In this Book

Pandemics, Pills, and Politics: Governing Global Health Security

Book
Stefan Elbe
2018
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The fascinating story of Tamiflu's development and stockpiling against global health threats.orld's most prominent medical countermeasure, Tamiflu.A pill can strengthen national security? The suggestion may seem odd, but many states around the world believe precisely that. Confronted with pandemics, bioterrorism, and emerging infectious diseases, governments are transforming their security policies to include the proactive development, acquisition, stockpiling, and mass distribution of new pharmaceutical defenses. What happens—politically, economically, and socially—when governments try to protect their populations with pharmaceuticals? How do competing interests among states, pharmaceutical companies, regulators, and scientists play out in the quest to develop new medical countermeasures? And do citizens around the world ultimately stand to gain or lose from this pharmaceuticalization of security policy?Stefan Elbe explores these complex questions in Pandemics, Pills, and Politics, the first in-depth study of the world’s most prominent medical countermeasure, Tamiflu. Taken by millions of people around the planet in the fight against pandemic flu, Tamiflu has provoked suspicions about undue commercial influence in government decision-making about stockpiles. It even found itself at the center of a prolonged political battle over who should have access to the data about the safety and effectiveness of medicines.Pandemics, Pills, and Politics shows that the story of Tamiflu harbors deeper lessons about the vexing political, economic, legal, social, and regulatory tensions that emerge as twenty-first-century security policy takes a pharmaceutical turn. At the heart of this issue, Elbe argues, lies something deeper: the rise of a new molecular vision of life that is reshaping the world we live in.

Table of Contents

Cover Page

Title Page

Copyright Page

Dedication

Epigraphs

Contents

pp. ix-x

Preface

pp. xi-xii

Acknowledgments

pp. xiii-xiv

List of Abbreviations

1. Encapsulating Security: Pharmaceutical Defenses against Biological Danger

pp. 1-28

Part One: The Development Challenges

2. Discovering a Virus’s Achilles Heel: Flu Fighting at the Molecular Scale

pp. 31-53

3. The Pill Always Wins: Gilead Sciences, Roche, and the Birth of Tamiflu

pp. 54-76

Part Two: The Acquisition Challenges

4. What a Difference a Day Makes: The Margin Call for Regulatory Agencies

pp. 79-105

5. Virtual Blockbuster: Bird Flu and the Pandemic of Preparedness Planning

pp. 106-133

Part Three: The Deployment Challenges

6. In the Eye of the Storm: Global Access, Generics, and Intellectual Property

pp. 137-162

7. “Ode to Tamiflu”: Side Effects, Teenage “Suicides,” and Corporate Liabilities

pp. 163-183

8. Data Backlash: Roche and Cochrane Square Up over Clinical Trial Data

pp. 184-210

9. “To Boldly Go …”: Pharmaceutical Enterprises and Global Health Security

pp. 211-232

Epilogue: Pharmaceuticals, Security, and Molecular Life

pp. 233-236

References

pp. 237-253

Index

pp. 255-261
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