Eric Eisner steers his gray Lexus past two security guards and into the lot of Lennox Middle School. The campus is close enough to LAX that airborne jets form a scrim in the sky. A third of the families in Lennox, which is 93 percent Latino, live below the poverty line. By eighth grade as many as half of the boys in the school will have joined a gang.
The most dangerous outbreak of an emerging infectious disease since the appearance of H.I.V., in the early nineteen-eighties, seems to have begun on December 6, 2013, in the village of Meliandou, in Guinea, in West Africa, with the death of a two-year-old boy who was suffering from diarrhea and a fever.
Just developing the vaccines to test in monkeys was a grueling, decades-long process that has killed scores of macaques since the 1990s. American researchers almost gave up. An experimental Ebola vaccine has been developed by the U.S. National Institutes of Health and pharmaceutical company GlaxoSmithKline.
One evening in late May, four senior employees of Merck, the pharmaceutical company, sat in the bar of a Hilton Hotel in Rockville, Maryland, wearing metal lapel pins stamped with the word “TEAM.” They were in a state of exhausted overpreparedness. The next morning, they were to drive a few miles to the headquarters of the Food and Drug Administration and attend a meeting that would decide the future of suvorexant, a new sleeping pill that the company had been developing for a decade.
In January 2012, the U.S. Food and Drug Administration approved Kalydeco, the first drug to treat the underlying cause of cystic fibrosis, after just three months of review. It was one of the fastest approvals of a new medicine in the agency’s history. Vertex Pharmaceuticals, which discovered and developed the drug, priced Kalydeco at $294,000 a year, which made it one of the world’s most expensive medicines.
Linneah sat at a desk at the Center for Sexual Medicine at Sheppard Pratt in the suburbs of Baltimore and filled out a questionnaire. She read briskly, making swift checks beside her selected answers, and when she was finished, she handed the pages across the desk to Martina Miller, who gave her a round of pills.