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Roche Scientist Becomes Global Point Man On Avian-Flu Drug
January 26, 2006
BASEL, Switzerland -- As concerns mount about a possible avian-flu pandemic, research scientist David Reddy has become the world's point man for a drug seen as the best available treatment for the bird-flu virus.
The 44-year-old New Zealander is head of pandemic-flu planning at Roche Holding AG, the Swiss manufacturer of the antiviral treatment Tamiflu. He oversees a team of 20 at the headquarters of Roche, which has come under intense pressure from government and health officials world-wide to increase production of Tamiflu, deliver the drug to frantic countries experiencing outbreaks in poultry and humans and defend its safety and effectiveness against a lethal virus named H5N1. On Saturday, such challenges are scheduled to be discussed by U.S., United Nations and other health officials during a session on "Containing a Global Pandemic" at the World Economic Forum's annual meeting in Davos, Switzerland.
Governments and public-health officials have also pressured Roche to allow other companies to produce the patented drug as a way to boost output. Dr. Reddy and his colleagues have negotiated deals giving companies in China and India permission to produce the drug for local pandemic use. Juggling demands from every corner of the globe has required 14-hour work days and a constant dose of diplomacy, says the soft-spoken Tamiflu chief.
Dr. Reddy starts most mornings poring over a stack of media reports about new outbreaks in birds and humans. The emergency phone calls soon start pouring in.
Late last year, his Roche colleagues in Indonesia phoned to report that avian flu had surfaced in several new human cases and in more than a dozen eagles and peacocks at the Jakarta zoo. Indonesia didn't have enough Tamiflu to treat the patients or the health-care and animal workers who were at risk of being infected. Could Roche send 20,000 doses tomorrow, the Indonesians wanted to know?
Dr. Reddy made several calls to the World Health Organization, a unit of the U.N., to get more detail on the outbreaks and to see how much Tamiflu was needed. With supplies so tight, Roche's policy is that most governments that order today shouldn't expect deliveries for several months. But Dr. Reddy says he can make an exception when a country has an outbreak. For Indonesia, he tracked down doses at a warehouse in Basel and shipped them the next day, he says.
He and his team did the same for Turkey early this month, sending 100,000 treatment courses immediately after H5N1 infections appeared in several Turkish children and adults. Roche charges what it calls "less developed" countries E12, or about $14.75, per treatment course. It has donated the drug to poorer countries and charges developed countries E15 per treatment course.
"Having this drug is a significant responsibility, given the role this drug could play," says Dr. Reddy, who grew up in Christchurch, New Zealand, and got a doctorate in cellular and molecular biology from the University of Auckland. Still, Dr. Reddy cautions that there has been a "loss of perspective" about the dangers of bird flu. "People think there's a pandemic today," he says. "It's important that we're able to keep working steadily here, that we don't get caught up in it."
Last year, as concerns grew that the virus would strike poorly prepared nations in Southeast Asia, Dr. Reddy handed over his other responsibilities overseeing HIV medicines to focus exclusively on Tamiflu.
Dr. Reddy and his colleagues have been on the hot seat since late last summer. The Tamiflu chief says he recently bought his assistant a bottle of wine to apologize for "driving him crazy" with work.
Early last year, Dr. Reddy traveled to Geneva to pore over two new scientific papers with Klaus Stohr, head of the global influenza program at the WHO. Past pandemics have swept around the globe virtually unchecked, but, in this new report, two teams of U.S. and U.K. scientists had concluded that a bird-flu outbreak in humans could be contained by enforcing strict quarantines and rushing between one million and three million doses of antivirals to the scene.
At the time, the WHO didn't have any Tamiflu stockpiled; Dr. Reddy tentatively agreed to donate three million doses to the agency and took the proposal back to senior management for approval, which was granted. This month, Roche agreed to donate an additional two million doses to the WHO emergency stockpile. Dr. Stohr calls Dr. Reddy and his team "extremely reliable."
Even as people line up to get Tamiflu, Dr. Reddy has had to answer concerns about the safety and efficacy of the medicine. In late December, the New England Journal of Medicine published an article about eight Vietnamese patients who were diagnosed with H5N1 and treated with Tamiflu. The results were mixed: Four of the patients lived, and four died. Most worringly, two of the deceased developed resistance to the drug before dying.
As phone calls from worried health officials and journalists poured in, Dr. Reddy convened a conference call to address the study. That four patients had survived provided some encouragement that Tamiflu can work, he said. Seven of the patients had been given the drug more than 48 hours after the onset of symptoms, when the drug is considered to be less effective, he noted. Still, the cases of resistance were a concern and demanded further study, he said. Roche would study higher doses to see if they were needed to overcome any resistance, he said.
Tamiflu prevents viral replication by repressing a key protein on the surface of the flu virus. It was originally developed to treat regular seasonal flu but has also proved effective at reducing the symptoms of bird flu. Roche is able to make about 55 million treatment courses a year but promises to boost output to 150 million this year and to 300 million by early 2007.
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