Psyche, Science, and Society

“Free market” fails us in influenza pandemic preparedness

October 6th, 2008

On another important matter that I’ve given little attention to recently, Revere reminds us that we are woefully unprepared for a flu pandemic, and the “free market,” even with massive government subsidies, isn’t doing anything about it. As Revere suggests, only governments are capable of pursuing the public interest in cases like this where private companies don’t see a profit. But this will only occur if we exert pressure. Otherwise the free market fundamentalists will endanger our health in yet another way. after all, whether Avian flu, or another strain, an influenza epidemic is as certain as death and taxes:

Red Flag on the Flu Vaccine Front

A story in CIDRAP News by the always excellent science journalist Maryn McKenna provides food for thought:.

A flu vaccine manufacturer’s decision not to build a US facility has highlighted the perpetual mismatch between flu-shot supply and demand–and the reality that the mismatch may undermine plans for pandemic flu vaccines.On Tuesday, Solvay Pharmaceuticals Inc. of Marietta, Ga., announced that it was canceling plans to build a US flu-vaccine manufacturing plant, a $386 million project that Birmingham, Ala., and Athens, Ga., have been competing for. The plant would have made both seasonal and pandemic flu vaccines–but at just about the moment when a final site selection was expected, the company announced that the economics of the two-year-old deal no longer make sense. (Maryn McKenna, CIDRAP News)

The US Government sunk almost $300 million into Solvay for design and development of the new plant but didn’t provide enough for capitalizing it. Apparently to make economic sense some companies require that someone else pay all the upfront costs. I’m sure this is true for Solvay, a chemical, plastics and pharmaceutical conglomerate based in Belgium. Why invest a dollar (or a Euro) in flu vaccine, even though it will make you a tidy profit, when you can invest in some other product that can make you a big profit. That makes business sense. So the losers in this one are US taxpayers (so what else is new?). But the problem, as McKenna points out, is probably deeper than a bad investment of tax dollars:

Nevertheless, the Solvay decision deprives the United States of a domestic source for pandemic flu vaccine if or when a global outbreak begins. And by refusing to offer supply into an uncertain market, the company is challenging the central assumption behind US and global planning for pandemic-vaccine capacity: that demand for seasonal vaccine will provide companies with a rationale for making more vaccine than they now do.Federal health officials have asserted many times that demand will boost manufacturing capacity to the level needed for a pandemic. To reach that level, the World Health Organization’s 2006 “Global Pandemic Influenza Action Plan” calls for countries to boost their flu-shot usage to 75% of their populations, including countries where seasonal vaccine has never been used.

Here’s how I would say this: the market doesn’t work for flu vaccine. It is like saying that a war is like the market and will call up a demand for an army. so between wars we can disband the military. I might like that, but if you believe there are real threats out there requiring a military this would be nonsense to you. Since most scientists think there is a pandemic threat out there, why should we let “the market” govern if we have the resources if and when we need them? Because the US government, especially this administration but not only this administration, worships the market (except when they don’t) and kowtows to drug companies (almost always).

If the market doesn’t work for flu vaccine I see no reason to throw up our hands and give up. We construct another mechanism. In this case it could be a global network of regional vaccine laboratories (maybe ten or a dozen, with some large regions, like the US, having several) that have adequate reserve capacity to ramp up production quickly in the case of need. In the absence of demand this produces unused and redundant capacity and is inefficient. As do standing armies in times of peace. The cost would be borne by the global community as a whole.

The alternative is to do as we are dong now, leave it to the private sector which has no incentive to meet the need, and should a pandemic arise will be able to respond too little, too late and at great cost, both because the demand will exceed supply and the loss in pain in suffering from the missed opportunity will be enormous.

The Solvay decision is another warning flag. Of course, we have shown a prodigious capacity to ignore warning flags

Entry Filed under: Avian flu, Medicine, Politics, Public Health, Social Issues