The economics of infection

Ebola is a truly frightening disease, with a fatality rate as high as 95 per cent (although the death rate in the current outbreak in West Africa is only 55 to 60 per cent). At the moment, it is largely confined to a heavily forested inland area where the borders of Liberia, Sierra Leone and Guinea meet, although cases have already appeared in the capital cities of all three countries.

Ebola is a truly frightening disease, with a fatality rate as high as 95 per cent (although the death rate in the current outbreak in West Africa is only 55 to 60 per cent). At the moment, it is largely confined to a heavily forested inland area where the borders of Liberia, Sierra Leone and Guinea meet, although cases have already appeared in the capital cities of all three countries.

It could get much worse. If ebola successfully made the jump to a more prosperous, densely populated country like Nigeria, whose citizens travel all over the world, the current 800 recorded deaths could become 8,000, or 80,000, or even more. And the worst of it is that there is no effective vaccine or treatment for ebola.

Let me rephrase that. There is no approved vaccine or treatment for ebola. There are candidates, some of which have shown promising results when tested on non-human primates. But they haven’t gone through the full testing process that is necessary before they are approved for human use, because nobody was willing to pay for it.

The normal procedure in the United States, home to more than half of the world’s major drug companies (“Big Pharma”), is that basic research for new drugs may be paid for by government grants or even by private philanthropy (like Bill Gates’s $200-million donation for research on a malaria vaccine), but the work of bringing the drugs to market is left to the commercial companies. All too often, they simply can’t be bothered.

It costs hundred of millions of dollars to take a drug through the whole approval process and put it on the market. That’s worthwhile if the drug will then sell at a high cost and be used regularly over long periods of time: a drug that fights “rich people’s diseases” like cancer or heart disease, say, or even something like Viagra.

But a one-shot vaccine that would mainly be used by poor Africans will never make a profit, so it is ignored.

Galvanized by the panic over ebola, the National Institutes of Health in the United States has now scheduled phase one trials of an ebola vaccine on human subjects for next month. But there are two more phases after that, and the earliest a vaccine could be approved for general use is next July.

And even in this emergency, it’s public money, not Big Pharma, that is funding the research.

The problem goes much wider than ebola and other tropical diseases. It extends, unfortunately, to the antibiotics that vanquished the bacterial infections that were once responsible for about 25 per cent of adult deaths. The last new class of antibiotics, carbapenems, was approved in 1980. Since then, nothing — even though the usefulness of existing antibiotics is rapidly eroding as resistant strains of bacteria emerge.

That’s a big threat, but antibiotics are still not big money-makers, as they are used for relatively short periods of time to fight some specific infection. So no new type of antibiotic has been developed by Big Pharma for more than three decades.

A minimum of 23,000 people in the United States died last year of infections that would once have been easily ended by antibiotics; in the European Union the total was 25,000.

There are some measures that would dramatically slow the spread of antibiotic-resistant bacteria. Far fewer prescriptions should be written for antibiotics, and doctors should be monitored to ensure that they are not over-prescribing.

Patients must complete any course of antibiotics that they begin, and report that they have done so. Over-the-counter sales of antibiotics in countries like China and Russia must cease.

Above all, it should be a criminal offence to feed antibiotics to animals just to make them grow faster and bigger. (That is where 80 per cent of the antibiotics consumed in the United States go at the moment.) And even when all that has been done, the rise of antibiotic-resistant bacteria will continue, though at a much slower pace. Bacterial resistance is an evolutionary process that can only be slowed, not stopped.

So we desperately need new antibiotics, and there are none forthcoming.

Without them, warned Dame Sally Davies, chief medical officer for England, “Modern medicine would quickly go out of the window.”

Almost all surgery, including things as commonplace as caesarian sections and hip replacements, and most cancer treatments as well, involve a significant risk of infection that must be controlled by antibiotics.

As British Prime Minister David Cameron told The Times: “If we fail to act … we are cast back into the dark ages of medicine, where treatable infections and injuries will kill once again.”

Yet Big Pharma will not fill the gap, for those companies are answerable to their shareholders, not to the public.

The case for direct state intervention to finance the development of the vaccines and antibiotics that the commercial sector neglects is overwhelming. And very urgent.

Gwynne Dyer is an independent journalist whose articles on world affairs are published in 45 countries. His new book, Canada in the Great Power Game 1914-2014, was published by Random House Canada on Aug. 4.

Just Posted

Red Deer raises $60,000 for Make-A-Wish Foundation

27 brave residents rappell down Stantec Building

People hurt in rollover near Red Deer

Occupants of a vehicle that rolled south of Hwy 11A were airlifted… Continue reading

Eager-beaver cannabis entrepreneurs already waiting outside Red Deer City Hall

Appications will be accepted on a first-come basis starting on Tuesday

Like father like son: Red Deer area Dreeshen family dedicates life to public service

There are three jobs that could be considered the Dreeshen family business:… Continue reading

Restaurant owner concerned about Gasoline Alley road changes

Nearly 20 trucks were lined up on the service road in front… Continue reading

WATCH: Hypnotizing show at Westerner Days

Hynotist and mentalist Joshua Seth performs three times a day at Westerner Days

Evacuation numbers remain at nearly 1,000 as B.C. wildfires rage on

SUMMERLAND, B.C. — Officials in British Columbia’s Okanagan region hope that fire… Continue reading

WWII hero’s lost Purple Heart returned to his family

NEW YORK — A lost Purple Heart medal has been returned to… Continue reading

California girl, 2, accidentally shot and killed by boy, 4

SAN BERNARDINO, Calif. — Authorities say a 4-year-old boy accidentally shot and… Continue reading

A hairy issue: Sailors tell the US Navy, ‘We want beards’

PROVIDENCE, R.I. — Now that women in the Navy can wear ponytails,… Continue reading

PHOTOS: River Town Saints rock Red Deer

River Town Saints play Westerner Days Friday in Red Deer

PHOTOS: Dogs, horses and more animals at Westerner Days

Westerner Park’s pavilions were filled with animals during Westerner Days

Red Deer residents can’t get enough mini-doughnuts

Mini-doughnuts were the biggest draw to Westerner Days according to a Red… Continue reading

Four-car crash, including RCMP vehicle, on Highway 2

Two sheriff vehicles were also involved in the collision

Most Read


Five-day delivery plus unlimited digital access for $185 for 260 issues (must live in delivery area to qualify) Unlimited Digital Access 99 cents for the first four weeks and then only $15 per month Five-day delivery plus unlimited digital access for $15 a month