inside you . . . even if in an altered form.’
‘I see,’ said Steven, silently thinking that it did seem to be an academic point but fee ling obliged to ask, ‘I take it there’s no alternative?’
‘Yes there is. There is a vaccine containing a completely inactivated form of the virus – all the virus particles are dead – but it has to be given by injection.’
‘So why not use that?’
North smiled. ‘Money, doctor, money, the bottom line to so much these days. We’re talking about maybe wiping out the last one per cent of the disease on earth. Pharmaceutical companies are commercial concerns. They exist to make money. The inactivated vaccine is very expensive to make and is in short supply. Governments in places like Pakistan, Afghanistan, Nigeria and India don’t want to spend money they don’t have to and the pharmaceutical companies don’t really want to make it because none of them wants to set up a hugely expensive production line to manufacture a vaccine which will kill off demand for itself almost as soon as it’s put into use.’
Steven let out a long sigh as he saw the problem.
‘You can’t really blame these countries for continuing to use the cheap vaccine to rid themselves of the immediate problem of polio without thinking too much about the finer points of epidemiology,’ said North.
‘Are there any countries in the world where polio is a major problem?’ asked Steven.
‘No,’ North admitted. ‘Cases of paralytic polio are currently running at one per cent of the numbers we saw in 1998.’
‘So . . .’ began Steven, feeling slightly embarrassed and wondering if he’d missed something.
North smiled and said, ‘It’s all right, I’m used to scepticism. There are those who see the complete eradication initiative as an academic exercise, an ego trip to wipe out a disease which to all intents and purposes is extinct as it is. The sugar lump vaccine has I admit reduced the occurrence of polio to a mere trickle of cases a year.’
‘I suppose I can understand their point of view,’ Steven confessed, ‘I mean given the financial mess we’re all in.’
North nodded in resignation. ‘Indeed. It’s hard to argue the case for a complete wipe-out, but the fact remains that, with a reservoir of the disease still out there, it can always make a comeback. It may be confined to just a few countries at the moment but they are troubled countries and internal strife encourages population movement. When people start hitting the road it’s not only their belongings they carry with them.’
‘Immigrants and refugees . . .’ murmured Steven thinking about his earlier conversation with Tally about TB making a comeback. ‘Where d id Simone Ricard fit into all this?’
‘She’d been working with the Med Sans vaccination team in the Pakistan/Afghanistan border region, one of the real remaining problem areas. It’s been a really tough nut to crack.’
‘Do you have any idea at all what she wanted so badly to talk about at the meeting?’
‘I’m afraid not. As I said, we didn’t really have a chance to speak and I didn’t even go on the trip to the Strahov monastery with the others where we might have had an opportunity to talk.’
Steven nodded , then changed the subject. ‘Your research group, doctor; do they all work on polio?’
North clearly didn’t see what Steven was getting at. ‘I suppose . . .’ he said uncertainly. ‘Various aspects.’
Steven appeared apologetic. ‘I suppose I was wondering why a research group in London was working on polio when it really isn’t a problem any more in the western world – I’m assuming that you get traditional funding from the UK research councils?’
‘Ah, I see,’ said North with a smile. ‘Well, yes , we have funding from the Medical Research Council and the Wellcome Trust and one of our students is supported by a pharmaceutical company, so I suppose you could call that "traditional". But we don’t actually
Learning to Kill: Stories