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Jun
16

KUDOS TO THE GHANA ACADEMY OF ARTS AND SCIENCES

KUDOS TO THE GHANA ACADEMY OF ARTS AND SCIENCES
By CAMERON DUODU

If there is a dangerous person in the world, it is an “educated person” who behaves like an illiterate. This is because when one is dealing with an illiterate person, one makes allowances for the opportunities the illiterate person may not have been given to extend his or her horisons, whereas, if one is dealing with an “educated person”, one makes a whole lot of assumptions. Some of these assumptions may not relate to reality but are crafted by the prejudices which one’s own background has created in one.

I shall never forget what a former Minister in Ghana told me one day. I had written about the Cabinet of which he was a member, and in discussing the Cabinet, I had roughly – and unwisely – classified them into conservatives and non-conservatives (on the basis of information gleaned from a member of the Cabinet.)

I had done it all in good fun, in the hope that I would convey to the Ministers, the way they were perceived by their own colleagues, in the hope that they might modify their attitudes a bit to accord with the needs of the time. Well, shortly afterwards, I went to interview one of the Ministers who had been described in my article as a conservative.

He looked at me and said, “Ei, so you want to get me out of the Cabinet?”

I said vehemently: ”No Sir!”

He retorted: “But you do! The Lord has revealed it to me! You are conspiring with certain people to get me out of the Cabinet!”

I was aghast! I respected this gentleman very much. His pedigree, especially in education, was peerless. And yet, here he was, telling me that the Deity had revealed to him that I was conspiring to remove him from the Cabinet of which he was a member!

I was so shocked that I didn’t know what to say. I think I mumbled something like, “But Sir, if I were conspiring against you, would I be here myself to interview you and give you a chance to publicise your policies as a Minister?”

Then it was that I realised that having studied at Oxford University and becoming a top educationalist in your own country, did not an intellectual make. It left a very sour taste in my mouth that a man with a background like that could speak like a catechist who had not made it to a seminary.

But if what one might term an “educated illiterate” is dangerous, then a scientist who is not broadly “educated” can diabolical.

An “uneducated scientist?” Is such a human paradox possible? I am afraid it is. For you can put instruments and chemicals and pages of text before a student, teach him or her to make experiments and evaluate the results, and at the end of the “course”, award a degree to the person. But if you do not inculcate values into the system of scientific knowledge you have imparted, you may have created a monster. What is called in Latin, a “deus ex machina.”

One of the more recent creations of such a nature was a South African scientist called Dr Wouther Basson, whose scientific practices were so misanthropic that he was nicknamed as “Dr Death”. In short, what he did was to develop and supply a “lethal triple cocktail of powerful muscle relaxants” to South African secret agents, which were used during Operation Duel (the systematic elimination of SWAPO prisoners of war captured in Namibia.)

Basson’s instrument of operation was a specially-created “7 Medical Battalion Group”, a specialist unit of the South African Military Health Service, which he pout to work on what was called “Project Coast”. Under this Project, Basson recruited 200 researchers, whose task was to secretly collect information about other countries’ chemical and biological warfare capabilities. He had a budget of $10 million per annum. Among his “successes” (and they were many) was to produce substances that enabled the Group to clandestinely kill 200 SWAPO prisoners. In the 1980s, Basson and his Group also carried out attacks and assassinations against members of anti-apartheid movements, as well as soldiers of the Mozambique army.

Basson did all this despite having sworn the Hippocratic Oath, which obliges doctors to:

“remember that…. that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug….Most especially, must I tread with care in matters of life and death.. .. Above all, I must not play at God….I will remember that I remain a member of society, with special obligations to all my fellow human beings…”

Funnily enough, when taken to court after apartheid had been decapitated, Dr Basson an incomprehensible exculpation from the unreconstructed, white-dominated South African judicial system! To judges trained in the apartheid era, his crimes against humanity were acceptable – he had merely obeyed the government of the day. It’s as if the Nuremberg Trials had never taken place.

Now, you mask: why is this guy telling me all this? The answer is that it appears some scientists have been taking the Ghanaian public for granted. They have agreed to use Ghana as a testing ground for a vaccine that is being developed against one of the molest deadly diseases in the world, Ebola, without first educating the Ghanaian public about what they were doing.

Please don’t get me wrong: vaccines are extremely important in the prevention of epidemics and other illnesses. But their development entails serious risks. For instance, Dr Hideyo Noguchi, after whom a research centre in Accra is named, died in Accra in May 1928, whilst
working on a vaccine against yellow fever. It is believed that he contracted the disease after injecting himself with the vaccine he was developing. Since then, of course, much safer ways have been developed for creating vaccines.

Nevertheless, in the case of Ebola, the pestilence is such a dreaded one that anything to do with it – especially a vaccine – must be totally open as otherwise it will be psychologically linked with the 11,000 or more people who have lost their lives in Guinea, Sierra Leone and Liberia since the Ebola outbreak in those countries in March 2014. Even countries with the best medical facilities in the world were urged by their fear-ridden citizens – and hysterical media – to prevent West Africans in general from flying into those countries. It took courage for the political and medical administrations in those countries to be able to resist these cacophonous calls.

Fortunately for Ghana, we were spared from the disease. And most Ghanaians would willingly do their best to help eliminate it, if the risks – or lack of risks – with regard to the development of a vaccine against the disease, are carefully explained to them. But of course, a huge backlash has occurred, because some scientists in our country appear to have agreed – in secret, it appears – with a foreign company called GlaxoSmithKline, to conduct trials of a vaccine against Ebola in the Hohoe district of Ghana, with a further test planned for Kintampo.

Whose fault was it that the trials came to public knowledge only because one of our radio stations, StarrFM, (which, like its peers, is more used to disseminating political gossip than scientific information) was the means of telling the public about the trials? If the Food and Drug Administration and the University of Health Sciences – the two bodies most closely associated with the vaccine project in Ghana – had done the right thing and carried out a public education campaign before signing on the dotted line – would the backlash have occurred? Maybe not.

What we do know is that a genuine public outcry against the project has taken place. occurred. One MP, for instance, told Radio Gold that some of his constituents had complained that they had been given the vaccine already, and that they had been suffering from aches and pains as a result.

Since the matter came into the public domain, the University of Health and Allied Sciences at Ho has been fingered as the main culprit. The University, according to its website, runs schools in: basic and biomedical sciences, allied health sciences, nursing and midwifery, public health, dentistry, pharmacy, medicine and sports and exercise medicine. (The website is currently displaying some inexplicable “Error 404”messages.)

Well, as is now known, the public education on the vaccine trial has been so dismal – if it existed at all – that the Minister of Health has ordered the suspension of the trial. He was expected to be questioned on it by Parliament on 16 June 2015. Earlier, the Speaker of the National Assembly had – rather unusually – also issued an order suspending the trial.

Now, no-one is saying that research into diseases should not be carried out in Ghana. What is indisputable is that when such tests are done here, the ethics governing tests should be fully observed. In particular, the people on whom the vaccine is tested should do so voluntarily, after the risks involved have been fully explained to them. They must give – and be capable of giving – what is called “informed consent”, and should not influenced in their decision by any psychological or financial pressure.

But in this instance, StarrFM has revealed that the participants in the trial were offered 200 Cedis plus a cellphone. Some were also to be offered transportation costs. In a country were poverty is so prevalent, C200 can mean the difference between having a meal and going hungry. Inducements to poor people to take part in medical tests are, in fact, quite common in developing countries. In India and Pakistan, for instance, people regularly sell kidneys, livers and other body parts to scientists who carry out transplants. These scientists always insist that the sales of body parts are done voluntarily, but an examination of the background of the sellers almost always produces an economic incentive.

Some Ghana Government spokespersons have, regrettably, been ambivalent about the Ebola vaccine tests. One Minister said on JoyFM Ghana decided to take part in the trial because the vaccine had also been tested “in Tanzania”, and Ghana did not want to give the impression that it did not want to co-operate in finding a vaccine that could defeat a disease that the whole world was worried about.

But that is not the issue, is it?. The issue is whether the proper – ethical – method has been employed with regard to the Ebola vaccine trial in Ghana. In any case, the Minister should kindly note that Tanzania became independent in 1961 – a full two years after Ghana had set up an Academy of Arts and Sciences precisely to give informed advice to the people and Government of Ghana, on issues of this nature.

Indeed, the Ghana Academy of Arts and Sciences has risen to its responsibilities and published a full statement on the Ebola vaccine trials. The statement is, as could be expected, full of academic jargon and careful reservations, but it clearly indicates that the Academy is not quite pleased with what has taken place.

The statement says that in January 2015, the Academy became aware, not officially but from a newspaper report, that a clinical trial for an Ebola Virus Disease (EVD) vaccine was due to start in Ghana before the end of March 2015. Given the uncertainties about the nature of the Ebola virus and risks in clinical trials, the Academy set up a 5-person Technical Committee, made up of Fellows
of the Academy, to undertake an urgent review of the matter and report to the
Academy.

In its preliminary report (says the statement) the Committee noted, among other things,
that the proposal before the Food and Drugs Authority (FDA) was for a Phase II
clinical trial of an Ebola Virus Disease (EVD) vaccine, developed by
GlaxoSmithKline and the US National Institutes of Health (NIH).

The Technical Committee advised that “such an undertaking must be preceded by a thorough evaluation of the available data, and the application subjected to the appropriate procedures.”
On the basis of its preliminary investigation and study, the Committee recommended a second look at the design of the study; a review of the basis for the selection of Ebola-unaffected countries like Ghana; and, because some Ghanaians have anti-bodies to the [Ebola] adenovirus, a fuller understanding of the adenovirus vector used in the development of the test vaccine.

The statement went on: “In discharge of the Academy’s mandate to provide independent science-based advice for policy making, the Council of the Academy asked the President of the Academy to bring these concerns urgently to the attention of the Minister of Health. This was immediately done, attaching a copy of the preliminary report of the Committee and confirming the Academy’s preparedness to provide all necessary support to the Ministry in dealing with this critical matter.

“After some delay, the Minister of Health convened a meeting on June 03, at which the
concerns and issues raised by the Academy were discussed with the technical
staff of the Ministry of Health (MOH), the Food and Drugs Authority and its
expert advisors, as well as the Principal Investigators in the GSK/NIH Phase II trials”.

The main concerns raised by the Technical Committee of the Academy relate to
the following: 1. Major uncertainties about the nature and origins of the Ebola virus, including the circumstances of its appearance in Guinea; 2. Whether the Zaire strain of the virus, which is the one being used in the GSK vaccine to be tested in Ghana, is the strain responsible for the Ebola epidemics in Liberia, Mali, Nigeria, Senegal and Sierra Leone, and the identity and characteristics of other strains of the Ebola virus that might exist.;

3. The committee also noted the use, in the GSK/NIH vaccine, of a gene particle of the wild species of the Zaire Ebola virus, rather than the gene particle of the Makona strain isolated inthe epidemic in Guinea; 4. What pre-clinical animal experimentations had been carried out with a vaccine based on the Makona strain to establish evidence of safety, immuno-genicity and
protection?

5. What basis is there for expecting that immune responses generated against the wild type Zaire Ebola virus GSK vaccine formulation (construct), with a live non- replicating chimpanzee adenovirus carrying a gene from Zaire Ebola virus, would be effective against the Makona strain or any other Ebola virus species and strains?

6. After a test vaccine had been shown in the vaccinated individual to produce an
immune response (immunogenicity), what guarantee would there be, in this
instance, that the vaccine would offer protection against the full Zaire Ebola virus
and other species and strains?

7. On the basis of research conducted so far towards vaccine development, what
was the likelihood of the present construct of vaccines protecting communities
against the rapid emergence of new, more virulent strains of the virus, as appears
to have happened with the Makona: the risk of false confidence deriving from the
use of a new vaccine must be noted;

8. What assurances do we have that the chimpanzee-derived live adenovirus
vector used in the GSK vaccine construct, although non-replicating for now, would
remain dormant and not itself cause a disease to compromise the health of the
people of Ghana?

9. It was to be noted that the application for the GSK Ebola vaccine Phase II trial in
Ghana includes children, even though the Phase I trial in the US, UK, Mali and
Switzerland was limited to adults, raising the question of dosage profiles for
children and other vulnerable groups in the Phase II trial;

10 (and perhaps most important) What evidence was there of strict compliance with the The International Committee on Harmonization Protocol Guidelines for Clinical Trials, including
full “informed consent” by all volunteers?

The Academy of Arts and Sciences statement added: “It was confirmed at the above-mentioned meeting between the President [of the GAAS] and Technical Committee of the Ghana Academy of Arts and Sciences, and staff of the MOH, the Food and Drugs Authority (FDA) and its expert advisors, and the Principal Investigators in the GSK/NIH Phase II trial, that the processes for the
approval of the Phase II clinical trial of the GSK Ebola Virus Disease test
vaccine had not been concluded. Our firm understanding was that the approval process would continue to take into account the concerns and issues raised by the Academy.

“ [Yet] “In the course of the meeting, it was mentioned [that] approval had already been given
to an application for a separate Phase I trial in Hohoe, of a test vaccine with a
different construct from the GSK test vaccine, which latter had been the focus of
concern of the Academy. This came as a shock to the Academy representatives at the meeting, as nothing had been said anywhere previously about a separate Phase I clinical trial application, let alone its approval. The Academy’s representatives therefore refused to discuss that matter.”

“However”, (the Academy statement added) it is to be noted that the Phase I trial of the GSK vaccine in Europe produced an adverse event, namely, prolonged bleeding, in 10% – 15% of the
vaccinated population. This is a serious adverse event that calls for extreme caution in approving clinical trials, both Phase I and Phase II, in the country. Moreover, it is the case that those vaccinated at Phase I and Phase II may be shedding the adenovirus vector into the surrounding community.

“In the absence of a map of adenovirus prevalence in the trial sites, there is a high
risk of an ‘escape virus’ merging with the endemic adenoviruses to create more
virulent strains. For that reason alone it is important that the exposed communities and, indeed,
the general public be adequately informed of such trials and their benefits and
risks.

“In conclusion, the Ghana Academy of Arts and Sciences wishes to state its firm
position that, subject to satisfactory answers to the issues it has raised, and
considering the gaps in our knowledge and state of preparedness, it would be
unsafe to undertake the proposed EVD vaccine clinical trials in Ghana.”

And there you have it. The people of this country should never be taken fir granted, for even though we may not have performed to the best of our ability scientifically and economically since we attained independence on 6 March 1957, we have laid the foundations for sagacious behaviour in most fields, and when the occasion arises, we shall get people who will speak truth to power. Kudos, then, to the Ghana Academy of Arts and Sciences, and its “membership of 111 Fellows
drawn from all fields of learning”.

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