Flu vaccine. There is a time.

Leaving aside everything else that has happened, now that H5N1 may have North America (Prince Edward Island, Canada) some outside-the-box thinking is certainly called for. Two of the infectious disease experts I recently interviewed with St. Jude Children's Research Hospital in Memphis are with what they claim is one of five WHO-affiliated major flu research centers and that they are coordinating research with their colleagues overseas, but that is a bit of a different issue than Revere's excellent point about possibly removing commercial barriers to development/distribution among drug companies, etc. (as contrasted with, for example, a 'research hospital' or non-profit 'institute'). One question is: how do you remove commercial 'barriers' but still give the vaccine makers some incentives? I myself don't want to wait for the answer to this 'coordination issue' until we're looking at tens of millions of dead.

Healthbizz: These are good questions and I don't have the answers. But let me sketch out some possibilities. (1) The national/international vaccine institutes would both develop and manufacture vaccines. In the US, until recently, two states did this (Massachusetts and Michigan). The importance of having distributed vaccine institutes is that there could be manufacturing capacity globally and regionally, not depending on big nations who will take their share off the top; (2) Use a contract mechanism to order vaccine manufacture from companies under a guaranteed profit (of a reasonable size but not the kind of obscene size characteristic of Big Pharma), like any other kind of government contracting (e.g., defense) where the profit is around 10 - 15%.

I'd be interested in other views (or contrary ones).

If it is all about making money, beating competitors, and piously bowing to the God of market forces while sneakily milking the Gvmt. that is the tax payer for what the traffic can bear there really isn t much hope of any concerted public action, be it in the health field or anywhere else, seeing the light of day.

To solve global problems, self-interest must be set aside, cooperation, collaboration must become values on their own, and fiddling about with % of funding, stipends, profits, gains; international or local laws -ignored these days anyway-, whatever, is pretty useless.

Well I am pessimistic today.

The calculated profits and taxes from national vaccin production surely will exceed every possible monetary reward for sharing virus isolates with other countries.
And who cares if neighbouring countries are having troubles with their deaths from H5N1? It keeps the others busy and they can't be strong ennemies at that time.

But if one political party could inform the public and start a campaign with this 'sharing' goal as one of its major election items, maybe some countries could, after some years, get this realized. I am not very hopeful about exactly those countries who are in big trouble now, for I think it is just their political structure (no real elections) and too little money spent on their folks (health, culling compensation money) that created the dubious advantage of having a lot of strains available and needing the money from vaccin production to sustain their powerful positions in the short term.

I really don't know how anyone could get one foot in the door. Diplomacy is great, but even in negotiating the offer has to be acceptable.

I suspect this will not be a popular option but.

Change the UN & WHO's role, give them teeth and a budget to match. These samples should not be a persons, governments, labs or bigpharmas property they should be held in trust by the WHO. The WHO should subcontract the research, the manufacture & hold the patents.
The market economy/nation state model is poorly equipped to handle global problems and bilateral agreements will not solve problems like pandemics or over exploitation of the oceans. There must be a better system and I for one dont think it is multi-national corporations the usual sci-fi successor to the nation states or religions which have been tried before with disastrous results.

JJ: It's a popular option with me. But who is going to give them this authority?

If you live in a democracy the only answer to that question is - we are.

I pay taxes at a local level so my streets are cleaned and the garbage collected.
I pay taxes at a regional level for the police & fire brigade.
I pay taxes at a national level for defence & air traffic control.
I want to pay taxes at a global level so someone can protect my interests on global warming, pollution and have a vaccine plant for when there is a global pandemic.

I would join, JJackson.
The 'organization with teeth' should have a direct way of receiving the global taxes, with as little corruption levels in between giver and organization as possible.
I liked Greenpeace for that receipe. WHO could do the same, but more independently with more stable income.
Maybe? But do you think of taxes obligatory or voluntarily?
And send informative news updates to its tax payers by e-mail?

JJ: Errr. It's not a money question (fortunately). You can't by legal authority (at least in theory). If you could we would be ruled (even more) by multinationals. Again, my question. Who gives WHO the legal authority?

Suppose the US is falling down on the job with regard to -- let's say global warming (not that this could ever happen, of course). WHO determines it is a health threat (it is). Who gives them the authority to make the US change its policies?

As I say, it's a popular option with me. Got any ideas as to who will bring it about? We don't have a World Gov. (which I would like but many other people fear). Of course it all depends on what kind of government.

I saw an article like what Healthbizz mentioned, about H5 influenza in geese on Prince Edward Island. Can someone tell me how many different types of H5 influenza there are? They said they didn't know what N subtype it was, but what else could it be?

Not that I would begrudge the UN anything, but guys do you really think their crooks are less than ours? We cant get our socialism in this country straight much less if the UN runs it. Do you really think that Big Pharma wouldnt first resist and then later being unable too, raise the prices to a level that no one would have a chance at reasonable cost healthcare?. We would see socialism on a whole new scale and taxes to go with it. Managed healthcare is a disaster along with group purchasing of vaccines or its productions. We are always going to get hosed. Anyone thinking we are not is sadly and historically misinformed. The only other alternative is to nationalize an industry and thats where the Clintons worked it to the nth degree. If we cant nationalize it we will tax it to the point that we have money to do other things like balance the budget. Got to think these things through. Has healthcare and its complete offering to everyone including the poor in the US produced anything but a disaster? It offers healthcare to people who dont work at the expense of those who do. In many cases the care of the poor is better than what the people who are actually paying for it get.

As for the assimilation of world health care by the WHO. There is a lot of damning evidence that the UN run WHO is deliberately witholding information and it is a political operation of the highest order and the former head made some really whacked out decisions. Mostly to the detriment of the health of the world. No doubt pressure being applied from some angle. I cant for the life of me see how spending several hundreds of millions of dollars for Tamiflu is or has helped anyone. They could have spent the money not on antivirals but on R&D on vaccine. We flew thousands of doses to Indonesia, but I havent seen anything in the clinicals that came back that indicated that H5 used it for anything other than a breath mint.

Healthbiz and the removal of commercial barriers and the assertion that he/she doesnt want to be dead while those barriers are removed. It goes to the heart of it. We alway have the utopian thinkers out there, but no way to pay for it. There is no way the industrialized world can pay for those that are not. There are simply too many of them. To level the playing field takes away the incentives to produce. Why should I work, the government will take care of me. Why should I develop vaccines? Some bastard attorney will sue me for a side effect. What will happen when we globalize it and only one or two mega-pharm companies are around and are big enough to pay the liability insurance for their crappy vaccine or pills.

JJ. You want to pay taxes at the world level for preserving your interests in global warming, pollution and a vaccine plant when there is a pandemic? Well, lets see Al Gore makes a movie quoting not the people who decide if HUMAN induced global warming is occuring, but only those that assess the effects of what has happened in the past. Then he calls it , "the vast majority" of scientists saying that global warming is a result of human intervention. What do we do if and when people start dying massively from global warming and we find out that its just an earth mechanism in process. Signing Kyoto would make China the world power at the expense of the EU and US economies. They are already the worlds largest polluter, the worlds largest consumer of oil, the worlds largest population. So lets see you want to pay taxes to make it even better for them as they trade in those bicycles for Mazdas and Mercedes.

The UN in charge of pollution control? The UN put out a memo last year telling all of its missions that they must do better at containing the pollution at their sites. It is becoming a threat to the environment at 263 sites around the world. Heavy metals, sewage, cellulose waste. Yeah these are the guys that I want in charge.

Ana has a right to be pessimistic, but should be optimstic. The diversity of the planet always changes politically, economically, and demographically. All things change. The idea of the UN is what we all strive for, but the reality of where we are is what we have to deal with. I am no better off now than I was with Johnson, Nixon, Ford, Carter, Reagan, Bush, Clinton or Bush. With the exception of Reagan, none of them impressed me. Either way none of what is suggested is going to happen in our lifetimes and maybe H5N1 or a cousin will shake the planet to its knees. Might not be such a bad thing.

Now as far as giving the WHO teeth.....That might not be a bad idea. I think we ought to have the right to go stomping into every country in the world anytime there is a bug outbreak...period. We ought to also have the right to do what is necessary to enforce quarantines, isolations and if necessary call out the troops to enforce them with the blue beanies. But to do so requires a country to give up its sovereignty. Not much chance of that happening but Utopia does exist.

Interrobang: I know of at least H5N1, N2 and N3. There may be more H5s, too. Maybe another reader knows.

Influenza viruses almost always cause benign disease in birds but subtypes of H5 and H7 have also caused serious disease and death in birds. These are the so-called Highly Pathogenic Avian Influenza viruses and as far as I know are all derived from low pathogenic counterparts. The H5N1 that is found in North American birds has been of the low path variety, but it could change to HPAI as have some other subtypes. The PEI goslings reported the other day are assumed to be low path (LPAI) but we won't know this until the N protein is determined and the sequences looked at. The two ways we determine if a virus is HPAI is via giving it i.v. to birds to see what happens (does it kill them) and by a characteristically widened cleavage site that seems to confer the ability to infect many more organ systems in the bird than the LPAI version.

Not good enough, Revere (my friend). Profit is inextricably tied -- biologically -- to survival. To ensure the survival, and prosperity, of your progeny, you must seek out a niche that conforms to your talents, your avarice, the limits of your conscience, your willingness to kill-rather-than-be killed. And myriad other considerations passed down through countless millenia.

Those who preceded us constantly engaged in these various, vicious activities: otherwise, we are not here. And, we are indisputably here.

At least two seminal influences on human behavior attempted to alter the obvious consequences of these primordial "birthright" activities; Christianity, and Communism. They both failed miserably. For the same reasons: They both failed to understand human nature.

They depended upon colossal, transcendent figures, that were larger than life. (You may safely insert Hitler here, too, of course.)To alter the course of what even the least sophisticated child knows: "I want." And I will accept no excuses, with regard to "why" I may not "have." That is our earliest lesson. "I want!" "Need," and "Idealism," rarely intersect. Especially where "profit" arises.

There is no way out, here. Our intractable, political (and religious) ontogony is our destiny. As it has been, so it shall continue to be.

Just a comment that I now find it much harder to read your excellent blog, because of the distracting moving advertisements that appear to the right of the text. I'm really on the point of giving it up. Just so you know.

Dylan: So spell it out. In this case it means . . . ?

Me, too, Mathematician. Especially when I want to concentrate on content. I have already used a piece of paper (doublefolded) to literally cover these 'moving' advertisements. I see it as symbolical in the clash between 'our' purposes of posting on this site and concomitant commercial ends from others. 'They' keep the structures and 'we' can, inside these, move on for our own goals.
Mixed feelings. But please don't give it up because of some visual effects.

? The more articles i read about bird flu,
the more concerned i am about the abilty of agencys, companys and goverments to overlook thier own agendas and work togther.
They should help the people to be prepared by adviseing them on their options,
ie, distribute a checklist to have at home, food water, needed medicine etc. in case it is needed ahead of time.
I know some have, and I take my hat of to them.
It seems that most goverments are more worried about the economic ramifications, ie not turning up for work,somone else getting lots of money from a vaccine, missed taxes etc, than they are about the people.People are the biggest asset!
I just wish people would help people, and helping people should be enough reward.
The WHO idea is ok, but they would have to be independant from all goverments and companys.
There would be lots of hurdles to jump, to make it work effectively, and stop corruption.
I wish you all well and hope the pandamic becomes a non event.

Math, tan06: The adverts are beyond my control but I will raise it with the publishers ASAP. I am able to tune them out but I understand not everyone can do that. I'll give it a try.

Cathy: I assume (I hope) you know about our sister project, The Flu Wiki. FW has a few thousand pages of content and is devoted to helping each other by providing information, links and discussion (see the Discussion Forums; link on left sidebar).

Sorry, Dylan, but that's a load of **** and this blind worship of The Almightly Holy Market (because of our reptilian or neolithic brains or whatever...) is exactly what has us marching like the dinosaurs to our doom.

The history of civilization holds countless examples of where we've been smart enough to forego instant gratification for long term gain (like say, agriculture or insurance) or to sacrifice individual desires to serve the common good (from agricultural co-ops to governments, religions, taxes, the rule or law) -- even to make the ultimate sacrifice (suicide bombers and your good ole average GI Joe).

We've come a long way, Baby! There ain't nothing we can't do if we take our heads out of the sand and put 'em together.

Political and corporate leaders with their narrow, short-term profit-related agendas have only been able to convince us to just give in and accept that we are the victims of our primordial genes because we've been too drugged by the carnival of bread and circuses to bother looking beyond tomorrow.

Regarding the adverts to the right: Using IE, I use less than full screen, and then pull the right margin to the left until the adverts disappear. Don't know if that works on firefox but I think it might.

Dylan: So spell it out. In this case it means...? - Revere

We are looking at it from where we now stand. That is our current vantage point, obviously. As it advances -- as it surely will -- that vantage point, and the attendant consequences that it generates, will likely shift dramatically.

At least one element of our Military is capable of sustained isolation for relatively protracted periods of time. That is the Navy, of course. We will not be in a benign, helpful mode, when this thing breaks. Whatever we do here, will depend -- first of all -- on containing, or eliminating all potential external threats. We are the preeminent power on the planet, at the moment. And we know who is running things, here.

We will not allow a powerful, potential enemy to escape by suffering a limited degree of catastrophe, that might somehow offset the current balance of power in the world. H5N1 has the potential (depending upon its degree of generalized devastation, and chaos), to "localize" the destruction of various geographical infrastructures.

The Chinese, for example, put together (well over a decade ago) a thoroughly comprehensive plan for engaging us in a form of "asymmetrical warfare;" this was designed to attack our infrastructure -- on all critical levels -- rather than contending with us on any "battlefields."

I suspect that we, on the other hand, will, at the very least, position our largest short-range nuclear missile platform submarines (and their killer escorts) off the Chinese East Coast, at the first real hint that this thing is truly breaking out; (nearly everything that they have, of any real value -- military, manufacturing, technology, intellectual assets, etc.), lies within a large geographical swath that is roughly a one-hour flight for any sub-launched missile.

If it was up to me, they would already be on station. The Chinese have a nearly four-to-one numerical advantage over us (and these people are not our "friends"); they can afford to lose far more of their best-and-brightest than we can. The pandemic is bound to produce many unanticipated consequences. It would be prudent to prepare for any that could conceivably produce the worst possible results (even if we are forced to "guess" what some of these might be).

The upper ranks of the Military (ours, at least) are awash in sycophants, and dumb assholes. But, I have no doubt that they have already thought this -- and many other scenarios -- out completely, and thoroughly. I've already thought it through, and I am by no means a "conspiracy theory" type.

Pandemic has lots of unspoken, unknown, and unacknowledged problems associated with it. And many of them we won't see at all...until it arrives. If you fail to plan -- appropriately -- for what can conceivably happen (particularly critical military contingencies), then you cannot expect to react accordingly when these things invariably materialize.

Katrina.

By the way folks, the Norko's have fueled their missile and Condi Rice has said that the MDS has been switched from standby to on. This means the US intends to knock that long range mother out of the sky if the Koreans fire it. That missile has no purpose other than to start a war because of its range. A defensive missile is one that goes after your local neighbors

Ours are defensive in nature now, not offensive unless you change the language of START II and the Russians agree. My biggest fear is that we will find it to be nuclear tipped and aimed for DC or New York.

Will Bush do them if they launch....? You can bet on it. It will be knocked down in international waters past Japan who is absolutely going nuts over this launch thing. They have a very formidable space launch capability and could produce nukes of their own in under three - six months for an A-bomb, two years to a hydrogen weapon. Just what we need right now is a SE Asian arms race.

As for Dylan. I hear what you are saying and as a proponent of use of all means necessary to stop avian flu from killing the world. It is as I said back on the old EM something with a window of opportunity that will close quickly. I dont think it would even be open on China though because its already endemic in too many areas.

Indonesia is and was a BIG maybe. There are not enough cases just yet to justify it. On the other I hand think you are in the Navy and you may or may not know of events in and around the South China Sea. Stay tight and frosty. This rest of this month and the next might prove to be some of the most interesting times in our history.

Dan D.: Thanks for the tip. I have also spoken to the powers that be and they are working on changing the annoying ad. Hope it happens soon.

Interrobang:

http://www.bloomberg.com/apps/news?pid=10000087&sid=a3punxR3zwWA&refer=…

"The H5N1 virus is one of 16 H5 subtypes. Only viruses of the H5 and H7 subtypes are known to cause the highly pathogenic form of the disease. Not all viruses of the H5 and H7 subtypes are highly pathogenic and not all will cause severe disease in poultry, according to the WHO."

David, Interrobang: I think (if I understood correctly) IB's question was which H5 subtypes are found in birds. My list now has seven: H5N1, H5N2, H5N3, H5N7, H5N8, H5N9.

IB: Is this your question?

There is a tool for PC's called Privoxy, from www.privoxy.org.
It filters all your browsing on your PC and rips out ads. Not perfect, but gets far more than half.

Norskhaus Design, IT division

(I free-styled a coffee table.)

GZB: Thanks for the tip. There are ad blockers for the Mac, too, although I haven't tried them. As far as I am concerned, anybody bothered by the annoying SEED ad should block it if they can. It's obnoxious. The people at Sb know this and are trying to do something about it.

Those disturbing advertisements are really gone.
Thank you very much, Revere. And everyone who gave advice on how to remove them by myself. I will use the information on other sites.

tan06: Good. Glad things have improved. We will try to keep on top of the publishers, but don't hesitate to let us know if there is a problem like this. The conditions for signing on here for all of the bloggers was complete and total independence, no exceptions. We are free to criticize the advertisers if we see fit and they have been told this might happen. I won't go out of my way to do it, but if it is appropriate I won't hesitate either.