# 2877
Regular readers no doubt will find the name of Dr. David Fedson familiar, as I've highlighted him a number of times over the past 3 years in this blog.
The most recent entry was on February 21st of this year with a column entitled Fedson On Meeting The Challenge Of A Pandemic where I discussed his latest paper which appeared in the March 2009 edition of the CDC's Journal of Emerging Infectious Diseases.
Dr. Fedson has long championed the idea that we need to be researching existing - easy and inexpensive to manufacture - drugs for use during an influenza pandemic.
He argues that antivirals and vaccines will either be in too short of supply, or will arrive too late, to do much of the world's population any good in a pandemic.
Today, FluTrackers unveils an extensive interview with Dr. Fedson, conducted by Sharon Sanders (aka Florida1)- President and editor of FluTrackers, and two other editors of the forum - Sally Furniss and Giuseppe Michieli.
Flutrackers, for those unfamiliar with it, is one largest flu forums on the Internet. You'll find a number of the other prominent forums listed in my sidebar.
Despite their name, Flutrackers' focus isn't just on pandemic flu, as their International membership tracks and analyzes many different reports of infectious diseases from around the globe.
In the interest of full disclosure, I am a senior member of Flutrackers. Of course, I am also a long time member of the Flu Wiki and frequent some of the other forums as well.
This interview is lengthy, so I'll only post the opening and then hope you will follow the links to read the rest.
I've taken the liberty to reformat some of the longer paragraphs to make them easier to read in my blog format. The opening paragraphs are by Sharon Sanders, followed by questions and answers.
Recently I interviewed David Fedson, M.D., an expert in pandemic preparedness and vaccine issues, regarding his latest paper: "Meeting the challenge of influenza pandemic preparedness in developing countries".
He earned his medical degree from Yale University in 1965. Later he obtained a fellowship studying smallpox in India, and interned at the Osler Medical Service at The Johns Hopkins Hospital. He was a Clinical Associate in the Laboratory of Clinical Investigation at the National Institutes of Health and was a Chief Medical Resident at the University of Chicago. He has held faculty appointments at the University of Chicago and also the University of Virgina, where he was the Harry T. Peters, Jr. Professor of Medicine and Head of the Division of General Medicine.
In 1995, Dr. Fedson joined the Medical Department of Aventis Pasteur MSD. There he concentrated his work on the epidemiology and cost-effectiveness of influenza and pneumococcal vaccination. In 1999, he received the Research Achievement Award in Adult Immunization in the United States, bestowed by the Centers for Disease Control and Prevention and the National Coalition on Adult Immunization. He participated in the establishment of the Influenza Vaccine Supply (IVS) International Task Force in 2001 which considers vaccine topics for the next influenza pandemic.
He retired in November 2002 and has continued to work on influenza and pneumococcal vaccination issues. He organized the Macroepidemiology of Influenza Vaccination (MIV) Study Group. Dr. Fedson has published over 160 scientific articles and papers on issues concerning adult immunization.
SS -- Dr. Fedson, thank you for giving this interview. In your paper you urge the leaders of developing countries, scientists, and international organizations to begin the research into inexpensive generic agents to mitigate an influenza pandemic, what response have you received?
DSF — I’ve received no response. Since I work alone and am not affiliated with an institution or organization, I’ve not expected to be contacted directly, However, the idea for conducting research on inexpensive generic agents is one that I have been “peddling” to international organizations, health agencies and influenza investigators for almost five years. I’ve received very few expressions of interest.
For example, on four separate occasions I‘ve asked WHO to hold a technical consultation to review the scientific merits of the generics approach and, if it seems reasonable, to set forth a research agenda. On each occasion, WHO has turned me down. The Gates Foundation has not been interested. I even met with a senior advisor to the Indonesian Health Minister to introduce him to these ideas, but I don’t think our conversation led to anything.
However, I have been encouraged by the response of a well-positioned Chinese investigator. When we discussed these ideas last fall, he said he would take them back to Beijing and get to work. He understands better than I that with 1.3 billion people to look after and few prospects for adequate supplies of pandemic vaccines and antivirals, his country will need one or more effective alternatives. Since several of the generic agents I’ve discussed are produced in China, Chinese health officials have a strong incentive to take the generics approach seriously. And China has many experienced investigators who are capable of doing the research.
SS --You have suggested the possibility of using statins, peroxisome proliferator-activated receptor (PPAR)a and PPARg agonists (fibrates and glitazones, respectively), chloroquine, resveratrol, catechins, and curcumin for treating pandemic influenza.
Why do you think research is lacking in determining the effectiveness of these agents to mitigate a pandemic?
DSF — From what we know of the molecular biology of these agents, they are among the most promising candidates for testing in research laboratories. However, they are not by any means the only ones. What characterizes them is that, with one exception, they are generically produced in developing countries and consequently they are inexpensive and could be made widely available. Of course, because they are generic agents, no pharmaceutical company is interested in sponsoring such research.
(Continue reading this Interview. . . )
