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US Public Health Service sets out plan for xenotransplantation
SCIENCE AND MEDICINE
NEWS Gro Harlem Brundtland secures top job at WHO
G
Associated Press
Harvard, USA, Brundtland held ro Harlem Brundtland was successive posts in government nominated on Jan 27 to head medical services before becoming WHO for the next 5-year term. Minister of Environment in “The health dimension has not 1974. 5 years later, had enough attenshe became Prime tion from world Minister, and was releaders. That has to elected three times. change; I see it as During her tenure, my first priority”, she chaired the said the former World Commission Norwegian Prime on Environment and Minister. Development, which The 58-year-old led to the 1992 Earth doctor was one of Summit in Rio de five candidates to Janeiro, Brazil. appear before the Speaking after the 32-member WHO Executive Board Executive Board. announcement, she She finally emerged emphasised WHO’s as their choice by Leading WHO into 2000 duty towards the securing 18 votes in developing world. “If we’re to live the fourth ballot, compared with up to the aim of the WHO constituten votes for Sir George Alleyne tion—to secure the highest attain(WHO, the Americas), and four able health for everyone—we have votes for Uton Muchtar Rafei to unite in our combat against (WHO, western Pacific). poverty. People in developing counEducated in Oslo, Norway, and
tries carry over 90% of the burden of disease, yet they have access to only 10% of the resources that are used for health.” Brundtland indicated that four areas in particular required renewed effort: ● To put health at the top of the political agenda; ● To help countries establish primary health-care services available to all their citizens; ● To be better prepared to respond to emergencies; ● To renew the “management style” at WHO through reform to make maximum use of its concentration of talent. Everyone working for WHO must have a “clear and ambitious mandate”, she said. Brundtland will take over the post on July 21; her appointment has to be endorsed by the World Health Assembly in May. Alan McGregor
US Public Health Service sets out plan for xenotransplantation he biomedical research animals of the moment may be cloned sheep and cattle, but, for now, the US government is focusing attention on pig hearts and other animal organs for xenotransplantation. At a public
meeting held at the National Institutes of Health (Bethesda, MD; Jan 21–22), the Public Health Service outlined its oversight plan for xenotransplantation, which includes a registry to track outcomes of each xenograft recipient. Major themes of PHS oversight plan A pilot registry is underway Infectious diseases in which the PHS is receiving ● Registry of trials and recipients to be clinical and laboratory data established about recipients from three ● Specimen repository to be established trial sponsors. In tandem with ● Proper animal-husbandry procedures to be the full registry, a central delineated repository to archive biological ● Trial sponsors to develop pathogen assays samples—from xenograft Regulation recipients, exposed health-care ● Food and Drug Administration to oversee workers, and source animals— all clinical trials will be created for future ● National advisory committee to deliberate public-health investigation. on policy Whether other close contacts Ethics of recipients should be moni● Trial sponsors to obtain proper informed tored and for how long consent from recipients and to offer samples should be held is still education and counselling to third-party under discussion. groups such as medical personnel and Such questions would likely patients’ close contacts come before the proposed National Xenotransplantation
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THE LANCET • Vol 351 • January 31, 1998
Advisory Committee, another component of the PHS oversight strategy. The committee of scientists, ethicists, and members of the public would review data and recommend policies in an attempt to balance the promise of greater organ availability with concerns over transplant-borne disease. The difficulties inherent in creating disease-free source animals were illustrated by changes to the draft PHS Guideline on Infectious Disease Issues in Xenotransplantation, which will be finalised later this year. PHS had originally excluded “recycled or rendered animal materials” from feed to avert prion-mediated diseases, but it was noted that this exclusion would effectively prevent early weaning of animals, also a disease-prevention measure. Louisa Chapman of the US Centers for Disease Control (Atlanta, GA) said that the guidelines have been revised accordingly. M Nielsen Hobbs
343
NEWS Gro Harlem Brundtland secures top job at WHO
G
Associated Press
Harvard, USA, Brundtland held ro Harlem Brundtland was successive posts in government nominated on Jan 27 to head medical services before becoming WHO for the next 5-year term. Minister of Environment in “The health dimension has not 1974. 5 years later, had enough attenshe became Prime tion from world Minister, and was releaders. That has to elected three times. change; I see it as During her tenure, my first priority”, she chaired the said the former World Commission Norwegian Prime on Environment and Minister. Development, which The 58-year-old led to the 1992 Earth doctor was one of Summit in Rio de five candidates to Janeiro, Brazil. appear before the Speaking after the 32-member WHO Executive Board Executive Board. announcement, she She finally emerged emphasised WHO’s as their choice by Leading WHO into 2000 duty towards the securing 18 votes in developing world. “If we’re to live the fourth ballot, compared with up to the aim of the WHO constituten votes for Sir George Alleyne tion—to secure the highest attain(WHO, the Americas), and four able health for everyone—we have votes for Uton Muchtar Rafei to unite in our combat against (WHO, western Pacific). poverty. People in developing counEducated in Oslo, Norway, and
tries carry over 90% of the burden of disease, yet they have access to only 10% of the resources that are used for health.” Brundtland indicated that four areas in particular required renewed effort: ● To put health at the top of the political agenda; ● To help countries establish primary health-care services available to all their citizens; ● To be better prepared to respond to emergencies; ● To renew the “management style” at WHO through reform to make maximum use of its concentration of talent. Everyone working for WHO must have a “clear and ambitious mandate”, she said. Brundtland will take over the post on July 21; her appointment has to be endorsed by the World Health Assembly in May. Alan McGregor
US Public Health Service sets out plan for xenotransplantation he biomedical research animals of the moment may be cloned sheep and cattle, but, for now, the US government is focusing attention on pig hearts and other animal organs for xenotransplantation. At a public
meeting held at the National Institutes of Health (Bethesda, MD; Jan 21–22), the Public Health Service outlined its oversight plan for xenotransplantation, which includes a registry to track outcomes of each xenograft recipient. Major themes of PHS oversight plan A pilot registry is underway Infectious diseases in which the PHS is receiving ● Registry of trials and recipients to be clinical and laboratory data established about recipients from three ● Specimen repository to be established trial sponsors. In tandem with ● Proper animal-husbandry procedures to be the full registry, a central delineated repository to archive biological ● Trial sponsors to develop pathogen assays samples—from xenograft Regulation recipients, exposed health-care ● Food and Drug Administration to oversee workers, and source animals— all clinical trials will be created for future ● National advisory committee to deliberate public-health investigation. on policy Whether other close contacts Ethics of recipients should be moni● Trial sponsors to obtain proper informed tored and for how long consent from recipients and to offer samples should be held is still education and counselling to third-party under discussion. groups such as medical personnel and Such questions would likely patients’ close contacts come before the proposed National Xenotransplantation
T
THE LANCET • Vol 351 • January 31, 1998
Advisory Committee, another component of the PHS oversight strategy. The committee of scientists, ethicists, and members of the public would review data and recommend policies in an attempt to balance the promise of greater organ availability with concerns over transplant-borne disease. The difficulties inherent in creating disease-free source animals were illustrated by changes to the draft PHS Guideline on Infectious Disease Issues in Xenotransplantation, which will be finalised later this year. PHS had originally excluded “recycled or rendered animal materials” from feed to avert prion-mediated diseases, but it was noted that this exclusion would effectively prevent early weaning of animals, also a disease-prevention measure. Louisa Chapman of the US Centers for Disease Control (Atlanta, GA) said that the guidelines have been revised accordingly. M Nielsen Hobbs
343