Big Pharma and Vaccines: An Uneasy Alliance, According to Adel Mahmoud

Ellen Gilbert

“Vaccines are a very fragile enterprise,” observed former president of Merck Vaccines Adel Mahmoud at the first “Biosecurity Seminar Series” event last week.

Mr. Mahmoud, who now has a joint appointment in Princeton University’s Department of Molecular Biology and in the Woodrow Wilson School of Public and International Affairs, offered a historic overview as well as a bird’s-eye view of recent developments in the production and dissemination of vaccines in the U.S. and beyond.

The history of vaccines dates back to early Chinese and Indian cultures, said Mr. Mahmoud. People living in the late Ottoman Empire are known to have swabbed smallpox sores with a small cloth that was then introduced into healthy nostrils. Although they did not know the word “pathogens,” he observed, these earlier civilizations knew that if you expose an individual to “something” from the sick, the exposed person might become resistant to the illness.

While scientists like Edward Jenner and Louis Pasteur made significant strides in understanding and using vaccines in the 18th and 19th centuries, Mr. Mahmoud reported that 20th century strides in vaccines — most notably the success of the polio vaccine — are considered by public health policy-makers to be the pre-eminent health achievement of the 20th century.

Jenner’s observation that local milkmaids who already had sores on their hands did not get sick with smallpox was important, said Mr. Mahmoud, but “this was no science in the context of our current knowledge.” And despite the fact that Jenner is credited with beginning the movement that led to the eventual eradication of smallpox, his methodology — which consisted of exposing children (his own included) to smallpox “would have gotten him in jail” if he tried it today.

Louis Pasteur’s important discovery of the attenuation of the microbe occurred perhaps even more casually, recounted Mr. Mahmoud. Like any good Frenchman, Pasteur went on a two-week vacation to Provence during August, leaving isolated chicken cholera in a bottle in his laboratory. When he returned, he inoculated the “old” culture into healthy chickens. The chickens became sick but recovered, much to the chagrin of Pasteur, who had expected them to die like a preceding batch of chickens that had received live cultures. Pasteur then inoculated fresh “virulent” bacterial culture into the same chickens, which surprisingly, failed to die, and thus he deduced that the bacterial culture had lost its “virulence” or disease-causing ability and had been “attenuated.” This concept forms the basis of vaccination.

While similar instances of “luck” informed discoveries of other vaccines, pharmaceutical industries have been reluctant to try their “luck” at developing and marketing vaccines, Mr. Mahmoud reported. A combination of a strict regulatory environment for the development and manufacture of vaccines, the recent anti-vaccine movement, and the perception that vaccines would not be big money-makers has resulted in a marked unwillingness by “big pharma” to take on the vaccine business.

This may change, however. Mr. Mahmoud described the acknowledged need for vaccines for diseases like HIV and malaria, and cited a recent Economist article that encouraged governments to invest in vaccine research and development. The threat of bioterrorism has also renewed interest in improving and creating vaccines. The sheer costliness of developing vaccines, however, has resulted in the acquisition of companies that already have vaccine departments, by larger pharmaceuticals, so the parent company doesn’t have to begin at square one. The fact that developing countries like India, Brazil, Korea, and China are now making vaccines that cost less (although there are no generics, yet) is also significant.

The Biosecurity Seminar Series is sponsored by the MacArthur Foundation. The talks take place from 12:30 to 2 p.m. in room 280 of the Carl Icahn Laboratory, off Washington Road on the Princeton University campus. On November 19, David Franz, the Associate Director at the Midwest Research Institute and a world leader in agricultural biosecurity and biodefense will speak on a subject to be announced. On December 3, Malcolm Dando will discuss “How the seventh review of the 2011 Biological Weapons Convention can improve life scientists’ understanding of biosecurity and the dual use dilemma.” Mr. Dando is a professor of International Security at the Department of Peace Studies at the University of Brandford in the United Kingdom. Grabriele Kraatz-Wadsack, Chief of the Weapons of Mass Destruction Branch, Office Disarmament Affairs at the United Nations, will talk about “U.N. activites in support of global actions related to biosecurity” on December 10.

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