Attachment

ny A previous decision. Throughout the discussion of the current review of the two manuscripts, the issue surrounding the NSABB's approval of publication of the 1918 H1N1 virus paper in 2005 has been raised as precedence for how we might proceed in this situation. I want for the record to be clear that I firmly believe we made a mistake in approving the publication of the 1918 virus paper. At the time I was one of the supporters of publication. We reasoned that the 1918 H1N1 virus, if it were to accidently escape or be intentionally released, would cause little public health consequence because of the previous circulation of H1N1 influenza virus prior to 1958 and again since 1977. We believed that the vast majority of the world's population would have sufficient crossprotective immunity to prevent any kind of H1N1 influenza pandemic as experienced in 1918. Well, with the appearance of A(H1N1)pdm09, we now realize there was virtually no populationbased immunity to either the new H1N1 virus or the closely related virus, the 1918 H1N1 strain. The exception was for those who had experienced H1N1 infection prior to the early 1950's when those circulating strains in humans did provide cross protection. Had someone taken the published data on the 1918 virus mutations, they could have created a virus that, had it been even accidently released, could have caused a pandemic much as the A(H1N1)pdm09 virus did. I share this observation not to be critical of the 2005 NSABB decision, as I was part of that decision. Rather, it's to remind us that you can't unring a bell. Any decisions that the NSABB makes with regard to the influenza issue may possibly have farreaching and yet unrecognized implications, like the 1918 virus situation. Summary In short, the NSABB March meeting should be a very important learning experience for the USG, the journal editors, and life scientists in general as to the need for a much more effective system to address DURC issues. One primary lesson that I believe is critical: The Board must involve disinterested subject matter experts to provide technical advice. I believe that the relative lack of subject matter expert input from those without a direct interest in the Board's decision be viewed critically by the larger policy and life science communities as the decision is debated over the upcoming days. As I stated before, I believe our recent experience is just the beginning, not the end of this type of scientific and policy conflict. As a said to Dr. Collins toward the conclusion of the March meeting, I wouldn't want to be in his shoes sitting before a Congressional hearing trying to explain why the NSABB and likely the USG supported the full Fouchier publication when we heard at the meeting that he has done more work and found one additional mutation that now confers H5N1 transmissibility between mammals without ferret passage. How will we justify one more "incremental finding paper" that now is a pretty complete cookbook when we didn't recommend redaction for the vast body of his work? If we believe redaction of the current manuscript is problematic in terms of international agreements, I think the next mutation paper will prove to be the straw that breaks the camel's back. It is unfortunate that the current NSABB action just kicked the can down the road to the next manuscript. I hope these comments are helpful as the NSABB moves forward. As someone who will soon be rotating off the Board after 7 years of service, I believe now, more than ever, of its importance.