Boom, or bust?

from Nature

Erika Check

Erika Check is Nature's Washington biomedical correspondent.

Hundreds of millions of dollars are pouring into US biodefence research. You might expect scientists working on infectious diseases to be unequivocally delighted. But things aren't that simple, says Erika Check.

Three years ago, Karl Hostetler founded a company called Chimerix, based on an eminently practical, if unglamorous, idea. Hostetler, who works at the University of California, San Diego, had invented a way to repackage the antiviral drug cidofovir so that it could be taken as a pill rather than intravenously. Faced with 'sexier' investment opportunities, however, venture capitalists weren't much interested, and the company's prospects looked bleak.

But in March 2002, Chimerix's fortunes changed dramatically. At a meeting in Prague, Hostetler and his colleagues revealed that cidofovir blocks smallpox infections in human cells and lab mice. The US government was searching desperately for smallpox treatments that could counter a potential bioterrorist attack, and giving patients cidofovir pills would be much easier than putting thousands of people on intravenous drips. So in September this year, the National Institute of Allergy and Infectious Diseases (NIAID), based in Bethesda, Maryland, gave Chimerix a five-year, $36-million-dollar grant to make and test cidofovir pills. "I doubt very much that we would have been able to obtain venture-capital funding to pursue this smallpox application," says Chimerix vice-president Kevin Anderson. "Given the investment climate of the past couple of years, it would have been virtually impossible."

Chimerix's windfall illustrates one side of the current boom in US biodefence spending. Since the still-unsolved mailed anthrax attacks of October 2001, NIAID has handed out some $1.8 billion for biodefence research. The money has allowed scientists such as Hostetler and his Chimerix colleagues to pursue work that should make the world a safer place.

But others see signs of trouble in the biodefence bonanza. Some researchers fear that it will distort priorities in infectious-disease research, sucking money away from work to understand and counter natural disease outbreaks that ultimately pose a greater threat to public health. Experts in weapons proliferation, meanwhile, are concerned that the expansion of labs working on potential bioweapons agents will increase the risk of these pathogens getting into terrorists' hands. And many microbiologists are confused and worried by the regulatory framework put in place to reduce this risk — they now fear being dragged through the courts by overzealous federal investigators over an innocent administrative slip-up. Indeed, these worries have been stoked to fever pitch by the prosecution, for alleged breaches of biosafety regulations, of plague researcher Thomas Butler of Texas Tech University in Lubbock (see 'A cause célèbre').

Building blocks

So far, the main way in which the influx of biodefence funding has changed the US scientific landscape is by supporting the creation of a network of new labs and centres. A year ago, there were just three maximum-security biosafety-level-4 (BSL-4) labs in the United States, where scientists could work on deadly and infectious airborne pathogens such as the smallpox virus. But thanks to NIAID funding, this capacity will be more than doubled. The agency is building two new BSL-4 labs — one in Fort Detrick, Maryland, on the campus of the US Army Medical Research Institute of Infectious Diseases, which already has its own BSL-4 lab, and the other at NIAID's Rocky Mountain Laboratories in Hamilton, Montana. In September, NIAID gave $120 million each to Boston University and the University of Texas Medical Branch at Galveston to build two more BSL-4 labs.

These facilities are just part of NIAID's effort to improve infrastructure for biodefence research. Also in September, the agency gave out eight grants totalling $350 million over five years to establish a network of regional centres of excellence in biodefence and emerging infectious diseases. These centres will pull together large teams of researchers based at various institutions, supporting everything from basic immunological research to training for 'first responders' — medical personnel who would aid the victims of a bioterrorist attack. NIAID also handed out nine grants of up to $21 million each to create a network of secure BSL-3 and BSL-2 labs, which will be used to study pathogens such as the yellow fever and West Nile viruses.

NIAID director Anthony Fauci says that the new labs and centres are a crucial element of the federal government's plan to improve the nation's ability to respond to a bioterrorist attack. "The people we've brought together have a commitment that goes from fundamental basic research in pathogenesis, all the way up to and including identifiable and usable countermeasures," he says. "The speed with which we're getting the research off the ground has been quite gratifying."

Meanwhile, NIAID has given individual researchers millions of dollars for projects aimed at helping to devise ways to counter specific disease agents that could be used in a bioterrorist attack. This year, according to estimates compiled by observers of the agency, NIAID has spent around $19 million on anthrax alone, and $12 million on research into poxviruses. Together, these pathogens absorbed half of the total biodefence funding given out last year, excluding spending on new labs and centres. Federal officials have classified these pathogens, together with the group of viruses that cause Ebola and other haemorrhagic fevers, as 'category A' agents, representing the most potent threats to national security.

David Walker, head of the new NIAID-funded regional biodefence centre in Galveston, argues that anthrax is the category A agent that is most easily prepared and disseminated by bioterrorists. And, as health workers saw during the anthrax mailings, antibiotics are ineffective against the bacterium after it begins to produce toxins in the body. "I think the emphasis on anthrax is well-placed, because we've already faced it and we're going to face it again," Walker says.

But other researchers argue that a narrow focus on a small group of pathogens will prove counterproductive in the long run. "There is a lot more emphasis put on organisms on a list than is either desirable or necessary," claims Stanley Falkow, a microbiologist at Stanford University in California. He argues that diseases such as influenza and other respiratory-tract infections routinely kill far more people than would die in a bioterrorist attack, and therefore deserve a greater share of the NIAID budget.

Distorted picture

If researchers were convinced that the increased emphasis on biodefence has been achieved entirely through 'new' funding that would otherwise never have found its way into NIAID's coffers, there would probably be few complaints. But incidents in recent months have raised fears that the biodefence push is distorting NIAID's overall priorities.

In July, for instance, the agency was forced to cut its grant awards for this year by $117 million, to fund the development of an anthrax vaccine. AIDS researchers in particular were up in arms over the decision. John Moore, who works on HIV at Cornell University's Weill Medical College in New York, claims that NIAID has since withheld the 'bridging funds' that it normally awards to scientists whose research proposals do not quite pass muster on first review but are likely to be approved in the next round if they revise their grant applications in response to referees' comments. NIAID officials say that the budget for bridging funds is the same this year as last. But Moore's complaints are symptomatic of the distrust that has been sown by the diversion of funds to the anthrax-vaccine programme.

Given that his own background is in AIDS research, Fauci is sensitive to the concerns of those working on HIV. But he argues that the anthrax-vaccine situation is atypical. The US Congress is still trying to pass the 'BioShield' bill to fund the development and purchase of countermeasures against biological attacks. Once it is passed, Fauci says, there will be no need