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LONDON—The long-awaited report of the House of Lords Select Committee on Science and Technology on the management of infectious diseases and epidemics in England, published today (July 18), claims the country has avoided epidemics owing "as much to good fortune as to good management."
But—with a glossy cover showing hand washing—the report washes its hands of the controversy surrounding the reorganization in April this year of the Public Health Laboratory Service (PHLS), the Centre for Applied Microbiology and Research (CAMR) at Porton Down, and several other laboratories, into the overarching Health Protection Agency (HPA).
Critics had suggested that the speed of the reorganization could compromise epidemic surveillance and preparedness. Responding to The Scientist on this point at a press conference yesterday, Committee Chairman Lord Soulsby said, "We are aware of the concern that's been expressed, and you can see it in our evidence, but we do believe the HPA will be aware of this concern and respond accordingly; we don't particularly believe there's going to be a problem."
Julius Weinberg, ex-chief of epidemiology programs at the PHLS and scientific advisor to the committee, told The Scientist after the press conference, "The committee's approach was to say the HPA is a given—it exists. They wanted to help guide the HPA in its development. So, much of this report is trying to support the HPA to become the key player. It would have been unhelpful to go over old ground."
William Stewart, chairman of the HPA, told The Scientist, "When any new agency is set up, or changes, people are never particularly assured… It's not only the PHLS but CAMR—there's a lot of overlap and similarity. We're getting cohesiveness and hybrid vigor that we didn't have before."
Maria Zambon, head of the respiratory virus unit at HPA Colindale, the ex-PHLS, was one of those whose evidence to the committee last December raised a series of issues facing the then proposed HPA, among them the funding of research important to epidemic surveillance. "We didn't criticize the formation of the HPA," Zambon told The Scientist. "We just made sure that there were remarks in the public domain about potential threats in the reorganization." She said it was "too early to say" if the issues have been taken into account.
The need for greater collaboration among professions "came up time and time again" in the evidence, said Baroness Emerton. Lord Turnberg, previously chair of the board of the PHLS, added, "The HPA is absolutely key to this… It's unclear as yet how the HPA will collaborate, for example, with local health authorities, or the National Health Service microbiology laboratories, or the primary care trusts. They really do need to have firm lines of collaboration in place… and we want to support the HPA in those efforts. And they need sufficient funding to carry out all these roles."
Vaccine production is also a challenge. "The preparedness for vaccination [in the face of a flu pandemic] in this country is not a happy situation," said Lord Soulsby. "If it's a totally new strain [of flu], the whole country would have to be vaccinated and we'd have to gear up to do that.
"The plan to distribute the vaccine is good, but only five or six major companies in the world produce it, and the countries producing it will want it for their own people first."
"Flu vaccine is produced on fertilized eggs," said Weinberg "and just obtaining enough eggs would be a huge problem." He told The Scientist that the committee had heard at the Centers for Disease Control and Prevention that even the United States did not have the capacity to produce flu vaccines in the face of a pandemic. "It will be difficult for any of the manufacturers to tool up. In part, we need a new method of producing vaccines. So we need to look at the whole vaccine production cycle, including basic research. Government may say that for strategic reasons we have to invest in these things at national level."
"CAMR have demonstrated they could produce vaccines in bulk in an emergency," said Lord Soulsby. "But, unfortunately, they are still waiting for permission to go into production again. We do believe we need our own facility that can respond in this way and not rely entirely on pharmaceutical companies. There is little vaccine production capability in the UK. It would seem unrealistic to us that an organization that has proved itself should not receive better support than it gets at present."
A CAMR spokesperson told The Scientist that during the Gulf War, CAMR produced 100,000 doses of vaccine against anthrax and has proposed to the Department of Health that it build a "rapid response vaccine facility," going all the way to production, filling, and packing, which would cost "some tens of millions of pounds."
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