small biotechnology companies. The grants have averaged about $20 million, including co-support from industry, to allow a molecule to get to the IND stage.

Importantly, all of the above calculations are estimates predicated upon the rapidity at which an existing lead molecule can be advanced toward an IND. Should a previously unexplored target be chosen for drug screening, the costs assuredly will be greater. In such circumstances, the molecular biology required for drug development would significantly increase costs.

The projected cost of medication development includes only the cost for licensure and not for the subsequent manufacture and storage of the large number of treatment doses that might be required to respond to an outbreak. The development of a drug to treat poliovirus infections is not expected to be of great interest to the pharmaceutical industry. Therefore, support for this program will have to come from alternative funding sources. They could include the Bill and Melinda Gates Foundation or a new foundation dedicated specifically to the development of a polio antiviral drug as a component of the global polio eradication program. The Rotary Club does not have such a foundation in place, but it has invested over $650 million in the eradication of polio and might regard the development of an antiviral as a good backup to ensure the eventual success of its investment. Finally, consideration of support from the National Institutes of Health, the Centers for Disease Control and Prevention, and the World Health Organization is essential.