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I am getting into canning, and half the people have absolutely no fear of Clostridium botulinum and half of them are terrified. It has a similar sporulation strategy and even boiling doesn't necessarily kill it. Most recipes that have been scientifically proven to be safe with possible botulism vector foods use pH and sugar content to ensure that the little fuckers can't divide. Some pressure cook to raise the max temperature, and pH still matters in many of those.

It's the same strategy bees use (modulo the heat). Honey can contain botulinum spores, but the pH is so low and the sugar crushingly high so it can't divide - until you try to make mead and fuck up the recipe. Or feed it to an infant.

Huh, I had no idea that honey was so acidic - looking it up, it's very possible for it to be as acidic as an orange.

I don't think I've ever had non-acidic honey. I wonder if that's particular bees, particular flowers, or counterfeit honey. I'm suspecting the latter. We are just beginning to come to grips with how much of it there has been.

> Basically the treatment was given when there was a flare up, because the organism was only vulnerable in that mode

Committing the sin of a double reply, different subject.

There are treatments for HSV, some experimental but I thought I heard one had just about cleared the FDA, that are a cocktail of drugs that kill serum herpes simplex but as a chaser to a drug that tricks HSV into coming out of dormancy. So while it would always be good for big pharma to spend more research on prevention and less on treatment, it's not like no progress is being made.

Whether they're sandbagging I really couldn't say.

> But despite public opinion of pharma companies, I never heard anyone say "thank you spores!" In fact we did continue to try to attack the spores.

I think this is a good example of the public imposing a sinister explanation on top of what is really an unfortunate reality: Pharma companies aren’t choosing to ignore the spore problem, they’re just focusing on treatments that can actually be made to work under our current technologies.

As long as there is more than one pharma company, there's an incentive to cure chronic conditions because you'll take all of your competitor's business away and can charge a price equal to the lifetime costs of the chronic treatment.

An efficient market is characterized by a perfect, complete, costless, and instant transmission of information...

You have conflated your incentive (a cure) with people who make and sell treatments (maximize profits).

As long as there are Pharma companies, there is incentive to make slightly better treatments. That is same effect lower production cost, or same cost and better effect.

It kind of sad that treatements have gone from prescription to subscription.

Just wanted to add as an additional wrinkle in the simple ecomnomic explanations : a lot of the "discovering drugs" part -still necessary before you can actually sell drugs, afaik-, hinges very much on having really good researchers work for you. And these researchers do care about curing diseases: I do not have one colleague that does not dream of being a new Salk. The market needs thus to correct for it: it tends to be more efficient / worth it to be ethical, because it is a prerequisite for top talent hiring in this space.

This is of course complicated further by the sheer pigheadedness of CEOs with a career half life of 3 years who come in, _revolutionize_ something by destroying it and antagonizing the workers, bloat HR a bit more and drive sales through something illegal; and finally move on, tallying that one a success.

I completely agree with you, but as you imply CEO-driven decisions can intervene.

https://www.propublica.org/article/how-big-pharma-company-st...

Two vaccine candidates use the same adjuvant. One demonstrates high efficacy at curing a disease killing over a million people per year in poorer countries, one demonstrates high efficacy in preventing shingles. Guess which one was prioritized for the adjuvant.

I can believe everything about that article except the explanation that the adjuvant itself was somehow the bottleneck. GSK simply didn’t see a way to make money from the TB case; the adjuvant seems tangential despite the way it was presented in the article. It reads as if the author just learned the word and didn’t understand its actual significance. The adjuvant function is useful in other contexts but vaccines!

Also shingles can be a serious disease. Doesn’t change the calculus of prevalence, but no need to be quite so dismissive.

It could be. It depends on the source and cost per dose of the adjuvant. Adjuvants from natural products can be supply limited and also costly to produce.

Regardless, it makes you wonder why they went forward with that particular adjuvant for the TB trial in the first case.

I'm not dismissing shingles, just triaging it relative to the seriousness of TB.

> Regardless, it makes you wonder why they went forward with that particular adjuvant for the TB trial in the first case.

Well sometimes you select an excipient or adjuvant because some other one you might have chosen has some interaction with your API (active pharmaceutical ingredient -- the thing you're actually trying to deliver). More often though they are pretty arbitrary: the program lead or someone on the team had used that compund before and knew how to handle it or already had all the literature needed for a regulatory submission (had an older submission) or perhaps the division you're submitting to is already quite familiar with that one so you use it.

And of course once you're approved for and done an initial trial (phase 1) with one formulation you don't want to go back and redo all the safety studies, especially for something that isn't the API itself, if you don't have to.

Note, I have not worked in vaccines, only in anti-infectives, so their can always be cultural and technical differences that I'm not aware of! Consider this the equivalent of "experienced Lisp, C++ and assembly programmer reads article written by a layperson about a problem with a Java program, and is dubious about the layperson's diagnosis".

:) I'm a synthetic biologist, but don't work with eukaryotes outside of knowing some basics about expression cassettes, so sure.

I don't know to what extent the ProPublica writer was informed by their sources, but they're typically pretty good journalists. Still, I get your point.

Everything is going the way of subscriptions. Ill probably be in subscription housing the rest of my life unless there is a crash in the property market.

Housing has always been a subscription, you can't really technically own your house (try not paying your land tax).

But only as long as the patent lasts. You usually can't sell a better cure if the original already cures. A treatment on the other hand leaves room for "improvement".

Of course you can make a better cure. Faster, less side effects, simpler route of administration, higher success rate,...

The patent is actually an argument for the cure. Because if you have a lifetime treatment, as the patent expires, anyone will be able to copy your treatment. It is called generic drugs and it is done all the time. If you have a cure, during the time you have the patent, you will be able to treat everyone, both existing and new cases, and make tons of money while your competitors will have nothing. After the patent expires and your competitors will be able to copy your cure, only new cases will remain. Still valuable, but far less than when you had the patent and there were plenty of people to cure.

Goldman Sachs Analyst thinks otherwise. The company behind the Hepatitis C cure seems to also not doing well with monetizing their cure. There are also countries like Brazil that just suspended the patent.

https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patie...

Assuming they don't collude, that is.

Could you share the name of the illness/pathogen? Very curious.