Examination of Witnesses (Questions 1080
- 1093)
WEDNESDAY 24 APRIL 2002
DR PAT
TROOP, DR
DAVID HARPER
AND DR
MARY O'MAHONY
1080. This is a medical question. To fulfil
that scenario how many vaccines do you require?
(Dr Troop) That would depend on a whole range of scenarios
depending on how an outbreak started. There are many different
ways in which it could start.
1081. Worst scenario, for example?
(Dr Troop) One worst scenario could be—
1082. I can see you are trying to avoid answering
the question.
(Dr Troop) No, I am not trying to avoid the question.
Chairman
1083. Honestly, Kevan, I think it is complicated.
(Dr Troop) What I am saying is it is not a straight
forward issue, it is a very complex issue about the kind of smallpox
attack one could have, and we have no evidence that we are likely
to have one. We have modelled the potential different scenarios.
If one looks at the pattern of response which was carried out
in the worldwide eradication where we have a huge worldwide experience,
the experience then was not mass vaccination of the population,
that was not the way that it was eradicated.
Mr Jones
1084. Can you stop trying to talk me out? Can
I ask you a specific question? You have said there is a model,
how many vaccines do you actually require for the model which
you will use in the UK in the response? You have said it is not
one per person, I accept that, so what is it? How many do you
need for that model you have got from the World Health Organisation?
(Dr Troop) I have not got in front of me a figure
of the number of people who might be affected by the different
scenarios. For me to pluck a figure out from different scenarios
I think would be quite wrong in this session.
1085. Could you write to us on that, that would
be very helpful. Can I say ten out of ten, I am sure your masters
in Whitehall will be very proud of you for not answering the questions.
(Dr Troop) That was not my intention. It was to explain
the complexity of this situation.
Chairman: As this area is not one which
instantly falls within the remit of the Defence Committee but
we have an interest, it would be helpful if you could give us
an indication of the literature. Secondly, the decision was highly
controversial and I would be amazed if one of our sister committees
was not looking at this in rather more detail. I am afraid, as
far as we are concerned, the time available does not allow us
to explore the position beyond what we have done. Certainly if
we did decide to do it, you are absolutely correct it is above
your grade. Well, I am not saying above your grade but a decision
would be made above your level. We might decide to pursue that
further. We just have a couple more questions.
Mr Howarth
1086. Can I just follow this up with Dr Troop.
There is very considerable public disquiet, if not to say amazement,
that a British company which is supplying the vaccine for every
citizen in the United States was ruled out of this equation here
and there was no open competition as there was in the United States.
It is my understanding, I wonder if you could help us on this,
that although the Minister, Lord Hunt of Kings Heath said, in
the House of Lords last week that ". . . five companies were
approached to see whether they could meet the specifications.
It is very clear a number of companies were given the opportunity
to put forward their case for being chosen." I understand,
certainly in the case of one company, the company supplying the
United States, that they were asked if they could supply but there
was no follow up. Can you tell us whether those British companies,
the five, were all invited to make submissions or were they just
phoned up and asked "Can you supply"?
(Dr Troop) There were meetings with all five against
an agreed set of procedures for each meeting which were identical.
Then each company was sent a detailed list of information for
a specification, exactly the same, then the information was received
back from all of them. Only one company met the requirement we
had to provide the vaccine that we wanted in the timescale that
we needed.
1087. Can you explain what those requirements
were and can you explain also to us why it was decided to choose
a different vaccine dealing with a different strain from that
chosen by the United States?
(Dr Troop) The questions that were sent were quite
long and complex and they were around obviously a whole range
of capabilities from them and timescales and so on.
1088. Presumably it was timescales and it was
costs?
(Dr Troop) Yes, and about licensing and so on, there
are a whole complex range of issues around vaccines which one
would ask about manufacturing and so on. There was quite a long
list of questions about quality because there were quite a lot
of different issues which were technical issues which were asked
of all these companies.
1089. Is it true that you are also paying the
costs of the licensing process of this PowderJect vaccine whereas
companies supplying the United States are paying their own costs
to meet the US licensing requirements?
(Dr Troop) No. All we have paid for is the cost of
the vaccine.
1090. It is not true that you are paying their
licensing costs?
(Dr Troop) No.
Chairman: Right. Thank you very much.
I am sure there are more questions to be asked but it will not
be this morning. The last question, Frank.
Mr Roy
1091. A final question. You touched earlier
on anthrax, what lessons have you learnt from the United States'
experience of the anthrax campaign last year?
(Dr Troop) We have learned a huge amount. Clearly
our PHLS colleagues were in almost daily contact with the Americans
during the time that we were getting the scares because at any
one stage we did not know if any one was going to be real so we
were planning as though they were going to be real. We were in
regular contact to make sure that we had the latest information
and the latest sharing of knowledge. In fact one of our experts
advised them in the States because we have a lot of expertise
in this country. Since then we have had an international agreement
with the Americans that we would share information and planning
and so on and now this has been broadened out into the G7 plus
Mexico and there have been two ministerial conferences and lots
of interaction of officials in between. A team of our staff both
from the PHLS and from the Department have been to the CDC to
work through with them all the lessons that they learnt and have
brought those back to build into our planning. We have a very
good relationship with the Americans and we have been doing a
lot of joint work to understand the lessons.
1092. I understand you are speaking to the Americans.
More specifically, what lessons have you learned?
(Dr Troop) I think one of the key ones was the issue
they learned about having the right infrastructure. It was this
issue about any response must be based on a sound system because
it is an add-on and therefore it has reinforced and pushed us
even more into making sure we have the sound infrastructure. Also,
we have learnt more about the capability, we have looked at how
one might use anthrax in different ways and we have looked at
the way they responded with the antibiotics and the decontamination,
all those different specific aspects of technical aspects we have
learned that we have been able to build into our plans. It has
made our plans much more robust.
Mr Roy: Okay.
Chairman
1093. Thank you very much. That was a very interesting
session. If there is any additional information that you feel
we ought to be sent, not the least being the modelling, make it
as complicated as you like and we will test Mr Jones on it after
he has read it. I am sure it is immensely complicated.
(Dr Troop) Okay.
Chairman: We have additional questions, I am
sorry we were not able to talk to you much longer but we have
time constraints. Thank you all for coming and I am sure we will
hear from you further.
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