Q & A with Dr. Amir Attaran

A League of Fans Special Feature

Dr. Amir Attaran

Amir Attaran is a Professor on the Faculties of Law and Medicine at the University of Ottawa, and holds the Canada Research Chair in Law, Population Health and Global Development Policy. Dr. Attaran is by training both a lawyer (LL.B., Vancouver) and a biologist (D. Phil, Oxford; M.S., Caltech). His research covers the gamut of both fields in order to explore different drivers of human well-being, particularly in the fields of human rights, health, and/or international development.

Dr. Attaran’s current research interests include studies on the social and policy determinants of health in areas ranging from malaria to AIDS to hypertension. He also conducts research on criminally counterfeit, falsified and substandard medicines; the role of intellectual property and trade law on access to medicines in less developed countries; and the application of human rights law in armed conflict and anti-terrorism.

Dr. Attaran has published widely in the leading journals of both the legal and biomedical professions. He is an editorial consultant to The Lancet, and on the editorial board of the Journal of Epidemiology and Community Health. His work has also been published in the Globe and Mail, New York Times, The Guardian, the Literary Review of Canada and other publications.

In recent months, Dr. Attaran has achieved public notoriety due to his Harvard Public Health Review article that called for moving or postponing the Olympic Games in Rio de Janeiro due to the outbreak of the Zika virus, which is flourishing in Brazil. The Zika virus is associated with pediatric microcephaly and brain damage. It’s also associated with adult conditions such as Guillain-Barre syndrome and acute disseminated encephalomyelitis.

Ken Reed, League of Fans’ sports policy director, recently interviewed Attaran.

Reed: In terms of the risks associated with the Zika virus, what are we actually dealing with here when it comes to the Olympic Games?

Attaran: We are dealing with something that has an unusual risk paradigm: a low probability of a very severe outcome. If it should happen, we’re looking at a terrible outcome; which means outbreaks of Zika in countries currently unaffected by the Brazilian strain of the virus, giving rise to clusters of brain-damaged children. The likelihood of that happening is not high but the gravity of it happening is tremendous.

It just doesn’t make sense to send 500,000 people — from literally every country on Earth — into Rio for the Olympics. Rio isn’t the fringes of the outbreak, it’s the heart of the outbreak. For any given individual, the risk is quite low. But when you multiply by 500,000 the odds are extremely high that somebody will take the disease elsewhere and seed a new outbreak.

The most vulnerable possible victims (women and their newborn children) can be affected adversely by the decision of someone else to go to the Olympics and bring infection home. The person going to the Olympics chooses his or her Zika risk, but the foreseeable victims do not. 


It’s important to note that nobody is actually disagreeing with us; it’s just that they don’t want to see the Olympics postponed or moved. And so they’re saying it’s not that big of a risk, why are we worried about it?

Reed: Some people believe you’re calling for the Rio Olympics to be canceled. However, that’s not the case, correct?

Attaran: I’ve never said the Olympics should be canceled. There is no reason to cancel the Olympics. The Olympics can go ahead, they should just go ahead in a different location, or at a different time in Rio, in such a way that this risk is mitigated.

Reed: The World Health Organization (WHO) came out in June and said that there isn’t any justification for moving, postponing or canceling the Olympic Games in Rio due to the Zika virus outbreak. Moreover, they said that apart from pregnant women, athletes and spectators should not hesitate in attending the Games. What is your reaction to that?

Attaran: It’s incompetent. It’s dangerous. And it shows WHO is political, not scientific.

The World Health Organzation has exhibited a sanguine, unscientific attitude to assessing the health risks of Zika, particularly when it comes to the Olympics. Its attitude is exemplified by the shocking comments of Dr. Bruce Aylward, who as WHO’s top official responsible for Zika said this on February 19, 2016:

“Brazil is going to have a fantastic Olympics and it’s going to be a successful Olympics and the world is going to go there. I just wish I was going there, but there’s not going to be a lot of problems there by then, so I’ll be somewhere else.”

It is bizarrely incongruous that just days after declaring Zika a “Public Health Emergency of International Concern”, WHO also declared that “there’s not going to be a lot of problems” in Rio de Janeiro for the Olympics—a contradiction, obviously. Nor did WHO have any scientific basis for this statement, because on the date Dr. Aylward said it, there were absolutely no reliable data on Brazil’s Zika outbreak.

For WHO to say of Zika in Rio that “there’s not going to be a lot of problems,” without data demonstrating so, proves that WHO’s attitude is not scientific and evidence-based, but politically-warped and simpleminded.

Reed: The U.S. Centers for Disease Control (CDC) and the U.S. Occupational Health and Safety Administration (OSHA) have both recommended postponing non-essential travel to Brazil. You and approximately 150 other health experts agree. However, WHO has appeared to cavalierly dismiss the negative potential consequences associated with the spread of the Zika virus. Why do you think that is?

Attaran: We agree with CDC and OSHA that workers should postpone non-essential travel, and note that this applies as well to Olympic workers (e.g. athletes, coaches, journalists).
It is deplorable that WHO is doing the opposite of CDC and OSHA, as by calling the Olympics “fantastic”, and declaring that its Director, General, Dr. Margaret Chan, will attend the Olympics. This just reinforces WHO’s bad reputation for behaving politically, rather than scientifically.

Reed: WHO, the International Olympic Committee (IOC), and others are saying the Olympics will be taking place in winter, the safest time of the year in Rio. What is your reaction to that line of thinking?

Attaran: That is a half-truth. Yes, it’s going to be winter. Yes, that’s the safest time of the year. But that doesn’t mean it’s safe. That requires betting on the weather. And as you know, some winters are warmer than other winters.

In fact, according to a consensus of climate models aggregated by Columbia University scientists, winter 2016 in Rio is predicted to be warmer than average, with a 90% chance of above-normal or near-normal temperatures this August.

You can have an unseasonably warm couple of weeks in winter, and if you do the mosquitos will be active for those weeks.

So, the argument for hosting the Olympics as scheduled boils down to, “We’re betting on the weather. Let’s hope it turns out well.” I for one am not willing to bet the brain damage of children on the weather. That to me is not an ethical position to take.

Reed: Have your views changed any on the issue of the Zika virus and the Olympic Games since the publication of your Harvard Public Health Review article a few months ago?

Attaran: What I’m saying today is very similar to what I said then. These are the fundamental points: 1) Going to Rio and back increases the risk of the Brazilian strain of the Zika virus spreading and setting up local clusters of transmission and local outbreaks of microcephaly and brain damage. That remains true. 2) No matter what personal protection measures you adopt – long sleeves, air conditioning, condoms, bug repellant, etc. – they all provide a lesser degree of protection than simply not going. 3) Even those who seem to oppose what I’m saying are not disagreeing with the above two points. They’re simply minimizing them.