"The word "Tipping Point", for example, comes from the world of
epidemiology. It’s the name given to that moment in an epidemic when a
virus reaches critical mass. It’s the boiling point. It’s the moment on
the graph when the line starts to shoot straight upwards."
— Malcolm Gladwell
Is it just me or are colds and flus starting to pack dramatically more punch these days? My wife is one of the most resilient people I know, has been down and out with a cold for 5 days. I have had two colds in the past year that were so bad that I couldn’t even get out of bed for two days and didn’t return to full strength for a couple of weeks. It could be that, at 42, I have become old and decrepit. However, it seems that the viruses are getting more powerful and, worse, the resulting bacterial infections following colds are uber-strong strains that have survived over a decade of mis- and over-use of antibiotics.
Meanwhile, most of the pharma companies have dropped their anti-infective programs since the end markets are not big enough to make it worth their while. In their place, several start-ups, like Replidyne, are working on novel approaches to deal with drug resistent bugs. Replidyne’s technology acts by directly inhibiting bacterial DNA replication. This is one of the few biotech segments where early stage companies are not competing with multiple large pharma in-house efforts.
Unfortunately, the biotech venture model is broken. The last five biotech IPO’s, which by definition are supposed to be homerun events, returned between 0.8 and 1.2 times capital invested. In venture capital, you generally want to match the amounts of capital with the level of risk. You want to deploy small amounts of capital early and increase amounts as risk factors are removed. However, in biotech, because of the high cost of drug trials, investors need to deploy $50-100m before they know if they have a credible working product. These companies can soak up $100-200m before getting through trials and nearing market launch. I’m not certain how to fix this model, but for all of good, we need to figure this out (certainly glad Bush has banned federal funding of stem cells…sorry, had to slip that in).
This combination (more potent organisms and declining pharma programs) is dangerous. While nothing catastrophic has happened to date, chaos theory shows that once a particular strain hits its tipping point, we quickly end up with an epidemic. This won’t necessarily be the catastrophic flu that the CDC and others are fearful of. It will also include increasingly debilitating colds and infections as well as the really nasty bugs hanging out in hospitals (can you say flesh eating bacteria…). I will do everything I can to stay out of hospitals.
In the interim, gives us all a break and keep those hands washed and stay at home if sick…
The combination of potent organisms and declining pharma programs is actually a good thing. What you neglect to mention is that organisms actually become more resistant to drugs and vaccines over time. There are now stronger strains of TB, malaria and other diseases which have emerged. Akin to how a flu shot has a small strain of each year’s specific flus in it, I’d think we’d be better off developing the Chinese and Indian methods of “vaccines” which involve using natural medicines so that humans adapt more easily to rapid changes in the environment.
Most of new biotech/pharma is a massive experiment which will return pennies on the dollar when accounting for side effects of drugs on people, though I suspect most venture capitalists or investors don’t care about this as long as they are able to get their money out with some returns.
I agree that alternative medicines will become increasingly important in dealing with the growing array of human issues. On the venture side, the model is broken, and except for the later stage investors, it is very difficult to make money. My concern, as firms are forced to go later stage is who fills in the early stage funding needs?
I don’t know how things are Chicago but I’d guess there are plenty of venture companies and high net worth individuals in places like Massachusetts and Silicon Valley who are taking bigger risks at earlier stages on biotech startups and startups in general. I know here in the Boston area biotech research and investment has been booming and companies have had much success in areas like genome science. I know in Canada, biotech startups get much help from the Canadian government at early stages of research in cooperation with university research labs and this has helped fuel the biotech boom in places like Toronto and Montreal. I think that model would work in U.S. if we as taxpayers were willing to fund more research at the university level and trust science a little more than religion. This hasn’t been the case at the federal level so the state of California has taken the lead on funding biotech and alternative energy funding with state bonds. The leadership on issues like these has to come from the those in state or federal governments.
All good options. I think, in the end, it will have to fall predominantly on government given the significant size of the checks to get to Phase I & II. Of course, we can always count on the President for research support in key areas like stem cell…:)