Thwart Zika

Slew of anti-abortion laws may thwart Zika research

The furor from the Planned Parenthood sting videos is driving a tide of bills, which range from outright bans on research using aborted tissue to prohibitions on donating the tissue. 

By Brett Norman

Even as mosquitoes carrying the Zika virus advance northward, lawmakers in 18 states are trying to block the fetal tissue research that might reveal the keys to unlocking the disease and preventing the massive birth defects associated with it.

The furor from the Planned Parenthood sting videos is driving the tide of bills, which range from outright bans on research using aborted tissue to prohibitions on tissue donations.

Scientists say such laws in states like Florida, Arizona, Ohio and Indiana — along with an escalating probe of fetal tissue research by House Republicans — are becoming roadblocks to the research needed to combat Zika. But the reaction has been muted because scientists fear the wrath of anti-abortion activists, even though many say the research is urgent to find the answers that could save children from birth defects or death.

“Basically the only insights we’ve had so far on Zika is with patients who have either lost a pregnancy or had miscarriages,” said Patrick Ramsey, an obstetrician at the University of Texas Health Science Center in San Antonio. “This is a situation where the vaccine is going to have to protect the mom and protect the baby. Fetal tissue is going to be needed to look at the effects.”

“I think if we’re serious about making sure that babies are not affected by the Zika virus, we need to know all we can, and we learn a lot from fetal tissue, as we do with other human tissues,” said Georges Benjamin, executive director of the American Public Health Association.

University of Wisconsin bioethicist Alta Charo said the anti-abortion lawmakers pushing these bills could inadvertently cause more abortions.

“Given the uncertainty around the effects of exposure while pregnant, halting fetal tissue research might slow efforts to prevent those effects or at least let women know if chances are high or low of serious birth defects,” she said. “And this in turn might actually lead more women to choose abortions, out of fear of terrible birth outcomes.”

Even so, the list of states enacting the bans continues to grow. Florida joined the roster on Friday, when Gov. Rick Scott signed sweeping anti-abortion legislation that prohibits donating aborted tissue. Although it stops short of banning the research itself, the law could block scientists’ access to fetuses from the state, including those stricken by Zika.

Florida is also among the states at greatest risk from the virus, which is carried by a species of mosquito endemic to the Gulf Coast. It's also a major travel hub for the Caribbean and South American, where the virus has already broken out. Recommended travel restrictions from the Centers for Disease Control and Prevention have extended ever northward as the temperatures have warmed. This month, the agency warned against pregnant women going to Cuba, just 90 miles south of the Florida Keys.

Five states go even further than Florida, banning research on aborted fetal tissue altogether — North Dakota, South Dakota, Oklahoma, Ohio and Indiana, according to a recent report by the Guttmacher Institute. Arizona would become the sixth state with a research ban, if Gov. Doug Ducey signs a bill approved Thursday by the Arizona legislature. He is expected to do so.

Republican Florida state Rep. Colleen Burton, lead sponsor of that state’s bill, said it was not intended to hamper research but to ensure the health and well-being of women. The legislation also imposes Texas-style restrictions on abortion clinics and prohibits public funding for Planned Parenthood.

“Our concern in Florida is that a woman’s decision to donate [fetal tissue] is made at the same time she is also making a decision to have an abortion, and there was no public good in her needing to make that decision, too,” Burton said.

Democratic state Rep. Mark Pafford countered “the bill was written to agitate a right-wing base for the elections.”

“They threw everything in it so people can go back to their districts and say we stopped the fetal tissue stuff, which isn’t even an issue in Florida,” said Pafford, who is also executive director of Florida CHAIN, a health care advocacy organization.

A House panel investigating fetal tissue research is turning up the heat on researchers as well. Following a March 2 hearing in which Republicans argued that fetal tissue from abortions should not be used in research, committee Democrats said Thursday that chairwoman Marsha Blackburn (R-Tenn.) planned to send up to 17 subpoenas demanding the names of individuals involved in acquiring the tissue or doing research on it.

Some universities and companies had redacted names from documents they sent to the committee out of concern about anti-abortion harassment or violence.

Scientists largely agree on the benefits of fetal tissue research and its potential for Zika.

The clearest evidence yet that Zika causes birth defects came from studying an aborted fetus from an Eastern European woman who had been infected while living in Brazil, where an estimated 5,000 babies have been born with small heads and brains since a massive outbreak of the disease.

Researchers found Zika in the brain tissue and were able to reconstruct the virus’ genome. That’s important because it likely rules out one alternative that had been suggested — that a reaction of the mother’s placenta to the infection, rather than the virus itself, was causing brain damage, Tony Fauci, director of the National Institute of Allergy and Infectious Diseases, said this month. “There’s been enough demonstration of the virus in the brain of the baby to indicate that it’s directly involved.”

Officials at the CDC declined to talk about the impact of the proposed state laws on research. But scrambling to respond to a potential outbreak in the continental United States, they posted guidelines to encourage submissions of fetal and infant tissues for Zika testing. In the desensitized language of medicine, the notice asks for samples from all organs, but especially the brain and eyes. “Maintaining the structure of the brain architecture is particularly important to help evaluate viral neuropathology,” the guidelines say.

Blunt talk about harvesting organs may seem grotesque to the public, but fetal tissue research has been critical to the production of vaccines for rubella, chickenpox, rabies and hepatitis A. Much current research on fetal tissue focuses on HIV/AIDS.

It’s needed for Zika now because scientists need to unravel how the virus is disrupting the development of fetuses and, potentially, to develop and test treatments.

“The fetal brain is different from brains even in children — cells are dividing, migrating and differentiating rapidly,” Eric Rubin, professor of immunology and infectious disease at Harvard, said in an email.

Researchers don’t yet know why the developing brain appears to be such a fertile place for the Zika virus to replicate. Understanding and preventing that “might require fetal tissue,” Rubin added, but he’s not sure that’s the case.

The response from scientists has been slow in part because of the desire to remain beneath the radar. But scores of research universities and physician societies signed onto a letter organized by the Association of American Medical Colleges citing “grave concerns” about legislation that would restrict the research or access to the tissue in general.

The Florida law could also impact non-Zika related research. In 2015, the National Institutes of Health gave about $2 million in grants to the University of Florida, the University of Miami and the Scripps Institute for fetal tissue projects, mostly for experiments related to HIV. Burton said her office fielded no complaints from the research community during the debate over the bill.

The universities did not respond to questions about whether the bill would interfere with the work.

The sting videos that set off the renewed scrutiny of the research suggested that Planned Parenthood and other organizations were illegally profiting from selling the tissue. Several state reviews, including one in Florida, found no wrongdoing. Planned Parenthood clinics in the state don’t provide fetal tissue to researchers.

Robert Golden, dean of the University of Wisconsin School of Medicine and Public Health, helped fight off an effort to ban fetal tissue research that had gained traction in his state last fall. He said politicians who would obstruct the work but take advantage of the benefits are hypocrites.

“With the horrors of the Zika virus and its almost certain spread to Florida, to me it’s unfathomable that anyone there would want to restrict this research,” Golden said.