White death

PROLOGUE

Turnberry Hotel

Ayrshire

Scotland

November 2004

‘I just don’t get it,’ complained Sir Gerald Coates as he and his colleague Jeffrey Langley hurried from the helicopter to the nearby 4x4 that was to take them the short distance to the hotel. ‘Why in God’s name bring us all the way from London to Scotland on a night in the middle of bloody winter for a meeting about medicines procurement?’

‘Someone obviously has a sense of the dramatic,’ Langley replied sourly as the driver closed the doors with one hand and held on to his cap with the other while the helicopter pilot increased revs again and took off into the night.

‘Rumour has it the PM himself was involved in calling it.’

‘Rumour had it there were weapons of mass destruction in Iraq.’

Coates gave a wry smile. ‘My source was better but I’m damned if I can see the point in coming all the way up here to discuss the cost of paracetamol, can you?’

‘Not unless there’s some showbiz angle we don’t know about.’

‘I can’t say I’d call this show business.’ Coates looked at the rain that was falling from the sky like stair rods, hammering on the roof of the car. ‘And what was the point of giving us only three hours’ notice?’

‘No doubt all will be revealed,’ said Langley as they reached the long, white frontage of the hotel. ‘Ye gods, what’s this all about?’

The Range Rover drew to a halt as its headlights picked out two armed soldiers in waterproof capes signalling them to stop. The driver lowered his window and said, ‘Sir Gerald Coates and Mr Jeffrey Langley.’

‘ID please, gentlemen,’ said one of the soldiers, shining his torch at the two men in the back while water dripped from his helmet.

Both men reached inside their overcoats, produced what was required and the soldiers waved them on.

‘What in God’s name…’ said Coates as they slowly passed rows of official vehicles interspersed with military and police cars. ‘I’d say someone’s sense of the dramatic is in danger of going off the scale.’

Langley was about to reply when their vehicle passed a long, black limousine parked at the main entrance to the hotel. A Stars and Stripes pennant hung wet and limp from the staff on the nose of the vehicle. ‘Ah,’ he said.

‘That would explain it,’ agreed Coates. ‘We’re only thirty minutes from Prestwick Airport.’

‘And the wide, blue Atlantic…’

‘… that divides our two great nations. Well, well, well…’

‘Curiouser and curiouser.’

The two men got out and entered the hotel after showing ID again. They exchanged a glance, noting the two Royal Marines, present on the door.

‘Thank you, gentlemen, please follow me,’ said the soldier who had been detailed to look after them.

Coates and Langley were relieved of their overcoats and given a few minutes to freshen up in the welcome calm and warmth of the washroom to the muted strains of Vivaldi before being shown into the room where the meeting was due to take place. There were about twenty people present — mostly men in dark suits although there were three women and two senior ranking military officers in uniform. They were seated just below the top table, which was currently unoccupied despite having place settings — a carafe of water and a note pad — for six.

Coates and Langley, who were seated halfway down one side, looked for familiar faces. They recognised a number of senior people from the Home Office and the Ministry of Defence and nodded when their eyes met. The man to Langley’s left was a consultant from the London School of Hygiene and Tropical Medicine, he read on the place card. ‘Any idea what this is all about?’ he asked in a friendly but mock-conspiratorial manner.

‘I was just about to ask you that,’ replied the man. ‘I haven’t the faintest idea.’

Coates got a similar response from the woman to his right, Dr Linda Meyer from the Center for Disease Control, Atlanta, Georgia. ‘One minute I was eating pasta with my family and talking about going bowling, the next I was packing for a trip across the Atlantic to wherever the hell it is we are right now.’

‘You’re in Ayrshire on the southwest coast of Scotland,’ said Coates.

‘Thank you,’ replied Meyer in a tone that suggested she really knew that much; she’d just been making a point.

The conversation paused as a Royal Navy officer came into the room and approached one of the men sitting at the other end of the table. He whispered something in the man’s ear and the man rose to accompany the officer out of the room.

‘I know him,’ whispered Linda Meyer.

‘I’m afraid I don’t,’ confessed Coates.

‘Homeland Security.’

‘Ah, interesting.’

‘And you are?’ asked Meyer, noting that Coates’ place card gave only his name.

‘I’m so sorry,’ said Coates. ‘You could say I was “homeland security” too. Albeit a much smaller homeland,’ he added in self-deprecating fashion. Coates and Langley were members of a special think-tank charged with advising the government on health matters linked to security issues.

‘Ladies and gentlemen, thank you for coming. I think we’re just about ready to begin,’ said the young man who took the microphone while the top table filled up. ‘This meeting has been convened at the specific request of both the Prime Minister and the President of the United States.’

He paused to let the murmur die down. ‘And so, without any more ado, I’ll hand you over now to Mr Simon Maltby, Secretary of State at the Home Office, who will tell you more.’

Maltby welcomed everyone and introduced those sitting on either side of him. He apologised for the short notice given, particularly to ‘our American friends’. ‘But, as I’m sure you’ll come to realise, what we have to discuss here tonight is of enormous importance to us all. Rather than use the more normal channels of government to disseminate information, the Prime Minister and the President decided to get all the key players together so that they might be told jointly about the problem that besets us. Mr Malcolm Williams, a specialist in strategic planning with MI5, will now fill you in on some background details.’

A tall, painfully thin man, who looked as if he might have been more at home in an academic common room, stood up and cleared his throat. ‘Ladies and gentlemen, many people believe that the biggest threat facing civilised society today stems from the rogue proliferation of nuclear weapons and terrorist bomb attacks. While not wishing to diminish these problems, it does not. It comes, as it has so often in the past, from disease. Throughout our history mankind has been at war with the microbial world. On several occasions we’ve come perilously close to losing that war as when great plagues swept the planet — smallpox in ancient Egypt, bubonic plague in fourteenth-century Europe, pandemic ’flu in the early years of the twentieth century — but in the end, we survived and prevailed. We survived because it was a straight fight, us against them, and we were the ones with brains. We had the capacity to study our enemy and design counter-strategies based on our knowledge of it. The microbes, of course, did not have the benefit of intellect.

‘This, I’m sorry to say, is no longer the case. Those who would destroy our society have teamed up with the microbial world to present perhaps the biggest challenge we have ever faced — biological terrorism. The possibility of biological weapons being used against us has been growing ever more likely and now has the potential to be catastrophic. AIDS, pandemic ’flu, tuberculosis, plague, anthrax, botulism, smallpox are all out there along with a host of others. Many have been genetically altered to enhance their killing capacity — disease enhanced by human malice, weaponised microbes.

‘These agents are cheap and easy to obtain and their culturing and growth is well within the scope of the average hospital lab technician. A garage in the suburbs could harbour enough biological mayhem to wipe out an entire city. Keeping tabs on nuclear weapon facilities is child’s play in comparison to monitoring garden sheds. We cannot hope to detect and head off every threat, so where does that leave us?’

Williams looked up from his notes and paused for a moment before saying, ‘We have to take action before the threat becomes reality. Acquired immunity is the key to our survival in this war and, in practical terms, that means vaccination. We need vaccines to protect our people against these agents and we need them quickly but the fact is — and this is the reason you are here — we either do not have these vaccines or we do not have the capacity to produce them in the quantities required.’

Williams looked around the room. ‘I can see you are all thinking we just step up research and production facilities and everything will be fine. If only it were that simple. Vaccine development and production in western civilisation is the province of the pharmaceutical industry and, rather than increase development and production because of the threat… they are currently scaling it down.’

This time a hubbub broke out in the room and Williams had to wait until it had subsided. ‘Top level talks in the past week between the UK and US governments and major pharmaceutical companies on both sides of the Atlantic have broken down without agreement. Even personal appeals from the Prime Minister and the President of the United States have failed to convince the industry that their vaccine programmes should be accelerated and expanded as a matter of extreme urgency. In short, they have declined to cooperate.’

‘But why?’

‘This is where I’m going to hand you over to my American colleague, Dr Milton Seagate from the US Defense Department. Dr Seagate is their chief analyst on health matters. He is also an ex-vice president of Schaer Sachs Pharmaceuticals.’

Seagate was a full head shorter than Williams, stocky and short-changed in the neck department. He tugged at the edges of his jacket, pulling them together in an unsuccessful effort to conceal a bulging waistline, but when he spoke the clown image gave way to a sharp, articulate delivery. ‘I believe you British might refer to my position as poacher turned gamekeeper.’

Polite laughter.

‘While it’s certainly true that I can see both sides of the argument, I am frankly of the opinion — in my gamekeeper role — that we have only ourselves to blame. Chickens are coming home to roost at an alarming rate. Thirty years ago vaccine production was a welcome and lucrative pursuit for the pharmaceutical industry. There was healthy competition among companies for supply contracts and money to be made but over the last ten years the situation has changed dramatically. Successive governments have demanded compliance with an ever-growing raft of rules and regulations. On top of that, it has become fashionable for politicians from all sides to attack pharmaceutical companies. The more cynical among us might suggest that this be for self-publicising ends, but heaven forfend.’

There was muted laughter.

‘Whatever the motivation, there is no doubting the damage these people have done. Senator Hillary Clinton’s “Vaccines for Children Program”, which introduced the prospect of a freeze on prices and the introduction of bulk purchase contracts, may have won her a round of applause from the American electorate but the end result for the drug industry was a whole bunch of vaccine producers throwing in the towel and deciding to call it a day. Senator Charles Schumer calling for government seizure of antibiotic patents from drug companies didn’t exactly build bridges either… Currently, he’s calling for the seizure of Tamiflu patents so that the US government can make its own arrangements for fighting pandemic ’flu. Can you really blame the drug companies for not wanting to play ball with politicians in an atmosphere like this?

‘Such companies have to deal with regulatory bodies who demand ever higher standards in the realm of safety testing before they will even consider letting products near the market place while regulatory bodies introduce ever tighter restrictions… and all because the public will accept nothing less than one hundred per cent safety where medicines are concerned.’

‘Quite right too,’ said someone out loud. It drew murmurs of agreement.

Seagate paused. ‘Let me tell you a story. Some years ago a vaccine was introduced against rotavirus. It unfortunately caused severe side-effects in something like 150 children worldwide. The press, of course, concentrated on these cases rather than the millions of other children the vaccine had protected with the result that, when a new vaccine against rotavirus came up for licensing some time later, the Food and Drug Administration (FDA) demanded that it be tested on a minimum of 60,000 individuals over a period of ten years before they would grant a full licence. A reasonable estimate would be that six million children a year died in the interim… in order to make sure that another 150 wouldn’t suffer side-effects. Still seem like a good deal?’

There was silence in the room.

‘There is no such thing as a one hundred per cent safe vaccine, ladies and gentlemen, but Joe Public’s refusal to accept that, along with the continual assertions by politicians that pharmaceutical companies are fuelled only by greed and self-interest, has led to the situation we now find ourselves in. There are now only a tiny handful of companies left with the will and the expensive, sophisticated set-ups necessary to operate in such a restrictive environment and even these are being squeezed because of the increasing threat of legal action against them from an ever more litigious society. No one in the business wants to get involved in vaccine production any more, let alone engage in the hugely expensive development of new ones… just when we need them most.’

‘But surely, if push came to shove, governments could take over the business of vaccine production for the vaccines we already have?’ suggested Linda Meyer. ‘I’m thinking of smallpox and tuberculosis.’

‘Forget it, Doctor. Vaccine production is a highly sophisticated business demanding specialised facilities and the knowledge and expertise that is only available in companies that have been doing it for many years. Smallpox vaccine production was run down in the aftermath of the disease being declared extinct by the World Health Organisation. We didn’t know at the time that the old USSR was full of labs stocking up with the virus which, in worst case scenario, is now being made available to terrorist groups. God knows what modifications have been made to the virus by genetic engineers. Likewise, there has been no general call for vaccination against tuberculosis for many years but the disease is making a big comeback and drug-resistant strains are becoming increasingly common. We need vaccines against AIDS and pandemic ’flu but there is no concerted effort being made to develop them. We’re running out of time, ladies and gentlemen. We need vaccines and we need them now.’

Seagate sat down.

Maltby thanked Williams and Seagate. ‘I think you can now see the problem, ladies and gentlemen. We desperately need new vaccines but nobody wants to make them. This is an impasse we have to break. Current intelligence suggests that if we don’t come up with new vaccines against plague, anthrax, botulism and tuberculosis very soon, we can say goodbye to western civilisation. The Prime Minister and the President have done their level best over the past few weeks to lean on the big players in the pharmaceutical industry and persuade them to step up their development programme, but without success. These people have decided that their shareholders come first, that there is no point in investing huge sums in developing vaccines when they’re just going to get bogged down in years of trials and testing with the added “bonus” of lawyers breathing down their necks all the time. This is why we summoned you here. We need to find a way out of this mess.’

‘Couldn’t you try a softer approach?’ asked a woman whose place card proclaimed her to be a senior adviser in the Department of Health.

‘We’ve tried schmoozing them,’ said the American sitting to the right of Maltby. He was George Zimmerman, Deputy Secretary at the US Department of the Interior. He had an air of aggression about him that Coates felt might warrant the euphemistic epithet, ‘does not suffer fools gladly’.

‘We’ve mooted tax breaks and grant incentivisation but maybe these guys are making too much money already. They’re not interested. It’s a no go.’

‘I was thinking about a more… relaxed environment for the companies to operate in…’ suggested the woman.

‘If you mean relaxing the rules and regulations about trials and tests, the FDA won’t have it. The public won’t have it. There’s already a great big spotlight shining on anything to do with drug safety. Committing political suicide isn’t going to help anyone. Our anthrax vaccine is a case in point. We’ve got the goddamn vaccine but we can’t use it to protect our boys because of some goddamned court room argument that’s been going on for years.’

‘There are some genuine concerns about the safety of that particular vaccine, Mr Secretary,’ said a silver-haired man wearing the uniform of a colonel in the British army.

‘Genuine concerns aren’t going to save your ass when the anthrax bug starts to fly, Colonel.’

‘We have to strike a balance,’ interjected Maltby quickly, trying to defuse the situation. ‘Look,’ he appealed to the room, showing the backs of his hands to the audience with raised thumbs, ‘we’re all in favour of sensible precautions but frankly, there comes a point when too much adherence to safety considerations is going to stop us getting out of bed in the morning. The public demands one hundred per cent safety when it comes to vaccines but they can’t have it… It’s not possible.’

‘What would an acceptable level of safety be, Minister?’ asked the colonel.

Maltby shrugged his shoulders and adopted a disarming smile as if he’d been asked something he couldn’t possibly answer.

Zimmerman was not so reticent. ‘If certain death is facing you, Colonel, anything with a better than fifty per cent chance of saving you is worth grabbing.’

Maltby didn’t disagree but looked as if he wished Zimmerman hadn’t quite put it that way.

‘I’m sorry, gentlemen,’ said Linda Meyer. ‘Maybe I’m missing something here but I’m really not clear about what it is you’re asking us to do…’

Maltby looked to Zimmerman who signalled with a nod that he should continue. ‘You people here are the brightest and best we have when it comes to health and security matters… on both sides of the pond. We need you to use your ingenuity and initiative to come up with answers. We need vaccines against the bacteria and viruses that threaten our security and we need them fast. Generous funding will be made available to support the best ideas and it will be channelled… discreetly… and with a minimum of bureaucracy.’

‘So you want us to succeed in persuading the drug companies to cooperate where you have failed?’ asked the woman from the Department of Health.

‘That would be one way,’ replied Maltby. ‘But maybe there are others. Who knows? We’re calling for initiative from the best minds we have.’

‘God, I need a drink,’ said Coates as he and Langley made their way to the bar. ‘What d’you make of all that?’

A waiter materialised at their table and Coates ordered two large gin and tonics.

‘Rock and hard place spring to mind,’ said Langley. ‘But let’s be honest, this is a situation that’s been waiting to happen. Public obsession with safety is grinding everything to a halt in the UK. Councils can’t put up a bloody Christmas tree without Health and Safety getting involved and lawyers getting all excited about the prospects. Kids aren’t allowed out on bicycles unless they’re encased in carbon fibre.’

‘We must make grazed knees a thing of the past,’ intoned Coates.

‘So how do we convince the boffins that they should spend time and money developing new vaccines for an ungrateful public who’ll require a public debate on Newsnight and a consultation with their solicitor before they’ll even consider taking them?’

Coates ran his finger lightly round the rim of his glass. ‘Well, Maltby did say that money wouldn’t be a problem… That’s a big plus.’

‘But the American pointed out that the pharmaceutical companies are already awash with cash.’

‘The big ones are…’

‘Would small ones have the wherewithal?’ asked Langley, picking up on Coates’ nuance.

‘They may not have the wherewithal but they do have the brains,’ countered Coates thoughtfully. ‘Some of the best biological scientists of our generation are to be found in small biotech companies. As I see it, there are three facets to the problem, design of new vaccines, testing them and finally manufacturing them on a scale large enough to protect an entire population. Let’s take it one step at a time. If you don’t have a vaccine, you don’t have anything to test or manufacture.’

‘So if I understand you correctly, you propose using government cash to help small biotech companies come up with new ones?’

‘Not quite,’ replied Coates as if he were still thinking it through. ‘We couldn’t possibly fund hundreds of small companies, knowing that most of them would fail anyway.’

‘Well, they’re certainly not going to do it themselves and the City isn’t going to touch investing in vaccines with a bargepole.’

‘I was thinking more along the lines… of a prize, a prize for success.’

Langley’s eyes opened wide. ‘You know, you may have something there. Everyone loves prizes these days. There seem to be prizes for everything. I sometimes think it can only be a matter of time before we see Wogan presenting prizes at the glittering binmen’s awards… The nominations for disposal of garden refuse are…’

‘We’d have to do it discreetly because we wouldn’t want to antagonise the big companies any more than we have already but, if the stakes were high enough, I reckon we might tempt quite a few smaller concerns to put their financial toes in the water and broaden their development base. What d’you think?’

Langley’s response was positive. ‘It would have the added attraction of limiting the entrants to those who really thought they could do it and more than that, to those who could persuade their bosses and backers that they could. Brilliant! We’d attract the brightest and best without even having to fund them unless they were successful. I think I’m going to buy you another very large drink.’