Biotech wants more money for flu prep. So do I. But not for them.

The headline seemed to say it all: "Funding Issues Stymie Pandemic Preparation." Right, I thought. All the money is going in to procurement, too little into shoring up a failing public health system. Little did I know:

The fear of bioterrorism and avian flu are driving a healthy new interest by biotech firms in developing products in the field of infectious diseases. "Even though we were developing a smallpox vaccine in 2000, there is no doubt that 9/11 was the moment that biodefense suddenly came up the funding ladder in the U.S.," said Clement Lewin, Ph.D., vp of marketing policy and strategy at Acambis, who spoke at 'EuroBio' late last year. (Genetic Engineering News)

Eurobio is the EU counterpart to the big biotech trade show in the US. I was at the last one and it was some show. It filled a gigantic conference center and the exhibit area was huge. In addition to a lot of big companies, the exhibitors were whole countries, trying to entice the biotech industry to locate there. It was weird. I walked around hoping to get some good freebies. They were also weird. One was some kind of cluster of little magnetized egg shaped things that when you tossed them as a group in the air made a strange buzzing sound. Given the amount of money spent on the exhibits, the pickings were kind of slim. At least at the public health meetings you could get lice shampoos for your kids or condoms so you wouldn't have to get lice shampoos for kids.

Back to EuroBio. The GenEn story goes on to pitch various biotech products, like Novovax's virus-like particle (VLP) fu vaccine. VLPs have no genetic material, just the viral protein antigen. This is the same technology as the human papilloma virus (HPV) vaccine now being aggressively marketed by Merck. The proteins are made in cultures of insect cells. We have posted on them earlier. So far these VLP flu vaccines are effective in animal models and some preliminary human trials conducted and more underway. This is promises to be a faster way to produce vaccine than using eggs and the facilities smaller scale and more easily replicated.

But this is still all procurement oriented pandemic flu preparation. That's where the money going now. How about those obstacles to pandemic preparation promised in the title?

Speakers presenting at 'EuroBio' concluded that although interest and, as a consequence, the funding to develop products to detect or treat infectious diseases have increased, there is still a long way to go if public health is not going to be seriously compromised in the event of a spontaneous or terrorist-driven pandemic.

"Setting up and running Biomedical Advanced Research and Development Authority (BARDA) in the U.S. to provide an integrated approach to ensure drugs and diagnostics tools are available for public health emergencies is a step in the right direction," Dr. Lewin commented. "However, we need to ensure that BARDA is staffed by people with industry experience and is also more flexible with its procurement policies or they will not be able to do this effectively.

"The preparedness for pandemic infections has improved, but if you look at the $560 million set aside each year by the Bioshield legislation, for example, this is still only $2 for every American. I would say in terms of being ready, we?re now moving from neutral to first gear, but we need to be in third gear to have a real ability to deal with serious outbreaks of infectious diseases."

Aha. So that's the obstacle. The money spigot into the biotech industry isn't open wide enough and the coins not flowing fast enough!

I have nothing against biotech innovation. But if it's a zero sum game, we are much better off taking the money and buying public health infrastructure: public health personnel in all the program areas that are needed for routine public health -- substance abuse, maternal child health, vital records, health statistics, infectious diseases, surveillance, etc. -- the bread and butter of public health. This strategy works for more than one strain or subtype of avian influenza. It works for everything.

Maybe the biotech industry will also produce exactly the right tool in the right amounts in a way it can be applied to everyone. Maybe. If we make an incredibly lucky guess and all the other pieces fall in to place. Otherwise, placing most our chips (in dollar terms) on a procurement strategy is the real reason pandemic preparedness is stymied.

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but, public health institutions would be overwhelmed
and useless in a severe pandemic anyway, I thought.

Vaccine is cheaper than hospital beds.

The Department of Health and Human services spent $3 Billion dollars on Tamiflu but then suddenly realized it has no means to distribute it. You can be sure that if a private individual or corporation in the U.S. did that someone would go to jail for fraud. I guess the fact that the money went to Gilead Sciences which Donald Rumsfeld is CEO must explain why that happened. Why no one is covering the story in the press. That part I can't figure out.

By Gregory Walter MD (not verified) on 16 Mar 2008 #permalink

Gregory: While I am on the same page in spirit, I'd say this: many companies are every bit as bad or worse (NB the current mortgage crisis). And the Rumsfeld connection has been noted extensively and given rise to many conspiracy theories about the falsity of the concern about bird flu. In fact, I think Rumsfeld's connection with Gilead ended long ago and he was not connected with them when he was at DoD. Nor is the Us Gov't the only Gov't stockpiling Tamiflu. There is a rationale for it, especially when you (a) have little else and want to look like you are addressing a problem, and (b) are part of an administration that thinks the solution to everything is to privatize it. This is not to say that Rumsfeld isn't a scumbag, and an incompetent one at that. It is just to say this isn't an explanation for much of anything.