Introduction

Since hitting Brazil in May 2015, the Zika virus has spread rapidly, infecting an estimated 1.5 million people. Zika, transmitted through mosquito bites and sexual activity, has been linked to microcephaly in newborn children. The emerging public health crisis is straining social, economic, and political institutions in Latin America, as countries attempt to simultaneously mitigate the virus’ impact and maintain important cultural. In this feature, HPR writers examine Zika’s effects and discuss potential solutions.

Image source: Flikr/Diego Torres Silvestre

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HPRgument Posts | February 24, 2016 at 1:48 pm

Medicine sans Morality

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The Zika virus, although only recently at the center of global concern, has actually been around for quite some time.  First detected in Uganda in 1947, it has plagued select areas of the world, mostly in Africa, for decades.  This year, Zika has broken out suddenly in at least 30 different countries and territories.  In some, like Brazil, Zika threatens to strain already-faltering health care systems, and has increased the level of children born with microcephaly and Guillain-Barré syndrome.

This particular outbreak, which is predicted to result in 3 to 4 million infections within 12 months, has garnered sizable international attention.  World powers, such as the United States, and private pharmaceutical companies are all seeking to develop a vaccine to stop the virus before it inflicts too much damage.  Zika is indeed deserving of this attention, and must be swiftly dealt with to prevent further human suffering.  However, this situation also provides us a unique opportunity to see the flaws in our global vaccination system and realize that the good that is done is not nearly all that could be done.

Human health has regrettably come to be valued based on its marketability.  Pharmaceutical companies generally do the dirty work of researching and developing vaccines.  They then sell those vaccines to governments and international organizations for public use.  However, private  pharmaceutical companies, just like any company, are inherently designed to chase profits.  The average vaccine takes 20 years and $1.5 billion to manufacture.  It’s a laborious task, involving biochemical research, pre-clinical trials, approval waiting periods, and animal and human testing.  Understandably, pharmaceutical companies want reimbursement for their efforts.  Unfortunately, this desire stands in the way of efficient vaccine development.

Malaria, tuberculosis, and HIV-AIDS offer three examples.  With the scientific knowledge we now have, it is very feasible that a concerted effort at developing vaccines for all of these diseases would yield success within the next decade.  However, as it stands, the potential market for these vaccines is too small to warrant the serious attention of most pharmaceutical companies.  Virtually every case of malaria, TB, and AIDS occurs in the developing world—in poor countries whose citizens can often only afford vaccines for incredibly low prices.  The fear is that the sale of such vaccines would fail to cover research costs; in short, there is no profit incentive to invest in preventing the 5 million deaths per year caused by the illnesses.

Corporate interests are undoubtedly intertwined with where, when, and how we produce vaccines for deadly diseases.  The currently unraveling story of Zika highlights this issue.  With the virus now threatening the developed world, the market for a vaccine has all but exploded.  Dozens of companies, such as France’s Sanofi and Pennsylvania’s Inovio, have expressed interest in dedicating huge sums of money to R&D, and their stocks have been steadily climbing.  Barack Obama has even asked the U.S. Congress for $1.8 billion in emergency research on Zika.  Given the broad international interest in a Zika vaccine, the relative projected ease of its development, and the large potential market, a virus with only three attributable deaths in its history has garnered more research attention than malaria or TB. No longer just an isolated problem in Central Africa, Zika offers financial promise for pharmaceutical companies across the globe.

What drives our desire for a cure, it seems, is not necessarily the number of human lives lost, but rather which lives are lost and whether those people can pay up.   The global campaign against Zika, while beautifully demonstrating our ability, has called into question our humanity.

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