BusinessWeek Online Getting a Jump on the Viral Invaders
Technology: NEWSMAKER Q&A
Vaccine maker Acambis' hunch in '99 that the disease could be a big problem
is paying off. Chief Science Officer Tim Monath talks about how the company is
facing the challenge
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As Chief Scientific Officer at Acambis (NasdaqNM:ACAM
- News), Dr. Tom Monath is
deeply involved both in the fight against terrorism and the battle against a new
threat: the West Nile virus and other emerging diseases [See BW Online, 8/9/02,
"A New Breed of Microbe Hunters"]. BusinessWeek Online reporter David Shook
recently spoke with Monath. Edited excerpts of their conversation follow. Q: How
did you know back in 1999 that West Nile virus might become a recurring problem
in the U.S.?
A: It was a bit speculative on our part, but after the epidemic in '99, we
predicted it might come to this. We submitted for a grant to look into a vaccine
for it from the National Institutes of Health. We were awarded $3 million [in
August, 2000] and immediately put that project into high gear. At the time, many
people wondered what we were doing, but now there's a lot of interest and envy
in our project.
Q: Acambis is a small company in the private sector, but the projects you've
been working on are decidedly public-health initiatives -- vaccines for the
masses. How will that pay off for a private biotech company?
A: When we first started some of these vaccine projects, there were a lot of
uncertainties about the future of epidemiology and the market for some of these
vaccines. But we've developed a technology platform, ChimeriVax, that allows us
to construct vaccines against many very serious problems around the world, like
Japanese encephalitis and dengue fever.
For those diseases, there is a clear market -- a huge demand. For the West
Nile program, yes, to some extent, it does involve looking into a crystal ball
to see what will happen in the U.S. from this point. But if you look at what has
taken place so far, it looks like a truly emerging disease. Because mosquitoes
that carry the virus and birds that are often infected by it are so influenced
by changes in climate and weather patterns, there are so many factors that could
spread the disease in ways we don't fully understand yet.
We do feel that these mosquito-borne diseases will occur with varying
intensity from one year to the next. We might see Chicago with thousands of
cases of West Nile infections one year, but no epidemic the next year.
This is never going to be a measles vaccine -- one where every child is
immunized. But we do see a substantial market for this vaccine.
Q: How does ChimeriVax work?
A: The idea is to use an old friend, the yellow-fever vaccine [which has been
used since the 1930s]. We started with that vaccine and removed the gene that
codes for the structural proteins of the virus.
Think of a virus as a bag of nucleic acid that has an envelope or coat that
protects it from the environment. That envelope contains antigens which your
body responds to, creating an immune response. We replace that coat with that of
the West Nile virus [for example]. But the bag inside is still the nucleic acid
of the attenuated yellow fever virus, which causes a completely asymptomatic
response, a very mild infection. The body then recognizes West Nile and creates
an immune response without actually being infected by the West Nile virus.
Q: So the principle behind ChimeriVax is you use a live virus, but a
weakened, genetically altered form of one?
A: Yes. All the best vaccines are live viruses because they carry the ability
to replicate in the body. The immune response to a live viral vaccine is much
greater than if you're using a killed virus. All the old vaccines for polio,
measles, and mumps are weakened forms of a live virus.
Q: What is the status of the West Nile vaccine?
A: The data so far have knocked our socks off. Right now all we have is data
from trials in monkeys. But the data look terrific. We'll begin human trials
probably in the first quarter of next year.
Q: Can you tell me anything about the smallpox vaccine you're developing for
the federal government?
A: We have a contract to deliver 209 million doses by the end of the year.
That program is moving along well. There is somewhat of a gag order on the
specifics about this, but I can say that the vaccine is made using modern
methods. It's a new vaccine but is derived from the old one. We are, in effect,
purifying the vaccinia virus used in the 20th century. [The purification may
eliminate some of the rare side effects of smallpox virus, such as fever.]
The idea is to develop a vaccine that matches the old one in all of its
clinical properties. That way, we can reasonably assume that it works because
the old vaccine worked so well. But of course, there's no way to test it.
Smallpox doesn't exist in nature anymore.
Q: So right now, most of your revenue is coming from the government contract
for a smallpox vaccine, worth more than $428 million over several years. But
your real emphasis is on other viral tropical diseases that actually are causing
problems in all corners of the world. Why?
A: There are 500 million people in the world traveling each year. There are
27 million Americans going to tropical areas annually. There's a huge demand to
protect against these kinds of infections. Japanese encephalitis and dengue
fever are two of the more virulent infections American travelers can get.
And we're not just talking about developing a travel vaccine for affluent
people. For ethical reasons, we want to make sure that any new promising product
is available to the developing world. We understand that many countries will be
unable to pay for it. It does get complicated in thinking about the economics of
these vaccines. But right now we're focused on developing them.
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"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
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