By David Bell at Brownstone dot org.

In our enlightened age the public seems tirelessly bombarded with warnings of existential threat from infectious disease. Another distant outbreak is spreading, this time it could be Disease X! "…and there is no vaccine …!" How, one might ask, is our species still extant?

A few decades ago, life was less torn by impending doom. Public health officials were investigating diarrhoea outbreaks linked to the local café. The Woodstock festival happened during the last large influenza pandemic, and no one really noticed, let alone wore a mask. They just listened to the music, lived as their ancestors had, and somehow managed to expand the species.

Medical technology and biotech innovation have blossomed since Woodstock. If you had a heart attack in the 1960s, you got some morphine for pain and a firm mattress, a bit of nitroglycerin under the tongue or some basic drugs to steady an erratic heartbeat. Now you will be rushed into a maze of tubes and monitors, clot-dissolving drugs and pacing wires, multiple modes of imaging followed perhaps by rapid surgery to remove a persisting blockage. Far fewer people die; it's all good and considered worth the money.

The world of infectious diseases is very different. It faces an intrinsic market failure. While an increasingly old and fat population ensures a growing cardiac disease market, infectious diseases are on an inexorable decline. Biotech innovation has churned out all manner of new tests to allow us to distinguish pathogens, strains of pathogens, and variants of strains, but from a declining background of illness. Germs develop resistance but we keep developing new antibiotics to replace those failing, imperfectly but sufficient to maintain the decline.

Vaccine development in this context is a bright spot amidst a dismal outlook – the golden egg that can be sold to the healthy rather than a declining market of the sick. Modified-RNA genetic therapeutics, reclassified as vaccines, now allow companies to virtually print new vaccines in months. But it's still necessary to convince people who are under no imminent threat to become consumers.

Additionally, while some vaccines such as those for measles can effectively reduce circulation of pathogens, most mortality decline even from measles occurred before the availability of vaccines for these "vaccine-preventable diseases." Nutrition, sanitation, and better living conditions removed up to 98% of measles deaths in wealthy countries. The marketing term 'vaccine preventable diseases' has helped, as has sponsorship of medical colleges, but the public is less readily bought than doctors and are increasingly aware that former scourges such as plague, typhus, and scarlet fever, for which no vaccines exist, have declined at much the same rate.

Vaccines for the classic vaccine-preventable diseases are also mostly beyond the 15-year window at which intellectual property commonly expires and potential for return on investment declines accordingly. This creates a challenge. Companies must replace existing vaccines with new technologies such as modRNA and claim they are somehow better, or find new diseases.

History has shown that very little is beyond the ability of humans to adapt. As Covid-19 further demonstrated, it is fear of infectious disease that matters – you don't need bodies in the street. So, you don't need bad new diseases, which would be difficult, but just stuff the public has never paid attention to before.

Locking down young and middle-aged people and wrecking their businesses, then coercing vaccination as a way back to 'freedom,' would have been impossible at the time of Woodstock in 1969, or even in 1999. It is too obviously egregiously fascist, and people then still retained memories of mid-20 century Europe.

The SARS outbreak in 2003 changed things, kindling possibilities for investment, and a lot of legwork went into behavioural science techniques afterward. Prepping of media and the public im...