Global goal for swine flu vaccine quest

THE surprisingly rapid global transmission of the so-called swine flu has captured the attention of the Rudd government and his counterparts in North America and Europe, sparking a worldwide race to develop an effective vaccine. Two Australian biotechnology companies, Adelaide-based Vaxine and Melbourne-based CSL Biotherapies, initiated the first vaccine trials in late July, followed by Europe and the US.

Finding a technological solution to swine flu _ technically, Influenza (A) H1N1 (swine flu) _ will be a key scientific advance, but vital questions of scarcity, fairness and safety loom large. The swine flu vaccine will almost certainly be scarce, with manufacturers unable to meet the huge global demand.

The industry is struggling to produce good vaccine yields with the H1N1 seed virus. At the same time, the vaccine may not be fully effective against the present strain of the virus or, worse, the virus may mutate, rendering the vaccine ineffective. The vaccine, moreover, will probably require two doses, further reducing supplies.

The World Health Organisation recommends the use of adjuvants, a substance added to a vaccine to improve the immune response so that less vaccine is needed.

Yet the US may not follow WHO guidelines, thereby depleting an already short vaccine supply. The US Food and Drug Administration has never approved a human vaccine containing adjuvants, and clinical trials in the US do not include adjuvants.

Governments face hard choices on how to ethically ration a scarce lifesaving resource such as a flu vaccine, particularly if the virus becomes more lethal: Who shall live when not all can live? In Australia and most developed countries, children and the elderly have had priority for seasonal influenza vaccines. Children and their careers should certainly be a high priority for swine flu vaccine because they rapidly spread the infection in day care and school. Yet privileging the elderly would be a mistake because they have contracted the new strain at the lowest rate and appear to have some immunity because of exposure to distantly related flu strains that circulated decades ago.

Instead, government should assign top priority to the most vulnerable who have died at a disproportionate rate from swine flu: those who have poor health such as heart disease, asthma or diabetes. This is also the fairest way to allocate scarce vaccines because people with multiple health conditions also tend to be the most disadvantaged in society, such as the Aboriginal community and other minorities. Healthcare and emergency workers also deserve priority because they provide essential services in the face of an epidemic.

It is vital that government makes allocation decisions fairly and transparently. The public has a right to know which groups will have priority access and why.

One key problem, however, is that the private market is still likely to privilege the rich and politically connected in gaining access. Business culture is geared towards satisfying consumer demand, so the industry will charge what the market will bear for a scarce, valuable vaccine.

Rich countries will face scarcity, but they will have much more ample supplies than poor countries. The pressure on governments to protect their citizens will be intense during a pandemic. The vaccine industry is likely to supply markets that can afford to pay and in countries where they are located. More than 90 per cent of the world's capacity to manufacture influenza vaccines is concentrated in Europe and North America.

Australia will also be well off because of its economic resources, small population and the fact key vaccine producers are based here. As the rich stockpile vaccines, poor countries in Africa, Asia and Latin America are left much more vulnerable.

Australia, Europe and the US are spending a fortune on vaccines and antiviral medication for influenza, but virtually none of these resources will benefit poor countries. Serious questions of global social justice arise when wealth, rather than need, becomes the primary allocation criterion. The mal-distribution of vaccines in the face of a global financial crisis will only widen the already yawning health gaps between the rich and the poor. Rich countries hoarding vaccines is also is a bad public health strategy because it allows the virus to circulate unchecked in highly populated developing countries.

Safety, of course, is just as important as equitable access. There is intense political and market pressure to move quickly on vaccine development. Many national regulatory agencies have set up fast-track approval processes, and the vaccine industry is pushing hard to finish clinical trials and gain government approval. The politics of swine flu is pushing toward mass public vaccinations in September and October, the beginning of the flu season in the northern hemisphere.

Dose-sparing strategies to avoid depletion of an already short vaccine supply will increase risks. Studies show that vaccines containing adjuvants cause more adverse effects. More worrying, because the clinical trials are so small, is that adverse effects will not be detected until the vaccine has already been used on a large population. It's essential to conduct rigorous post-marketing surveillance to pick up rare, but serious, effects.

Hefty public and private spending on influenza treatments will result in a windfall for the pharmaceutical industry, with Roche reporting that sales of Tamiflu (an antiviral medication that ameliorates flu symptoms) have tripled. GlaxoSmithKline is predicting huge profits from a vaccine. At the same time, the industry is seeking liability protection in the event that the vaccine causes unintended harm to health. Patients groups, too, will want to be sure to be compensated for any ill-effects from vaccinations.

Reminiscent of the present situation, the media fanned emotions about a catastrophic swine flu epidemic in 1976 that never emerged. Pharmaceutical companies lobbied governments hard _ and successfully _ for resources and liability protection. In the US, Gerald Ford advocated a mass immunisation campaign. Unfortunately, the vaccine caused several cases of a serious paralysis called Guillain-Barre syndrome, which was politically disastrous for the president. The 1976 swine flu affair is instructive and suggests caution in rushing to vaccinate the public without proper clinical trials.

The Rudd government needs to assess carefully the risks and benefits of rapid approval and roll-out of a vaccine. Thus far swine flu has been mild, with most patients making a full recovery. The fear, of course, is that H1N1 will mutate, becoming much more lethal. This was what happened with the second wave of the 1918 Spanish flu, which killed more than 50 million people in a much less populated world. It is a remote possibility, but one that demands watchfulness.

The most prudent course today would be to conduct careful clinical trials with due scientific deliberation; use the vaccine on high-risk groups, phasing in the full population only as evidence of safety and effectiveness becomes clearer; and conducting post-market surveillance for adverse effects.

And even if it's not politically expedient, justice requires that scarce and safe vaccines go to the most disadvantaged in Australia and worldwide. Equitable access to a vaccine against swine influenza is not merely a moral imperative. It is also critically necessary for the success of any pandemic strategy to safeguard global health.

Spreading Lionfish Invasion Threatens Bahamas

The spiny, venomous lionfish can kill three-quarters of a reef's fish population in just five weeks, according to one study. Michael Dwyer/AP

The spiny, venomous lionfish can kill three-quarters of a reef's fish population in just five weeks, according to one study.Michael Dwyer/AP

In 1992, Hurricane Andrew smashed an aquarium tank in Florida. About a half-dozen spiny, venomous lionfish washed into the Atlantic Ocean, spawning an invasion that could kill off local industry along with the native fish.

People come to the Exuma Islands in the Bahamas to kayak between tiny, uninhabited islands and dive in the shallow, turquoise water. Above the water, the landscape looks like a pristine tropical paradise. But the same isn't true beneath the waves.

"In 2005, the first lionfish showed up, and we didn't pay much attention to it," says Oregon State University zoology professor Mark Hixon, who has studied reef fish here for almost two decades. "The next year, we saw a few more. Then in 2007 there was a population explosion. There were so many lionfish around that they were eating the fish we were studying, and we had to start studying the lionfish. There was nothing else to do."

Lionfish are native to the Indian and Pacific oceans. But in the past few years, they've spread up the Eastern seaboard and throughout the Caribbean. The Bahamas have been hit the hardest.

At NOAA.gov

They're hard to miss with their red and white stripes and a tall row of venomous spines down their backs. The fan-like fins look like a lion's mane. And like lions, they are ferocious predators. Last year, Hixon co-authored a study with Mark Albins that showed a lionfish can kill three-quarters of a reef's fish population in just five weeks.

"This year we're going to see if that's gotten worse — because the number of lionfish has definitely increased in the intervening year," Hixon says.

What Stops A Lionfish?

Diving around a coral reef, Hixon shines a light under every ledge, looking for lionfish and the fish they like to eat. After a few minutes, he waves his light frantically under an overhang. A lionfish the size of a football fans the water with its huge, quilled fins. These days, the only thing unusual about spotting a lionfish in the Bahamas is seeing just one of them.

Back on the boat, Hixon is upbeat. Last year his team pulled more than a dozen lionfish off this reef. "And this year, there's just one," he says. "What that tells us is that our removals took, and lasted a whole year."

But Hixon says divers can only catch so many. So he's also studying native lionfish in the Pacific Ocean to understand what keeps their populations in check.

Parasites could be one limiting factor. Zoologist Paul Sikkel peers through a microscope at the gills of one of the lionfish Hixon's team has just caught.

"Wow! Just so clean," Sikkel exclaims. "There's nothing in there. Have a look. A local fish, you'd see a bunch of really small worms on those red gill filaments. And they squirm, so it's easy to pick them out. But there's nothing on there."

The parasites that would be swarming over a local fish aren't going near the lionfish. Sikkel says that might be one secret to the invasion.

"If you consider parasites a sort of a tax that fish have to pay, a lot of their energy gets diverted into parasites, and so a fish that doesn't have those [parasites] can develop more of its energy into its own growth and reproduction," Sikkel says.

Tourism, Fishing Fall Prey

Until marine predators or parasites learn to feed on lionfish, the best hope for slowing the spread may be humans. The fish are a delicacy in Asia, but not in the Bahamas, given the painful sting their spines can inflict. A few restaurants serve lionfish now, and there's an effort to teach Bahamians how to catch and cook them.

From The USGS

Animated Map Of The Invasion

Lakeshia Anderson with the Bahamas Department of Fisheries says the livelihoods of many islanders depend on slowing the invasion.

"With the quantities of lionfish that we've found in our waters and the amount of food they consume, it has the potential of really collapsing our commercially important species — our fishing industry in general," Anderson says.

But that's not all. Tourism is a $5 billion-a-year industry and accounts for half the employment in the Bahamas. Anderson worries that if the lionfish continue to devour colorful reef fish, divers will vacation elsewhere.

Hixon says in some places, the damage is already done.

"I was diving on a reef I've studied since 1991," he recounts. "It was so degraded, and there were so few fish in what used to be a teeming reef, that at one point I was overcome and went to tears."

He says in the best case scenario, some natural control will kick in and lionfish will become a minor part of the Caribbean and Atlantic reef community.

Flying frog among 353 new Himalayan species: WWF

A flying frog, the world's smallest deer and the first new monkey to be found in over a century are among 350 new species discovered in the eastern Himalayas in the past decade, the WWF said Monday.

But the environmental group said the vital habitats of the mountain range were facing growing pressures from unsustainable development in the region, which spans Nepal, China, India, Bhutan and Myanmar.

In a report released here, it said climate change, deforestation, overgrazing by domestic livestock and illegal poaching and wildlife trading threatened one of the biologically richest areas of the planet.

"In the last half-century, this area of South Asia has faced a wave of pressures as a result of population growth and the increasing demand for commodities," said the report, "The Eastern Himalayas -- Where Worlds Collide."

"Only 25 percent of the original habitats in the region remain intact. For the unique species of the Eastern Himalayas, this means that today 163 are considered globally threatened," it said.

The WWF said 353 new species were discovered in the region between 1998 and 2008, among them a red-footed tree frog known as a "flying frog" because its large webbed feet allow it to glide when falling.

Another new species was a kind of caecilian, a limbless amphibian that resembles a giant earthworm and lives underground -- a significant discovery because caecilians are among the planet's least-studied creatures.

Other highlights were the world's smallest deer -- a miniature muntjac standing just 60-80 centimetres (25-30 inches) tall that was found in northern Myanmar -- and the first new monkey species to be discovered in over a century.

The WWF said the new species of macaque was one of the highest-dwelling monkeys in the world, living in India's Arunachal Pradesh state at between 1,600 and 3,500 metres (5,000 and 11,500 feet) above sea level.

Among the 242 new plant varieties discovered was an ultramarine blue flower found by two intrepid Chinese botanists who descended into a gorge in Tibet that is twice as deep as the Grand Canyon in places.

The WWF described the rare bloom as "dramatic in both colour and form" and said its colour changed with the temperature, making it particularly remarkable.

The eastern Himalayas is home to 10,000 plant species, 300 mammal species and nearly 1,000 bird species, and is the last place on earth where the greater one-horned rhino can still be found.

"This enormous cultural and biological diversity underscores the fragile nature of an environment which risks being lost forever unless the impacts of climate change are reversed," said Tariq Aziz, leader of the WWF's Living Himalayas initiative.

The report's findings come as world leaders prepare to gather in Copenhagen in December to reach agreement on a new climate deal to replace the Kyoto Protocol.

Food crisis could force wartime rations and vegetarian diet on Britons

The British people face wartime rations and a vegetarian diet in the event of a world food shortage, a new official assessment on the UK’s food security suggests today.

Even though the nation is 73 per cent self-sufficient in food production, higher than during the 1950s, the food chain is at risk from global influences such as a worldwide increase in population, climate change bringing extreme weather patterns, higher oil prices and more crops being grown for bio-fuel instead of food.

Supplies in future may also be disrupted by animal disease outbreaks, disruption of power supplies, trade disputes and interruptions for shipping and at ports.

The UK however has one of the highest cereal production capabilities in the world with seven tonnes grown per hectare, compared a world average of 3.3 tonnes per hectare.

In the event of an extreme event, cereal crops would be used to feed the nation and ensure that each person received sufficient daily calories.

But people would have to consume less — the average number of calories eaten per day in the early 1960s was about 2,100, whereas the most recent figure compiled by the United Nations Food and Agriculture Organisation is 2,800.

Even during the Second World War Britain did not have to rely wholly on domestic food production, but Hilary Benn, the Cabinet Minister with overall responsibility for food policy, has ordered officials to prepare for a scenario where the country could feed itself.

In the event of an extreme emergency the most dramatic consequence would be every person eating a predominantly vegetarian diet — more cereals, fruit and vegetables and less meat and poultry. Cereals used to feed farm animals would be shifted into human food production.

A paper setting out the food security assessment states that the food on offer would be “a highly restricted, if sufficiently nutritious diet”.

One of the biggest threats to the supply chain would be restrictions in trade of meat and poultry from Argentina and Brazil or of GM soya, the main commodity used to feed livestock in Britain.

The threat of climate change however will also require new growing techniques such as reduced water usage in agriculture.

In times of normal trading, however, the Government also wishes to ensure that the nation eats a healthier diet and is particularly concerned that low-income households are able to afford fresh fruit and vegetables.

Ministers are also anxious that consumers have confidence in the safety of food and further work is to be undertaken to help reduce the incidence of food poisoning caused by common bugs such as salmonellas, listeria, E.coli and campylobacter. Hygiene inspections at food outlets by local authority enforcement officers is likely to be stepped up.

Mr Benn today called for a radical rethink on the way the UK produces food. He also insisted that GM crops in future could help boost food production especially if some varieties were drought-resistant or required less water, fertilisers and pesticides.

He backed the need for GM crop trials to find out the facts about the new technology and to use the science to boost production.

“We need a radical rethink in how we produce and consume food. Globally we need to cut emissions and adapt to the changing climate that will alter what we can grow and where we can grow it. We must maintain the natural resources — soils, water and biodiversity — on which food production depends.”

“And because we live in an interconnected world — where the price of soya in Brazil affects the price of steak at the local supermarket — we need to look at global issues that affect food security here. That’s why we need to consider what food systems should look like in 20 years and what must happen to get there.”

He is anxious to engage the wider public in debate about the future of the country’s food security as well as how best to help people eat healthier diets and to ensure that new production techniques do not damage the UK’s natural resources.

A new UK food strategy is to be published before the end of the year.

Boulder & 'Julia': Can Boulder channel its inner Julia Child -- while being locavore and vegan?

When Julie Powell decided to cook her way through Julia Child's "Mastering the Art of French Cooking," she found her passion and changed her life.

How would Boulder's notoriously particular eaters -- many of whom view food through a environmental, health and political lens -- interpret one of Child's classic recipes, the bacon, cream and egg tart, Quiche Lorraine?

At Culinary School of the Rockies, appreciation for Julia Child's role in modern American cooking is a given. Office staffers are trying out Child's recipes and blogging about them a la Julie, and the school is offering a home cooking class -- nearly full at the time of this writing -- on Aug. 15 called "Brunch and Julia."

Chef Adam Dulye says American cooks have come back to essence of Child's approach -- sourcing impeccably fresh local ingredients and combining them in straightforward, flavorful ways.

"I think it's definitely back to simple is the way to go," he says. "Only three or four items on a plate. This is a pork chop (that) tastes like a pork chop."

Not the multi-ingredient, layers of exotic ingredients that were popular in the 1980s and 1990s.

Of Child's cooking, he says: "It's going to the market and cooking it. In Boulder, we have a great opportunity to do (Quiche Lorraine) from the ground up. There are people who mill flour, fresh eggs, a couple of dairies, John Long pork. Haystack puts out a firm goat cheese. Dulye might throw in a few of the last spring onions.

While Quiche Lorraine is likely to please locavores, for vegans it's pretty tough sledding. Matt Burns sous chef at Leaf Vegetarian Restaurant says the staff does make eggless egg dishes, but that quiche would be particularly challenging.

He says a custard might be approximated using tofu, soy milk and ground flax seed to help thicken it. Soy cheese and a soy bacon product completes the not-exactly appetizing picture.

"That's why we don't do it here," he says of making quiche at Leaf.

The one bright spot would be the crust, which can be made authentically with shortening, flour, salt and water.

The crust is the ingredient in Quiche Lorraine that causes consternation for Celiacs and others who eat gluten free. One option is to go crustless -- but that would be a timbale rather than a quiche. Another option is to make a crust of grated potatoes. Or you can try a pie crust created by local cookbook author Elana Amsterdam, who has just released her book, "The Gluten-Free Almond Flour Cookbook." As you might surmise from the cookbook's name, she would use almond flour -- she prefers blanched almond flour -- to make a crust, which she says is delicious and healthful.

Perhaps the best approach is not to attempt to recreate the substance of Child's cooking, but rather its spirit -- using high quality ingredients in a way that shows off their essence. Thus, better not for a vegan to try to make a quiche, whose defining quality is the happy marriage of egg and cream. For gluten free eaters, anything approaching French pastry is probably out of the question, although an almond crust is made from a food Child would recognize as opposed to, say, xanthan gum.

Above all, Dulye says, Child would want people to spend some time and care cooking whatever their beliefs or health require.

"To some degree, Julia would sit back and have a good laugh at some of the stuff we do in our kitchens," he says, listing the purchase of pre-made pie crust as an example. "She would say, 'Oh, they'll learn. They'll come around."

Dalai Lama voices concern over climate change

Tibetan spiritual leader the Dalai Lama who arrived Sunday in the Buddhists dominated town of Leh in Jammu and Kashmir on a three-week visit voiced his concern over climate change caused by global warming, which he said had started showing its "ill-effects on humanity".

The Dalai Lama, who is in Leh to interact with his disciples, was speaking to a group of prominent citizens of Leh.

The Buddhist spiritual leader said that allout efforts needed to be made to reverse the trend of global warming.

He was received by Chief Minister Omar Abdullah, who especially flew from Srinagar Saturday evening to receive the spiritual leader at Leh.

The Dalai Lama recalled his friendship with the chief minister's grandfather Sheikh Mohammad Abdullah and father Farooq Abdullah.

China, Congress and Climate Change

This week brings two related and interesting stories on the prospects for domestic climate change legislation and progress in Copenhagen when the international community gathers in December to try to hammer out a post-Kyoto treaty on climate change. The first is that China’s top climate negotiator is “optimistic” that the international community will reach agreement on a new treaty in Copenhagen. It’s unclear what the basis for his optimism is given that he also reiterated in strong terms China’s opposition to limits on the amount of greenhouse gases China emits. I’m curious whether there are tea leaves to be read in the fact, though, that China is expressing not only optimisim but also some urgency about the need to tackle the climate change problem. Envoy Yu Quingtai also said that global warming is so “fearsome” that “we cannot afford to fail.”

The second story is that ten Senate Democrats from midwestern and southeastern states, including Ohio, Minnesota, West Virgina, Pennsylvania and Michigan, wrote a letter to President Obama saying that they will not support domestic climate legislation unless it provides protection to domestic industries that would be hurt be foreign competition in countries that do not limit greenhouse gas emissions. Notably, the letter appears not to demand that other countries (read: China) enact domestic carbon limits before the Senators will back any U.S. climate bill. But the letter does — in its very first sentence — support border adjustments, which are tariffs imposed on imports of goods from countries without domestic greenhouse gas limits based on the embedded carbon content of the goods (for a great analysis of the legality of such border adjustments see Cara’s post here). The House version of the Waxman-Markey climate bill also contains border adjustments.

The two stories highlight a major conundrum President Obama will face both in Copenhagen and with Congress in attempting to limit both international and domestic emissions. If the U.S. agrees to a treaty without limits on China, India and other rapidly growing economies the Senate will never ratify the treaty (remember that the Senate refused to ratify the Kyoto accord on the same grounds). Moreover, Congress appears unlikely to pass climate change legislation without a border tax adjustment, particularly if Obama comes home with a treaty that fails to commit China and India to binding emissions limits. But of course China, India and other trading partners without domestic greenhouse gas emissions limits will virulently object to border tariffs based on carbon content. Obama opposes the adjustments and has called them “protectionist” (see Nobel Laureate Paul Krugman’s defense of border adjustments here).

It’s not clear to me how Obama resolves this conundrum. He has recently praised China for its tough fuel economy standards and China has been selling its progress in producing solar and hydroelectric energy. But those steps forward would do little to alleviate concerns over U.S. domestic limits that would affect the steel, aluminum and cement industries.