Why Government-Funded Ebola Research Is Outpacing Big Pharma
When the crisis hit, the public research sector went into overdrive.
Dr. John M. Dye Jr. works in the lab at the U.S. Army Medical Research Institute of Infectious Diseases in Frederick, Maryland. Image: DoD
Since the current Ebola outbreak in West Africa first roared to terrifying life in March, there has been a deluge of research announcements related to the disease.
Over the last eight months, ad hoc research consortiums were formed at universities and government labs, leading to the fast-tracked development of experimental vaccines. Research was refocused to address Ebola in stunning displays of adaptability. Treatments and vaccines that had been undergoing relatively quiet development for years were brought to light. Basic knowledge about the disease has grown rapidly.
All of these achievements have one thing in common: they emerged from the government-funded public sector of research.
During the outbreak, institutions with ties to government money have displayed the kind of readiness, flexibility, and fervor to innovate that supposedly characterizes the world of corporations and private interests—a world that has remained largely silent during the ongoing outbreak that has claimed so many lives.
The current outbreak has put the world community to its test
As Leigh Phillips noted in his excellent Jacobin essay "The Political Economy of Ebola," public health officials have long bemoaned the private sector's lack of interest in vaccine development and basic research into Ebola.
"We have a [vaccine] candidate, we put it in monkeys and it looks good, but the incentive on the part of the pharmaceutical companies to develop a vaccine that treats little outbreaks every 30 or 40 years—well, that's not much incentive," Anthony Fauci, director of the National institute of Allergy and Infectious Diseases (NIAID), a key funder of Ebola research, told Scientific American.
A select number of pharmaceutical companies have recently begun to pump money into Ebola research, often in partnership with (and funded by) public entities. But this is less an encouragement than a grim reminder that numbers are what matter in the world of corporate vaccine development, perhaps especially if they indicate a climbing infection rate.
The public sector's willingness to invest long-term in research that is not immediately profitable is its chief virtue, allowing it to quickly funnel funding into areas that will drive that foundational work forward.
Over a decade ago, the NIAID began funding Ebola research projects under the banner of the Regional Centers of Excellence for Biodefense and Emerging Infectious Diseases (RCE) program. That initiative was replaced in 2014 by the Centers of Excellence for Translational Research program, which carries on much of the work accomplished under the RCE and funds research into specific medical countermeasures for infectious diseases.
In the US, much of today's Ebola research is indebted to the work accomplished under these programs, and the many other publicly-funded research initiatives undertaken since Ebola was first identified in 1976.
"The work of these researchers is coming to light as a result of the current outbreak and consequent uptick in public interest in this topic," Tarik Jasarevic, the World Health Organization's Ebola spokesperson, told me. "All avenues of study are being explored right now, because we need to find effective, safe ways to prevent transmission and protect against infection from a very deadly pathogen that has claimed the lives of more than 5,000 people in the current outbreak."
The perception of the government as a slow-moving bureaucracy that can't keep up with the private sector is a popular one, even when it comes to research funding. But recent developments in Ebola research have proven this assumption false, according to Clive Gray, a professor of immunology at the University of Cape Town in South Africa.
"The regulatory bodies, like the FDA for example, needed immediately to speed up—it's kind of endogenous bureaucracy, if you like—and you know what? They've done that," Gray told me. "They approved a particular vaccine construct within days. That's record time."
Here, Gray is referring to trials of an experimental vaccine developed by researchers at the University of Maryland School of Medicine in partnership with the NIAID. The vaccine is currently undergoing trials in Mali and, according to Gray, it's two months ahead of schedule.
Funding for Ebola research has also accelerated in the midst of the outbreak. In October, the NIAID made special accommodations for Ebola researchers and extended the deadline for grant submissions. The total amount of funding went up, an NIAID representative told me, although no figures are public yet.
On top of that, President Obama requested that Congress allocate $238 million to the National Institute of Health (NIH) for the immediate development of Ebola treatments. The US is not alone, either: On November 3, the Canadian government approved a $27.5 million windfall to the Public Health Agency of Canada (PHAC) for Ebola research.
Perhaps the most famous example of the public sector's success in fast-tracking Ebola related research is ZMapp, the antibody treatment developed by a small San Diego company in partnership with NIAID, PHAC, the US Army Medical Research Institute of Infectious Diseases (USAMRIID), and several other government organizations. But ZMapp, which was developed as part of a decade-long Ebola research effort, is just one instance of how public money has been crucial to developing treatments for Ebola.
Ralph Baric, a professor of epidemiology at the University of North Carolina School of Medicine, believes that public funding has been essential to how Ebola research has accelerated since the outbreak began.
"When a lot of people do research, they have some kind of system that they're studying, and that system can be amenable to any number of pathogens," Baric told me. "They may be studying the influenza virus with their system, but it can be amenable for studying Ebola or SARS. Many people probably predict that the increase of funding on that pathogen increased priority by the NIH, and so their preliminary data that they generated would allow them to compete for those pots of money."
Baric's lab developed a genetic strain of mice that can manifest human-like symptoms when infected with diseases like West Nile and SARS for use in testing vaccines and treatment. When the Ebola outbreak began, his team repurposed their work for Ebola and began collaborating with the NIH's Rocky Mountain Laboratories to study the virus.
Baric's work is just one example that illustrates how the public sector reacts to crises with remarkable nimbleness by aggressively funding new research and incentivizing the repurposing of ongoing work. There are many more examples, like the work done by researchers at the Boston University School of Medicine to identify presymptomatic markers of hemorrhagic fevers like Ebola.
I don't know one private company—I'm sure they exist, but I don't know one—that has such an altruistic outlook
"The current outbreak has, I think, put the world community to its test," Gray told me. "I would even go as far to say that this ebola outbreak has tested everything from public health measures right through to vaccine, basic science measures. Everybody is mobilized."
Actually, not everyone has mobilized, at least not with the same speed. As many have pointed out, Ebola has been an unprofitable disease for the majority of its known existence, and corporate research concerns have largely steered away from it.
The immense costs of developing a treatment for a disease like Ebola—deadly, but not as widespread as malaria, for example—largely outweigh the potential economic benefits for pharmaceutical companies. The costs required to protect the public good are too much for the market to bear in most cases. Only the public sector can spend money on what will merely save lives.
"I don't know one private company—I'm sure they exist, but I don't know one—that has such an altruistic outlook, because they have to keep themselves alive," Gray told me. "I think public funding is completely different. It's all in relation to public well being—the public good. Therefore, you need to step in and make things work."
If a vaccine or treatment for Ebola passes clinical trials and becomes a viable avenue for stymying the outbreak currently devastating so much of West Africa—something that could happen sooner rather than later—we will have the public sector to thank.