Washington, D.C.—President Bush’s vague plan for coping with a serious outbreak of bird flu is based largely on fear and greed. There is no secret about this. He seeks to get people’s attention by scaring the citizenry with visions of millions of people dying from a pandemic so bad it leads to martial law, mass quarantines, restrictions on travel, and so on. He wants to encourage private business to meet the crisis by producing more of existing drugs such as Tamiflu to combat a flu plague and entice the drug companies to work harder and faster to make a vaccine by ensuring its profitability.
The answer to a bird flu pandemic is not a passive first-world population riveted to the TV, watching one person after another drop dead across the world as sickened birds fly closer and closer and finally land in our midst.
The answer lies in effective communication at all levels among different nations, through their medical establishments, scientists, and spotters, so that as soon as sick or dead birds are found, the birds in surrounding areas can be culled. This is a job for the World Health Organization, which is part of the United Nations, the organization Bush and his ambassador, John Bolton, are determined at all costs to wreck.
While developed countries race to lay in supplies of antiviral drugs, there is little interest in the animals themselves and in animal-human interaction where flu can begin and spread. The WHO and Food and Agriculture Organization have only 40 veterinarians between them. “Reducing human exposure requires education about handling poultry and a fundamental change in cultural attitudes towards human- animal interactions and husbandry in many parts of the world,” writes The Lancet, the British medical journal. “In some African countries, people sleep in the same places as poultry. In southeast Asia, ‘wet markets,’ where live poultry are traded and slaughtered on the spot, pose a risk of human transmission. And in Central Asia and Eastern Europe, hunting of wild birds may have played a major part in the spread of avian influenza.”
Changing the interplay of animals and humans may meet considerable resistance among small poultry farmers in poor countries, who face the loss of whole flocks in a mass culling. If farmers are offered too little to cull their birds, they won’t do it. And if too much money is proffered, “the money will be an incentive to deliberately infect their flocks,” Milan Brahmbhatt, the World Bank’s lead economist for East Asia and the Pacific, told The Lancet.
The overall effect of a pandemic in Asia will be to drive small poultry farmers out of business and open the way for U.S.-style industrial chicken farming, with ownership concentrated in the hands of a few. Among the major exporters are China and Thailand (Southeast Asia now accounts for about a quarter of the world poultry business). Most of their chickens go to Japan. Many countries are banning imports from these two nations, and that is running up the price of chickens worldwide and promising to up exports from such places as the U.S., Brazil, and the EU.
A serious effort to stave off a pandemic also means stopping the pharmaceutical companies from scaring people to make more money. It is by now well-known that the drug companies provide huge sums of cash to politicians—$133 million to federal candidates since 1998, according to the Center for Public Integrity, with upwards of $1.5 million going to Bush, the top recipient. The industry operates an elaborate lobby in Washington that in 2004 spent $123 million and employed an army of 1,291 lobbyists, more than half of whom were former federal officials. The industry’s sales machine aims to bypass doctors with TV and other advertising aimed directly at the patient, appealing to his or her judgment over that of a physician.
In the case of making and marketing drugs to combat flu, the results are disastrous. The industry claims it can’t make flu vaccines because there is no money in it. When asked about last year’s flu vaccine shortage by CBS’s Bob Schieffer, Bush said the industry was fearful of damage suits concocted by ambulance-chasing lawyers. He explained the shortage this way: “Bob, we relied upon a company out of England to provide about half of the flu vaccines for the United States citizen, and it turned out that the vaccine they were producing was contaminated. And so we took the right action and didn’t allow contaminated medicine into our country.” This was not true. The American inspectors had approved flu vaccine shipments from a U.S. producer’s British company. It was British inspectors who blocked shipment of the questionable vaccine from the American firm.
With no vaccine in sight, the U.S. government, along with others, is belatedly stocking up on Tamiflu, a drug that supposedly offers some defense against bird flu. But last week Japanese newspapers told how children who were administered Tamiflu went mad and tried to kill themselves by jumping out of windows. In a cautionary statement the FDA noted 12 deaths among children, and said there are reports of psychiatric disturbances, including hallucinations, along with heart and lung disorders. Roche, the manufacturer, is quoted by the BBC as stating that the rate of deaths and psychiatric problems is no higher among those taking its medication than among those with flu. The company is increasing Tamiflu production to 300 million doses a year to meet demand.
Rumsfeld’s drug connections
There are other reasons people are leery of Tamiflu. Given the rip-offs in Iraq and after the hurricanes, people are understandably interested in knowing just who is going to get rich off the plague. Secretary of Defense Donald Rumsfeld, himself former CEO of drug company Searle, currently owns stock in the one company that owns Tamiflu patents—to the tune of at least $18 million. Rumsfeld says he understands why people might question his holdings, but selling them would raise even more questions. So he is hanging on to what he’s got.
A flu pandemic could mean a reduction in travel. A recent Citicorp report says likely economic losers would include airlines (such as British Airways, Lufthansa, and Air France), insurers like AXA, and luxury-goods conglomerates such as Richemont.
The report adds: “Winners could include drug makers such as Gilead Sciences, Roche, GlaxoSmithKline, and Sanofi-Aventis. Other possible winners are hospital chains such as Rhoen Klinikum, cleaning-products makers such as Henkel, Ecolab, and Clorox, as well as home entertainment companies such as Blockbuster and Nintendo.”
In order for the pharmaceutical companies to profit from making flu vaccine in the administration’s $7.1 billion pandemic flu plan, Bush now is proposing to ban liability suits against them except in cases of willful misconduct. As for those injured by a flu vaccine, possible lawsuits remain an open question.
With a worldwide market estimated at more than $1 billion, there’s big money in a flu plague. Kimberly-Clark’s Chinese subsidiary is already ramping up manufacture of new lines of medical masks, wipes, and hand-washing liquids, according to Business Week, with consulting firms Kroll and Booz Allen Hamilton selling flu preparedness advice to companies and governments. “Crisis is an opportunity as long as you see it first,” Pitney Bowes’s Christian Crews tells the magazine.
If all Bush wants to accomplish is to see the drug industry make more money, any fight against the flu will be uphill.
Additional reporting: Isabel Huacuja and Ali Syed