Saturday, December 05, 2009

Mutant diseases and turtle research

The cold season has been in the country for a month now. Diseases that showed up during the warmer months tend to mutate to a “cousin” and slightly different strains during the cooler months. Such is the case of flu and its mutant varieties – ordinary flu, bird flu, cow flu, and swine flu, among others.

This week, both the Department of Health (DOH) and the World Health Organization (WHO) announced that they are tracking the flu virus in the country as it is now flu season in the northern hemisphere and many people are traveling across continents for the Christmas holiday season. Thus, the flu virus can easily mutate as innocent people who contracted the flu but do not show clear symptoms yet move across the northern and southern hemispheres and the tropics. The WHO noted that the strain has been mutating in many countries.

PAGASA reported yesterday that Metro Manila’s recent temperature records were 2 degrees Celsius colder than average temperatures in the past 30 years. It was a cold November and it will be another cold December as the northeast monsoon is surging. Such cooler than average weather means more susceptibility of more people to cold weather diseases.

As public demand for newer and more powerful medicines and vaccines against certain flu strains and other diseases rise, supply of such innovative drugs should also rise. For many diseases, this might be the case. But for some, like HIV/AIDS, disease-killing vaccines are not invented yet. There is turtle-pace in research.

Why is this so, and what are the incentives and disincentives that are hounding the research and vaccine development against HIV?

While pharmaceutical and biotech companies have the expertise in vaccine development and commercialization, and almost all vaccines used globally today come from them, it is notable that private sector R&D investment in anti-HIV is small. How did it come to this situation, considering that AIDS is a high profile killer disease that has victimized thousands of lives already?

Jeffrey Harris, “Why we don’t have an HIV vaccine, and how we can develop one”, Health Affairs, Nov./Dec. 2009, Vol. 28 No. 6, made these 3 observations why there is low private sector spending, in anti-HIV/AIDS research. One, political risk. Governments’ decisions to implement large-scale vaccination program or not is volatile and uncertain. Two, another political risk, the growing threats of compulsory licensing (CL) against the effective, safe, popular and highly saleable products. Add also drug price control policies that are in place in some countries like the Philippines. And three, scientific risks: all-or-none proposition from vaccine R&D, that an innovator company must spend big and lose big, or earn big, in discovering a very elusive treatment against the HIV scourge.

A combination of various interventionist and statist policies that demonize innovator companies mainly because they are big and are global corporations, is the main reason why there is turtle pace in medicine R&D for both old and new or emerging diseases.

The current drug price control policy that was imposed by both the Department of Health and the Office of the President is now 3½ months old. It should be noted that it was not an ordinary price-freeze type of control, such as the one imposed after the 2 devastating typhoons that hit Metro Manila and northern Luzon provinces in late September to mid-October this year. Rather, it was a coercive and mandatory price cut by 50 percent that targeted medicines against some of the top 10 killer diseases in the country, but medicines that were very popular and highly saleable. An element of envy against successful and innovative products cannot be discounted as the main motive for such price control order by the government.

One danger of such subjective and almost arbitrary declaration of drug price control, is that innovator companies that have more powerful and more revolutionary medicines and vaccines, will not bring their products into the country. There will always be a fear of another round of drug price control policy anytime, without regard for explicit public health emergencies , but only for consideration of political emergencies by the politicians in power.

The ultimate loser of this situation will be the Filipino patients. Both poor and rich patients. When we are saving the lives of our beloved family member or friend, money becomes a secondary issue. The main issue is the availability of life-saving drugs and treatments that can kill the diseases that weaken the body and spirit of persons who are close to our heart.

Mutant diseases should be met by mutant medicines and treatment, not by turtle-pace research and treatment, discouraged by heavy politics and political intervention in what are clearly non-political concerns like saving the lives of people who are dear to us.

* Note: this article, with a table in it, was originally posted at

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