I need to clearly state that when I criticized David Hoffman's "Going Viral" piece in the New Yorker last week, I was not criticizing the author. Mr. Hoffman has a very well developed story here. Because of my negative vibes, Mr. Hoffman was kind enough to send me a copy of the six-page article for closer review. And mind you, I don't like the TMTI program any better, but this is an excellent article about a thoughtful and smart government leader who believed that he had to make a difference about a potential massive health crisis.
Dr. Darrell Galloway, the director of DTRA's CB directorate in 2009, was a man with a mission. He knew that using federal funds allocated for military biodefense against the swine flu challenge was outside the mandate, but dammit, there were lives at stake (if the flu got worse). Using the funds for the swine flu might be a test case for the government's wishful effort to quickly develop medical countermeasures against "unknown" diseases. So he told his staff, we got the money, let's do this.
A day later, at a meeting in the Pentagon, Galloway ran into stiff objections. Several officials said it was a mistake for the military to get involved in the swine flu outbreak. Galloway felt that the government was reacting too slowly to the spread of the pandemic. "I finally got fed up and blew my stack," Galloway told me. "I said, 'I didn't come here to ask anybody's permission to do this. I have done it.' " He got up and left, and the meeting broke up. Afterward, no one tried to stop him.
Now Galloway doesn't get mad easily. He's a very nice, quiet, professorial type. It takes a lot to rile him. But let me make clear, this is exactly what I found offensive. It's not that a medical doctor in charge of $600 million in research funds every year made a deliberate decision to step outside of his charter and investigate swine flu. It was because no one in OSD had the balls to stop him from using his funds that were supposed to develop capabilities to protect military personnel for a public health panic that ended up not being an emergency.
I think medical scientists live in a different world. They don't care where the money comes from or who is in charge as long as they're doing good science to save lives. That's admirable. However, it makes for lousy public policy, since they also don't consider the time and money it takes to come up with a solution. Let's get past the point that TMTI was a horrible idea, that it was so overfunded that Congress took $250 million from DOD over a three year period for lack of funds execution, that it spent more than a billion dollars before people admitted that it failed to produce a "broad-spectrum" medical countermeasure that could be quickly fielded, that DOD is going to spend another billion on it regardless of its failure.
OSD has medical laboratories at Fort Detrick that mostly do military R&D for medical treatments. When directed by Congress, they dabble in other public health issues that don't benefit the military. TMTI doesn't fund the Detrick labs, it funds pharmaceutical firms who think they have a unique, new approach, and who enjoy the opportunity to advance their science and technology program with DOD money. And then there's the fact that DHHS has the mission and a hell of a lot of funds (in excess of $80 billion a year, other than Medicare and Medicaid) to pay for research like this.
So Galloway took a chance, he spent DOD money on a public health issue that ended up being much less than what everyone had feared it would be. Nothing wrong with his attempting this, to try to do the noble thing with money that had been diverted from chem-bio defense money and that was at risk if not spent that year. But it was lousy policy for the decision makers to not stop him, and now it's a precedent to divert more chem-bio defense funds to public health "good ideas."



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