The Outbreaks Are Here, Where’s Our Response Plan?

The news of the first Zika case in Pierce County—the 14th in Washington State—reminds us that the spread of disease is inevitable. While we don’t have in our region the kind of mosquito that transmits Zika, the latest infected patient returned from a visit to Puerto Rico. Thanks to modern travel, whether by mosquitoes or infected humans, only a unique environmental factor could contain a disease where it started. If we know that a virus exists in a certain area, we should take it as a given that it could appear anywhere.

Given the certainty that disease will spread, there are a number of things we must do to be ready:

Having a response system in place is of utmost importance—for the safety of people everywhere. Here in the United States, we can no longer assume these infectious diseases are not a problem for Americans. Not only did Ebola and Zika virus make their way rapidly onto U.S. soil, but ancient diseases like leprosy are creeping up in numbers here as well. When the headlines fade, it’s easy to forget why we need a system at the ready; each of us has a responsibility to keep this topic top of mind for our public health policy makers.

  • We must continue research. When people question the importance of funding little-known diseases or ones that are not perceived as a threat to the developed world, they need look no further than Zika, Dengue Fever, and Ebola to understand why this type of research is incredibly vital to the well being of humankind. We must first understand the basic biology of these infectious agents and how they spread, in order to be prepared.
  • We must continue funding. As funding cycles ebb and flow, from sources like the National Institutes of Health and private foundations, we must be mindful that funding for disease research and product development is mandatory for us to be ready to protect ourselves.
  • We must develop vaccines in a different way. Current methods of vaccine development—which take large amounts of time and money—don’t work when a speedy response is of the utmost importance; scientists are hobbled by the time table of the human immune system. We need to find new ways to develop vaccines quickly and cost-effectively.

All these elements provide the basis for rapid response, but how do we execute the plan when the outbreak is upon us?

This requires another paradigm shift. Instead of producing vaccines in rich countries and struggling to ship enough to protect the entire world, we need to help develop vaccines in the countries where they are needed most.

One way is to share important technology. As part of a project funded by the Biomedical Advanced Research and Development Authority (BARDA), part of the U.S. Department of Health and Human Services, IDRI is partnering with developing country vaccine manufacturers to vastly improve their ability to respond quickly during an influenza outbreak. BARDA and the World Health Organization identified institutes in developing countries that are able to make influenza vaccines, and IDRI provides the technologies for adjuvants, which are added to a vaccine to increase the body’s immune response. This new approach to making vaccine technology available to developing countries means a rapid response to an outbreak where it’s needed most.

Another way is to build new companies in countries where disease is endemic. This serves the dual purpose of developing vaccine technologies on site and providing the catalyst for new industries that can offer training and employment. With an investment from the South African government, IDRI has formed a company called Afrigen Biologics, which is dedicated to the local development and production of vaccines of critical importance to Africa, including tuberculosis and HIV. This also provides a platform for rapid scale-up of vaccine development in case of outbreak. This is a model that can be replicated in other parts of the world, if companies are willing to share their expertise.

We must be proactive rather than reactive when it comes to global health. We cannot wait for Zika to abate and then make a plan for the next infectious disease. By then, it will be too late.

Author: Steve Reed

Steve Reed is the founder, president and chief scientific officer of Seattle-based IDRI. He co-founded Seattle-based Immune Design, a startup vaccine developer. Previously, Dr. Reed co-founded Corixa Corporation in 1994, where he served as Chief Scientific Officer until leaving in 2004. His academic appointments include Professor of Medicine at Cornell University Medical College in New York and Research Professor of Pathobiology at the University of Washington. He serves on several editorial review committees, has served as a member of the Tropical Medicine Review Board of the National Institutes of Health, and is a member of the Vaccine Development Steering Committee of the World Health Organization. Dr. Reed was born in rural eastern Washington, graduated from Whitman College in 1973, and received a Ph.D. in Microbiology and Immunology from the University of Montana in 1979. That year he was appointed as Scientist of the National Institute of Amazon Research in Manaus, Brazil, where he directed research on tropical diseases. Dr. Reed joined Cornell University Medical College in 1980 as Assistant Professor of Medicine, continuing to work in Brazil as manager of the Cornell-Bahia program in International Medicine. He joined the Seattle Biomedical Research Institute in 1984 where he worked until founding IDRI in 1993. Dr. Reed’s research interests have focused on the immunology of intracellular infections, and on the development of vaccines and diagnostics for both cancer and infectious diseases. He has more than 170 original articles, several book chapters, and holds 59 issued patents for diagnostics, vaccines, and therapeutics of infectious diseases and cancer.