said in a telephone interview Friday. In June, she sent a draft of an article she was preparing for the January 2011 issue of the Journal of Policy History to Dr. David J. Sencer, a former director of the Centers for Disease Control. He prodded the government to investigate.

In the 1940s, Professor Reverby said, the United States Public Health Service “was deeply interested in whether penicillin could be used to prevent, not just cure, early syphilis infection, whether better blood tests for the disease could be established, what dosages of penicillin actually cured infection, and to understand the process of re-infection after cures.”

It had difficulties growing syphilis in the laboratory, and its tests on rabbits and chimpanzees told it little about how penicillin worked in humans.

In 1944, it injected prison “volunteers” at the Terre Haute Federal Penitentiary in Indiana with lab-grown gonorrhea, but found it hard to infect people that way.
In 1946, Dr. Cutler was asked to lead the Guatemala mission, which ended two years later, partly because of medical “gossip” about the work, Professor Reverby said, and partly because he was using so much penicillin, which was costly and in short supply.

Dr. Cutler would later join the study in Tuskegee, Ala., which had begun relatively innocuously in 1932 as an observation of how syphilis progressed in black male sharecroppers. In 1972, it was revealed that, even when early antibiotics were invented, doctors hid that fact from the men in order to keep studying them. Dr. Cutler, who died in 2003, defended the Tuskegee experiment in a 1993 documentary.
Deception was also used in Guatemala, Professor Reverby said. Dr. Thomas Parran, the former surgeon general who oversaw the start of Tuskegee, acknowledged that the Guatemala work could not be done domestically, and details were hidden from Guatemalan officials.

Professor Reverby said she found some of Dr. Cutler’s papers at the University of Pittsburgh, where he taught until 1985, while she was researching Dr. Parran.
“I’m sifting through them, and I find ‘Guatemala ... inoculation ...’ and I think ‘What the heck is this?’ And then it was ‘Oh my god, oh my god, oh my god.’ My partner was with me, and I told him, ‘You aren’t going to believe this.’ ”

Fernando de la Cerda, minister counselor at the Guatemalan Embassy in Washington, said that Mrs. Clinton apologized to President Colom in her Thursday phone call. “We thank the United States for its transparency in telling us the facts,” he said.
Asked about the possibility of reparations for survivors or descendants, Mr. de la Cerda said that was still unclear.

The public response on the Web sites of Guatemalan news outlets was furious. One commenter, Cesar Duran, on the site of Prensa Libre wrote: “APOLOGIES ... please ... this is what has come to light, but what is still hidden? They should pay an indemnity to the state of Guatemala, not just apologize.”

Dr. Mark Siegler, director of the Maclean Center for Clinical Medical Ethics at the University of Chicago’s medical school, said he was stunned. “This is shocking,” Dr. Siegler said. “This is much worse than Tuskegee — at least those men were infected by natural means.”

He added: “It’s ironic — no, it’s worse than that, it’s appalling — that, at the same time as the United States was prosecuting Nazi doctors for crimes against humanity, the U.S. government was supporting research that placed human subjects at enormous risk.”

The Nuremberg trials of Nazi doctors who experimented on concentration camp inmates and prisoners led to a code of ethics, though it had no force of law. In the 1964 Helsinki Declaration, the medical associations of many countries adopted a code.
The Tuskegee scandal and the hearings into it conducted by Senator Edward M. Kennedy became the basis for the 1981 American laws governing research on human subjects, Dr. Siegler said.

It was preceded by other domestic scandals. From 1963 to 1966, researchers at the Willowbrook State School on Staten Island infected retarded children with hepatitis to test gamma globulin against it. And in 1963, elderly patients at the Brooklyn Jewish Chronic Disease Hospital were injected with live cancer cells to see if they caused tumors.

Elisabeth Malkin contributed reporting from Mexico City.

Source:
http://www.nytimes.com/2010/10/02/health/research/02infect.html

Gov’t demands UK to ‘avoid’ military tests in Malvinas Islands

Vice-Foreign Minister Alberto D'Alotto announced



The government rejected United Kingdom's plan of performing military tests in Malvinas Islands and cualified it as an "unacceptable new provocation and likely to lead to an armed situation in the region."

Deputy Foreign Minister Alberto D'Alotto announced during a press conference held at the Government House that the Naval Hydrographic Service received a report from the UK which stated the possibility of "performing missile tests from the islands."

"The Argentine government expresses its formal and energetic protest to this planned military exercise and demands the British government refrain from carrying it out," D'Alotto said, reading from the letter.

President Cristina Fernández condemned the plan via her Twitter account, saying it represented "a militarization of the South Atlantic."

Nearly 30 years after the two countries fought a war over control of the British-ruled islands, tensions have increased this year because Argentina is angry British firms are searching for oil and gas in the seas around them.

In 1982, Britain sent a naval force and thousands of troops to reclaim the islands after Argentine forces occupied them. About 650 Argentine and 255 British troops died in the 10-week conflict.

Britain has a permanent military presence on the islands, called Las Malvinas in Argentina, and maintains a force of 1,076 troops and four ships in the region.

Source:
http://www.buenosairesherald.com/BreakingNews/View/47660

Tensions remain over biological access protocol

Lisbeth Fog
2 April 2010



[BOGOTA] After nine years of meetings about international rules on providing equitable resources, a major step was reached last week (22–28 March) with agreement on a draft text that is intended to form the basis of a protocol on access and benefit sharing.

At the Ad Hoc Open-ended Working Group on Access and Benefit-sharing of the Convention on Biological Diversity (CBD), which met in Cali, Colombia, representatives from 193 countries agreed to use the draft as the basis of a protocol to be submitted to the tenth Conference of the Parties to the CBD, which will be held in October in Nagoya, Japan.

The UN hailed the meeting as a great step forward in the quest to use the world's biodiversity fairly.

"Cali has entered history as the birthplace of the draft Nagoya Protocol on access and benefit sharing," said Ahmed Djoghlaf, the UN's executive secretary to the CBD.

But the draft remains highly controversial, and participants have been forced to arrange a further, week-long meeting to take place in Canada in July to prepare the draft for October's meeting in Nagoya.

Agreeing a protocol is one of the three objectives of the CBD. The goals is to ensure that benefits arising from the use of genetic resources from plants, animals or microorganisms are shared in a fair and equitable way with local communities or countries that provide them.

"We expected a bigger step, but undoubtedly Cali's text is a step forward," said Oscar Lizarazo, legal consultant for GeBiX, the Colombian Centre for Genomics and Bioinformatics of Extreme Environments.

Krystyna Swiderska, a senior researcher at the International Institute for Environment and Development in the United Kingdom, told SciDev.Net: "The real negotiations on a draft protocol only started on Thursday and I was not entirely surprised to hear that the negotiations broke down on Friday evening, given the very divergent positions between parties."

"The industrialised countries want easy access to genetic resources in other countries," she said. "If they have their way, the protocol will at most require compliance with existing legislation in the developing countries.

"On the other hand the biodiversity-rich developing countries want to assert national sovereignty over biological resources, and to ensure that the protocol binds industrialised countries to sharing any benefits."

Industrialised countries also want the protocol to focus only on genetic resources, while developing countries want to ensure that derivatives and traditional knowledge are included, added Swiderska.

"And industrialised nations want compliance with the protocol to be enforced through individual contracts for example between drug companies and governments while developing nations want to include [legal] measures for compliance with the protocol itself," she said.

Source:
http://www.scidev.org/en/news/tensions-remain-over-biological-access-protocol.html

Dopamine primes kidneys for a new host

Transplant patients may fare better if brain-dead organ donors receive an infusion of the compound before surgery

By Nathan Seppa


Giving dopamine infusions to brain-dead organ donors while they still have a heartbeat seems to fortify their kidneys against the rigors of transplant, a new study shows. Patients receiving a kidney from such donors are less likely to require multiple sessions of blood-cleansing dialysis immediately after the transplant operation, researchers report in the Sept. 9 Journal of the American Medical Association.

What’s more, treating a donor with dopamine seems to prevent some of the damage to kidneys that happens while the organs wait to be transplanted, the scientists find.

Brain-dead donors supply the majority of kidneys for transplant. Such donors often have suffered trauma or brain hemorrhage and have no chance of regaining brain function.

Although dopamine is best known as a neurotransmitter that guides brain signaling, the chemical has been used in intensive care units to stabilize blood pressure in patients, says study coauthor Benito Yard, an immunologist at the University Clinic of Mannheim in Germany. Dopamine can also quell inflammation and preserve blood vessel cells, both of which might benefit a kidney headed for transplant.

In the new study, 122 brain-dead organ donors received infusions of dopamine while 137 similar donors did not. All donors had a heartbeat when they received the dopamine, but they had no brain function as measured by electroencephalography and they needed a ventilator to breathe.

After each organ transplant, the scientists monitored the health of the kidney recipient. Of recipients getting dopamine-exposed kidneys, 25 percent needed multiple kidney dialysis sessions during the week after transplant. Of those getting a kidney not exposed to dopamine, 35 percent needed the multiple sessions.

“This is a big deal for the recipient,” Yard says. A need for dialysis indicates that a donor kidney hasn’t started to filter blood yet. “The sooner it starts to function, the better it will be,” for the patients’ long-term prospects, he says.

In this study, recipients who needed multiple dialysis sessions in the week after surgery were more than three times as likely to have their new kidney fail within three years as were people who got only one dialysis session or none.

Dopamine may be particularly protective in kidneys that face delays before transplant. It usually takes several hours or even a day to get a kidney from donor to recipient, during which time the organ must be kept cold to slow tissue damage. In patients receiving a kidney that had been in storage for more than 17 hours — which was one-fourth of the kidneys in this study — 91 percent of dopamine-exposed kidneys were still functioning three years later compared with only 74 percent of kidneys whose donors didn’t get dopamine. In addition to preserving blood vessel health, Yard says, dopamine exposure before transplant seems to mitigate inflammation in the kidney that can attract the attention of the recipient’s immune system and raise rejection risk.

“I think this study is very elegant, especially since dopamine is routinely used in intensive care medicine,” says Duska Dragun, a transplant nephrologist at Charité Hospital in Berlin. “At least in Europe, it is very difficult to estimate how long a kidney will be in cold storage,” she says. Dragun argues that the new trial is good enough to warrant use of dopamine for kidney transplants.

Source:
Sciencenews

Alo ciencia venezolana!

Un articulo recientemente publicado en la revista Science acerca de la situacion cientifica/academica en Venezuela.


Science 29 May 2009:
Vol. 324. no. 5931, pp. 1126 - 1127

Venezuela:
As Research Funding Declines, Chávez, Scientists Trade Charges
Barbara Casassus*


Venezuelans have grown accustomed to blunt remarks from their president, Hugo Chávez, elected in 1998 with an agenda of empowering the poor. Still, academics were taken aback this month when Chávez turned his scorn on them: During his weekly television program on 3 May, Aló Presidente, Chávez said that researchers should stop working on "obscure projects," such as whether life exists on Venus, and instead go into the barrios to make themselves useful. The words sent a chill through the scientific community, as did Chávez's comment that his recently appointed minister for science, technology, and intermediate industry, Jesse Chacón Escamillo, should "put the screws" on "feeble scientists" to get better results.


To many observers, it was another sign of the growing tension between Chávez and the academic establishment, particularly involving well-established research centers in Caracas. Nerves were already on edge following Chávez's dismissal in April of science minister Nuris Orihuela, a geophysical engineer, and her replacement by Chacón, an engineer and Army lieutenant. Critics say Chacón has scant scientific credentials but has been close to Chávez since at least 1992, when he backed Chávez's failed coup attempts.

Disaffected researchers say they fear that science funding is becoming more politicized. This is one of many concerns they've added to a growing catalog of perceived government failures or threats. Heading this list is a complaint that the government has made broad cuts in funding for institutions that support research. This has come partly in response to declining government petroleum revenues. But critics say the trouble runs deeper—that research is being mismanaged, and that the government has fired, demoted, or blacklisted dissidents.

Claudio Bifano, president of the Venezuelan Academy of Physical, Mathematical and Natural Sciences in Caracas, sent a letter with outstanding grievances to Science this month (www.sciencemag.org/cgi/content/abstract/1176733). They are, he wrote, "just a fraction of the many actions that clearly reveal an aim of the government to control all of the national scientific activity and the higher education system, putting Venezuela's scientific activities at risk." Bifano says that the government recently decreed the creation of about 40 new universities—on top of 51 existing public and private institutions. He says that Venezuela has insufficient academic resources for 90-odd universities and does not need that many.

"We are worried about the dilution of funding, which could lead to the closure of universities not aligned to government policies," adds biologist Roberto Cipriani, head of environmental studies at the Simón Bolívar University (USB) in Caracas. Scientists also view a 3-year-old program called LOCTI, which taxes companies to create a fund for research and innovation, as a disappointment. Publication indexes show that peer-reviewed publications from Venezuela have declined recently, says Cipriani. He notes that the ISI Web of Knowledge shows that science and technology articles written by Venezuelans dropped 15%, from 968 in 2006 to 831 last year.

Other groups are protesting what they view as threats to research. A petition by the Caracas chapter of the Venezuelan Academy for the Advancement of Science, posted last week for comment (http://asovac.net/bitacora/?p=3372), states that the "fundamental pillars of Venezuelan science are in grave danger."

It claims that a key government science program—Misión Ciencia—has produced few tangible results despite massive spending and deplores budget cuts ordered in March that, it says, translate into a 33% reduction in operating budgets for the Central University of Venezuela (UCV), in Caracas, and several other institutions. These are having "a severe effect on [UCV's] basic scientific and technological research programs," the declaration adds.

On 14 May, about 20 scientists stood in silence for 5 minutes during a meeting of some 250 researchers at UCV to protest Chávez's statements on Aló Presidente and the government's withdrawal of certain awards funded by LOCTI. The protesters from the Venezuelan Institute for Scientific Research remained silent because the ministry had told them to make no public statements, say sources in Caracas who did not want to be identified.

Whatever its flaws, LOCTI has been helpful to some institutions, researchers say. USB, the largest single recipient of LOCTI cash, received about 100 grants a year from 2006 through 2008, about 20% of the amount given to universities and agencies, says USB president and chemist Benjamin Scharifker. USB marine resources manager Eduardo Klein, a professor in the department of environmental studies, says he has been able to build labs and buy equipment that would not have been possible without LOCTI—including a 4000-square-meter, $7 million center for marine biodiversity now under construction. But Klein adds that funding needs are determined at the top: "The ministry decides on projects without our participation."

While some institutions have done well, scientists say that critics of government policy rarely escape punishment. A widely cited example this year is biologist Jaime Requena, a Cambridge, U.K.–educated professor at the government's Institute for Advanced Studies (IDEA) in Caracas. Requena and his supporters say that IDEA's director stripped Requena of his professorship just before his retirement, costing him his pension rights. IDEA took this step, according to an independent group, the Human Rights Commission of the Venezuelan Association for the Advancement of Science, after Requena published a letter in Nature criticizing the government for restricting support of the social sciences. Requena wrote that this government decision was one reason why Venezuela's scientific publications have fallen to a 25-year low point.

Speaking for the science minister, IDEA president Prudencio Chacón, who is not related to the minister, denied that the government is imposing political control over science, stifling dissent, or cutting research budgets. He also said that Requena was dismissed because "he worked in two places simultaneously," left work "several times without permission from his supervisor," and because IDEA requested the purchase of software that Requena had developed. Requena and his backers deny the charges. IDEA's statement recognizes the significance of the dispute, however, saying it has become one of the "political flags" of government critics.

* Barbara Casassus is a writer in Paris.