Stefan Elbe

Popping the Great Global Tamiflu Bubble

One of the hottest terms out there these days is National Security. It’s an excuse, a terrifier, and a weapon. Pretty much anything can be framed in terms of national security. Pandemics, Pills and Politics follows a drug called Tamiflu through its struggle for attention to a global asset in national security.

The book traces Tamiflu’s birth as an adaptation of a similar drug, Relenza, to its largely unsuccessful career as a prescription drug that battles flu symptoms and complications. (It got to the point where Gilead, the inventor and patent holder, tried to revoke its licensing agreement with La Roche). The turning point was the fear of pandemics. The international spread of AIDS and SARS put irrational fear into national governments the world over.

Quite suddenly, countries all over the world demanded La Roche supply them with warehouses full of Tamiflu to protect their populations. They remembered the shortage of HIV/AIDS meds, the flu epidemics of the past, plus SARS and the looming threats of Swine flu and Bird flu. It resulted in panic buying – not by patients, but by governments, on an unprecedented scale. In Europe, instead of buying for the EU, individual countries sought their own stocks, and needlessly overpaid. They all had to build proper medical storage facilities and some sort of national distribution, which no government had and which none were prepared for. An international conference assembled to determine the need for a generic version and backup manufacturers. It was madness writ large.

Along the way, Stefan Elbe treats us to La Roche’s intransigence in hiding its clinical findings from researchers, claiming, at different times, that the research was proprietary or private, or that it had been shown to others, so it was not available. Or just not responding. There is also the sickening story of its approval by the Food and Drug Administration, and the inevitability of its success once the original researchers were removed from the process. The message was clear – approve it.

The punchline to all this is that Tamiflu doesn’t work. At best, it might reduce flu duration by one day. If a patient were taking Tamiflu, Relenza or a placebo, they couldn’t tell the difference. Governments all over the world were and are caught in a bubble of their own making. It was global overreaction, and La Roche made a fortune.

Elbe writes from a careful, peer-review perspective. Everything is well documented. But the book is clinically dry. No characters are developed. There is no drama and no excitement. The long, tortured path of Tamiflu from conception to approval is grindingly retold for posterity, but not for satisfaction. The point, however, is insuppressible: national security does not make a good partner for pharmaceuticals and their distribution.

David Wineberg… (altro)