It was the nightmare many had been expecting. Five years ago, hard on the heels of 9/11, someone sent anthrax spores through the US mail to journalists and politicians. Five people died, and at least 17 more got sick. The culprit was never caught.
This relatively unsophisticated attack confirmed fears, already growing in the US, that with a bit more effort a determined bioterrorist could spread disease and mayhem across the nation. To combat the threat, the Bush administration launched an unprecedented biodefence effort. To date it has spent $44 billion - three-quarters of it aimed at protecting civilians - on new organisations, training, and buying existing remedies such as the classic smallpox vaccine.
Has this massive spending made Americans any safer? According to experts at the Center for Biosecurity at the University of Pittsburgh, the answer is no. Last month, they announced that the US remains unable to defend itself against any anthrax attack involving more than a few envelopes. So what has gone wrong?
The centrepiece of the administration's biodefence effort is Project BioShield. Launched in 2004, it is designed to turn drug companies into defence contractors, delivering products to counter potential bioweapons. Project BioShield has $5.6 billion to spend by 2014 on drugs to be stored in what is known as the Strategic National Stockpile. Yet, contrary to expectations, the pharmaceutical industry has not beaten a path to Project BioShield's door. The sluggish response has prompted a bill in Congress, expected to pass this year, that attempts to make BioShield more industry friendly (see "Into the valley of death").
Missing the point
Yet many biosecurity specialists say these adjustments do nothing to alter the fact that Project BioShield may be missing the point. They see problems in two crucial areas: the limited range of pathogens that BioShield is targeting, and inadequate plans for deploying the countermeasures it does have.
On the face of it, BioShield's underlying strategy seems sensible. Normally companies don't make remedies for the rare diseases thought most likely to be used as weapons, as there is no profit in it. So BioShield promises companies that it will buy particular drugs and vaccines for the threats it fears most, in theory giving the companies an incentive to do the rest.
Why, then, has the response so far has been so unimpressive? Project BioShield has awarded contracts for seven products, worth $2 billion. Two are for antibody-based therapies for botulism and anthrax. One is for 10 million doses of the military's existing anthrax vaccine - a concoction of bacterial debris whose alleged side effects have led some soldiers to prefer court-martial to vaccination. The single biggest slice of funding, $878 million, has been pledged to VaxGen of Brisbane, California, for 75 million doses of a purer, new-generation anthrax vaccine. An order is also expected for 20 million doses of an improved smallpox vaccine from the Danish firm Bavarian Nordic, while Project BioShield has provided $4 million to universities to fund basic pathogen research.
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