Kristian Storm, professor of immunology, was wrapping up a telephone conversation with a colleague in France when Marie Skov knocked tentatively on his half-open door and popped her head into his office. ‘Sorry, I just wanted to . . .’ she said, before she realised that Storm was on the phone, but he quickly waved her inside. ‘Two minutes,’ he mouthed, and Marie sat down on a small sofa just inside the door. Her timing was perfect: Storm wanted to talk to her about an important matter.
While the Frenchman was reaching the conclusion to his lengthy monologue, Storm reminisced about his first meeting with Marie. She had turned up at his office, practically tripping over her own toes to such an extent it was almost comical. She looked like a ruffled baby swallow, Storm had thought. His best protégés were always students who were not yet ready to fly solo, those who found it the most natural thing in the world to hide their light under a bushel because they did not know yet what else to do. They listened to him, they could be moulded and they needed Storm. Privately Storm called them his swallows and only his father would have understood why. As a child, Storm had found a baby swallow on the ground, still damp from the yolk sac, bald and lost. He was convinced that his scientist father would tell him to let nature take its course and ignore the baby bird. But Storm’s father had found a large leaf and carefully scooped the baby bird back into the nest under the gutter from where it had fallen.
‘Swallows are tough,’ he had said to his son. ‘Just you wait and see.’
Three weeks later the garden had been filled with fearlessly diving swallows, and Storm had searched the grass along the wall in vain and even double-checked the bin, but could find no trace of the baby bird.
‘Oh, you won’t find it,’ Storm’s father had said. ‘It’s up there.’ He pointed towards a boomerang in the sky. Ever since then Storm had loved swallows.
When Storm had finally concluded his conversation with the Frenchman, he watched Marie for a moment. She had got up and was studying the photographs on his wall, which was covered with framed pictures and postcards from ex-students from around the world. There were also diplomas and newspaper cuttings and wooden African masks decorated with beads. His life. Storm got up and positioned himself next to Marie, who was taking a close interest in an old black-and-white photograph.
‘That’s me and my father, Birger Storm,’ Storm said, pointing to the picture. ‘My mother died when I was very young, but my father decided to bring me up himself, without a nanny. If you knew how many times I slept on a mattress on the floor in his office when he had just started working at the Faculty of Medicine! You could say my choice of career is the result of a work-related injury.’ He chuckled to himself. ‘My father died thirty years ago. He was the victim of a conspiracy. But I gather you’ve already heard.’ Storm watched Marie, and when she nodded, he wanted to know more. ‘What have you heard?’
‘That he was falsely accused of sexual harassment,’ Marie said honestly, ‘and that he killed himself, even though he was cleared.’
Storm nodded slowly and returned to the photographs on the wall. ‘Ah,’ he said, pointing to another picture. ‘This shack is the research station for the Belem Health Project in Bissau. My passion these last five years. I’m well aware that it looks like a pimped-up woodshed, but great science is happening behind its flimsy planks, trust me.’ He laughed.
‘That’s Silas Henckel, isn’t it?’ Marie said, gesturing to the next photograph. ‘I recognise him, even though I don’t think I ever met him.’
Storm got a lump in his throat. The photograph had been taken two years ago and he was standing between two of his PhD students: Tim Salomon, who would soon become the first Guinean PhD student at the Belem Health Project, and Silas Henckel, who had drowned in a terrible accident in 2007.
Marie misinterpreted his silence. ‘I’m sorry, I didn’t mean to upset you,’ she interjected.
‘You haven’t, but it’s hard for me. Because in a way it was my fault that Silas died.’
‘Your fault?’
‘Never force a workaholic to take a vacation,’ Storm said. ‘I meant well, obviously. It was early December and Silas had just returned to Bissau after a lengthy trip to an impassable area of south-eastern Guinea-Bissau between the two Dulombi-Boe national parks, which border Guinea. Unfortunately, there was something very wrong with his figures so I sent him back to do them again. He was very unhappy, and when he had gone, I started to feel bad about it. It would be Christmas soon and, even though Silas was the toughest student I’ve ever had, I was sure that he didn’t fancy spending Christmas in the bush. So I gave him a two-week holiday at a resort in Gambia as a Christmas present. There wasn’t time for him to repeat the survey of the entire area before Christmas anyway, so a break in slightly more comfortable surroundings was perfect. So went my thinking. I booked it, paid for it and ordered him to go. “You’ve earned it,” I wrote.
‘I myself went to Skagen to celebrate Christmas with some friends and didn’t return to the department until the twenty-eighth of December. I discovered numerous emails in my inbox and messages from Bissau on my answering-machine. While in Gambia, Silas had gone out with local mangrove fishermen and fallen overboard. He got caught in some fishing net and drowned. Naturally I flew to Africa straight away.’
For a moment, Storm stared vacantly into the air, then he shook his head.
‘After bringing his coffin back, I found a message from Silas on my answering-machine. I had never got further with replaying my messages after Christmas than the news about Silas, but there were others and one of them was from him. He had called on a poor-quality line from the resort, thanked me for the enforced holiday, wished me a merry Christmas and asked me to call him back urgently.’
‘I really am very sorry,’ Marie said.
‘The other guy is Tim Salomon,’ Storm said, pointing to a young African man. ‘Fortunately, he is very much alive and you’ll meet him soon. Tim is my success story. The child of an unemployed widow in Bissau, he was doomed to a life in the cashew plantations – that’s how most Guineans support themselves – but his teacher had spotted his potential and put him up for a full scholarship at Kingston University in London. Tim even completed a master’s in biology before he returned to Bissau. That was where I was lucky enough to meet him and he started working for me, first as an interpreter but he soon became my right-hand man, assistant and friend. Apart from having a brilliant mind, his great advantage is that he’s a native Guinean. Tim’s father was a missionary and he was brought up as a Christian, but even so, he knows better than anyone else how to treat the various ethnic groups without treading on anyone’s toes.
‘Silas’s death hit Tim hard, and everything ground to a halt for several months. But now it’s back up and running, I’m glad to say. I look forward to you meeting him.
‘And here we have Thor, the little pen-pusher, just look at him!’ Storm pointed to another picture. Marie looked at the photograph, which showed a group of men gathered around an iron pot on an earthen floor. Apart from Thor, Marie recognised Silas and Tim; the rest appeared to be locals, all busy eating the grey and brown contents of the communal pot.
‘Thor came to Guinea-Bissau once and it was a total disaster. He couldn’t keep his socks white, he couldn’t sleep at night because of the mosquitoes whining around outside the mosquito net. One evening he forgot that you risk getting infected with parasites if you brush your teeth in tap water, and when he remembered, he flipped out completely. That day proved to be the final straw.’ Storm tapped his finger on the glass. ‘We were in a village to collect data and the local tribal leader invited us for lunch. And this is how they do it. Rice and fish in a communal pot and one spoon for each. When Thor realised he wasn’t going to get his own plate, I simply had to take that photo. We all thought it was hilarious.’
Storm howled with laughter, and when Marie joined in, he laughed even louder.
‘By the way,’ he said, when they had calmed down, ‘I’ve been meaning to tell you something. Don’t mind Thor. He has a grudge against every potential academic rival, and it has been like this since he was my student almost eight years ago, with a doctorate in between. But he’s all right.’
Storm squeezed Marie’s arm and went back to his desk. ‘Please would you sit down for a moment,’ he said, indicating the visitor’s chair. ‘I want to talk to you about something important. About your master’s. It’s time.’
Marie looked so terrified that Storm couldn’t help winding her up by putting on a very stern face. Marie’s debilitating insecurity often masked her intelligence. She was in fact extremely bright and on top of that she was great company. Storm could not remember ever working with a student with whom he was as much in tune as he was with Marie. Even when they worked at opposite ends of the laboratory and hours passed without them speaking, there was a special atmosphere. In the last few months, they had even started joking with each other, and Storm had realised Marie was not timid at all. On the contrary, her sense of humour was so subtle and dry that it might take Storm several moments before he twigged her allusion and could share the joke. All in all, Marie was a gift from Heaven, both for him and for his research project. And he told himself that Marie felt the same.
‘So, what are your thoughts about your master’s dissertation?’ Storm asked.
Marie looked worried. ‘I would really like to write it here, in this department. I really would,’ she then said. ‘And I hope it won’t be a problem that I can’t travel to Guinea-Bissau.’
‘You can’t travel to Guinea-Bissau?’ Storm said, feigning surprise.
‘Jesper has started training to be an orthopaedic consultant,’ Marie said. ‘Don’t you remember me telling you? He’s working ever so hard and I can’t go to Africa because who would look after Anton? Jesper can’t take time off. I was hoping it wouldn’t be a problem. But I . . .’ She fell silent.
‘Oh,’ Storm said. ‘Never mind. I’m sure Thor won’t mind acting as your supervisor back here at home.’
For an instant Marie seemed deeply disappointed, then she narrowed her eyes and gave him a sly look. ‘You’re teasing me,’ she said.
Storm grinned from ear to ear. ‘Marie,’ he said, ‘do you really think it would even cross my mind to dump my best student in the last twenty-five years on Thor Albert Larsen? You must be out of your mind. If you want to stay with the Department of Immunology, if you have the guts to specialise within this contentious field, I’d like to supervise your dissertation myself.’
For a moment Marie seemed about to cry. ‘I’d really like that,’ she then said, almost lost for words. ‘I mean, thank you, I would absolutely love it. Thank you so much.’
*
In the weeks before Marie started work on her dissertation, Storm briefed her thoroughly about the Belem Health Project and his research in Guinea-Bissau. Marie was busy with her finals and Storm had plenty to do, but whenever the opportunity arose, they would meet at two o’clock in Storm’s office where he would explain the background for his research, while Marie listened and took notes.
‘How had it all begun?’ Marie wanted to know.
‘With one single unplanned observation,’ Storm said.
In 2004 Storm was sent to Guinea-Bissau by SIDA, the Swedish International Development Co-operation Agency, with a brief to discover the reasons for and find ways to lower the extremely high child mortality rate in the small West African country. With him Storm had brought the Swedish nutrition expert Olof Bengtsson from the University of Lund, and a team of local assistants, including Tim. During three visits between 2004 and 2006 Storm and Bengtsson gathered data on 28,000 children under five, who lived in the four big suburbs of Bissau. They created a medical record for each child that covered every aspect of its development, health and the nature and date of any vaccines it had received. It was a gargantuan task, which resulted in the first systematic monitoring of children in the history of Guinea-Bissau.
One of the first discoveries made by Storm and Bengtsson was the low rate of vaccination cover. Alarmingly few children were vaccinated, a situation that needed to be addressed as quickly as possible. Storm and Bengtsson alerted the WHO to their findings, and by the following year enough new health clinics had opened and enough campaigns had been run in Bissau and surrounding areas for the proportion of children being vaccinated to have risen dramatically.
In 2006, when Storm and Bengtsson were finalising the processing of their data, they made a surprise discovery. They had spent most of their week crunching statistics on their measles and TB data and late one night, shortly before their return home, they were discussing the graphs they had printed out and spread across the floor.
Storm was the first to see it.
As they would have expected, mortality had dropped among the children who had been vaccinated against measles and tuberculosis, but the extent by which it had fallen was much greater than they had anticipated.
The two scientists stared at the figures and scratched their heads.
Bengtsson started re-evaluating their survey method, but broke off to ask Storm whether he was planning to return to Africa next year if SIDA extended the funding. Absolutely, Storm had replied. Storm had never believed in overseas aid, but felt that their work had a purpose. They were laying down the basic structure for a public health-care system, and when the SIDA money ran out, they could hand over important data to the Guineans. Bengtsson nodded slowly. Personally, he had doubts whether he would continue. First, he was about to land an exciting new job, he revealed, and second, he had been taken aback by how deeply the poverty affected him. He had young children of his own and found it hard to watch babies die from diseases that would have been treatable if only they had been born on another continent.
Bengtsson got up to fetch two cold Cristal beers from the fridge and Storm looked at the chart of diseases that most commonly claimed the lives of children in Guinea-Bissau. Malaria was, not surprisingly, a major culprit, but respiratory diseases and diarrhoea were high on the list of most frequent killers of young children. Storm could hear Bengtsson open the fridge in the research station’s kitchen, then the pop of bottle caps and finally his footsteps across the hallway. Then the lights flickered and he was plunged into darkness.
Bengtsson swore.
The generator kicked in a moment later and the lights came back on. Storm stared at the printouts. What the hell was that? He quickly rearranged a few sheets of paper and pushed others aside and, like an obstinate 3D picture, it suddenly came into focus.
‘“Bloody hell, Bengtsson,” I said,’ Storm continued. ‘“Just take a look at this.” We didn’t sleep that night. Or the next, for that matter. I’ll never forget it, Marie.’
‘What did you see?’ Marie said, holding her breath. All the time Storm had been talking, her notepad had lain untouched in her lap.
‘We realised why the mortality rate had fallen so disproportionately among children who had been vaccinated against TB and measles since the time we had alerted the WHO to the low vaccination cover. Not surprisingly, the children were much less likely to die from TB or measles against which they were now protected, but they were also less likely to die from other illnesses, such as malaria, respiratory diseases and diarrhoea. It was weird, but no matter how we examined the figures, the picture was the same: vaccinated children were less likely to die, and not just from the diseases they had been vaccinated against but from all diseases. Finally we agreed that it could mean only one thing: the TB and measles vaccines had an as-yet-unrecorded strengthening effect on the immune system to such an extent that overall mortality rate was halved.’
‘Halved!’
Storm banged his fist on his desk. ‘Right, that’s enough for today,’ he said, and glanced at his watch. He was delighted at how disappointed Marie looked when she picked up her bag and left.
*
Bengtsson and Storm had discussed the phenomenon all night, Storm told Marie, when she was back in his office a few days later, notepad on her lap. What the hell did it mean? While Storm ran the data through the statistics program once more, just to be on the safe side, Bengtsson finalised their statistics on the DTP vaccine, another standard immunisation in the WHO’s global vaccination programme. This vaccine protected against diphtheria, tetanus and pertussis, also known as whooping cough.
‘Same results here!’ Storm yelled excitedly to Bengtsson, from his end of the room when he had double-checked the TB and measles vaccines and printed out the exact same graph a second time. ‘What about the DTP?’
‘Nothing. No positive correlation,’ Bengtsson called, from the other end of the room and showed Storm a negative graph. ‘Quite the opposite.’
‘But these,’ Storm said, flicking his fingers on his pile of graphs, ‘they speak their own clear language!’
The WHO had to be alerted immediately, but how? From a research point of view it was problematic that their observation was a by-product of work carried out to resolve a different issue because it meant they had not followed the appropriate protocol for this new discovery, which was alpha and omega for the validity of a scientific observation.
‘And that’s exactly why I hate strategic research,’ he interjected, and Marie nodded.
Dawn had arrived before Bengtsson and Storm had decided their next move. For better or worse, the WHO was a conservative organisation. It could not simply change its global and deeply embedded vaccination programme on the basis of one set of new observations, but then again, their data was so significant that they must contact the WHO without delay. Finally they agreed that their position would be stronger if their approach was backed up by a well-established aid organisation such as SIDA. It did not matter that SIDA would end up taking the credit for their observation. This was about human lives, not personal promotion.
*
Back in Denmark, Storm had immediately set to work on writing the report to SIDA, and in a fairly extensive footnote, he accounted for their accidental observation. He called it The Non-specific Positive Effects of Vaccines and his tentative conclusion was that something in the TB and measles vaccines appeared to strengthen the immune system so much that anyone vaccinated did not just develop immunity towards those particular diseases but higher resistance towards diseases in general.
Storm emailed his report to Sweden, and when Bengtsson had added his comments, he sent it to SIDA’s headquarters in Stockholm.
It was two weeks before the start of term; Storm’s full-time and project staff were starting to return to the Department of Immunology and the place was buzzing. There were meetings, final adjustments to syllabuses, lecture-hall bookings and intense master’s dissertation and PhD supervision work for Storm to carry out because he had been abroad. Even so, the discovery in Guinea-Bissau was constantly on his mind.
What if it was really true that certain vaccines boosted the immune system? What did that mean? Surely that the working of the immune system was fundamentally different from what people had thought until now. That a specific vaccine did not just protect against a specific disease but against a broad spectrum of diseases. As if the immune system was intelligent, Storm realised, and could apply information to other situations. Like the brain. An adaptive immune system!
It was mindboggling.
In the midst of that hectic autumn, Storm wrote a brief article about his initial thoughts on the adaptive immune system. He sent it to the university’s intranet newsletter, Uni-Net, and had not in his wildest dreams imagined that it would lead to anything other than a few grunts from his peers, who were all busy with the new term.
‘But, Marie,’ Storm said, ‘I’m telling you, they went crazy.’
To his surprise, the most bilious reaction came from Storm’s own ranks in the shape of his former PhD student Stig Heller, who was now working at the Karolinska Institute in Stockholm. Heller had clearly reached for his red pen as soon as he read Storm’s piece on Uni-Net because only two days later he uploaded a lengthy rant in which he demolished line by line Storm’s rather cautiously expressed views about the possibility of an adaptive immune system. The whole thing was codswallop, Heller wrote. It was one thing to challenge the boundaries of classic research – Heller did not have a problem with that – but Storm’s ideas about the adaptive immune system ‘didn’t fall far short of creationist non-science and other flat-Earth theories’.
‘Heller and I batted the ball back and forth a bit,’ Storm said, with a smile, ‘but in the end I just lost interest because it was clear that Heller, the sourpuss, only cared about inflating his own ego. I should mention that he had just been passed over for the lecturer post here in the department, which went to Thor Albert Larsen, so it wasn’t hard to work out why Heller had a major grudge against me, the department and my whole area of research. Quite unfairly, I hasten to add, because I had expressed a preference for Heller, but our human resources committee felt our research profiles were too similar so they picked Thor instead. Now, of course, I couldn’t say any of that to Heller and, besides, I had more important things to do than mollify a petulant child. Do you happen to know Stig Heller?’ Storm asked Marie.
Marie shook her head.
‘Once he was one of my golden boys, bright as a button and deeply committed until he made an inexplicable U-turn. Anyway, back to the matter in hand,’ Storm said. ‘I emailed two valued colleagues in Ghana and Haiti who had also gathered vaccination data using the same method as we had in Guinea-Bissau and asked for insight into their measles and TB immunisation and mortality rates. They responded quickly and I got a shock when I saw their figures. When I had fed all the data to the statistics program and printed out the graphs, their results were identical to the ones I had from Guinea-Bissau. In Ghana and on Haiti, overall mortality had halved among the children who had been vaccinated against measles and TB. It meant that the phenomenon in Guinea-Bissau could no longer be considered a one-off.
‘Then I noticed I had overlooked an attachment to the email from my Haitian colleague. “Records_DTP” was the file name and when I opened it, my colleague had written “Sending this as well. Didn’t know if DTP is also of interest?” at the top of the page.
‘And, no, I wasn’t really interested in the DTP data. Bengtsson and I had already looked at the figures in Guinea-Bissau and the vaccine against diphtheria, tetanus and whooping cough would not appear to have the same positive side effect as the measles and TB vaccines. Even so, I opened the document and my jaw dropped. Because what was it Bengtsson had said?’
‘Quite the opposite,’ Marie answered straight away.
‘Exactly! I immediately opened our files with the raw DTP records from Guinea-Bissau and found the graph Bengtsson had prepared on the basis of those figures. Then I entered all the DTP figures from Ghana and Haiti into the statistics program and saved everything in a folder, which I named “Quite the opposite”. I hit print and practically sprinted down the corridor to the printer room – I tell you, Marie, my heart was pounding.
‘All three graphs were negative. In Guinea-Bissau, in Ghana and on Haiti, DTP-vaccinated children had twice the mortality rate of unvaccinated ones. They no longer died from diphtheria, tetanus or whooping cough, so the vaccine worked as it was intended to, but they died from all sorts of other things: diarrhoea, pneumonia, malaria and simple fever. And they were dropping like flies.’
Storm had rung Bengtsson in Lund in a state of agitation.
‘I sensed his reluctance right away,’ Storm told Marie. ‘In Bissau he had been raring to go, but now he was . . . dragging his heels. At first I couldn’t understand it. Our theory was that vaccines had certain non-specific, positive effects, but now it would appear that one vaccine might be harmful, and I told him that we had to act. I would write a follow-up note to SIDA immediately and alert them to the negative correlation, which we had initially overlooked, but I wondered if we shouldn’t contact the WHO directly rather than wait for SIDA. What did Bengtsson think? If the DTP vaccine killed children, time was of the essence! Bengtsson asked me if I had any idea what I was saying, the implications of my discovery. “But it’s what the data tell us, not my personal opinion,” I stressed. Even so, he said. The outcome would be the same: the WHO, health authority to the whole world, had blood on its hands. Thousands of dead children in Guinea-Bissau and possibly hundreds of thousands across the globe! “Is that really what you’re claiming?” he asked. At this point I got seriously hacked off. “Bengtsson,” I said to him, “you’re only guilty when you do something wrong intentionally. And the WHO isn’t killing children in Africa on purpose, that goes without saying. This has nothing to do with me wanting to point the finger. It’s about research. About what our numbers prove. We must do something. Now!”’
Then Bengtsson announced he had got the job he had mentioned when we were in Africa. It wasn’t official yet, but he would shortly be leaving his post as a lecturer at the University of Lund and start work with Pons, the new Swedish research facility.
‘And that’s when I despaired, Marie,’ Storm said. ‘Have you heard about Pons?’
Marie thought the name rang a bell.
‘Do you know who Göran Sandö is?’ Storm then asked her.
Yes, of course Marie knew who he was. World-famous Swedish consultant epidemiologist and a member of the Nobel Committee. Something of an enfant terrible, if the rumours were to be believed, and with his dark, curly hair, he had also made an impression on many women.
‘Sandö is my highly treasured, favourite aversion,’ Storm said. ‘He’s a brilliant scientist and orator and the top boss of Pons. Pons is a research hybrid set up to bridge the gap between the classical virtues of the university and industry’s ever-growing focus on profit. It’s affiliated to the University of Lund, where it’s based, and half the group’s funding comes from the Swedish Exchequer, while the other half comes from private investors. So you can see why Pons most certainly isn’t my cup of tea. However, I rather like Sandö. In his own cashmere-clad fashion, his self-promotion is actually quite refreshing. Even so, Sandö represents everything about modern research that I object to. His own achievements take centre stage, he’s blatantly ambitious, there’s a short distance between research and invoicing, and the whole thing is wrapped up in a lot of waffle about doing it for “the greater good of science”, though we all know that politicians hold a loaded gun to the head of science. Bengtsson insisted that his decision to withdraw had nothing to do with the fact that he was now working for Sandö. He just felt we would be making a serious accusation and we were basing it solely on a series of observational studies, which were begging to be demolished. He had no desire to be hung out to dry for lack of professionalism, he said, or, worse, being accused of scientific fraud.
‘“Quite honestly, Storm,” he said to me, “the WHO has used the DTP vaccine for twenty years. How come no one has noticed that the vaccine is a lethal injection?”
‘“Yes, why do you think that is, Bengtsson?”
‘“What we were doing in Guinea-Bissau was front-line research,” I continued. “For one brilliant moment, your humdrum research career made sense and now you worry about being accused of scientific fraud? We saw something and we have a duty to act on it! When did morality and ethics disappear from science, eh, Bengtsson?”
‘I think I might have been shouting at him at that point,’ Storm said, and smiled cheerfully at Marie.
Bengtsson withdrew from the project, and three days later, SIDA’s reaction to the report and the follow-up note, which Storm had composed and forwarded to them, arrived. SIDA always welcomed new scientific observations, but as a publicly financed body it had a duty to report to the research committees at the University of Stockholm and must comply with fundamental conditions for scientific responsibility and accountability. As a result, SIDA could under no circumstances support research that had completely exceeded its original remit, and where the scientists had failed to submit a change of hypothesis that went so far beyond the original protocol for their planned research.
‘It was pretty much at this point,’ Storm said to Marie, ‘that I hurled my pencil holder at the wall. I’ve never read such spineless, rhetorical drivel.’
*
‘Once I had calmed down, I wrote to the WHO,’ Storm continued, the next day, and hit some keys on his computer. ‘Hang on, let me just bring up my letter. Here it is. I describe my observations in detail and refer to identical observations on Haiti and in Ghana. I wrote everything with all due caveats and took care to stress the weaknesses of the study. “Unplanned observation”,’ he read aloud. ‘“Absence of preceding hypothesis and protocol. Incomplete data collection. The observational nature of the study.”
‘“There is no doubt that it would have been preferable,”’ Storm read on, ‘“for my study not to have had these weaknesses. However, it is not ethical to use blind testing with placebos when studying living human beings, least of all when it concerns vaccinations, which have been global policy for many years. After all, we cannot suddenly make vaccination in a population a lottery when the accepted view is that vaccination is the right choice. Ergo,”’ Storm concluded his reading aloud, ‘“in this precarious situation we are forced to let the figures in a regrettably solely observational study decide that the phenomenon should be examined more closely without delay, and funds should be allocated for extended studies in Guinea-Bissau immediately.”’
‘Good letter,’ Marie said.
‘Yes, that’s what I thought,’ Storm said. ‘I also enclosed the text for an article I had written for Science about my observations, then sent the whole thing to the WHO’s headquarters in Geneva. I emailed the article to Science. Very soon afterwards, I received a reply from Terrence Wilson, editor-in-chief of Science. He was extremely excited and wanted to publish my article in volume 315, the following January, 2007. He even wrote that he had asked a professor of theoretical science from the Sorbonne to write a general article about major scientific breakthroughs in violation of scientific convention and thus believed he had warded off potential criticism of the lack of protocol. “I do see the problem,”’ Storm quoted Wilson, ‘“but then again, I believe it would be deeply unethical not to act on those observations immediately.”
‘Deeply unethical. Of course, I couldn’t agree more,’ Storm said to Marie.
The days passed and Storm had heard nothing from the WHO. Two weeks later he began to lose patience. In the middle of it all, Terrence Wilson from Science called and said there was a small problem. In principle, he was still interested in the article, but he had subsequently received two other articles related to the same topic and needed a little extra time to explore any impact these new articles might have on Storm’s contribution. Initially it meant Science would have to postpone publication indefinitely. Storm asked where the new articles had come from, but Wilson refused to divulge that information. Storm had hung up in anger.
In the weeks that had followed, Storm tried contacting the WHO on a daily basis, but without success. Eventually he had to turn his attention to lectures, departmental meetings and student supervision, but he decided that if he had not heard from the WHO before the upcoming autumn half-term, he would fly to Geneva and go to the WHO’s headquarters himself.
Two days before the autumn half-term, Storm received a cutting from an article that had just been published in the Bulletin of the World Health Organization, the WHO’s own periodical. The article totally pulled the rug from under Storm’s feet. The headline read: ‘Scientist’s criticism of DTP unfounded.’ It was a well-written and pithy article, which reviewed the history of the DTP vaccine and its benefits, and concluded that the criticism which had recently been levelled at this particular vaccine had no basis in fact, but that the WHO, ‘in order to eliminate any doubts, had immediately initiated further analysis of the DTP vaccine’. Gobsmacked, Storm reviewed the article’s literature list to see if there were other articles concerned with non-specific vaccine effects or if the author of the article in the Bulletin of the World Health Organization had had the cheek to refer to Storm’s as yet unpublished article. Storm had included his Science article in his letter to the WHO for information only.
The author of the article in the Bulletin of the World Health Organization was Paul Smith, and Storm Googled him. He was the head of WET, the WHO’s epidemiology task force, and had written several articles about the DTP vaccine. However, Storm could not find a single article that questioned the effect of the vaccine in developing countries, neither in Smith’s literature list nor in PubMed, the scientific-article database, which he trawled through for the umpteenth time. An enraged Storm called the WHO’s main switchboard. After being transferred half a dozen times, he finally got hold of the editor-in-chief of the Bulletin of the World Health Organization.
‘Paul Smith has no right to refer to an article, my article or my figures, that I have yet to publish,’ Storm thundered, and the editor-in-chief said that he believed Smith was referring to other scientists’ criticism of the DTP vaccine, not Storm’s.
‘Which other scientists?’ Storm demanded. ‘Which articles, which periodicals, and when were they published?’
The editor did not know that because he had been away on business, but he would discuss it with a colleague and get back to Storm.
‘Which he obviously never did,’ Storm said to Marie.
The next day Storm received an email directly from Paul Smith, who thanked him for getting in touch regarding the non-specific effects of the vaccine. He wanted Storm to be aware that ‘the WHO took his letter very seriously’ and had instantly allocated money from their contingency funds to further investigations. However, they would not be inviting Storm to participate in this work; Smith did not mention his underhand references to Storm’s article.
Storm had been sitting crestfallen behind his desk when Terrence Wilson from Science emailed him with the coup de grâce. He was unable to print Storm’s article after all, he wrote, because he had now received no less than three articles that proved that the DTP vaccine was quite safe. Wilson stressed that it had not been an easy decision, as Storm’s figures really were very persuasive, but because they were the accidental result of an observational study, and there was therefore no way of knowing exactly what could have influenced them, Science had decided that Storm’s article was too risky. However, he would very much like to hear from Storm again, if he could produce figures from a planned study that confirmed the negative effects of DTP.
That same week, the Bulletin of the World Health Organization published a two-page spread on vaccine criticism in general and firmly rejected all accusations. In the week that followed, the article was quoted in thirty-seven electronic peer-reviewed journals, then mentioned in forty-five newspapers and magazines across the world. Storm even found a note in the Danish newspaper Information, to which he had been a loyal subscriber for more than thirty years, saying, ‘Accusation against the WHO’s vaccination programme dismissed.’
When Storm saw it, he banged his head against the desk.
*
‘I was knocked out for a week,’ Storm told Marie. ‘But then I clicked the heels of my ergonomic sandals and contacted the Danish National Research Foundation and – wouldn’t you know it? – they granted me two million kroner for further analysis in Guinea-Bissau. Furthermore, they contacted Paul Smith from the WHO’s epidemiology task force and invited him and a number of other VIPs, me included, to a meeting in Copenhagen.
‘The only fly in the ointment was that the date of the meeting wasn’t until nine months later, the fifteenth of July 2007.
‘It was regrettable, the Danish National Research Foundation said. They had done everything they could, but that was the first available date in Paul Smith’s diary.’
When Storm had ended the call, he was fuming. It was inconceivable that a Danish child would be allowed to die from an approved vaccine without tabloids such as Ekstra Bladet immediately clearing the front page, and the switchboard at the Patient Complaint Agency being inundated with calls. Inconceivable. His figures cried out to heaven that children in Guinea-Bissau were dying like flies from the DTP vaccine and the only thing the WHO could be bothered to do was turn up for a wishy-washy professional-user meeting nine months hence? At this point Storm got up, walked up two floors, knocked on the head of the institute’s door and requested a leave of absence.
*
Storm used his grant from the Danish National Research Foundation to establish the Belem Health Project in the Belem area of the town of Bissau; it was a research station devoted exclusively to the study of non-specific effects of vaccines. Tim Salomon was hired as the project’s first local PhD student, and on 1 January 2007, Storm and Silas Henckel flew to Bissau.
Slowly but surely Storm extended the population survey to large parts of Guinea-Bissau. He despatched teams of students and local helpers to rural areas, and for many months it was hard toil with little to show for it. They had a minimum six-month wait before they could survey vaccinated children again and they had to wait a whole year before they could draw any serious conclusions from a nationwide set of data. Storm had never worked so hard in his life. In addition to supervising his students in Bissau and Copenhagen, he wasted an irritating amount of time applying for new grants. The two million kroner from the Danish National Research Foundation was spent, and when Storm had had new applications turned down twice in a row, he sold his house in Frederiksberg, which he had inherited from his father, and put 1.5 million kroner of his own money into Belem.
Shortly afterwards, however, he got the good news that the Belem Health Project had been affiliated to Statens Serum Institute and endowed with a small but ongoing grant of half a million Danish kroner per year. The Belem Health Project moved into bigger premises in Bissau and Storm extended his leave of absence from the University of Copenhagen for another six months.
In July 2007, a few weeks before Storm was due to return to Denmark to attend the Danish National Research Foundation’s meeting with Paul Smith and the other big shots, he was finally in possession of all the surveys from the rural areas. He, Tim and Silas were rushed off their feet trying to analyse the latest figures. On the last night, Storm stuck the sheets up on the wall as the data was processed and silence spread across the room. He stood in front of a wall filled with graphs and, for a moment, could not bear to look up at them. Then he heard Silas exclaim, ‘Holy shit.’
Storm looked up.
On every single graph the DTP vaccine was associated with increased mortality.
*
‘My presentation in Copenhagen ended up lasting four hours,’ Storm told Marie. ‘The guest list had crept up to fifteen and I was bombarded with questions. It was a once-in-a-lifetime experience. At that moment I truly believed I had finally got through to them. Even Paul Smith was listening. After my presentation we immediately agreed to have an immunology workshop at the London School of Hygiene and Tropical Medicine in January the following year, and an American professor invited me to give three lectures at the University of California in Berkeley. It was almost surreal. The year before I had been on the rack because no one took me seriously, and now here I was with the whole assembly as putty in my hands. Or so I thought. Because, do you know what happened? Sweet FA. The attendees went on their merry way and it was business as usual. The WHO still hasn’t revised the historical data on which their global vaccination programme is based. They haven’t reviewed the DTP vaccine, and they haven’t allocated as much as one euro for a fresh evaluation of the obvious benefits of the TB and measles vaccines. The truth finally dawned on me at the workshop at the London School of Hygiene and Tropical Medicine last autumn. It was a total waste of time. Three days of pointless discussion of the methodology problems associated with observational studies, which left none of us any the wiser. One of the participants, the American immunologist Peter Bennett, even got up during one of my talks and exclaimed that our figures were “the worst crap he had ever laid eyes on”. Even though his outburst triggered a sea of heartfelt protests, we were in serious trouble. Bennett is a Nobel Prize winner for medicine and an extremely influential man, and there was a large number of medical journalists present. The incident was mentioned in several periodicals and they made it sound as if our observations were far too vague and that our theory about non-specific effects was merely a whim.’
Storm paused and took a deep breath.
‘And that’s where we are now, Marie. It’s 2009 and the WHO runs the same vaccination programmes it always did. I publish on the subject regularly, as I have done all along, but sadly in shorter articles in less prestigious periodicals. I can’t get published in any peer review journals, even though I now have the support of several colleagues across the world. None of that matters one jot as long as the WHO remains to be convinced. The WHO has the final say. Only they and they alone can review the vaccination programmes. My goal is a big feature in Science. The fine gentlemen in Geneva might be able to ignore one mad Dane, but if I can get through to a leading journal such as Science, then they’ll be forced to listen. One article that explains everything. The complete data from Guinea-Bissau, which I hope to have ready for Christmas, supported by convincing animal studies performed in the best possible laboratory by the best possible people.’ Storm looked gravely at Marie before he said, ‘And that’s where you come into the picture.’
At last he fell silent and he watched Marie closely.
For a moment she sat quietly and said nothing, then she stuck out a resolute hand to him. As they shook, he had the strong sense that they were sealing a deal. He could not have been better pleased.