Today’s Google Doodle celebrates the 100th birthday of Jonas Salk.
Several of the articles marking the occasion debate why Salk did not patent the polio vaccine. A contributor on Forbes calculates that Salk could have made about $2 billion if he had done so. Amar Prabhu’s post is a detailed and fascinating history lesson about Salk’s and Albert Sabin’s work.
A post on Slate by Brian Palmer says that “What Would Salk Do?” is the wrong question to ask in 2014. Specifically it is an intuition pump:
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…a misdirection from complex questions. It represents an easy but wrongheaded way to avoid the messy work of constructing a system to incentivize medical breakthroughs and make them widely available in the context of 21st-century economic realities. That’s not to say Salk was a propagandist or a panderer — he probably meant every word he said [about the vaccine belonging to the people of the world]. But his thoughts on the polio vaccine applied to a specific situation at a specific time in our history.
People had been donating to the National Foundation for Infantile Paralysis to support the development of the vaccine, so patenting the treatment would have meant that people would have had to pay for it twice:
There was near unanimity within the organization that the public had already paid for the polio vaccine through their donations, and patenting it for profit would have represented double charging. That’s what Jonas Salk should have said to Murrow — not that all vaccines belong to the people, but rather that this vaccine belonged to the people.
It’s hard to imagine the American public donating money to develop an Ebola vaccine as people did to support the polio vaccine research:
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In the 13 years leading up to the vaccine’s roll out, the budget of the National Foundation for Infantile Paralysis swelled from $3 million to $50 million. An entire generation of microbiologists received money from the foundation…
Obviously Ebola is a different kind of public health problem than polio, but it’s hard to image a Jonas Salk existing in the world today – for a variety of reasons. The biggest difference is that the health research ecosystem has fundamentally changed since Salk’s time. Also, funding models are now inadequate for this kind of work but the financial challenges of developing a vaccine remain the same.
Salk worked on a vaccine for AIDS at the end of his life (he died in 1995) so he was somewhat familiar with how our healthcare system works today. In his article about Salk’s patent decision, Prabhu points out that rich people use most of the world’s medicines, so that population at least can afford to pay for the development of vaccines (whether they will actually use the vaccines once they are on the market is another question).
So maybe it is foolish and naive to expect a researcher in 2014 to develop an Ebola vaccine for free. We’ve put the free market at the top of the healthcare food chain so we have to accept the priorities that result.
Footnote: In reading about Salk’s work, I learned how the March of Dimes got its name:
In the single year that the polio vaccine was unveiled, 80 million people donated money to the National Foundation for Infantile Paralysis, which spearheaded the vaccine effort. Many donors could only afford a few cents, but gave anyway (hence the foundation’s modern name, the March of Dimes).
