Bioscope ‘08

by  Dr. Barbara Price

We can measure the costs of fighting disease, but do we have a strategy?

          Despite the billions of dollars we will spend this year to fight disease, we do not always have the right approach. In fact, there are so many approaches to treating and preventing disease that it can be difficult to know where to start.

          At the end of 2001, after the anthrax attacks, many developed countries launched a new assault on possible biological agents that could be used as threats. The obvious immediate focus was on anthrax, a non-communicable disease that is rarely seen in nature as a respiratory agent. Seven years later we have spent billions on research and production, including improved quality control for anthrax vaccines, improved vaccine systems and even improved detection of anthrax. We understand better how anthrax spores germinate, infect and produce the toxins that eventually can kill. We know how to better detect the spores. We still do not know how the respiratory infections in the US Postal workers lead to some of the complications they experience, but I'm sure that in the not too distant future, we will understand that. But do we have any agreement on where to spend our disease dollars? Was the cost of all the research on anthrax worth the investment?

          Which are the more important diseases to understand and develop treatments and preventions for? The pandemic possibles such as the various influenzas, smallpox, and/or HIV/AIDS, malaria, tuberculosis, measles, rotavirus, whooping cough, cancers, and/or unknown emerging, as well as old diseases such as plague, typhus, cholera, and polio (which never quite disappears) and others?

          Research in HIV has enabled millions to live longer, at least in developed countries, because of innovations in drugs and greater understanding of viral infections. Cancer research improves the lives of millions each year, but do we have a plan? Is it better to develop ways to prevent and treat measles and buy the drugs or is it better to build BSL-4 labs that study only a few diseases?

          We've spent millions on Ebola and Marburg, over $130 million in October 2008, to develop vaccines. While these are severe diseases without viable treatments, they do not infect many people. But they are elegantly simple viruses and we have learned much from the studies even if we do not have a treatment or vaccine. Is that part of the justification for the money for studying these diseases?

          Our resources, even our global resources, are limited and our approaches need to be prioritized and have focus. If we laugh at ourselves while we in the US vote for an economic bailout bill of over $700 billion dollars to give to banks (which they in turn use to buy other banks and reward their executives with million dollar bonuses), what will we do when we are able to look at the money spent on diseases? Will we be able to look back and say we had a plan?

For the Professional in Government and Industry with an interest in Nuclear, Biological and Chemical Defense, Disarmament and Verification; Emergency and Disaster Medical Planning; Industrial Health and Safety; and Environmental Protection