When much of the Capitol was shut down because of the threat of anthrax, many Americans were left wondering what could be next. Smallpox? Plague? Ebola virus?
In a nation that read the human genetic code, you would think it would be possible to get vaccinated against anthrax and these other potential scourges. But you can't--the vaccines just aren't available. As for treating the most deadly inhaled anthrax infections, there are fears the antibiotic Cipro could soon be in short supply. The Bush Administration is responding with a $1.5 billion proposal that includes boosting the nation's stockpiles of antibiotics for anthrax sixfold and accelerating production of smallpox vaccine, the only treatment for smallpox.
These steps are not enough, however, especially on the vaccine front. "Medicine has no better way of preventing diseases" than vaccines, says industry veteran Dr. Stanley A. Plotkin, professor emeritus at the University of Pennsylvania. "If you start from that recognition, we need to promote their development and production."
OLD DESIGNS. The basic problem is that vaccines--despite their stunning successes against scourges such as polio, smallpox, and yellow fever--have been a poor stepchild to drugs for the pharmaceutical industry. Thus, most are decades old--at a time when the supporting science is undergoing a revolution. The current anthrax vaccine, for instance, is a 40-year-old design laden with impurities that cause reactions. It's not even proven to prevent the inhaled version of the disease. "We now know how to make a better vaccine," says Dr. Thomas P. Monath, research chief at Acambis, a British biotech company making smallpox vaccine.
With today's genetic wizardry, scientists can read the genetic code of pathogens and determine which parts might best stimulate the immune system to fight the bugs. "Any lab in the field can select the pieces and stuff them into a known safe vaccine, inject it into a mouse, and get it to neutralize anthrax," says Andrew McMicheal, director of Oxford University's Institute of Molecular Medicine.
The smallpox vaccine is one that needs improving. The U.S. stopped vaccinations for the general public in the early 1970s, because the risk from the vaccine was greater than the risk of the disease. Today, it makes sense to use it only during an actual epidemic. But a safer product could be given to everyone--neutralizing smallpox as a bioterror weapon.
Developing better vaccines costs big bucks. "Who will invest $100 million for development if there's no market?" asks Monath. "That is where the government has to step in." The good news is that vaccine development for Third World diseases is getting a $1 billion-plus boost from foundations. Research fueled by a similar amount from the federal government could piggyback on the innovative ideas being spawned, as well as on the vast expertise in big pharmaceutical companies. Congress also needs to expand a 1986 law that provides compensation when children are proven to be harmed by vaccines. It will reduce the chances of manufacturers being driven out of business by lawsuits.
Of course, vaccines are only part of the answer. If rogue scientists create a diabolical genetically engineered virus, even a crash program to develop a vaccine would take months--too late to quash an epidemic. That's why vaccine experts say another crucial piece of the puzzle is tackling lethal germs at their source. "We need to make sure that the Russian stockpile of biological agents is contained or destroyed," explains Dr. Harry L. Keyserling of Emory University, "and that scientists involved in their biological warfare campaign don't use their skills for countries that might foster terrorism."
Under President Clinton, the government began pumping hundreds of millions into measures to thwart bioterrorism, including restarting smallpox-vaccine production. Now, we need to step up new vaccine development--which will also help to tame other diseases around the world. Today's anthrax-laden envelopes may seem scary. But we faced far graver dangers from diseases like polio and smallpox just half a century ago. New vaccines solved the problem then. They're a big part of the solution now.
With Heidi Dawley in London and Amy Barrett in Philadelphia
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