Monday, October 10, 2005

Pandemic Preparedness

Another WaPo editorial today deserves a little comment.  A month ago, I wrote about the warnings that the USA is not adequately prepared for an outbreak of avian influenza, should the virus mutate such that human-to-human transmission occurs readily.  (Note that the link to the article I cited has expired; the new, still-working, link is here.)  Bloggers have been keeping up with the risk of a pandemic, especially Hedwig at Living the Scientific life, in her weekly Birds in the News posts.  In her 21st edition, she laments the decline in funding for public health offices.  Those cuts are reminiscent of the recent cuts in funding for FEMA, as noted by Kevin Drum at Washington Monthly:
June 2005: Funding for the New Orleans district of the U.S. Army Corps of Engineers is cut by a record $71.2 million. One of the hardest-hit areas is the Southeast Louisiana Urban Flood Control Project, which was created after the May 1995 flood to improve drainage in Jefferson, Orleans and St. Tammany parishes.
The WaPo editorial makes the point that there are things that the government could be doing, but is not:
The solution lies not in antivirals but in a vaccine that could be tailored, relatively quickly, to whatever form the virus takes, as well as help for U.S. hospitals, which are filled to capacity. The administration is aware of the former problem; the president met Friday with vaccine manufacturers, and the National Institutes of Health has been conducting vaccine research. But legislation is needed to facilitate research and rapid production of vaccines. That's a difficult task, given that American pharmaceutical companies, scared off by liability issues and low profits, no longer make vaccines at all.

Some in Congress have been working on a successor to last year's failed Bioshield legislation, which was intended to break the vaccine deadlock. Sens. Orrin G. Hatch (R-Utah) and Joseph I. Lieberman (D-Conn.) have introduced Bioshield II, which would absolve vaccine manufacturers of liability and give them patent incentives to produce vaccines. Sen. Richard Burr (R-N.C.), chairman of the bioterrorism and public health preparedness subcommittee, has announced his intention to introduce an innovative bill that would set up an agency, similar to the Defense Advanced Research Projects Agency, to invest in early research into drug and vaccine development in conjunction with the private sector.
Personally, I agree with the notion of removing or limiting liability for vaccine manufacturers, because that is a major impediment in the industry.  At the same time, however, I would like to see a fund established for the few claims that would arise, inevitably, from the widespread use of any pharmaceutical agent.  In the case of vaccines, there is obviously great public good to be had from their use, but that good cannot be realized without exposing some individuals to harm.  I  think it would be fair to compensate persons who are harmed by their participation in a vaccine program, since they took on a risk for the benefit of society as a whole.  I would hate to see the potential legal liability have the unintended consequence of heightening a threat to the entire population.