Global Health Research Congress

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Moving vaccines away from the horse-and-buggy stage | 

Today is the first full day of the Pacific Health Summit, which this year is focused on vaccines and “harnessing opportunity in the 21st Century.”

Harnessing seems like the right word.

Vaccines are kind of horse-and-buggy. They are perhaps the single most cost-effective and powerful health intervention that exists.

Yet we still grow the annual flu vaccine in chicken eggs. And we usually don’t exactly know why a vaccine works — because we don’t fully know how the immune system works.

That’s a problem for scientists and vaccine manufacturers. But it’s also a chronic problem of public perception, because this can make it hard for experts to convince vaccine skeptics and fearful parents that the shots are safe and low-risk.

Last night, at the opening dinner of the summit, which some have taken to calling the Davos of global health (because of its exclusivity and high-powered attendees), one of the world’s leading scientific experts in immunology said the science of vaccines today is “dreadful.”

The Pacific Health Summit, I should note, is an off-the-record meeting and I’m required to get permission before quoting anyone. I wasn’t able to catch up with Tony Fauci, the director of the National Institute of Allergy and Infectious Diseases, to ask him if I could report that he said that. So for now, let’s assume he didn’t.

But other scientists, who met in Seattle just before the Pacific Health Summit, said much the same thing.

Tom Paulson

Global Health Research Congress

Across the street from the summit, in the waterfront Marriott Hotel, was the second annual Global Health Research Congress. There, vaccine experts from academia and industry spent two days trying to come up with a set of basic recommendations to give to the policymakers, government representatives and others at the summit.

Today, at the summit, Ken Stuart of Seattle Biomed (and the organizer of the research congress), presented the scientists’ top three recommendations:

  • Share information
  • Work together
  • Support new technologies

Well, duh. That sounds pretty obvious and easy. It took this incredibly smart bunch two days to come up with that?

Actually, it turns out none of those three recommendations will be that easy to accomplish — just as it’s easy enough to say we should get all children around the world vaccinated but not easy at all to make it happen.

I won’t go into all the details of the debate, but the reason why none of those recommendations will be easy is that vaccines are created by at least two very different kinds of people — basic scientists working in academia and the researchers and business folks who work in the drug industry. They don’t always work well together.

For example, here’s one response to the first suggestion that scientists be more strongly encouraged (i.e., required and enforced) to share their data on the government’s web-based system known as clinicaltrials.gov.

“If you do that, you’ll just muck everything up and nobody will be happy,” said Rip Ballou, a top vaccine scientist at GlaxoSmithKline working on malaria vaccines. Part of the problem is that academicians and industry researchers, Ballou said, have very different incentives and needs.

The idea of sharing information and working together is nice, he said, but until there is greater appreciation of how to bridge that gap there won’t be much more than talk.

Stuart’s colleague at Seattle Biomed, Alan Aderem, agreed:

“Teamwork in industry is absolutely essential,” said Aderem. “But teamwork in academics is the kiss of death,” because of the need to ‘publish or perish’ as an individual.

Stuart said the point of the research congress is to find some way to resolve these differences, bridge these gaps, to support the kind of basic science that will move vaccines from the horse-and-buggy stage while also making it work for industry.

“We have two very different cultures here,” Stuart said.

Seattle’s week of private meetings on global health | 

This week, several “invitation-only” meetings will be held in Seattle featuring hundreds of leading experts in global health from around the world.

They all revolve around the Pacific Health Summit, which starts Wednesday.

One of those confabs orbiting the summit is the Global Health Research Congress, which starts today.

Launched in Seattle last year with backing from the Gates Foundation, the Congress’ stated aim is to help scientists inform and complement policy discussions at the Pacific Health Summit — which also gets Gates money and is difficult to summarize as its intended purpose has “evolved” over time. More on that below.

Both meetings this year are focused on vaccines — exploring how best to discover, develop and distribute.

These goals clearly represent a public good.

Yet their discussions and decision-making are private.

Journalists, like me, are allowed in to the meeting and all the formal discussions. But even for the sessions we are allowed to sit in on, we have to get permission from any attendee before making public what they say.

It’s annoying and cumbersome. I complain about it almost every year and then usually go anyway. I’m not the only one. Here’s a 2009 article by Sandi Doughton on the exclusivity of the new “Davos of global health.”

And last week, I ran into at least one world-renowned expert in global health who said he is refusing to attend the Pacific Health Summit due to this restraint on free and open discussion. Continue reading