2006 Mid-Atlantic Bio: The challenges of infectious disease

On the second day of the 2006 Mid-Atlantic Bio conference, Dr. Tony Fauci, director of the NIH’s National Institute of Allergy and Infectious Disease (NIAID), delivered a fascinating speech on emerging and re-emerging infectious diseases. He kicked off his talk with a quote from physician and anthropologist T. Aidan Cockburn. “We can look forward with confidence to a considerable degree of freedom from infectious diseases at a time not too far in the future. Indeed…it seems reasonable to anticipate that within some measurable time…all the major infections will have disappeared.”

Cockburn predicted the eventual eradication of infectious disease in 1963, just as Dr. Fauci was embarking on a career in the field. But fortunately for Fauci, Cockburn’s prediction couldn’t have been farther from the truth. What Cockburn didn’t take into account was that infectious disease never really abated in other countries and that disease would evolve in the U.S. In recent years we’ve seen the emergence and re-emergence of some of the most serious infectious diseases the world has ever know, including HIV/AIDS [1], bird flu [2], SARS, West Nile virus, malaria, and, most recently, extreme drug-resistant tuberculosis [3]. These diseases have challenged scientists and health workers alike, but they’ve also opened up new opportunities for the healthcare industry to develop new methods of dealing with infectious disease.

HIV/AIDS, Fauci observed, is perfect example of an emerging disease. While we may not realize it, we’re currently living through one of the greatest health disasters in history: tens of millions have died of the disease and many more have been infected. But despite the high human cost, Fauci says the global effort to halt the disease stands as a testament to what can be achieved if health officials around the world support drugmakers in their quest for a cure. The sum total of antiviral drugs developed for HIV/AIDS is greater than the number of antiviral drugs created for all other viruses combined. This is no accident. Lawmakers and health officials gave the industry an incentive to develop these drugs which accounts for the wide variety of treatments available today. A robust financial commitment, more researchers and better infrastructure has led to understanding of the etiology and pathogenesis of HIV/AIDS. This, in turn, promotes faster drug development. Imagine if we were to put this much effort into other diseases.

Influenza, in all its forms, is the re-emerging disease we’re probably all most familiar with. Each year between 250,000 and 500,000 people die of the flu and if all flu deaths in history are added up, influenza emerges as the second worst pandemic in human history (behind the Bubonic Plague). Every year the virus mutates just enough to warrant a new vaccine. While those in poor health need the flu shot, most people have enough immunity to the flu that they can survive without it. But every once in a while the flu mutates so much that no one’s body has immunity to it. This happened three times in the 20th century and could happen again with the bird flu. In order to prevent a worldwide pandemic, Fauci says health officials should go about developing a H5N1 vaccine the same way they poured money and resources into HIV/AIDS research. He also noted updating our vaccine production technology is necessary for meeting the demand for new treatments

The deliberate disseminated infectious diseases like anthrax have posed threats to public health and caused concern among the general population. And in recent weeks, food-borne pathogens such as E. coli and botulism have caused several products to be pulled from supermarkets shelves. As Fauci notes, there will always be new threats that pose challenges that the industry must meet. The extraordinary capability of microbial pathogens to persist, emerge and re-emerge has been in a delicate balance with public health measures, biomedical research and technological advances. Neither man nor microbes will ever triumph over each other. But through new innovation in the biotech and pharmaceutical industries, health officials will improve their ability to prevent, diagnose and treat infectious disease. - Maureen [4]