Brainstorm Health: Fighting Pandemics, Obamacare Drama, Allergan Stock Slides

April 30, 2018, 6:37 PM UTC

Happy Monday, Dailies. Nobody knows the ins and outs of vaccine development like my friend Dr. Bruce Gellin. So when the Bill & Melinda Gates Foundation and Larry and Lucy Page launched their new $12 million public challenge to develop a universal flu vaccine, I asked Bruce if he’d share some thoughts on the effort. Bruce, who gave a fantastic presentation at FORTUNE Brainstorm Health this year on the centennial of the 1918 pandemic flu (read the writeup here), is president of global immunization at the Sabin Vaccine Institute in Washington, D.C., where he leads the institute’s influenza program. Prior to that, he served as the Deputy Assistant Secretary for Health and Director of the National Vaccine Program Office at the U.S. Department of Health and Human Services, where he was the architect of HHS’s first pandemic plan. Bruce, who has been an advisor to the World Health Organization, is also quite simply the smartest person I know when it comes to the opportunities and challenges of vaccines generally—which offer the most bang for the buck in global public health of any intervention around. So with that, here’s Bruce:

Clifton Leaf, Editor in Chief, FORTUNE

This year marks a century since the 1918 “Spanish flu” swept across the world, killing an estimated 50 to 100 million people and infecting one quarter of the world’s population. Despite the medical advancements and innovations of the past 100 years, the world remains unprepared for when, not if, the next influenza pandemic emerges.

The new $12 million Ending the Pandemic Threat: A Grand Challenge for Universal Influenza Vaccine Development from the Bill & Melinda Gates Foundation and Lucy and Larry Page is an important and necessary step intended to spark innovative ideas toward finding a game-changing solution to end the threat of flu. The Grand Challenge is exactly that—a challenge to all to bring their ideas to the table to seek a solution to the looming threat of an influenza pandemic. Unlike more traditional requests that target the usual suspects of the scientific elite who have built a career studying influenza, this challenge is calling for orthogonal approaches to problem solving at the intersections of disciplines where innovations so often come from.

Ongoing research to fill in the many scientific gaps is critical. Research that is underway with support from public funds in the United States and abroad by the National Institutes of Health (NIH), and the European Commission and various philanthropic organizations like the Bill & Melinda Gates Foundation and Wellcome Trust as well as by industry, the biotechnology sector and venture capital must continue. And Congress deserves credit to ensure that this science is advanced. But new research strategies, collaborations and novel and even revolutionary approaches are required.

The Gates Foundation and Page Family are right to encourage the world’s best thinkers across a variety of disciplines beyond the traditional flu community to join the quest. It’s the nature of science to take one step at a time, but we should also keep in mind that unexpected insights can spark innovation. Science history is filled with tales of unexpected discovery and strange bedfellows. The next great idea could come from anywhere. Given the risk of a global pandemic, this investment isn’t high risk, it’s necessary and we all look forward to seeing the ideas that might come from areas of science that we previously never thought to ask.

Today most routine childhood vaccines are more than 90 percent effective, yet this season’s flu vaccine was only 36 percent effective. A universal flu vaccine that is as safe, effective, affordable and widely used as our childhood vaccines, which have erased diseases that used to be a part of every child’s life, could make flu a distant memory. Vaccine development—particularly for a complex virus like influenza—is challenging. But this shared global quest is essential to improve—and save—the lives of millions of people around the world.

This Grand Challenge is being launched during the centenary year of the 1918 flu pandemic, with the goal of identifying novel, transformative concepts that would lead to development of a truly universal flu vaccine. Such a vaccine would alleviate the need for annual seasonal influenza vaccination campaigns and would prepare the world for the next influenza pandemic.

Alongside independent efforts such as the Grand Challenge, Sabin has embarked on a three-year initiative to help move the world closer to ending the threat of flu. Our work will focus on fostering innovative approaches from diverse disciplines to accelerate the development of a universal flu vaccine. We will be an innovation broker, building bridges, creating networks and inviting disruptive thinkers to the table to explore new angles that complement, and challenge, traditional biomedical research in order to spur the next breakthrough.

This year’s influenza season is a stark reminder of just how important this work is to remove the threat of influenza—seasonal and pandemic—forever.

(Learn more about Sabin’s flu work.)

(Learn more about Ending the Pandemic Threat: A Grand Challenge for Universal Influenza Vaccine Development.)

More news below.


The brain's immune system and Alzheimer's. There's still a fair amount of debate over the nature of Alzheimer's, and the best way to tackle the disease, in the scientific community. Nature has a piece up on this very issue that frames one of the underlying biological questions in a provocative light: Might "friendly fire" in the brain itself, prompted by brain immune cells called microglia, be exacerbating the condition? Here's how Nature puts it (albeit in some jargon-y terms): "How might microglia, which evolved to keep the brain in good order, become a force for the bad in Alzheimer’s? Last year, [scientists] published evidence suggesting a plausible mechanism for the switch, at least in their mice. They found that activated microglia discard the remnants of inflammasomes in tiny clumps called specks, and that these specks go on to seed new amyloid-β clusters, spreading the disease across the brain." (Nature)


Allergan shares fall on strategy concerns. Shares of Botox-maker Allergan slid about 5% in Monday trading as CEO Brent Saunders expressed opposition to a fundamental shift in the company's business and development strategy. “Running the company in large part as it exists today is not only an option, but also the baseline against which all options need to be considered,” Saunders said during an earnings call today (earnings which, it should be noted, beat Wall Street expectations). Some observers had been hoping a more major shift in strategy would be announced, but Saunders' comments implied that staying the course may very well be an option. Allergan said it is considering moves such as acquiring more firms in bolt-on deals, buying back shares, or divestitures. (Reuters)


SCOTUS to review death penalty case for man with rare disorder. The Washington Examiner reports that the Supreme Court will hear the case of a Missouri death row inmate who is seeking a form of capital punishment other than lethal injection. The man, Russell Bucklew, has argued that current lethal injection methods would cause him to essentially choke on his own blood during the execution process because he suffers from the rare disorder cavernous hemangioma; instead, Bucklew has been pushing for death by lethal gas. (Washington Examiner)

Another Obamacare repeal push may be on the way. Conservative lawmakers in Congress may make one final push to repeal the Affordable Care Act (aka Obamacare) ahead of the upcoming 2018 Congressional midterm elections. That's not to say such an effort would actually succeed, and the Trump administration has already made numerous moves to subvert the health law largely without help from lawmakers. But it could put Obamacare in the spotlight once again following a surprisingly strong open enrollment season for the law and the specter of some skeptical insurers re-entering the markets next year. (New York Magazine)


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