Carta Abierta a Dr. Margaret Chan, Director General, Organización Mundial de la Salud, OMS

The authors of the letter would like to thank Carolina Juliann for her generous work on the spanish translation.


Carta Abierta a Dr. Margaret Chan, Director General, Organización Mundial de la Salud, OMS

(Reenviada al Comité Internacional Olímpico)

Estamos escribiendo para expresar nuestra preocupación sobre los próximos Juegos Olímpicos y Paraolímpicos en Rio de Janeiro. La declaración de la OMS sobre el Zika como una “Emergencia de Salud Pública de Interés Internacional”, respaldado por descubrimientos científicos que resaltan la seriedad del problema, hacen necesario que los Juegos Rio 2016 sean pospuestos y/o relocalizados—pero no cancelados—en nombre de la salud pública.

Hacemos este llamado a pesar del amplio fatalismo en torno a que los Juegos de Rio 2016 son inevitables o “muy grandes para fallar”. La historia nos enseña que esto es incorrecto: los Juegos Olímpicos de 1916, 1940 y 1944 no solo fueron pospuestos o relocalizados, si no que cancelados. Otros eventos deportivos han sido movidos debido a enfermedades, tal como la Liga Mayor de Baseball lo hizo por el Zika, y la Copa Africana de Naciones lo hizo por el Ébola. La FIFA reubicó la Copa Mundial Femenina de China a Estados Unidos por la epidemia del SARS, basado en recomendaciones de expertos/as académicos/as, tal como muchos de nosotros/as.

Actualmente muchos/as atletas, delegaciones y periodistas están luchando con la decisión de si participar en los Juegos de Rio 2016. Estamos de acuerdo con la recomendación del Centro para el Control y Prevención de Enfermedades que los/as trabajadores/as deberían “considerar retrasar el viajar a áreas con transmisión del virus Zika activa”. Si esa recomendación fuera respetada uniformemente, ningún/a atleta tendría que elegir entre arriesgar contraer el virus y participar en una competencia para la que muchos/as han entrenado toda su vida.

Pero nuestra principal preocupación es la salud mundial. La cepa de virus del Zika en Brasil afecta la salud en maneras que la ciencia no ha visto antes. Es un riesgo innecesario que 500,000 turistas extranjeros/as de todos los países asistan a los Juegos, potencialmente adquieran esa cepa, y vuelvan a sus hogares en lugares donde se puede convertir en una epidemia. Si eso ocurriera en lugares de menores recursos, que aún no han sido afectados (por ej. Sur de Asia y África), el sufrimiento seria tremendo. Es antiético correr el riesgo, siendo que los Juegos que podrían realizarse de todas maneras, si fueran pospuestos y/o relocalizados.

En nuestra opinión, múltiples nuevos descubrimientos científicos requieren que la OMG reconsidere nuestra recomendación sobre los Juegos Olímpicos y Paraolímpicos 2016. Por ejemplo:

1. La cepa del Virus en Brasil causa microcefalia y probablemente Síndrome Guillain-Barre. Más aun, dado que humanos, animales y estudios in vitro demuestran que el virus es neurotrópico y causa la muerte de células, es biológicamente posible que hayan otros daños neurológicos aún por descubrir, como existen en otros virus similares (por ej., dengue).

2. Mientras que el riesgo a un individuo es bajo, el riesgo a una población es, sin lugar a dudas, alto. Actualmente, el gobierno de Brasil reporta 120.000 posibles casos de Zika, y 1.300 casos confirmados de microcefalia (con otros 3.3000 en investigación), lo cual está por sobre los niveles históricos de microcefalia.

3. La ciudad de Rio de Janeiro está altamente afectada por el Zika. El gobierno de Brasil reporta que el Estado de Rio de Janeiro tiene segundo número de casos probables de Zika más alto en el país (32.000) y la cuarta más alta tasa de incidencia (195 por cada 100.000), demostrando transmisión activa.

4. A pesar del nuevo programa de erradicación de mosquitos en Rio, la transmisión de la enfermedad transmitida por mosquitos ha aumentado en vez de disminuir. Siendo el Zika una nueva epidemia que carece de datos históricos, usando la fiebre del dengue como proxy, los casos en Rio desde Enero a Abril del 2016 han aumentado en 320% y 1150% en comparación al mismo periodo el 2014 y 2015, respectivamente. En el sector del Parque Olímpico (Barra da Tijuca) ha habido más casos de dengue que en el primer cuarto del 2016 que en todo el 2015.

5. El sistema de salud en Rio esta tan severamente debilitado que hace un último esfuerzo contra el Zika imposible. Recientemente el gobierno estatal de Rio declaró un sector de salud de emergencia, y el gobierno de la ciudad de Rio redujo el financiamiento contra enfermedades transmitidas por mosquitos en un 20%. Mientras que el virus es el agente infeccioso del Zika, su verdadera causa son las bajas condiciones sociales y de sanidad de Rio—factores que carecen de una solución inmediata, y que se ven aun peor cuando los escasos recursos de salud son redirigidos a los Juegos.

6. Es posible erradicar el mosquito Aedes Aegypti, el cual transmite el Zika, de Rio. De hecho, ese mosquito fue erradicado de Brasil en los años 50, pero volvió luego que los esfuerzos de control decayeron. Por lo tanto, realizar los Juegos en presencia del mosquito que transmite el Zika es una decisión y no una necesidad.

7. No se puede contar con la naturaleza como defensa. Mientras que el nivel de actividad bajo de los mosquitos durante los meses de invierno en Rio reducen el riesgo individual de infección para turistas, esto es en parte compensa cuando las personas que están infectadas vuelven a sus hogares durante los meses de verano del hemisferio norte y en la época alta de actividad de los mosquitos, lo cual aumenta el riesgo a la salud pública que mosquitos locales adquieran y esparzan el virus—lo cual quiere decir que ambas estaciones son relevantes en el curso de la epidemia. Además, la infección se puede esparcir a través de donaciones de sangre y transfusiones, particularmente en países pobres que carecen de análisis para el Zika.

En resumen, la evidencia indica que: (i) La cepa del virus Zika en Brasil tiene consecuencias medicas más serias que lo sabido anteriormente, (ii) que Rio de Janeiro es una de las partes más afectadas de Brasil, y (iii) que los esfuerzos para erradicar el mosquito en Rio no están siendo suficientes y, en cambio, la enfermedad acarreada por mosquitos ha aumentado este año. Es por lo tanto imperativo que la OMS una evaluación nueva y basada en la evidencia del Zika y los Juegos, y sus recomendaciones a turistas.

Dado que el Zika es una nueva emergencia, sus incertidumbres—sobre flujos de viaje durante los Juegos, de epidemiologia, de entomología—hacen imposible que actualmente los modelos matemáticos predigan el curso de la epidemia con precisión. Por lo tanto, por ahora, cualquier decisión sobre el Zika y los Juegos debe ser más cualitativa que cuantitativa. Si se consideran las siguientes opciones:

(a) Realizar los Juegos en Rio 2016 se llevan a cabo como programados;

(b) Realizar los Juegos en Rio después que el Zika sea controlado, y;

(c) Realizar los Juegos en un sitio libre de Zika que tengan instalaciones de los estándares de las Olimpiadas.

Es irrefutable que la opción (a) de realizar los Juegos como programado tiene un mayor riesgo de acelerar el contagio de la cepa viral de Brasil que las otras alternativas. Posponer y/o relocalizar los Juegos también mitiga otros riesgos debido a problemas históricos con la economía, gobernanza, y sociedad en general en Brasil—los cuales no son problemas aislados si no que un contexto que hace el problema del Zika imposible de resolver con los Juegos a realizarse prontamente.

Nos preocupa que la OMS rechace estas alternativas debido a un conflicto de interés. Específicamente, la OMS ha entrado en una alianza oficial con el Comité Internacional Olímpico, en un Memorándum de Entendimiento que continua siendo secreto. No hay ninguna razón por la que la OMS no revele este Memorándum de Entendimiento, dado que es una práctica estándar cuando hay conflictos de interés. El no hacerlo pone en duda la neutralidad de la OMS, por razones descritas en detalle en el Apéndice.

La OMS debe revisar el tema del ZIKA y posponer y/o relocalizar los Juegos. Similar a lo que la FIFA hizo para el SARS con la Copa Mundial Femenina, recomendamos que la OMS reúna un grupo independiente para que le dé a la OMS y a la COI recomendaciones de una manera transparente, en un proceso basado en la evidencia en el cual la ciencia, la salud pública, y el espíritu deportivo sean lo primordial. Dadas las consecuencias éticas y a la salud pública, el no hacerlo sería irresponsable.


Los firmantes

Authors: Prof. Amir Attaran (University of Ottawa: aattaran@uottawa.ca), Prof. Arthur Caplan (New York University, USA: arthur.caplan@nyumc.org) Dr. Christopher Gaffney (University of Zürich: christopher.gaffney@geo.uzh.ch), Prof. Lee Igel (New York University, USA: lee.igel@nyu.edu).

1. Prof. Akira Akabayashi, Department of Biomedical Ethics, School of Public Health, The University of Tokyo Faculty of Medicine, Tokyo, Japan

2. Prof. Paul S. Appelbaum, Director, Division of Law, Ethics & Psychiatry, Department of Psychiatry, Columbia University, New York, USA

3. Prof. Kwame Anthony Appiah, Department of Philosophy, NYU Law, New York University, New York, USA

4. Prof. Thalia Arawi, Founding Director, Salim El-Hoss Bioethics & Professionalism Program, Faculty of Medicine, American University of Beirut, Beirut, Lebanon

5. Prof. Dr. Pedro Arcos, MD, Ph.D., Director, Unit for Research in Emergency and Disaster, Faculty of Medicine and Health Sciences, University of Oviedo Campus del Cristo, Oviedo, Spain

6. Prof. Amir Attaran, School of Epidemiology, Public Health and Community Medicine and Faculty of Law, University of Ottawa, Canada

7. Ms. Stephanie Augustine, Researcher, Department of Maternal Fetal Medicine, North Shore University Hospital, Manhasset, USA

8. Dr. Patricia Almeida Ashley, Associate Professor, Department of Geoenvironmental Analysis, Institute of Geosciences, Universidade Federal Fluminense, Niteroi, Rio de Janeiro State, Brazil

9. Dr. Pejman Azarmina, Senior Medical Director, CardioDx Inc., California, USA

10. Prof. Robert Baker, Bioethics Program of Clarkson University & The Icahn School of Medicine at Mount Sinai, Schenectady, USA

11. Dr. Behnoush Bakhtiari, DDS, Research Assistant at the University of Washington, USA

12. Prof. Francis Barany, Dept. of Microbiology & Immunology, Weil Cornell Medicine, New York, USA

13. Dr. Alison Bateman-House, Division of Medical Ethics, Department of Population Health, New York University School of Medicine, New York, USA

14. Prof. Dr. Alexander Batthyany, Cognitive Science Program, Dept. of Philosophy, University of Vienna, Austria

15. Prof. Frances Batzer, Department of Obstetrics & Gynecology, Thomas Jefferson University, Philadelphia, USA

16. Prof. Angelica M. Baylon, External Relations Director, Maritime Academy of Asia, Kamaya Point, Philippines

17. Mr. Andy Beckmann, Biologist, CEO, German Pest Control Association, Germany

18. Dr. Namiranian Behdad, MD, Our Lady of Fatima University, College of Medicine, Philippines

19. Prof. Solly Benatar, Founding Director, University of Cape Town Bioethics Centre, Department of Medicine, University of Cape Town, Cape Town, South Africa 20. Prof. Cecilia Benoit, Centre for Addictions Research of British Columbia, Department of Sociology, University of Victoria, Victoria, Canada

21. Mr. Edward J. Bergman, Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA

22. Prof. Kenneth Berkowitz, Department of Population Health and Department of Medicine, School of Medicine, New York University, New York, USA

23. Prof. Ivy Lynn Bourgeault, Canadian Institutes of Health Research Chair in Gender, Work and Health Human Resources Telfer School of Management, University of Ottawa, Ottawa, Canada

24. Prof. Marie A. Bragg, Department of Population Health, New York University School of Medicine, New York, USA

25. Dr. Joe Brierley, Consultant Critical Care & Bioethics, Great Ormond St Hospital, London, UK; President of the European Society of Paediatric and Neonatal Intensive Care, UK

26. Dr Berit Bringedal, Senior Researcher, Institute for Studies of the Medical Profession, Oslo, Norway

27. Prof. Amy Brown, Maria Fareri Children’s Hospital at Westchester Medical Center, Department of Pediatrics, New York Medical College, Valhalla, USA

28. Prof. Arthur L. Caplan, Division of Medical Ethics, New York University Langone Medical Center, New York, USA

29. Dr. Susan O. Cassidy, MD, JD Founder, CriticalMD, Florida, USA.

30. Dr. Rhyddhi Chakraborty, Researcher, Philosophical Bioethics, Global Public Health and Social Justice, American University of Sovereign Nations, USA.

31. Prof. Theeraphap Chareonviriyaphap, Department of Entomology, Kasetsart University, Bangkok, Thailand

32. Dr. Wiboon Chongrattanameteekul, Associate Professor, Department of Entomology, Kasetsart University, Bangkok, Thailand

33. Prof. Cheryl Cline, Office of Bioethics, Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Canada.

34. Dr. Wayne Conlan, Principal Research Officer, Vaccines Program, National Research Council, Canada

35. Dr. Catherine Constable, Instructor, Department of Medicine, New York University Langone Medical Center, New York, USA

36. Prof. Glenn Cohen, Petrie-Flom Center for Health Law Policy, Biotechnology & Bioethics, Harvard Law School, Cambridge, USA

37. Prof. Aleksandar Damjanovic, Clinic for Psychiatry, Clinical Center of Belgrade, Serbia

38. Dr. Aimée Dechter, Ph.D., Research Coordinator, Department of Sociology, University of Washington, USA

39. Prof. Patrick Derr, Chair, Department of Philosophy, Clark University, Worcester, USA

40. Prof. Débora Diniz, Faculty of Law, Universidade de Brasília, and Bioethics Program, FIOCRUZ, Brasília and Rio de Janeiro, Brazil

41. Prof. Ames Dhai, Director, Steve Biko Centre for Bioethics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

42. Dr. Hasan Erbay, MD. PhD., Department of Medical Ethics and History of Medicine, Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar, Turkey

43. Dr. Ferenc Falus, MD, Forer Chief Medical Officer (CMO) of Hungary, Hungary

44. Prof. Eric Feldman, Health Policy and Medical Ethics, University of Pennsylvania Law School, Philadelphia, USA

45. Dr. Holly Fernandez-Lynch, Executive Director, Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics, Harvard University, USA

46. Prof. Juan Ramon Fernandez Torres, Professor of Administrative Law, Universidad Complutense of Madrid, Spanish solicitor, Madrid, Spain

47. Prof. Dennis V. Ferrero, International Public Health Consultant, University of the Pacific, Department of Biological Sciences, California, USA

48. Prof. Chris Feudtner, Department of Pediatrics and Department of Medical Ethics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA

49. Prof. Donald Forthal, Professor of Medicine and Molecular Biology & Biochemistry Chief, Infectious Diseases, University of California, Irvine, USA

50. Prof. Samuel R Friedman, PhD, Director, Institute of Infectious Disease Research, National Development and Research Institutes, New York, USA

51. Dr. Christopher Gaffney, Department of Geography, University of Zürich, Zürich, Switzerland

52. Dr. Javier Gomez Garcia Yanes, PhD, Molecular Biologist and Immunologist, Freelance Science Writer and Reporter, Madrid, Spain

53. Prof. William Gardner, Children’s Hospital of Eastern Ontario Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Canada

54. Prof. Robert P. George, McCormick Professor of Jurisprudence, Princeton University, Princeton, USA

55. Prof. Grover Gilmore, Dean, Applied Social Sciences, Case Western Reserve University, Cleveland, USA

56. Miguel Górgolas, MD, MSc, DTM&H, PhD, División of Infectious Diseases, FJD. Autonomous University of Madrid, Spain

57. Prof. Moti Gorin, Director, Jann Benson Ethics Center, Colorado State University, USA

58. Prof. Linda Granowetter, Department of Pediatrics, New York University Langone Medical Center, New York, USA

59. Dr. Michele Grundstein, Board Certified Family Physician, Plantation, Florida, former assistant professor of medicine University of Miami Miller School of Medicine and Medical Director of Miami Dade Fire Fighter Wellness Center, USA

60. Dr. Sigurdur Gudmundsson, MD, Ph.D., Former Medical Director of Health (Surgeon General) in Iceland; Former Dean of the School of Academic Health Sciences, University of Iceland; Professor of Medicine, University of Iceland; Consultant in Infectious Diseases, University Hospital, Reykjavik, Iceland

61. Prof. Abhik Gupta, Ph.D., Professor and Dean, School of Environmental Sciences, Assam (Central) University, Silchar, India.

62. Prof. Sally Guttmacher, College of Global Public Health, New York University, New York, USA

63. Prof. Negin Hajizadeh, Department of Medicine, Hofstra Northwell School of Medicine, Hofstra University, Hempstead, USA.

64. Mr. George Halvorson, Chief Executive (Retired) Kaiser Permanente, and Chair, InterGroup Understanding, Sausalito, USA

65. Prof. Deborah S. Hamm, Department of Psychiatry, Columbia University Medical Center, New York, USA

66. Prof. Samuel K. Handelman, Assistant Professor (Research), Department of Molecular Virology, Immunology & Medical Genetics, Ohio State University Wexner Medical Center, USA

67. Prof. Alice Herb, Division of Humanities in Medicine at State University of New York, Downstate Medical Center, New York, USA

68. Prof. Brian Hjelle, M.D., Dept. Of Pathology, University of New Mexico Health Sciences Center, Albuquerque, USA

69. Dr. David Hoke, Attending Physician, Department of Emergency Medicine, Union Hospital, Elkton, MD, USA

70. Prof. Søren Holm, Centre for Social Ethics and Policy, School of Law, University of Manchester, UK.

71. Prof. Lee H. Igel, Tisch Institute for Sports Management, Media, and Business, New York University, New York, USA

72. Prof. Judy Illes, Canada Research Chair in Neuroethics, Department of Medicine, University of British Columbia, Vancouver, Canada

73. Prof. Rosario Isasi, MPH, Research Assistant Professor, Dr. John T. Macdonald Foundation, Department of Human Genetics, Institute for Bioethics and Health Policy, John P. Hussman Institute for Human Genomics, Interdisciplinary Stem Cell Institute, University of Miami Leonard M. Miller School of Medicine, USA

74. Dr. Mahmood-uz- Jahan, M.D., PhD., Director, Bangladesh Medical Research Council, Dhaka, Bangladesh

75. Prof. Dale Jamieson, Chair, Department of Environmental Studies, New York University, New York, USA

76. Prof. Yeremias Jena, M. Phil., M.Sc, Professor of Medical Ethics at Atma Jaya School of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.

77. Prof. Steven Joffe, Vice-Chair, Department of Medical Ethics and Health Policy, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA

78. Prof. Ken Johnson, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Canada

79. Prof. Nora Jones, Associate Director, Center for Bioethics, Urban Health and Policy, Lewis Katz School of Medicine, Temple University, Philadelphia, USA

80. Prof. Therese Jones, Associate Director, Center for Bioethics and Humanities, Director, Arts and Humanities in Healthcare Program, University of Colorado Anschutz Medical Campus, Denver, USA

81. Prof. Jernej Jorgačevski, PhD, University of Ljubljana, Faculty of Medicine, Institute of Pathophysiology, Slovenia

82. Prof. Matthias A. Karajannis, Division of Pediatric Hematology/Oncology, New York University Langone Medical Center, New York, USA

83. Prof. Douglas I. Katz, Department of Neurology, Boston University School of Medicine, Braintree, USA

84. Prof. Ralph V. Katz, Professor of Epidemiology, Fellow of the American College of Epidemiology F.A.C.E.), and Founding Chair, Department of Epidemiology and Health Promotion, New York University, New York, USA

85. Ms. Lisa Kearns, Research Associate, Division of Medical Ethics, New York University Langone Medical Center, New York, USA

86. Prof. Fazlollah Keshavarzi, PharmD, MPharm Lecturer, Clinical Pharmacy Department, Faculty of Pharmacutical Sciences, UCSI University Kuala Lumpur, Malaysia

87. Prof. Aaron Seth Kesselheim, Division of Pharmacoepidemiology & Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Harvard University, Boston, USA

88. Dr. Abbas Kharabi, University of Malaya, Kuala Lumpur, Malaysia

89. Dr. Azarmindokht Khosravi, MD, City of Hope National Medical Center, California, USA

90. Dr. Armin Khosravi, Dental Branch of Isfahan Azad University, Oral and Maxillofacial Surgery Department, Iran

91. Dr. Jörn Klein, Associate Professor, University of Southeast-Norway, Norway

92. Dr. Robert Klitzman, Professor of Psychiatry, Director, Masters of Bioethics Program Columbia University, New York, USA

93. Prof. Craig Klugman, Chair, Department of Health Sciences, DePaul University, Chicago, USA

94. Prof. Georgy Koentges, Ph.D., Laboratory of Systems Biomedicine and Evolution, School of Life Sciences, University of Warwick, UK

95. Prof. Adam Kolber, Center for Health, Science, and Public Policy, Brooklyn Law School, Brooklyn, USA

96. Prof. Craig Konnoth, Senior Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania Law School, Philadelphia, USA

97. Prof. Ralph A. Korpman, School of Medicine, Loma Linda University School of Medicine, Loma Linda, USA

98. Dr. Ronald L. Krall, Center for Bioethics and Health Law, University of Pittsburgh, Pittsburgh, USA

99. Prof. Sheldon Krimsky, Department of Urban and Environmental Policy & Planning, Department of Health and Community Medicine, Tufts University, Boston, USA

100. Dr. Andrew R. Lai, MD, MPH, Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, California, USA

101. Dr. Sara Landolt, Department of Geography, University of Zürich, Zurich, Switzerland

102. Prof. John Lantos, Director of Pediatric Bioethics, Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, USA

103. Prof. John Last, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada

104. Prof. Stephen Latham, Director, Interdisciplinary Center for Bioethics, Yale University, New Haven, USA

105. Dr. Thuy Le, Oxford University Clinical Research Unit, Oxford University, Ho Chi Minh City, Vietnam

106. Prof. Arthur Leader, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Canada

107. Mr. Leonard leBlanc, Research Fellow, Eubios Ethics Institute, Japan

108. Prof. Trudo Lemmens, Scholl Chair in Health Law and Policy, Faculty of Law, University of Toronto, Toronto, Canada

109. Prof. Samuel R. Lucas, Department of Sociology, University of California-Berkeley, USA; Faculty Affiliate, Institute for Research on Poverty, University of Wisconsin-Madison, USA

110. Prof. Betty Wolder Levin, School of Public Health and Health Policy, City University of New York, New York, USA

111. Prof. Bruce Levin, Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, USA

112. Prof. Ariane Lewis, Department of Neurology and Department of Neurosurgery, New York University Langone Medical Center, New York, USA

113. Dr. Ana Lita, Director, Global Bioethics Initiative, New York, USA

114. Prof. Julian Little, Director, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada

115. Prof. Sergio Litewka, Institute for Bioethics and Health Policy, Miller School of Medicine, University of Miami, Miami, USA

116. Prof. Alex John London, Director, Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, USA

117. Prof. Darryl Macer, Ph.D., Hon.D. President, American University of Sovereign Nations, Arizona, USA; Director, Eubios Ethics Institute, Christchurch, New Zealand

118. Prof. Tim Mackey, Director, Global Health Policy Institute, Department of Anaesthesology and Public Health, University of California at San Diego, San Diego, USA

119. Prof. Ruth Macklin, Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, USA.

120. Prof. Cheryl Macpherson, Bioethics Department, St George’s University School of Medicine, True Blue, Grenada

121. Dr. Charles J. Macri, MD, Obstetrician Gynecologist, Charles J. Macri Clinic, Washington, USA

122. Prof. Brian Martin, Director, Graduate Program in Public Health, Eastern Virginia Medical School, Old Dominion University, Norfolk, USA

123. Dr. Jan Marzinek, Department of Biological Sciences, National University of Singapore, Singapore

124. Prof. Raymond Sanchez Mayers, Ph.D., Associate Professor, Director, Latino/a Initiatives for Service, Training, and Assessment (LISTA), Rutgers University School of Social Work, New Jersey, USA

125. Prof. Thomas Mayo, Southern Methodist University Dedman School of Law, University of Texas Southwestern Medical School, Dallas, USA

126. Mr. Michael Mawadri, Emergency Coordinator with Action for Development (AFOD) in South Sudan, South Sudan

127. Prof. James McCartney (Reverend, Order of St. Augustine), Department of Philosophy, Villanova University, Villanova, USA

128. Prof. Martin McKee, MD, Founding Director of the European Centre on Health of Societies in Transition; Research Director of the European Observatory on Health Systems and Policies; London School of Hygiene and Tropical Medicine, London, UK

129. Prof. John Merz, Department of Medical Ethics & Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA

130. Jennifer Miller, PhD., Department of Population Health. NYU School of Medicine; President, Bioethics International, New York, USA

131. Mr. Alan Milstein, Sports Attorney, Sherman, Silverstein, Kohl, Rose & Podolsky, Moorestown, USA

132. Prof. Christine Mitchell, Executive Director, Center for Bioethics, Harvard Medical School, Boston, USA

133. Prof. Salimeh Pour Mohammad, PhD, Researcher in System Studies, University of Hull, UK

134. Dr. Hadi Mohseni, MD, MRCPCH(UK), Baylor-Malawi Paediatric Mentorship Program, Zomba, Malawi

135. Prof. Jonathan D. Moreno, Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA

136. Prof. Dr. Martin Müller, Department of Geography, University of Zürich, Zurich, Switzerland

137. Prof. Carin Muhr, Department of Medical Science, Uppsala University, Uppsala, Sweden

138. Prof. Christian Munthe, Professor of Practical Philosophy, Department of Philosophy, Linguisics and Theory of Science, University of Gothenburg, Sweden

139. Dr. Frederick Naftolin, M.D., Professor of Obstetrics and Gynecology and Environmental Medicine, Director, Reproductive Biology Research, New York, USA

140. Dr. Itamar Netzer, Department of Gynecology and Obstetrics, Rambam Healthcare Campus, Israel

141. Prof. Anna Nolan, Department of Environmental Medicine , Department of Medicine, New York University Langone Medical Center, New York, USA

142. Dr. Sean O’Donnell, JD, MPH, PhD, Department of the History of Science, Harvard University, Cambridge, USA

143. Prof. Stjepan Oreskovic, Andrija Stampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia

144. Prof. Jesus Ricardo Parra Unda, Facultad de Ciencias Químico Biológicas, Universidad Autonoma de Sinaloa, México

145. Prof. Brendan Parent, Division of Medical Ethics and Co-Director NYU Sports and Society Program, New York University, New York, USA

146. Prof. Shamina Parvin Lasker, Head of Department of Anatomy, Samorita Medical College; Secretary General, Bangladesh Bioethics Society, Dhaka, Bangladesh.

147. Dr. Eva Patalas, Clinical Associate in Pathology, Massachusetts General Hospital, Boston, USA

148. Prof. Pasquale Patrizio, Division of Reproductive Endocrinology & Infertility, Yale School of Medicine, New Haven, Connecticut, USA

149. Prof. André F. Pilon, Associate Professor at the School of Public Health, University of São Paulo, Brazil

150. Prof. Sean Philpott-Jones, Department of Bioethics, Clarkson University, Schenectady, NY

151. Dr. Carolyn Plunkett, Division of Medical Ethics, New York University Langone Medical Center, New York, USA

152. Dr. Catherine Pound, Assistant Professor of Pediatrics, University of Ottawa; Consulting Paediatrician, Children’s Hospital of Eastern Ontario, Canada

153. Prof. Stephen G. Post, Department of Family, Population & Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, USA

154. Dr. Maja Potokar, Research Fellow, University of Ljubljana, Faculty of Medicine, Slovenia

155. Prof. Kathleen Powderly, Director, John Conley Division of Medical Ethics and Humanities, SUNY Downstate Medical Center, Brooklyn, USA

156. Prof. Duncan Purves, Environmental Studies and Bioethics, New York University, New York, USA

157. Prof. Vojin Rakic, Founding Director, Center for the Study of Bioethics, Head of the European Division of the UNESCO Chair in Bioethics, University of Belgrade, Serbia

158. Prof. Dina Reveh, Ph.D., Professor (emerita) of Genetics, Department of Life Sciences, Ben Gurion University of the Negev, Beersheba, Israel

159. Prof. Vardit Ravitsky, School of Public Health, Université de Montréal, Montreal, Canada

160. Prof. Avad Raz, Department of Sociology and Anthropology, Ben-Gurion University of the Negev, Be’er-Sheva, Israel

161. Dr. Mary Redmond, MD FRCSC, GenSurg CVT Surg, Chronic Pain Management Specialist, Ottawa, Canada

162. Prof Kathleen Reeves, Director, Center for Bioethics, Urban Health, and Policy, Lewis Katz School of Medicine, Temple University, Philadelphia, USA

163. Prof. Michael Ristow, M.D., Professor of Energy Metabolism, ETH Zurich (Swiss Federal Institute of Technology), Switzerland

164. Prof. Donald R. Roberts, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, USA

165. Dr. Philip Rubin, Principal Assistant Director (Retired), Office of Science and Technology Policy (OSTP), Executive Office of the President of the United States, New Haven, USA

166. Prof William Ruddick, Founding Director, Center for Bioethics, New York University, New York, USA

167. Prof. Sergio Ponce-de-Leon, Teaching Director, Instituto Nacional De Ciencias Medicas Y Nutricion, Mexico

168. Prof. Maya Sabatello, Department of Psychiatry, Columbia University, New York, USA

169. Dr. Mojgan Saleuhipour, Faculty of Biomedicine, South Baylo University, CA, USA

170. Prof. Judit Sandor, Director of the Center for Ethics and Law in Biomedicine, Central European University, Budapest, Hungary

171. Prof. Pamela L. Sankar, Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA

172. Prof. Arthur Schaefer, Founding Director, Centre for Professional and Applied Ethics, University of Manitoba, Canada

173. Prof. Doris Schroeder, Centre for Professional Ethics, College of Health, University of Central Lancashire, UK

174. Prof. Udo Schuklenk, Ontario Research Chair in Bioethics, Department of Philosophy, Queen’s University, Kingston, Canada

175. Prof. Evan Selinger, Department of Philosophy, Rochester Institute of Technology, Rochester, USA

176. Dr. M. Selvanayagam, Professor, Dean of Research and President of India Association of Bioethics, India

177. Prof. Seema K. Shah, Department of Pediatrics, University of Washington School of Medicine, Seattle, USA

178. Prof. William S. Silvers, University of Colorado Denver School of Medicine, Denver, USA

179. Prof. Peter Singer, University Center for Human Values, Princeton University, Princeton, USA; and School of Historical and Philosophical Studies, University of Melbourne, Melbourne, Australia

180. Prof. Maria Fiatarone Singh, Chair of Exercise and Sport Science, Faculty of Health Sciences, Sydney Medical School, University of Sydney, Australia

181. Prof. Dominic A. Sisti, Ph.D., Director, The Scattergood Program for Applied Ethics of Behavioral Health Care; Assistant Professor, Department of Medical Ethics & Health Policy, Perelman School of Medicine at the University of Pennsylvania, USA

182. Prof. Daniel Skinner, Assistant Professor of Health Policy, Department of Social Medicine, Ohio University, Dublin, USA

183. Raquel R. Smith, Ph.D., Prof. Of Clinical Psychology, American University of Sovereign Nations, Arizona, USA; Community Emergency Response Team (FEMA) Instructor and Manager

184. Prof. Robert Smith?, Department of Mathematics and Faculty of Medicine, University of Ottawa, Ottawa, Canada

185. Prof. Jeremy Snyder, Faculty of Health Science, Simon Fraser University, Burnaby, Canada

186. Prof. Robert W. Snyder, Esq. Attorney at Law, Professor of Healthcare Management and Finance, American University of Sovereign Nations School of Medicine, USA

187. Prof. Alissa Spielberg, JD, MPH, Women’s & Gender Studies, Wellesley College, United State

188. Dr. Thomas H. Steinberg, Ph.D., Courtesy Research Associate, Institute of Molecular Biology, University of Oregon, USA

189. Prof. Martin Strosberg, Bioethics Program of Clarkson University & The Icahn School of Medicine at Mount Sinai, Schenectady, USA

190. Prof. Eileen Sullivan-Marx, Dean, School of Nursing, New York University, New York, USA

191. Norman K. Swazo, Ph.D., M.H.S.A., Professor of Philosophy and Public Health, School of Humanities & Social Sciences, School of Health and Life Sciences, North South University, Dhaka, Bangladesh

192. Prof. Leonore Tiefer, Ph.D., Department of Psychiatry, NYU School of Medicine, New York, USA

193. Dr. Mitra Tavakoli, Senior Lecturer in Medicine University of Exeter, Medical School Exeter, UK

194. Prof. Edwin van Teijlingen, Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK

195. Prof. Henk ten Have, Director, Center for Healthcare Ethics, Duquesne University, Pittsburgh, USA

196. Dr. Jordan Tesluk, Postdoctoral Fellow, National Core for Neuroethics, Department of Sociology, University of British Columbia, Canada

197. Dr. Tatsuhito Tonooka, Former Director of Health, Otaru Care Center, Otaru, Japan

198. Ms. Ananya Tritipthumrongchok, General Manager, International Peace and Development Ethics Centre, Kaeng Krachan, Thailand

199. Prof. Duunjian Tsai, M.D., Ph.D., Professor, Taipei Medical University, Taiwan

200. Dr. Johan Ullman, M.D., Anaesthesiology & Intensive Care, and Occupational Medicine, Navy Medical Officer (res) Sweden

201. Prof. Connie Ulrich, Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, USA

202. Prof. Erick Valdés, Universisad del Desarrollo, Chile

203. Prof. Robert M. Veatch, Kennedy Institute of Ethics, Georgetown University, Washington DC, USA

204. Prof. J. David Velleman, Professor of Philosophy and Bioethics, New York University, New York, USA

205. Dr. Andreas Vilhelmsson, Department of Clinical Sciences Division of Social Medicine and Global Health, Lund University, Sweden

206. Dr. Ford Vox, Brain Injury Medicine, Shepherd Center, Atlanta, USA

207. Dr. Gary I. Wadler, Past Chairman, World Anti-Doping Agency (WADA) Prohibited List Committee, Recipient of the International Olympic Committee’s President’s Prize in 1993, Manhasset, USA

208. Prof. Jeanette Ward, Ph.D., Adjunct Professor, Nulungu Research Institute, Broome, WA, Notre Dame University, Australia

209. Mr. Wendell Wallach, Lecturer, Yale Interdisciplinary Center for Bioethics, New Haven, USA

210. Dr. Juan N Walterspiel, MD, FAAP, Pediatric Locum Ukaia Valley Medical Center, CA, USA

211. Dr. Nacy Walton, Associate Professor at the School of Nursing, Ryerson University, Toronto, Canada

212. Prof. Vivian Welch, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada

213. Prof. Bruce Wilcox, Faculty of Public Health, Mahidol University, Bangkok, Thailand

214. Prof. Benjamin Wilfond, Director, Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Department of Pediatrics, University of Washington, Seattle, USA

215. Prof. Bryn Williams-Jones, PhD, Professeur titulaire / Full Professor, Director; Programmes de bioéthique, Département de médecine sociale et préventive, École de santé publique de l’Université de Montréal; Editor in Chief, BioéthiqueOnline, Montreal, Canada

216. Dr. Chris Willmott, Department of Molecular & Cell Biology, University of Leicester, UK

217. Dr. Loren Wissner Greene, MD MA (Bioethics), Clinical Professor of Medicine (Endocrinology) and ObGyn, Associate Faculty of Division of Medical Ethics and NYU Center for Bioethics, New York, USA

218. Prof. Wendy L. Wobeser, Division of Infectious Diseases, Queen’s University, Kingston, Canada

219. Prof. Paul Root Wolpe, Asa Griggs Candler Professor of Bioethics and Director, Center for Ethics, Emory University, Atlanta, USA

220. Dr. Elizabeth Wrigley-Field, Robert Wood Johnson Foundation Health and Society Scholar, Columbia University; Assistant Professor, Sociology, University of Minnesota, USA

221. Prof. Sanni Yaya, School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada.

222. Prof. Boris Yudin, Department of Humanitarian Expertise and Bioethics, Institute of Philosophy, Russian Academy of Sciences, Moscow, Russia

223. Dr. Diana Zuckerman, President, National Center for Health Research, Washington DC, USA


Apéndice: Organización Mundial de la Salud (OMS) y Comité Olímpico Internacional (COI) en asociación.

La OMS tiene hace décadas una asociación de alto nivel con el Comité Olímpico Internacional.  Esta asociación fue ratificada el año 2010 en un evento donde la Directora General de la OMS y el Presidente del COI firmaron un memorándum de entendimiento, el cual es secreto ya que ni una de las partes lo ha revelado.

De forma inapropiada, la OMS ve su rol no sólo como proveedor de  asesoramiento en salud pública.  Estableció un “Grupo asesor interdisciplinario virtual”, cuyo “punto importante de promoción”, de acuerdo a la OMS es “que este grupo pueda ayudar IN BIDDING FOR MAJOR EVENTS” (como los Juegos Olímpicos).

Este es un claro conflicto de interés, puesto que la OMS debe también evaluar y hacer recomendaciones acerca de OLYMPIC TRAVEL durante una Emergencia de Salud Pública de Interés Internacional (PHEIC por sus siglas en Inglés).

La relación tan cercana entre la OMS y el COI es evidente en los comentarios del Director Ejecutivo de la OMS responsable de Zika sólo días después de que fuera declarado como Emergencia de Salud Pública de Interés Internacional: “Brasil va a tener unas Olimpiadas fantásticas y van a ser exitosas y el mundo entero va a estar ahí.  Sólo desearía estar ahí, pero no van a haber mayores problemas para entonces”

Con mucho respeto, esta es una declaración preocupante.  La OMS no puede asesorar de forma creíble riesgos sanitarios de Zika y las Olimpiadas cuando deja la neutralidad de lado.  Declarar que “van a ser unas Olimpiadas exitosas y que el mundo entero va a estar ahí” implica que la OMS le ha dado a las Olimpiadas una luz verde incondicional sin tener en cuenta la rápida y emergente evidencia médica, entomológica y epidemiológica, la cual debe considerarse al evaluar si esta gran multitud reunida podría acelerar la propagación de la cepa brasilera del virus Zika por todo el mundo.  Prejuzgar que “no habrá mayores problemas” antes de examinar esta evidencia es extremadamente inapropiado por parte de la OMS y sugiere que se necesita un cambio de liderazgo para restablecer su credibilidad.