Wall St. Journal column today: "Drugmakers v. Bioterror"
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>>BUSINESS WORLD
By HOLMAN W. JENKINS, JR.
Drugmakers v. Bioterror
It has become conventional to treat pharmaceutical companies as on a par with -- well, even child molesters have defenders. One drug company, though, has managed to play cavalry coming over the hill to take the dark out of the government's "Dark Winter" scenarios for a smallpox apocalypse.
A year ago, Aventis Pasteur, the Canadian division of France's Aventis, opened a refrigerator in its Pennsylvania research lab and produced 120 liters of 40-year-old smallpox vaccine. Voila, our national stockpile of 15 million doses, the presumed sum and total of existing U.S. vaccine, had become 100 million doses. Better yet, studies underway at Vanderbilt and elsewhere strongly indicate that the drug remains effective when diluted in a ratio of 10:1. Voila, combined with the existing official stock, the country now has a potential one billion doses.
The Dark Winter scenario for a smallpox attack, so named for a think-tank exercise carried out by ex-government officials before Sept. 11, 2001, was designed to be extreme. The retired colonel who drew up the script that subsequently launched a thousand news stories called his nightmare concoction "absolutely worst-case."
For one thing, it featured a weaponized smallpox distributed unobtrusively in several public places simultaneously, infecting thousands of people before the first symptoms appeared. By contrast, a naturally spreading smallpox would be far easier to corral, since a natural carrier is already producing visible sores and barely able to move when the disease reaches its most infectious stage.
Also critical to the Dark Winter scenario was a national vaccine stock for only 15 million people, placing officials in a dilemma about whom to save after existing stocks were clearly seen to be inadequate to stop the virus's spread. As the wargame's author foresaw, what provoked the lurid outcome of chaos and martial law was the premature exhaustion of vaccine supplies while smallpox was still rampant.
We are in a much better position than we believed a year ago. Our much-maligned pharmaceutical industry turns out to have been a strong line of defense against an emerging biowarfare threat that we had previously ignored.
Nor is it a coincidence, given our lack of the drug-price controls that have become the norm in most Western countries, that much of the world's pharmaceutical research is here. Ours is the last major market in the world hospitable to risk-taking investment in the drug business. Yet even here ignorant or dishonest voices have been on the march, arguing that it's fair and rational to treat the opportunity cost of capital tied up in drug laboratories as an imaginary cost -- i.e., one we are entitled to disregard when deciding whether the high apparent profit margin on drug sales can be confiscated and redistributed without harm to the industry's incentive to invest.
With its usual gusto, the Bush administration has launched strenuous plans to protect the country from smallpox. These have already run into practical complexities, such as the reluctance of health-care employees to court the known risks of the vaccine when so much about the threat remains unknown and conjectural.
As of last week, barely a thousand had been inoculated. This problem might have been foreseen. It takes the form of what economists call a "common pool" problem, in which benefits are shared widely but costs borne narrowly. The obvious solution might be to pay medical workers for the trouble and risks we are asking them to take on behalf of the rest of us.
In any case, the White House has gotten the ball rolling well enough to be reasonably sanguine about protection even given the disappointing progress of voluntary vaccination. The administration obviously believes Iraq has the smallpox virus, and there are enough independent straws in the wind for anyone else to believe it too. A dying King Hussein is said to have warned a prominent American researcher, Michael Osterholm, about Iraq's smallpox capabilities.
We have a cadre of immunized medical personnel who could quickly be deployed to the site of an outbreak. We have sizeable stocks of vaccine that are usable in a pinch. Most important, doctors and emergency-room personnel are primed to recognize the disease, which they weren't a year ago. We probably don't need to be in a hurry to vaccinate the 10 million "first responders" envisioned in Phase Two of the Bush plan. And we can probably leave it to the commercial marketplace to offer smallpox vaccine to those in the wider public who may eventually decide they want it.
More important now is to keep building up stocks of vaccine and to husband what we have on hand for a far more likely smallpox emergency. That's the chance that Saddam Hussein would release smallpox in Iraq in the event of war, using refugee flows to carry the disease into neighboring countries. His goal would be to bog down the U.S. in a humanitarian crisis while destabilizing nearby governments that are supporting our war plans, not to mention taking vengeance on Iraq's Shiite and Kurdish majority, who can be expected to welcome U.S. troops as liberators.
This is the smallpox scenario that should keep us awake at night. At home, anthrax is a more worrisome terrorist weapon. The amounts used in the post-Sept. 11 mail attacks were theoretically sufficient to kill millions of people. And Canadian research had shown months earlier that finely-milled anthrax could be spread far and wide in the mail without a visibly sick, barely ambulatory carrier going around and kissing people on the lips. Plus, we already know there's an anthrax terrorist out there.
Of course, the best prophylactic is one the drug industry can't provide: A muscular Pax Americana that saves countries from having to become little Saddams and lay up stores of nuclear bombs and doomsday germs to ward off aggressive neighbors who have their own such weapons. In the meantime, the bioterror threat is one more reason to rethink our penny-wise crusade against the drug research industry.<< |
