Pathfinders: Down on the Pharma

The flu season is upon us again and readers will be delighted to hear that swine flu has not been idle. Tests have been taking place after a woman died last month from swine flu contracted at a country fair in Ohio, and three more cases were reported from Minnesota. The flu strain, H1N2, is derived from the 2009 H1N1 virus, is air-borne and carries the pandemic M gene. All victims had prolonged contact with pigs, however a different strain, H3N2, has caused 296 infections across 10 US states since July this year (http://www.cdc.gov/flu/spotlights/h1n2v-cases-mn.htm). The message at present is that people at high risk should stay away from pigs, state fairs or Korea, where the H1N2 strain is said to be a ‘triple reassortant’ virus in that it is a mix of avian, swine and human flu (http://www.nature.com/news/need-for-flu-surveillance-reiterated-1.11382).

Scientists are being cautious, obviously. Nobody is going to cry wolf this time, after they got the blame for the huge panic in 2009. Although there was a swine flu pandemic on that occasion it was nothing like the civilisation-ending apocalypse the excitable media had led everyone to believe.

The Centre for Disease Control in Atlanta, which publishes regular information on pandemic threats, is part of a global body of research institutions which, for obvious reasons, would be required almost exactly as-is in a socialist society. Nobody can possibly question the value of what such institutions do. Even creationists, who claim not to believe in evolution, rush fast enough for their annual vaccinations and understand well enough the need for them. We humans are locked in an arms race with microbes and only the most vigilant monitoring stands between us and some disaster of truly biblical proportions.

Other threats, however, are more debatable. Many of the scientists working on the H1N1 virus in 2009 objected to the research being published, for fear that terrorists could use the work to create a synthetic weapon. After 9/11 and a brief wave of anthrax letter-bombs the USA took this threat very seriously, and set up the Biowatch programme, which consisted of networks of sensors in urban areas including underground stations, designed to spot attempts to poison the public (New Scientist, 15 September). Ten years on and Biowatch has produced a null result, which ‘proves’ to its supporters that it has worked. This is like the old joke that an elephant-repellent spray must be working if you can’t see any elephants. Detractors however point to the billion dollar bill and the fact that in the same decade there has not been a single biological terrorism attack anywhere in the world. Given the clumsy, low-tech efforts of many would-be bombers in the past, perhaps the threat of such people managing to develop a bioweapon has indeed been overstated.

But what is one to make of the fact that a very real and present threat, one which everybody knows about, is actually being increasingly ignored? Hospitals are riddled with MRSA and c. Diff. so that it can be more dangerous to go to hospital than stay at home. 60 percent of infectious disease specialists report encountering infections untreatable by any antibiotic. Just when antibiotic resistance is becoming a world-wide problem, it turns out that drug companies are pulling out of antibiotic research (‘NIH superbug outbreak highlights lack of new antibiotics’, WashingtonPost, 25 August). Why? The answer is revealing.

In the first place, the antibiotic honeymoon is over. Like peak oil, we’ve hit peak bio, after which every development is harder and more expensive. It is all about the return on investment. When the field lay wide open in the 1940s and there was plenty of claim to stake and patents to be had, it was a bonanza. Now the well is dry, but unlike oil there is no way to wean humans off the need for antibiotics without seeing a return of the bubonic plague and other horrors. But drug companies are businesses which worry about profit, not plagues, so they are doing the sensible thing and pulling the plug on antibiotic research. You can’t argue the logic when you can make more money out of an erectile dysfunction drug than out of antibiotics. Of the 12 largest pharmaceutical companies only 4 are still doing any research.The largest, Pfizer, has laid off 1200 workers and closed its antibiotic research centre in Connecticut and moved to Shanghai and out of antibiotic research altogether.

Alternatives to antibiotics are, like alternatives to oil, scarcely credible at present. The widely-mooted idea of engineering viruses to eat bacterial pathogens is still some way off, with the first clinical trial in Western Europe only taking place in 2009. Bacteriophages are hard to make, because unlike antibiotics they are not one-size-fits-all. Each pathogen strain requires a different phage, and when a pandemic may present multiple strains simultaneously this is an obvious disadvantage. They are also hard to store, and of course each one has to go through independent regulatory hurdles before being approved for use. Given the increased expense of development plus the tightly restricted potential for patent exploitation, this is likely to make phage research even more unattractive to big pharma than antibiotics. In the event of a pandemic, phage research and production may very well be too slow and cumbersome to respond.

Antibiotics too are facing even more severe regulatory hurdles because of the scare surrounding the antibiotic Ketek, which led to a number of deaths in 2006. With lawyers circling hungrily, no drug regulator is taking any chances. At a time when new drugs are becoming ever more vital, regulators are stamping on the brakes.

‘It’s a case of evolution outrunning capitalism,’ says the Washington Post report. But it’s not a case of capitalism somehow failing to keep up with evolution, as if the two are locked in mortal combat. While the money was in antibiotics, capitalism delivered. Now it isn’t, capitalism has simply lost interest in the matter. The fact that the human race could potentially be decimated doesn’t enter into it.

This is one of the worst indictments of capitalism that it’s possible to make, its absolute defiance of common sense and the interests of the human species it supposedly serves. When science, logic and self-preservation all indicate one road, and money indicates the other, capitalism doesn’t think twice. People who congratulate capitalism for its competitive drive to produce innovation should reflect on the fact that no matter how much ingenuity it inspires in humans desperate to pay their rent, it stands capable at any moment of making the wrong decision just when the consequences could be fatal.