Kendall Hoyt

 

On her book Long Shot: Vaccines for National Defense

Cover Interview of March 19, 2012

In a nutshell

The ability to develop new vaccines quickly is essential to national security and public health. Historically, the U.S. has excelled at responding to national health emergencies. World War II-era programs developed ten new or improved vaccines, often in time to meet the specific objectives of a military mission.  However, since that time rates of vaccine innovation have been falling, not rising.

The idea that we will have the drugs/vaccines that we need, when we need them, is less true today than it once was. The molecular biology revolution has yielded a myriad of tools that facilitate new development. But key research capabilities have eroded, rendering innovation less likely and supplies more vulnerable. As man-made biological threats proliferate and new diseases continue to emerge naturally, we have an urgent need to understand the conditions that foster timely innovation.

Many celebrated late twentieth-century developments—the explosion of scientific sub disciplines and bioengineering techniques, the specialization and dispersion of firm capabilities, and the growth of outsourcing—have actually frustrated vaccine development efforts. The present environment gives developers access to a wider range of scientific expertise and sophisticated techniques, lower overhead, risk-sharing arrangements, and near-term market efficiencies.  But it also leads to higher overall development times and failure rates largely because the development process has become so disaggregated.

Few understand the seriousness of this problem because widespread errors in official vaccine license records create the false impression that innovation has steadily increased over time. These data create support for innovation policies that have not worked well for vaccines of global health and national security importance.  Present day vaccine programs tinker with push/pull policies (such as research grants or market guarantees) to spur innovation, but they rarely scrutinize the development process itself to address critical obstacles to innovation.

Long Shot probes the history of vaccine development for lessons that can inform our efforts to rebuild twenty-first century biodefense capabilities, especially when the financial payback for a particular vaccine is low, but the social returns are high.