The Pharmacy And The Taxpayer

SARS was certainly a serious ailment, but the taxpayer dollars that went into battling it were far out of proportion with the actual menace. In fairness, it must be acknowledged that this is more obvious in hindsight; but for observers in the medical field, it was clear even at the time that the hyper-reactivity to this ailment was not warranted. But now that SARS appears to have waned, the medical and pharmaceutical people are rabbiting away about an impending influenza pandemic that will sweep the world and kill hundreds, thousands, millions … take your pick; any day now, to boot. Having enjoyed the limelight and the ready cash that went with SARS, they are looking for the next taxpayer-funded growth industry. Hang on to your wallets. As a corollary, we are also paying for a similar but quieter slipping of fingers into taxpayer pockets. In several provinces, particularly Ontario, there is an ongoing and expanding effort to lift dollars from unwitting taxpayers in order to protect us against a virtually non-existent peril: rabies. Don’t get me wrong--I’ve read Stephen King’s Cujo, I know that rabies is a killer. I also know that throughout North America, it is about as low as a disease can get on the list of public health risks. Even the people who manufacture the antidote don’t rank it as a serious threat on this continent. But the people who are spending your tax dollars do. In Ontario, millions of dollars are being poured into questionable research whose only purpose appears to be to protect the career aspirations of a small group of scientists. Research among wildlife rehabilitators, the folks who care for orphaned and injured wildlife, has shown that what was initially thought to be mere stupidity on the part of the Ontario government is actually spreading to other North American jurisdictions as their scientists begin to recognize a great career bandwagon. And the pharmaceutical companies are leading the charge as they dip into our pockets without a modicum of shame. Frightening stories about rabies are good for supporting a lucrative rabies control business and easy fodder for media who, without examination, broadcast exaggerated tales that inspire the public's mind with the spectres of Dracula or Cujo. But due to highly successful dog and cat vaccination programs, only an average of one or two human cases appear in North America every year. Giving some perspective to that, more than 40 Canadians die every year from bee stings. Indeed, many more people die in Canada every year from non-rabid animal attacks. The big kahuna these days for the rabies research crowd is ‘raccoon strain’ rabies. It first appeared in Florida in the 1940s and has gradually moved up the Eastern Seaboard until it entered Canada in 1999 near Brockville, Ontario. Research to date is not definitive, but this is not the same strain as the rabies carried by bats, skunks, and foxes. It is known to kill raccoons and other animals, but the evidence on humans is sketchy. Indeed, since the first discovery in the 1940s, there has been only one death linked to raccoon rabies; and some research suggests this victim may actually have been exposed to a raccoon previously bitten by a rabid fox, making the death possibly linked to the fox strain rather than the raccoon strain. Certainly, wildlife rehabilitators routinely work with raccoons without harm, and large urban areas like New York City have large raccoon populations--including many thousands carrying rabies--without significant problem. This calls into question whether raccoon strain rabies represents any human threat at all, let alone a serious one. The Centre for Disease Control in the United States reports an average of one to two deaths per year across North America from all forms of rabies and yet the state of New York continues to fund expensive rabies research rather than directing their funds to more pressing health issues. In fact, their experience translates into taxpayer-funded rabies research costs of approximately $35 million per death. On a comparative basis, proportional spending on other diseases would require New York to spend $800 million for influenza research/prevention, $1.3 trillion for cancer, and so on. But they don’t; the rabies research funding is grossly out of whack with the risk. A small but determined group of Canadian and United States scientists have propelled rabies into a thriving ‘industry,’ despite rabies representing one of the lowest public health risks in North America. The ‘industry’ is made up of government scientists, academics and vaccine and bait manufacturers who have grown dependent on millions of dollars of public funds each year. Using deception, the rabies ‘industry’ has been able to obtain increasing amounts of money for rabies research, testing and control. Remarkably, this is in spite of declining cases and the lack of threat to humans owing to pet vaccinations and the availability of human post-exposure treatment. In the face of increasing competition from new, real human health risk diseases such as BSE, the rabies ‘industry’ has aggressively pursued a higher public profile. This profile, and the fear-mongering that accompanies it, is generated by fish and wildlife agencies and other government interests whose budgets benefit from rabies funding. Naturally, the pharmaceutical companies have an enormous vested interest as well. It is the quest for research funding that drives rabies programs. An analysis of these programs and the players behind them exposes serious concerns about the lack of evaluation that goes into government funding decisions. Public dollars should be spent on public policy priorities and on projects that reflect evidence-based science. Rabies research funding simply does not meet these criteria. No one would seriously suggest doing nothing about raccoon rabies control. On the contrary, there is a need to follow the very successful example of Ohio and others where surveillance, aerial baiting as necessary, and public education are the progressive tools used to fight the disease. But the research dollars being spent in eastern North American jurisdictions, including in Canada, is far out of proportion with the actual risk. In these days of rapidly diminishing healthcare finances, taking the money away from these career scientists and their scare-mongering boondoggle could free up money for far more important health costs, including far more important research. With special thanks for background material to Donna DuBreuil, President, Ottawa-Carleton Wildlife Centre. A grand old lady, who will almost certainly slap me for that remark. Partial list of Source Material 1. Canadian Medical Association Journal at: http://www.cmaj.ca/cgi/content/full/168/6/761-a) 2. Merlin D. Tuttle, ‘Rabies: Economics vs. Public Safety’: “If public health warnings were based on actual probability of harm … rabies would rank near the bottom of the list of threats … now the second rarest disease in the United States and Canada. ” 3. Aventis Pasteur Limited, manufacturer of the rabies vaccine Imovax™ 4. Questionable Research Funding is the Fuel that Keeps Unwarranted Rabies Programs Alive – prepared by Ottawa-Carleton Wildlife Centre, October 4, 2004/Updated November 12, 2004 5. Shantel Ivits, Trent Central Student Association Vice President University Affairs: “Millions of dollars in public funding continue to flow into this project [DNA Cluster project and rabies research], and we have yet to see a formal business plan. It’s irresponsible that the university would pursue a project that risks becoming a white elephant to our already cash-strapped institution.” [Proofreader's note: this article was edited for spelling and typos on February 15, 2005]