
几内亚比绍没有批准由美国政府和私营合作伙伴资助的有争议的新生儿乙肝研究,该国卫生部长周二表示。
Guinea-Bissau has not approved the controversial hepatitis B study in newborns that would be funded by the US government and private partners, the African country’s minister of health said on Tuesday.
该研究不会调查疫苗的安全性或有效性,而是追踪诸如总体死亡率或神经发育状况等“非特异性”健康结果,一直得到美国卫生与公众服务部(HHS)部长、长期反疫苗活动家罗伯特·F·肯尼迪 Jr.的支持。
The study, which would not investigate the safety or effectiveness of vaccines but would instead track “nonspecific” health outcomes like overall mortality or neurodevelopmental conditions, has been championed by Robert F Kennedy Jr, secretary of the US Department of Health and Human Services (HHS) and a longtime anti-vaccine activist.
丹麦研究伦理委员会的成员被告知几内亚比绍官员已批准该研究的更新设计,这影响了一些委员会成员上周投票决定继续进行试验。
Members of a Danish research ethics committee were informed that officials in Guinea-Bissau had approved an updated design of the study, which influenced some committee members’ votes to proceed with the trial last week.
但卫生部从未同意或授权该试验,卫生部长奎宁·南特在葡萄牙语新闻发布会上表示,他将该研究称为“测试”。
But the health ministry never agreed to or authorized the trial, said Quinhin Nantote in Portuguese at a press briefing, where he referred to the study as “tests”.
“卫生部未根据目前流传的出版物所呈现的条款授权这些测试,”卫生部长说。他表示,几内亚比绍官员看到媒体报道称该国已批准该研究时感到“惊讶”。
“The ministry did not authorize the tests under the terms presented in the publications currently in circulation,” the health minister said. He said officials in Guinea-Bissau were “surprised” to see media reports that the country had given approval to the study.
“任何涉及人类的科学研究倡议,尤其是涉及儿童的,必须严格遵守适用的国家立法、国际伦理原则、有能力的评估和批准机制,”南特说。
“Any scientific research initiative involving human beings, particularly children, must strictly comply with applicable national legislation, international ethical principles, competent evaluation and approval mechanisms,” Nantote said.
他在几内亚比绍召开紧急会议后发表了上述讲话,会议参与者包括班迪姆健康项目、当地伦理委员会、国家公共卫生研究所(Inasa)和扩大免疫计划(PAV)。
He spoke after convening an emergency meeting in Guinea-Bissau with the Bandim Health Project, the local ethics committee, the National Institute of Public Health (Inasa) and the Expanded Vaccination Program (PAV).
班迪姆健康项目由丹麦研究人员彼得·Aaby和克里斯汀·斯塔贝尔·贝恩运营,他们数十年的研究在过去一年里曾受到质疑。
The Bandim Health Project is run by the Danish researchers Peter Aaby and Christine Stabell Benn, whose decades of research have been called into question in the past year.
哥本哈根大学的丹麦研究员夏洛特·斯特罗姆(Charlotte Strøm)表示,他们几乎所有论文中的主张“具有高度误导性”。她曾共同撰写研究,显示阿比(Aaby)、斯塔贝尔·本(Stabell Benn)及其合著者在25项研究中有24项未发现显著结果,且他们选择不发表可能不支持其观点的研究。
The claims made in nearly all of their papers are “highly misleading”, said Charlotte Strøm, a Danish researcher who has co-authored research showing that Aaby, Stabell Benn, and their co-authors had no significant findings in 24 out of 25 studies and that they’ve chosen not to publish research that may not support their viewpoints.
“当研究人员以这种方式运作并放弃适当的方法论严谨性时,他们实际上是在亲自决定结果,而这不是科学,”斯特罗姆说,称其为“有问题、可疑[且]不道德”。
“When researchers operate like this and abandon proper methodological rigor, they literally decide on the results themselves, and that is not science,” Strøm said, calling it “problematic, questionable [and] unethical”.
她补充道:“我认为这确实令人担忧。”肯尼迪多次赞扬他们的工作,他说这表明接种疫苗后,“可能出现大规模损伤,灾难性损伤,而这些问题就在眼前却被掩盖”。
She added: “I believe there is serious cause for concern.”Kennedy has repeatedly praised their work, which he says shows that after vaccination, “you can have mass injuries, and catastrophic injuries, and they’re hiding in plain sight”.
截至发稿时,阿比、斯塔贝尔·本和弗雷德里克·舒尔茨-布赫霍尔泽(Frederik Schaltz-Buchholzer)未回应《卫报》的提问,即为何丹麦伦理委员会成员被告知该试验已获地方当局批准,以及为何该试验无法在丹麦进行。
Aaby, Stabell Benn and Frederik Schaltz-Buchholzer did not respond by press time to the Guardian’s questions about why the Danish ethics committee members were told the trial had been approved by local authorities and why it could not be held in Denmark.
在丹麦,乙肝阴性父母所生的婴儿不会接种该疫苗,病毒检测广泛进行且发病率较低,且完善的医疗体系能够追踪健康结局并提供及时全面的医疗服务——因此丹麦是开展此类研究的理想场所。
In Denmark, infants born to hepatitis B-negative parents do not receive the shot, there is widespread testing for and low incidence of the virus, and the robust healthcare system can track health outcomes and provide timely and comprehensive medical care – making it an ideal location for such a study.
“即便提出此试验本身就完全不道德,”埃默里大学研究员BK泰坦吉(BK Titanji)表示,因为安全有效的疫苗已存在数十年。
“It’s completely unethical that this trial is even proposed,” because a safe and effective vaccine has been available for decades, said BK Titanji, a researcher at Emory University.
蒂坦吉表示,看到几内亚比绍方面反对这项试验令人感到“安心”。她补充道:“此类研究必须接受最高级别的伦理审查。这项研究的对象是最脆弱的群体——新生儿,而研究开展地又是一个资源匮乏的国家。”
It’s “reassuring” to see Guinea-Bissau pushing back on the trial, Titanji said, adding: “A study like this one needs the highest level of ethical scrutiny. You are going to be conducting a study on the most vulnerable population, which is newborn babies, in a country that is resource-constrained.”
最近,蒂坦吉在申请于喀麦隆开展合作研究时,必须在申请材料中提交大量证明文件。她指出,那其实只是一项调查,并非涉及人体受试者的医学研究。“我无法直接对埃默里大学的伦理审查委员会说‘我已获得喀麦隆方面的许可’,我必须提供相关文件。”她强调,研究人员应当公开这些文件以及经过更新的研究方案,详细说明研究的具体实施流程。
When Titanji recently applied for approval of a collaborative study in Cameroon, she had to include extensive documentation in her application – and it was a survey, not medical research on human subjects, she said. “I can’t come to Emory’s [institutional review board] and just be like: ‘I got permission from Cameroon.’ I have to provide the document.”The researchers should release these documents and an updated protocol showing how the study would be conducted, she said.
众多专家严厉批评这项在非洲开展的试验,称其“极其违背伦理且残忍”、“带有新殖民主义色彩”且“具有危害性”。
Experts have decried the African experiment as “horribly unethical and cruel”, “neocolonialist” and “damaging”.
非营利组织“为科学挺身而出”的创始人兼首席执行官、研究员科莱特·德拉瓦拉指出:“几内亚比绍政府敢于抵制美国与丹麦利用其儿童开展实验,这一举动意义重大。我们绝对应当尊重该国的主权。”德拉瓦拉还提到,通过联合国儿童基金会以及全球疫苗免疫联盟采购足量疫苗,便足以每年为几内亚比绍的所有新生儿接种疫苗,所需费用约为13,200美元。
“For the government of Guinea-Bissau to stand up against the United States and Denmark exploiting its children is no small statement,” said Colette Delawalla, a researcher and founder and CEO of the non-profit Stand Up for Science. “We absolutely must respect their sovereignty as a nation.”It would cost approximately $13,200 to buy enough vaccines through Unicef and Gavi, the Vaccine Alliance, to immunize all newborns in Guinea-Bissau each year, Delawalla pointed out.
她补充道,所有相关方都应携手合作,确保几内亚比绍的每一位新生儿都能接种到首剂乙型肝炎疫苗。“事情其实再清楚不过:我们既可以利用黑人婴儿来推行伪科学,也可以花区区20美分就能挽救这些孩子的生命。”目前尚不清楚美国是否仍计划推进这项研究;此前有报道称,美国疾病控制与预防中心今年已再次拨款160万美元用于资助该试验,珀辛广场基金会与蓝钟基金会也将提供相应数额的私人资金予以配套。
Everyone involved should work together to ensure that every baby in Guinea-Bissau receives the birth dose of the hepatitis B vaccination, she added. “This is not muddy water: we can use Black babies to further pseudoscience or we can save children’s lives with a 20-cent shot.”It is unclear whether the US plans to move forward with the study, even after reporting indicated that the US Centers for Disease Control and Prevention (CDC) has again set aside $1.6m for funding for the trial this year, to be matched by private funding from the Pershing Square Foundation and the Bluebell Foundation.
“该研究未获批准,”美国卫生与公众服务部在一份声明中告诉路透社。该机构尚未回应《卫报》关于该试验的提问。
“The study has not been approved,” the HHS told Reuters in a statement. The agency has not responded to the Guardian’s questions about the trial.
丹麦委员会至少有四名成员在试验获批准程序被快速推进后辞职。委员会的规则必须被修改,因为随机对照试验超出了其职责范围。当委员会成员要求提供几内亚比绍批准的更多信息时,未提供进一步细节。
At least four members of the Danish committee resigned after approval for the trial was fast-tracked. The rules of the committee had to be changed because randomized controlled trials were outside of its purview. When committee members requested more information about the Guinea-Bissau approval, no further details were provided.
该研究计划在几内亚比绍招募14,000名新生儿,其中一半将在出生时接种疫苗,另一半则在生命的前六周被拒绝接种。乙肝在该国广泛流行,儿童感染可能导致严重的终身影响。
The study would enroll 14,000 newborns in Guinea-Bissau, half of whom would be vaccinated at birth and half of whom would be denied the immunization for the first six weeks of life. Hepatitis B is widespread in the country, and infection in children can have serious lifelong effects.
几内亚比绍目前有一个过渡性军政府,自去年11月政变以来一直在执政。该国在1月请求非洲疾病预防控制中心(Africa CDC)派遣专家团队来帮助评估该研究。在此期间,南托特当时表示,该研究被“取消或暂停”。
Guinea-Bissau, which currently has a transitional military government following a coup in November, requested in January a team of experts from the Africa Centres for Disease Control and Prevention (Africa CDC) to help evaluate the study. In the meantime, Nantote said at the time, it was “canceled or suspended”.
几内亚比绍的其他官员也对该研究表示反对。“这根本不会发生,就这样,”外长若昂·贝尔纳多·维埃拉在二月表示。
Other officials in Guinea-Bissau also pushed back on the research. “It’s not going to happen, period,” the foreign minister, João Bernardo Vieira, said in February.
世界卫生组织(WHO)表示愿支持在几内亚比绍所有新生儿出生时推广乙肝疫苗。“世卫组织随时准备支持几内亚比绍,随着该国考虑其前进道路,并加快出生剂量的引入和加强实施,”该组织在二月的一份声明中表示,该声明是在反对该试验时发布的。
The World Health Organization (WHO) has offered support in rolling out the hepatitis B vaccine at birth to all newborns in Guinea-Bissau. “WHO stands ready to support Guinea‑Bissau as it considers its way forward and in accelerating the introduction of the birth dose and strengthening implementation,” the organization said in a February statement pushing back on the trial.