Interferon: The Science and Selling of a Miracle Drug (review)

The notion of a "magic bullet"—that is, a highly efficient, science-based treatment—was born with the high visibility of therapies such as antirabies vaccine and antidiphtheria serum, was reinforced by the introduction of insulin, and was stabilized through the development of antibiotics. The fascination with "miracle drugs" may be seen as one of the key aspects of the transformation of the public image of science. The nineteenth-century model of the popularization of science attempted to teach the public how science works and to familiarize it with complicated scientific concepts. By contrast, the twentieth-century model of popularization depicts science as a series of unique events ("discoveries," "breakthroughs") rather than as process and method, and focuses on the surprising, the sensational, the attention-catching. The interferon story, one may argue, started with the extensive press coverage of antirabies treatment in Pasteur's Parisian laboratory, and then of Koch's (short-lived) cure of tuberculosis and the discovery of antidiphtheria serum. From the late nineteenth century on, a high level of visibility in the media became a central component of the trajectories of new therapies. Such visibility shaped, to a great extent, interferon's fate.

Interferon was presented in the early 1980s as a potential cure for malignancy, a view summarized in an often-reproduced cover of Time magazine from 1981. High hopes for this substance were moderated later: while useful, it did not become the "penicillin of cancer." Toine Pieters's book, grounded in thorough archival research and in numerous interviews conducted in several countries, tells the story of interferon hype and its consequences. It also tells much more. The "biography" of interferon is dramatic: it has many highs and lows and is rich in major developments and unexpected turns and twists. Pieters's statement that the subject of his book is the "nine lives of interferon" is not a metaphor, merely a description.

The story starts with the quasi-accidental observation of an antiviral substance by Alick Isaaks and Jean Lindenmann. Pieters narrates interferon's first hour of glory, the disappointment that followed its early clinical trials, and then the complex transformation of a natural antiviral compound into a putative cure for cancer—the second high point in its career. The new life of interferon, Pieters shows, was made possible through the obstinacy of some scientists—but mainly through the lobbying of its "promoters," for example, the American immunologist Mathilda Krim, who was successful in interesting both public organizations, such as the National Cancer Institute, and industrialists in this molecule (or rather, family of molecules). At the peak of interferon's career, in the 1980s, numerous start-up biotechnology companies were involved in a "race" for its mass production using molecular biology techniques. At that time interferon enjoyed an unprecedented media coverage, partly fueled by its rarity. When this molecule became available for large-scale clinical testing, it was found that the hopes linked to it were exaggerated.

Pieters ends his book with an analysis of the multiple ways of "normalizing" interferon and of integrating this molecule into the treatment of different pathologies. The normalization, he shows, was a success story. In spite of the fact that this drug is expensive, that (contrary to early hopes) it induces serious side effects, and that it is far from being a "miracle treatment," interferon, after a stormy early career, became a solid commercial success.

Because of its complexity, interferon's trajectory is an especially efficient illustration of multilayered articulations between the laboratory, the clinics, industry, the media, and the state. Pieters has not followed all the possible threads of the interferon story—this would be a truly Herculean task—but he has made an excellent job of unraveling its main lines. His book is recommended to all those interested in medical innovations, their public image, and their political consequences.