Outgoing senior WHO scientist regrets mistakes in debate over whether SARS-CoV-2 is airborne | Science

Indian pediatrician Soumya Swaminathan last week Announced on Twitter He is leaving his position as a senior scientist at the World Health Organization (WHO) at the end of this month. She plans to return to India and work in public health.

Swaminathan, 63, joined the WHO in 2017, and in March 2019, the agency’s first chief scientist post was created by executive order. Tedros Adhanom Ghebreyesus Be assured that “WHO anticipates and constantly monitors the latest scientific developments.” During the COVID-19 pandemic, Swaminathan was one of those who fielded questions from reporters at countless press conferences on the agency’s global response. Talking about the science of COVID-19 “wasn’t really considered one of the roles of a general scientist,” he said — but he accepted the role. His biggest regret is not recognizing the possibility of SARS-CoV-2 being spread by aerosols early in the pandemic.

WHO is yet to name Swaminathan’s successor larger refugees from the top management of the agency.

ScienceInsider caught up with Swaminathan to discuss his time at WHO, his future plans and advice for his successor. The questions and answers have been edited for brevity and clarity.

Q: Why are you leaving?

A: The most important thing is that after 5 years of working at the international level, I want to return to work at the national level. As India and many other countries have prioritized health, I believe there is a once-in-a-century opportunity to change our approach to health with a more systemic approach, one that focuses on prevention and health promotion. [and] focus on determinants of health. For now, I will probably be working with a research foundation in Chennai. I don’t know what else to do right now.

Q: Did working at the WHO show you any limitations to working at the international level?

A: That’s what we’ve been fighting for. WHO has an important responsibility to highlight issues and present data based on the best evidence, free from conflicts of interest and politics. But all the work, such as investment, policy translation, and actual implementation, is done in the countries. So most advance loans go to countries; At the same time, if they do not do this, they must also be held accountable.

Q: Can you give an example?

A: Most countries in the world do not have good systems for measuring and reporting causes of death. This is a huge disadvantage. You can’t do good policy planning if you don’t know what the burden of different diseases is, how it evolves over time, and how interventions help.

– Before your arrival, there was no role of senior scientist in WHO. How has your perception of the character changed? What will you tell your successor about this?

A: This is a multifaceted role. During the pandemic, I became the spokesperson for the WHO, which was not part of the role of the chief scientist. As I set out in 2019, I had two or three big visions. The first one really had to work on our norms and standards. We want to develop what we call a live approach to guidelines, where we want to update all recommendations in real time, as we did for the treatment of COVID-19. But making them available in an easy-to-use format for countries means that someone in a primary health clinic doesn’t have to read those thick books, but can look up the latest WHO guidelines on snakebites or bites in an app. another problem they face with their patients.

Sometimes some Member States or interest groups get upset and ask us to change the recommendations. So, at that time, the senior scientist should stand very strong.

Q: Can you give an example?

A: A few years ago, we issued strict guidelines saying that antibiotics should not be used to promote growth or prevent disease in livestock because it creates antimicrobial resistance. Several member states were very upset. They did not want to issue this recommendation because it affects their industry. We followed our guidelines, we didn’t change them.

Q: I think it helps if you have the support of the CEO.

A: Tedros has always taken a scientific view, but he is willing to change his mind if we present him with other evidence. During the time of COVID-19, there was a lot of focus on the spread of airborne infectious diseases, a lot of research was done, and engineers from other fields, for example, came to the field. So I’ve been asked to convene an internal and external group to see if it’s time to change the definitions and terms we use to describe it. I was hoping it would be out before I left, but it might take a few more months.

Q: As a senior scientist, was not airing SARS-CoV-2 your biggest mistake?

A: We should have done this a long time ago based on the evidence we had, and it cost the organization. You can argue with that [the criticism of WHO] It’s not fair, because when it comes to mitigation, we’ve talked about all the methods, including ventilation and masking. But then we didn’t forcefully say, “This is an airborne virus.” We regret not doing more.

Q: Why not? What went wrong?

A: I think it’s a mixed bag. I was very new to the general scientist role and it was undefined; What does a general scientist do during a pandemic? I tried to do what I thought was best. What happens at WHO is that the technical department makes the guidelines, and in the scientific department we just set the norms for how to make the guidelines. So it’s not my responsibility, no one asked me to participate in that stage. … The current paradigm is based on the flu, because most of our pandemic preparedness is the flu. Similarly, SARS-1 was so different in its pathogenesis that we could not fully predict it. But in the beginning it had to be based on some things. So, here’s what I think I’d say to the next chief scientist: If new evidence comes out, especially if it’s a situation that challenges our understanding from other fields, get involved early!

Q: You said earlier that you started with two or three priorities. What are the others?

A: One is to act as a bridge between the global scientific community and the health community. We explore areas where technology is growing rapidly, such as gene editing, artificial intelligence, and 3D organ printing. Another direction is to promote norms and standards for research and information sharing, to ensure that more research is done in low- and middle-income countries, and that researchers there get the recognition they deserve.

Q: Where do you feel you have had the most success?

A: I think it will put the science industry on track, give it a lot of global visibility, and connect with the larger scientific community. Last month, we signed a memorandum of cooperation with the International Council of Science with 130 scientific academies around the world. Last year, we established the WHO Scientific Council, chaired by Nobel laureate Harold Warmus.

Another thing I am proud of is the establishment of the WHO mRNA Vaccine Technology Center based in Cape Town, which aims to provide messenger RNA vaccines to Africa. Moderna and BioNTech-Pfizer refused to share any technical know-how or help us in any way, but South African scientists were still able to develop a vaccine. Of course, now it must pass all stages of clinical trials. So I can’t say I was completely successful. But the first results are very encouraging. Finally, I am proud to have played a role in WHO communications.

Q: You used to communicate on Twitter occasionally. How do you see the future of this platform?

A: I’m not sure what will happen. I just wait and see. But I’m not so optimistic that it will be a good platform going forward. If public health people start to leave Twitter, it doesn’t make sense to stay there, but it’s too early to judge.

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