After the lab scientists and biotech companies lay the scientific groundwork for a new vaccine, they typically look for a partner with pockets deep enough to finance expensive rounds of clinical trials needed to apply for a licensure application.
"It costs roughly
The only players with that kind of dough are governments _ more on that option later _ and Big Pharma. But major pharmaceutical companies only push through their pipelines products that will sell.
"If there's a market, things get made," says Monath, who is a former chief scientific officer for vaccine maker Acambis, where he oversaw development projects on vaccines for C. difficile, West Nile virus and smallpox, among other diseases.
So rotavirus vaccines, which prevent a common diarrheal disease that afflicts rich and poor children around the world, make it to market. But if you want vaccines to protect against deadly Ebola viruses _ which trigger sporadic outbreaks that infect scores of people in some of the poorest countries of the world _ the math doesn't add up.
"There has to be a substantial demand," explains Osterholm. "That's why today we've not seen the commercialization and licensure for example for either of an Ebola virus or something as common as West Nile virus."
Childhood vaccines are a solid business because new customers are born every year. But to date,
Its future path cannot be predicted, which is another strike against the business prospects of a
If, as people fear, it spreads from Saudi Arabia when several million Muslims disperse back to their home countries after next month's Hajj pilgrimage, vaccine won't be in the medicine kit.
"Vaccines are slow-moving boats," says Hotez. "You could accelerate it so it's not going to take a decade. But it's not going to be done in two years either."
Osterholm and Monath both support the idea that developing a vaccine for camels _ or steering the current vaccine work toward an animal product _ would make more sense. That is, of course, if it's shown that camels are actually involved in the spread of the virus to people. To date the evidence is persuasive, but not proof positive.
Monath says, in general, more use should be made of animal vaccines to protect people. If horses don't contract Hendra virus from bats, for instance, they cannot pass the virus to trainers and others who have contact with horses. (Hendra infections have occurred in
But Hotez points out that option will only work while
Treanor, who is chief of infectious diseases at the
Still, most governments cannot afford such expensive emergency supplies. And even those that can may choose not to spend scarce funds on an expensive tool they may never need.
It all adds up to an iffy prognosis for
Says Monath: "I think we'll see whether the problem justifies the response, in this case vaccine development. It will take some time to know. But you have to be very cautious about promising vaccine in a short time frame on the human side."
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