Pandemics, Pills, and Politics: Governing Global Health Security

281 Pages·2018·7.17 MB·English

by  Stefan Elbe

Pandemics, Pills, and Politics
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Pandemics, Pills, and Politics
Governing Global Health Security
Stefan Elbe
JOHNS HOPKINS UNIVERSITY PRES S BALTIMORE
To the Reader: Nothing in, or referenced in, this book should be construed as offering
medical advice. Although every effort has been made to ensure the factual accuracy of
the contents, no liability can be accepted for any use of the information in the book.
This book was brought to publication with the generous assistance of the Eur o pean
Research Council.
© 2018 Johns Hopkins University Press
This work is also available in an OA edition, which is licensed under a Creative
Commons Attribution-NonCommercial-NoDerivatives 4.0 International License:
https://creativecommons.org/licenses/by-nc-nd/4.0/.
All rights reserved. Published 2018.
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Library of Congress Cataloging- in-P ublication Data
Names: Elbe, Stefan, 1975– author.
Title: Pandemics, pills, and politics : governing global health security / Stefan Elbe.
Description: Baltimore, Mary land : Johns Hopkins University Press, [2018] |
Includes bibliographical references and index.
Identifiers: LCCN 2017043199 | ISBN 9781421425580 (pbk. : alk. paper) |
ISBN 9781421425597 (electronic) | ISBN 1421425580 (pbk. : alk. paper) |
ISBN 1421425599 (electronic)
Subjects: | MESH: Global Health | Health Policy | Security Measures— trends |
Influenza, Human— drug therapy | Phar ma ceu ti cal Research
Classification: LCC RA418 | NLM WA 530.1 | DDC 362.1—d c23
LC rec ord available at https:// lccn . loc . gov / 2017043199
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whenever pos si ble.
To Alexander
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And we must come together to prevent, and detect, and fight e very
kind of biological danger— whether it’s a pandemic like H1N1, or a
terrorist threat, or a treatable disease.
— President Barack Obama
We w ill seek to advance access to and effective use of technologies to
mitigate the impact from outbreaks of infectious disease, regardless of
their cause.
— US National Security Council
Our nation must have a system that is nimble and flexible enough to
produce medical countermea sures quickly in the face of an attack or
threat, w hether it’s one we know about t oday or a new one.
— US Secretary of Health and Human Ser vices
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Contents
Preface xi
Acknowl edgments xiii
List of Abbreviations xv
1 Encapsulating Security: Phar ma ceu ti cal Defenses against
Biological Danger 1
Part One: The Development Challenges
2 Discovering a Virus’s Achilles Heel: Flu Fighting
at the Molecular Scale 31
3 The Pill Always Wins: Gilead Sciences, Roche, and the Birth
of Tamiflu 54
Part Two: The Acquisition Challenges
4 What a Difference a Day Makes: The Margin Call
for Regulatory Agencies 79
5 Virtual Blockbuster: Bird Flu and the Pandemic
of Preparedness Planning 106
Part Three: The Deployment Challenges
6 In the Eye of the Storm: Global Access, Generics,
and Intellectual Property 137
7 “Ode to Tamiflu”: Side Effects, Teenage “Suicides,”
and Corporate Liabilities 163
8 Data Backlash: Roche and Cochrane Square Up over
Clinical Trial Data 184
9 “To Boldly Go . . .”: Phar ma ceu ti cal Enterprises and Global

Health Security 211