Saturday, October 16, 2004

A Small Wager

The flu vaccine shortage demonstrates the danger of relying on the free market to look after public health; the pressing need for such vaccines demonstrates a larger flaw in capitalist thinking.

As a matter of homeland security (or, if you prefer, common sense), it's essential to monitor new flu strains. A new flu pandemic could kill millions of people worldwide, and have political and economic repercussions beyond Osama Bin Laden's wildest dreams.

The factory farms of Mainland China and Southeast Asia are a breeding ground for new flu strains; humans, pigs, and birds live together in filthy conditions, wallowing in each other's dung. This set-up is partly a matter of poor planning - with a focus on short-term benefits and achieving economies of scale - and partly a matter of tradition.

The typical right-leaning economist would argue that the factory-farm system keeps food costs low. And that's quite true...but only up until a new virus rears its head, and (as happened recently) 44 million chickens have to be culled, and killed, and burned in gigantic pyres. In any sane financial model, the cost of dealing with these outbreaks would be considered when assessing the cost/benefit ratio of factory farming; since massive contagion is inevitable under the current overcrowded system, the logical solution would be to invest in prevention, instead of letting the situation spiral out of control again and again and again.

Just as we saw with Mad Cow Disease in the UK, short-term objections to the cost of prevention turn out to be false economy; in the case of poultry-rearing, the long-term costs of a pandemic would far outstrip the cost of reducing the risk of contagion (especially interspecies contagion) on farms. To believe otherwise is to fall prey to the same irrational thinking that might make someone skimp on the cost of a filling this month, and end up paying for a root canal in a year.

The problem is, preparing for a pandemic takes a massive investment of time and money well before the pandemic starts...and if the pandemic then doesn't happen, the vaccines will probably be useless and the manufacturers take a large loss. A public-health organization can take that risk; a for-profit drug company can't, unless it's subsidized by a government. But as we all know from listening to Grover Norquist, such subsidies are evil.

The World Health Organization describes how this state of affairs affects our dealings with the deadly Avian Flu (H5N1) currently raising havoc in China, Vietnam, and Thailand:

"Vaccine manufacturers respond to market forces. Companies may be reluctant to produce a vaccine for an event, such as a pandemic, that cannot be predicted with any certainty and might not be caused by currently circulating strains. Some uncertainty has also centered on rights to use the special technique of reverse genetics, a patented procedure, that is needed to produce the prototype 'seed' vaccine against H5N1.

"At the beginning of April 2004, WHO made the prototype seed strain for an H5N1 vaccine available to manufacturers. To date, only two of the world’s roughly 12 major companies producing influenza vaccines have taken work on a pandemic vaccine significantly forward. These two companies, Aventis Pasteur Inc. and Chiron Corp., both located in the USA, have produced small batches of vaccine for use in clinical trials. These trials, which require several months for the compilation and analysis of data, are needed to fine-tune vaccine composition, test safety, and meet other licensing requirements. Trials are not expected to begin before year-end."
So there you have it. We've allowed market forces to decide who will work on an H5N1 vaccine, and they have decreed that only two companies will do the work, and that they won't exactly be knocking themselves out to get it done on time. If no H5N1 pandemic occurs, there's no harm done. The problem is, these companies will take the same gamble next year, and the next, and eventually they'll lose. Which is a shame, because they're gambling with our lives.


Thersites said...

But on the bright side, Bush is on a first name basis with Jesus. So when we run out of flu vaccine, wecan all all line up for Christ shots.

Kevin Drum has a long post on this, too.

Biblio said...

Hi Phila,
I'm trying to take away the sting of having Pastabagel comment on your new blog!
Nice work. You're one of my faves over at Eschaton, so I'll add you to the old blogroll.
Keep on keepin' on, friend!