One could view President Bush’s speech on avian flu cynically without much difficulty. He was, after all, coming off what one could characterize as the worst week in his presidency. He first announced a respectable Supreme Court nomination, then asserted he is on top of the avian flu threat — and as is usual with politicians of all stripes, announced he will spend some $7.1 billion of the taxpayers’ money to prepare to meet that threat.
Are these announcements intended to shore up his tattered standing in the polls?
The cynical view of his political motives should be tempered, however, by the fact that worldwide flu epidemics have occurred and, as recently as 1957, killed 70,000 people in the United States. This happens, as Dr. Henry Miller of the Hoover Institution at Stanford explained, because the flu virus mutates — gradually and regularly enough to require a new strain of vaccine every year, and sometimes sharply, creating a variant to which people have little immunity.
The avian flu so far has not mutated into a strain that is highly transmissible from human to human, but among those infected through close contact with birds, almost 50 percent have died (compared with about 1 percent for the average flu bug). It might never mutate into a pandemic-style threat to human beings, but some flu virus almost certainly will.
This is the kind of large-scale, cross-border problem governments in theory are designed to solve. But government programs can also make problems worse, so simply creating and funding a program is no guarantee it will help.
For example, everybody is now deploring a shortage of conventional flu vaccine and the fact that so few pharmaceutical companies are in the vaccine business anymore.
That situation, however, is almost entirely the result of the no-doubt well-intentioned program, instituted early in the Clinton administration, to help improve vaccination rates. In practice, Dr. Miller said, the program “did almost everything possible to make vaccine production unprofitable and unattractive.” The Centers for Disease Control demanded “extortionate” discounts for vaccines purchased by the government. Add that to FDA overregulation and lawsuit liability, and the number of companies making flu vaccine in the U.S. has declined — to one.
President Bush talked about lawsuit-liability reform, but the more detailed version of the program released Tuesday was still light on details. It did not include regulatory reform or a program of reciprocity of vaccine regulatory approvals between the U.S. and the European Union. Nor did it include, as Dr. Miller has recommended, giving companies tax credits for vaccine research and development costs.
Dr. Miller advocates “proof of concept” research on gene-splicing technology that could reduce from the current nine months the time it takes to produce mass quantities of vaccine. The administration proposal calls for subsidizing research but doesn’t mention the proof-of-concept idea or gene-splicing specifically.
As past experience shows, government programs can be counterproductive. In subsidizing vaccine research (arguably a “public” good) government must be careful not to embrace the industry so closely that it chokes it. One approach might be to offer a substantial cash prize to any company that successfully produces certain products rather than micromanaging research through direct subsidies.
Private companies can take measures on their own. Switzerland-based Roche makes Tamiflu, the only drug available that has been effective in treating people infected with avian flu. USA Today reported that Roche said it plans to build a new plant in the United States to produce more of the drug and “(w)hile the firm has ruled out relinquishing the patent on the drug, which is protected until 2016, it also has said it was seeking other companies to help speed production due to increased demand.”
With or without government assistance, developing a new flu vaccine and new manufacturing techniques will take time. Most of us would do well to remember the low-tech approaches our mothers tried to teach us: washing our hands frequently, staying home when we’re sick, limiting contact with others who are sick, and perhaps being prepared to comply with quarantine orders.
We hope government can help us to do better than muddle through the next large-scale influenza threat, but it wouldn’t be prudent to count on it.